Nearly all Escherichia coli isolates detected in fecal samples among children with diarrhea in Mozambique were resistant to ampicillin, according to results of a study published in the International Journal of Infectious Disease.

Investigators collected a single stool sample via fecal swab from children younger than 15 years of age who were hospitalized for diarrhea. Patients with hospital-acquired diarrhea were not eligible for inclusion. After collection, culture analysis and biochemical characterization were performed to detect E coli strains. Using multiplex polymerase chain reaction assays, investigators also determined diarrhoeagenic E coli (DEC) pathotypes targeting specific genes. They used the Kirby Bauer method to assess antimicrobial susceptibility.

Among 732 fecal samples assessed via culture analysis, 262 grew E coli. Of 208 samples tested by PCR, 101 (48.6%) were positive for DEC pathotypes. The predominant E coli pathotypes were enteroaggregative (66.3%), enteropathogenic (15.8%), enterotoxigenic (13.9%), and enteroinvasive (4.0%). Multiple pathotypes were detected in only 8.9% of the samples.


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Isolated DEC pathotypes were most frequently resistant to ampicillin (97.8%), followed by tetracycline (68.3%), chloramphenicol (28.4%), nalidixic acid (19.5%), and gentamicin (14.4%).

This study was limited by the lack of available resources for adequate E coli and antimicrobial resistance testing.

“Knowledge of antimicrobial resistance of DEC is important for selecting the appropriate therapy in serious diarrhoeagenic infections and formulating local guidelines on the use of antimicrobials,” the investigators concluded.

Reference

Manhique-Coutinho L, Chiani P, Michelacci V, et al. Molecular characterization of diarrheagenic Escherichia coli isolates from children with diarrhea: A cross-sectional study in four provinces of Mozambique: Diarrheagenic Escherichia coli in MozambiqueInt J Infect Dis. Published online April 28, 2022. doi:10.1016/j.ijid.2022.04.054