Frequency and Antimicrobial Susceptibility of Diarrheagenic Escherichia coli Obtained from Patients with Acute Diarrhea in a Tertiary Care Hospital, Bangladesh

  • MR Kabir Assistant Professor of Microbiology, Comunity Based Medical College
  • MA Hossain Professor & Head, Department of Microbiology, Mymensingh Medical College.
  • MM Alam Professor (C.C) & Head, Department of Microbiology, Community Based Medical College
  • SK Paul Associate Professor, Department of Microbiology, Mymensingh Medical College.
  • Z Begum Associate Professor, Department of Microbiology, Comunity Based Medical College
  • US Parvin Assistant Professor, Department of Microbiology, East West Medical College, Dhaka
  • N Haque Medical Officer, Department of Microbiology, Mymensingh Medical College.
  • N Kobayashi Professor, Sapporo Medical University
Keywords: Acute diarrhea, Diarrhaegenic Escherichia coli, Multiplex PCR, Antimicrobial Susceptibility

Abstract

Escherichia coli (E. coli) is an important group of pathogens associated with diarrhea among children. Despite the fact that diarrhaegenic Escherichia coli (DEC) has been identified as a major etiologic agent of childhood diarrhea, only a few studies have been performed in Bangladesh to identify these organisms. The objective of this study was to determine the frequency and antimicrobial susceptibility of DEC obtained from patients with acute diarrhea. To detect DEC in patients with acute diarrhea, a total of 300 stool specimens were tested by multiplex polymerase chain reaction (PCR). The antimicrobial susceptibility of DEC were tested by Kirby-Bauer disc diffusion technique as per recommendation of CLSI (Clinical and Laboratory Standards Institute), 2010. Out of 300 stool specimens collected from patients with acute diarrhea, the DEC was detected in 18% (54/300) cases. The dominating strain was Enterotoxigenic E. coli ( ETEC) (13%, 39/300), followed by Enteroaggregative E. coli (EAEC) (5%, 15/300) and no Enterohemorrhagic E. coli (EHEC), Enteroinvasive E. coli ( EIEC) and Enteropathogenic E. coli ( EPEC) could be detected. Detected ETEC were 100% sensitive to Ceftriaxone, Nitrofurantioin, Amikacin, 94% sensitive to Nalidixic acid, 89% sensitive to Gentamycin, 83% sensitive to Ciprofloxacin, 79% sensitive to Cephalexin, 39% sensitive to Amoxycillin, 46% sensitive to Tetracyclin and 31% sensitive to Cotrimoxazole. Detected EAEC were 100% sensitive to Ceftriaxone, Nitrofurantioin, Amikacin, Nalidixic acid, 90% sensitive to Gentamycin and Ciprofloxacin, 85% sensitive to Cephalexin, 41% sensitive to Amoxycillin, 49% sensitive to Tetracycline and 31% sensitive to Cotrimoxazole. Both ETEC and EAEC isolates exhibited decreased susceptibility for Amoxycillin, Tetracycline and Cotrimoxazole. Our results revealed that ETEC and EAEC, had significant association with acute diarrhea and should be considered as potential pathogens. Guidelines for appropriate use of antibiotics in tertiary care hospitals need updating.

DOI: http://dx.doi.org/10.3329/cbmj.v2i2.16698

Community Based Medical Journal 2013 July: Vol.02 No 02: 46-51

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Abstract
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Published
2013-10-28
How to Cite
Kabir, M., Hossain, M., Alam, M., Paul, S., Begum, Z., Parvin, U., Haque, N., & Kobayashi, N. (2013). Frequency and Antimicrobial Susceptibility of Diarrheagenic Escherichia coli Obtained from Patients with Acute Diarrhea in a Tertiary Care Hospital, Bangladesh. Community Based Medical Journal, 2(2), 46-51. https://doi.org/10.3329/cbmj.v2i2.16698
Section
Original Articles