The role of entero-aggregative Escherichia coli (EAEC) strains on diarrheic children in some southern States of Nigeria

Abstract

The role of entero-aggregative Escherichia coli (EAEC) strains on diarrheic children in some southern States of Nigeria was carried out in this paired control study. Escherichia coli isolates from stool specimens of children with diarrhea were matched with controls and tested in HEp-2 cell adherence assay. A total of 800 E. coli strains (2 strains for every test subject) from both 250 children with diarrhea and 150 apparently healthy controls were examined for aggregative adhesion using HEp-2 cells. Statistically significant (P<0.05) EAEC strains were obtained from the diarrheic children 40.6% as against 20% from the control. In this study, Bayelsa State recorded the highest isolate with 21.4 vs 12%, followed by Rivers State (10.8% vs 4.0%), then Imo State the least (8.4% vs 4.0%). Children within 4-8 years age range recorded the highest prevalence in the States studied. High prevalence of intestinal parasites were seen on both groups although the diarrheal group had a statistical significant (91% vs 36%) prevalence (P<0.05). The parasites were Giardia lamblia, Ascaris lumbricoides, hookworm and Trichuris trichuria . This showed that intestinal parasites are also important factor in the etiology of diarrhea in this area. There was mixed infection between parasites and EAEC in 5 test subjects in Bayelsa State, but none in the other States and also none from the control. The entero-aggregative E. coli showed marked resistance to conventional antimicrobial agents like cotrimoxazole, ampicillin and chloramphenicol with 80.3%, 81.2% and 61.6% respectively, while the cephalosporins: cefuroxime and ceftazidime showed low resistance with 3.3% and 4.3% respectively, indicating that the cephalosporins will be a good choice for the empirical treatment of bacterial infectious diarrhea in this region.

Keywords: HEp-2 cells, Intestinal parasites, Mixed infection, Antimicrobial agents, Cephalosporins