Background

Pathogenic Escherichia coli (E. coli) represents an important etiology of acute gastroenteritis in children. Among the pathogenic E.coli, enteropathogenic E.coli  (EPEC) is associated with acute gastroenteritis in children.

Objectives

The present study aims to detect the presence of t typical EPEC and atypical EPEC in children with community acquired diarrhea in age ≤ 5 years old by polymerase chain reaction for eae, bfp, Stx genes Also, to determine the presence of ESBL by phenotypic method and by polymerase chain reaction for TEM, PER, CTX-M genes.

Methodology

  The isolated E.coli  were subjected to antimicrobial susceptibility test by  the disc diffusion method according to clinical laboratory standard guidelines (CLSI) .  E.coli  with resistance to cefotaxime were examined  for the presence of ESBL by the double discs method. Polymerase Chain Reaction was done to detect EPEC; eae, bfp, Stx genes and ESBL; TEM, PER, CTX-M genes.

Results

A total of 290 isolates of E. coli were isolated from children with community acquired diarrhea, EPEC was identified by the presence of eaeA gene in 115 isolates of E.coli. Typical EPEC with eaeA+, bfp +, stx – genotype profile was detected in 81 (70.4%) of EPEC and atypical EPEC with eaeA+, bfp –, stx –   genotype profile was detected in 34 (29.6%) of EPEC isolates. The most frequent detected ESBL genes in EPEC were CTX-M (46.9%) followed by PER (11.3%) and TEM (9.6%.). There was a significant increase in resistance to ampicillin, cefuroxime, cefotaxime, ciprofloxacin, gentamicin, Trimethoprim/sulfamethoxazole, amikacin in EPEC compared to non EPEC. Moreover, there …