Role of Enterotoxigenic Bacteroides fragilis in Children Less Than 5 Years of Age With Diarrhea in Tabriz, Iran

Abstract

BackgroundDiarrhea is the most frequent health problem among children in developing countries. Defining the etiology of acute diarrhea is critical to disease therapy and prevention. Some anaerobic bacteria such as Enterotoxigenic Bacteroides fragilis (ETBF) strains cause diarrheal disease by production of enterotoxin in children less than 5 years old.ObjectivesThis study aimed to evaluate the prevalence of ETBF among common bacteria and viruses causing diarrhea in children aged less than five years.Materials and MethodsOne hundred diarrheal stools were cultured for detection of aerobic and anaerobic pathogen bacteria by direct plating on selective media and antibiotic susceptibility tests were performed according to clinical and laboratory standards institute (CLSI) guidelines on isolates of ETBF. The enterotoxigenic gene among B. fragilis isolates was also investigated using the polymerase chain reaction (PCR) method. Detection of viral pathogens was carried out using the latex agglutination test.ResultsTen B. fragilis were isolated from 100 diarrheal fecal specimens. All isolates were susceptible to metronidazole, while 10% were susceptible to clindamycin. Four (40%) ETBF were isolated. Rotaviruses (57.2%) and adenoviruses (18.6%) were the most frequently detected etiological agents.ConclusionsETBF is one of the etiological agents that may cause diarrhea in children but it is not the commonest of them. Metronidazole is still an effective antibiotic against B. fragilis. Viruses are the most important etiological agents of diarrhea in children less than 5 years of age.

Identification of enterotoxigenic Bacteroides fragilis in patients with diarrhea: A study targeting 16S rRNA, gyrB and nanH genes

“…Narimani et al (2016) demonstrated that none of the B. fragilis isolates harbored bft gene as their isolates were obtained from healthy individuals in Tehran, Iran [32]. In a study recently conducted in the north-west of Iran, four ETBF isolates were recovered from diarrheal fecal samples of the 100 outpatient and hospitalized children under the age of 5 years [33]. A study by Zamani et al (2017) conducted in Tehran and aimed to provide evidence of association between B. fragilis and ulcerative colitis (UC) and non-in ammatory bowel disease (nIBD).…”

Prevalence of Enterotoxigenic Bacteroides Fragilis in Stool Specimens Collected from Children Less Than 5 Years Of Age in Iraq

“…In the age range of 1-5, bft was found in 31 (39%) diarrheal and 31 (16%) control specimens, although there was no significant difference (P = 0.088) [26]. A study from Iran, without control specimens, used anaerobic culture methods of 100 diarrheal specimens only and reported a bft rate of 5.72% [27]. Ramamurthy et al conducted a case-control study in India and demonstrated an ETBF rate of 7.2% in each the 446 patient and 428 control specimens, with no statistical difference [28].…”