Molecular Prevalence and Epidemiological Characteristics of Diarrheagenic <i>E. coli</i> in Children under 5 Years Old in the City of Koula-Moutou, East-Central Gabon

Abstract

Background and Purpose: Diarrhoeagenic E. coli (DEC) is one of the germs responsible for childhood diarrhea in developing countries. This study aims at determining the prevalence of the five main pathotypes of DEC isolated from faeces of children under five years old with diarrhea or not, living in the city of Koula-Moutou. Methodology: Isolates of E. coli were phenotypically screened on chromID TM agar and molecularly by multiplex PCR to detect the presence of enteroaggregative E. coli (EAEC), enteropathogenic E. coli (EPEC), enterotoxigenic E. coli (ETEC), enterohemorragic E. coli (EHEC) and enteroinvasive E. coli (EIEC). The evaluation of their sensitivity to 12 β-lactam antibiotic molecules was carried out by Kirby Bauer method. This method has also made it possible to characterize phenotypically the different β-lactamases produced. Results and Conclusion: Overall, at least one DEC pathovar was detected in the 63 E. coli strains with phenotypic and molecular frequencies of 63.5% and 68.5% respectively. Thus, ETEC (28.3%) and EHEC (28.3%) were the most frequent DEC in diarrheal isolates. ETEC/EHEC hybrid was recorded in both groups with rates of 7.5% in diarrheal cases and 10.0% for controls. The results showed produced carbapenemase type β-lactamases

Antimicrobial Resistance Rates and Surveillance in Sub-Saharan Africa: Where Are We Now?

“… 36 Other important E. coli pathotypes have been implicated, namely: enteroaggregative E. coli (EAEC), Shiga toxin-producing E. coli (STEC), enteroinvasive E. coli (EIEC), and diffusely adhering E. coli (DAEC), which are important in specific regions globally. 37 In SSA, the precise burden associated with diarrheagenic E. coli is not known; however, prevalence rates ranging from 14.7% to 82% have been reported in Nigeria, 37 Gabon, 38 Burkina Faso, 39 Kenya, 40 South Africa, 41 and Tanzania. 42 Children under the age of five have the highest risk of infection in the region.…”

A Systematic review on the status of diarrheagenic Escherichia coli (DEC) pathotypes in Nigeria; the year 2000 – 2022

“…Hybrid pathotypes are pathotypes that are not easily or distinctly classified into a particular pathovar due to the possession of coding or virulent genes that expressed the characteristics of more than one pathotype. Studies have shown that the evolutionary phenomenon that leads to the development of hybrid DEC strain could be due to the acquisition of coding genes of one DEC pathotype by a different DEC pathotype through the horizontal movement of genetic materials [47,56]. We, therefore, hypothesize that continual hybridization and exchange of genetic elements between DEC pathotypes may in the future lead to the evolution and emergence of novel DEC pathotypes with potentials and characteristics that may surpass those of the current pathotypes.…”

“…In contrast to the observations of this review, other studies reported the preponderance of ETEC pathovar in causing childhood diarrhoea than other pathotypes. These include a study from Ghana [9], Gabon [47], and Bulgaria [48]. Another study from South Africa reported the detection of DAEC as the most prominent DEC in their study area [49].…”

“…Studies have shown that hybridization between EAEC and ETEC is on the rise [56,59]. The reason for the rise was said to be because EAEC pathovar easily incorporates or assimilates other virulence determinants to engender epidemic strains [47,60]. This phenomenon is particularly significant as the pathogenic potentials of the hybrid and the host range may be enlarged.…”

“…Based on specimen types, 47 From the clinical sources, 80% (8/10) and 20% (2/10) of the articles documented the detection of DEC pathotypes from direct stool and rectal swabs respectively.…”