Diarrhoeagenic Escherichia coli are not a significant cause of diarrhoea in hospitalised children in Kuwait

The importance of diarrhoeagenic Escherichia coli (DEC) infections in the Arabian Gulf including Kuwait is not known. The prevalence of DEC (enterotoxigenic [ETEC], enteropathogenic [EPEC], enteroinvasive [EIEC], enterohemorrhagic [EHEC] and enteroaggregative [EAEC]) was studied in 537 children <...

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Published in:	BMC microbiology Vol. 9; no. 62; p. 62
Main Authors:	Albert, M John, Rotimi, Vincent O, Dhar, Rita, Silpikurian, Susan, Pacsa, Alexander S, Molla, A Majid, Szucs, Gyorgy
Format:	Journal Article
Language:	English
Published:	England BioMed Central Ltd 30-03-2009 BioMed Central BMC
Subjects:	beta-Lactamases - metabolism Causes of Child, Hospitalized Child, Preschool Complications and side effects Demographic aspects Diarrhea Diarrhea - epidemiology Diarrhea - etiology Diarrhea - microbiology Drug resistance in microorganisms Drug Resistance, Bacterial Escherichia coli Escherichia coli - classification Escherichia coli - genetics Escherichia coli - isolation & purification Escherichia coli - metabolism Escherichia coli Infections - epidemiology Escherichia coli Infections - microbiology Feces - microbiology Genes, Bacterial Genetic aspects Health aspects Humans Infant Infant, Newborn Kuwait - epidemiology Microbial Sensitivity Tests Prevalence Research article Serotyping Kuwait
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Summary:	The importance of diarrhoeagenic Escherichia coli (DEC) infections in the Arabian Gulf including Kuwait is not known. The prevalence of DEC (enterotoxigenic [ETEC], enteropathogenic [EPEC], enteroinvasive [EIEC], enterohemorrhagic [EHEC] and enteroaggregative [EAEC]) was studied in 537 children < or = 5 years old hospitalised with acute diarrhoea and 113 matched controls from two hospitals during 2005-07 by PCR assays using E. coli colony pools. The prevalence of DEC varied from 0.75% for EHEC to 8.4% for EPEC (mostly atypical variety) in diarrhoeal children with no significant differences compared to that in control children (P values 0.15 to 1.00). Twenty-seven EPEC isolates studied mostly belonged to non-traditional serotypes and possessed beta and theta intimin subtypes. A total of 54 DEC isolates from diarrhoeal children and 4 from controls studied for antimicrobial susceptibility showed resistance for older antimicrobials, ampicillin (0 to 100%), tetracycline (33 to 100%) and trimethoprim (22.2 to 100%); 43.1% of the isolates were multidrug-resistant (resistant to 3 or more agents). Six (10.4%) DEC isolates produced extended spectrum beta-lactamases and possessed genetic elements (blaCTX-M, blaTEM and ISEcp1) associated with them. We speculate that the lack of significant association of DEC with diarrhoea in children in Kuwait compared to countries surrounding the Arabian Gulf Region may be attributable to high environmental and food hygiene due to high disposable income in Kuwait.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1471-2180 1471-2180
DOI:	10.1186/1471-2180-9-62