Open AccessMolecular characterization of diarrheagenic Escherichia coli pathotypes: Association of virulent genes, serogroups, and antibiotic resistance among moderate‐to‐severe diarrhea patients
Author(s) -
Thakur Nutan,
Jain Swapnil,
Changotra Harish,
Shrivastava Rahul,
Kumar Yashwant,
Grover Neelam,
Vashistt Jitendraa
Publication year - 2018
Publication title -
journal of clinical laboratory analysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.536
H-Index - 50
eISSN - 1098-2825
pISSN - 0887-8013
DOI - 10.1002/jcla.22388
Subject(s) - diarrhea , virulence , microbiology and biotechnology , antibiotics , biology , antibiotic resistance , serotype , norfloxacin , escherichia coli , enteroaggregative escherichia coli , virology , ciprofloxacin , medicine , gene , enterobacteriaceae , genetics
Background Diarrheagenic Escherichia coli ( DEC ) signifies as an important etiological agent of moderate‐to‐severe diarrhea. This study was primarily focused on molecular identification of DEC pathotypes; their association with serogroups and estimates of resistance profiles against different antibiotics regime. Methods Five hundred seventy‐two stool specimens from diarrhea patients were investigated for DEC pathotypes. Molecular pathotypes were identified by amplification of virulence genes associated with distinct pathotypes followed by sequencing. Diarrhea is a self‐limiting disease, however, severity and persistence of infection suggest antibiotic use. Therefore, AST and MIC were determined against common antibiotic regimen. Correlations between molecular pathotypes and serogroups were analyzed by somatic “O” antigen serotyping. Results The present findings reveal incidence of DEC as an etiological agent up to a level of 21% among all diarrheal age groups. DEC infection rate was higher in children. Enteropathogenic E. coli EPEC , a molecular pathotype of DEC , was found as a predominant pathotype with highest frequency of 13.7%. Two other molecular pathotypes enterotoxigenic E. coli ( ETEC ) and enteroaggregative E. coli ( EAEC ) accounted for 5.7% and 1.3%, respectively for all diarrhea incidences. Serological analysis deciphered somatic antigens O26, O2, and O3 as major serogroups identified among EPEC , ETEC , and EAEC pathotypes, respectively. All DEC pathotypes exhibited high levels of antibiotic resistance except for cotrimoxazole and norfloxacin. Conclusion Comprehensive molecular characterization of DEC pathotypes, their incidence estimates, and antibiogram patterns will help in ascertaining better diagnostic and therapeutic measures in management of diarrheal diseases.