Prevalence of Antibiotic Resistant Diarrheagenic E. Coli Isolated from Stool Samples of Diarrheic Children Under 5 Years in Sokoto, Nigeria

Abstract

Diarrheal diseases continue to pose substantial public health challenges, especially in children under the age of 5. Diarrheagenic Escherichia coli (DEC) is the second most common cause of diarrhea in children after Rotavirus. This study aimed to assess the prevalence of antibiotic-resistant DEC recovered from diarrheic children aged 0-5 years in Sokoto. Stool samples were obtained from 300 diarrheic children attending two hospitals in Sokoto. Bacterial isolates that showed colonial morphology suggestive of E. coli were subjected to antibiotic susceptibility testing. PCR was carried out to confirm the presence of DEC and resistant genes among the multiple antibiotic-resistant isolates. Structured questionnaires were administered to determine the risk factors that predispose the children to diarrhea. The results revealed a 21% prevalence of E. coli isolates, out of which 75% displayed resistance to Ampicillin, 75% to Nalidixic acid, 30% to Gentamycin, 23% to Ofloxacin, 74% to Cefotaxime, 23% to Ceftriaxone, 18% to Nitrofurantoin, 10% to Imipenem, and 73% to Cefuroxime. Out of the 30 E. coli isolates with a MAR index of ≥ 0.2, 12 were found to be multidrug-resistant (MDR). All four MDR E. coli selected were confirmed to be DEC using the UidA gene. Out of all the four MDR DEC confirmed, only one class 1 integron was detected, raising concern about the misuse of commonly used antibiotics. This study highlights the need for implementing antibiotic stewardship programs and infection control measures to combat the growing threat of antibiotic-resistant DEC within Sokoto.