Molecular Based Detection of Diarrheagenic Escherichia coliin Individuals With and Without Diarrhea in Khartoum locality

Abstract

Diarrhea is considered as a major public health problem worldwide. Diarrheagenic strains of Escherichia coli can be divided into five main categories, Enteropathogenic E. coli (EPEC), Enterohemorrhagic E. coli (EHEC), Enterotoxigenic E. coli (ETEC), Enteroaggregative E. coli (EAEC) and Enteroinvasive E. coli (EIEC). This study aimed to shed light on the detection of diarheagenic E. coli strains by multiplex PCR, and its prevalence among diarrheal cases and healthy individual, and their resistance to specific antibiotic. This was an analytical case control study. It included seventy participants (35 diarrheal positive for the presence of E. coli patients were recruited as cases, and 35 healthy people who were positive for the presence of E. coli were recruited as control group). This study was carried out at different hospitals, in Khartoum locality (Sudan) from January to May, 2017. Stool samples were collected and cultured in MacConkey Agar and Salmonella-Shegiella Agar. E. coli was isolated from each sample and identified by biochemical test then preserved for further investigation. Polymerase chain reaction was done for all isolates to detect Diarrheagenic Escherichia coli. In this study, among cases and controls, male group was greater 41(58.5%) than females 29(41.5%). In addition, detection of EAEC and EPEC strains among cases group were 7 (20%) and 3 (8.6%) compared to controls group that were 10 (28.6%) and 7 (20%), respectively, while, EIEC and EHEC strains in cases group were 9 (25.7%), 6 (17.1%) and in controls group were 2 (5.7%), 5 (14.3%), respectively. There was no significant association between the prevalence of Diarrheagenic Escherichia coli among cases and controls groups except in EIEC (P value= 0.017). In case of resistance to antibiotics; cases group was more resistance V to Ciprofloxacin, Ceftriaxone, Cephalexin and Augmentin 14 (40%), 16 (45.7%), 26 (74.3%) and 35 (100%) than controls, 6 (17.1%), 12 (34.3%), 20 (57.1%) and 34 (97.1%), respectively. In addition, there was significant correlation between detection of EHEC and resistance to Ciprofloxacin, Ceftriaxone and Cephalexin among E. coli isolated from cases. On contrary, EAEC, EPEC, and EIEC did not reveal significant association between their detection and resistance to specific antibiotic among E. coli isolated from cases.