Introduction/Background: Enterohaemorrhagic Escherichia coli (EHEC) O157:H7 is the most important serotype of E. coli responsible for serious intestinal and extra-intestinal disorders worldwide, but no molecular based study for EHEC as the causative agent diarrhea was performed in the Sudan. EHEC is a subset of Shiga toxin (stx) producing E. coli (STEC) which includes well recognized human pathogens. STEC produce high level toxins of a protein family referred to as Shiga toxin and Shiga-like toxins (SLTs; alternatively known as verocytotoxins VTEC or VTs). EHEC O26:H11 and O111:H8 have emerged as the most important non-O157:H7 EHEC. These toxins are mediating intestinal disease in children and adults, and if the cases left untreated these toxins may contribution to the development of extra-intestinal sequelae e.g., the haemolytic uraemic syndrome and neurological disorders. Objective: This study was conducted for the detection and molecular characterization of Shiga like toxin (stx) of E. coli O157:H7, E. coli O26:H11, and E. coli O111:H8 in Sudanese patients with diarrhea using PCR and multiplex PCR. Materials and methods: A cross sectional laboratory-based study was carried out in Khartoum, Sudan during the period from June to October 2020. All patients with confirmed E. coli diarrheal disease was included in this study. The isolates have been identified by using the biochemical, serological, molecular identification and characterization tests. SPSS IBM (software version 20.0) was used for analyses. Results: Out of 100 patients with diarrheal disease a total of 96 patients were confirmed of having E. coli organisms. All 96 E. coli bacteria were seropositive identified as members of the EHEC. Ten isolates of E. coliO157:H7, E. coli O26:H11, E. coli O111:H8 have been selected as follows; five, three, and two respectively. The selected isolates followed by multiplex PCR to detect the genes of stx toxins of E. coli O157:H7, E. coli, O26:H11, and E. coli O111:H8 and comparing between them. The multiplex PCR revealed that E. coli O157:H7 were carrying stx1 and stx2 genes represented by two bands, while E. coliO26:H11 and E. coli O111:H8 were carrying one stx2 gene represented by one band. Conclusions: E. coli O157:H7 produce stx1 and stx2 while the other serotypes E. coli O26:H11 and E. coli O111:H8 produce stx2 only. Effective control of pathogenic strains of E. coli requires a multifaceted approach. To reduce the frequency and severity of human exposure to STEC, controlling dietary sources and environmental sources such as cattle, water troughs, feed and manure is critical in breaking the cycle of infection and re-reinfecting with STEC.
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