Prevalence and susceptibility profile to antibacterial drugs of diarrheagenic Escherichia coli isolated from children with acute intestinal infection
Abstract
Escherichia coli is a common inhabitant of the gastrointestinal tract of humans and warm-blooded animals, often ass o ciated with diarrhea. Different pathotypes can be distinguished for this bacterium, depending on virulence factors and the disease it causes. To isolate and identify E. coli , stool samples were transferred to Endo medium, and the cultures were inc u bated at 37 ± 1 C for 18 – 24 hours under aerobic conditions. Lactose-positive and lactose-negative colonies were subcultured onto Olkenytskyi medium (trisaccharide agar) for primary biochemical identification and slant and meat-peptone agar for accumulation of pure culture . T he cultures were incubated at a temperature of 37 ± 1 C for 18 – 24 hours under aerobic cond i tions. Suspected E. coli cultures were subjected to serotyping in agglutination reaction on a glass of pure culture with polyv a lent and monovalent sera. The sensitivity of pathogenic E. coli of a certain serotype to antibacterial drugs was determined by the disk diffusion method in accordance with the requirements of the recommendations of the European Committee on Ant i microbial Susceptibility Testing. In 2022 – 2024, 3,484 stool samples from children with acute intestinal infection who were inpatients at the Municipal Non - C ommercial Enterprise “ City Clinical Hospital No. 6 ” of the Dnipro City Council were e x amined. 202 cultures of pathogenic E. coli strains were isolated, the overall efficiency (seeding rate) was 5.8%. It was found that the highest research effectiveness in 2022 was observed in the winter period of the year, in 2023 – in the summer-autumn period, and in 2024 – in the summer period. The specific gravity of isolated pathogenic E. coli strains among boys and girls with acute intestinal infection during the studied period wa s stable and amount ed to 58.9% for boys and 41.1% for girls. For the period 2022 – 2024, among the isolated pathogenic E. coli strains, the most frequently encountered strains were serotype O 18 – 14.4%, serotype O 44 – 18.8%, serotype O 78 – 7.4%, serotype O 145 – 5.4%, serotype O 26 – 5.0%, serotype O 103 – 5.0%. The overall susceptibility profile to antibacterial drugs of pathogenic E. coli strains isolated from the stool samples of children with acute intestinal infection in 2022-2024 was 54.5% for ampicillin, 49.0% for amoxicillin-clavulanic acid, 91.6% for ceftriaxone, 96.9% for ceftazidime, 97.9% for cefepime, 89.1% for cefoxitin (screening), and 93.6% for ciprofloxacin. The aim of the study was to determine the prevalence of pathogenic E. coli serotypes and the antibacterial drug sensitivity profile of the isolated strains among children with acute intestinal infection.References
Amin, M. A., Akhtar, M., Khan, Z. H., Islam, M. T., Firoj, M. G., Begum, Y. A., Rahman, S. I. A., Afrad, M. H., Bhuiyan, T. R., Chowdhury, F., Faruque, A. S. G., Ryan, E. T., Qadri, F., & Khan, A. I. (2025). Coinfection and clinical impact of enterotoxigenic Escherichia coli harboring diverse toxin variants and colonization factors: 2017–2022. International Journal of Infectious Diseases, 151, 107365.
Anueyiagu, K. N., Agu, C. G., Umar, U., & Lopes, B. S. (2024). Antimicrobial resistance in diverse Escherichia coli pathotypes from Nigeria. Antibiotics, 13(10), 922.
Ashenafi, G., Tilahun, D., Aliyo, A., & Sisay, B. (2024). Magnitude of enteric pathogens associated with diarrhea and antibiotic resistance of enteric bacterial pathogens isolated among children under 5 years of age in Bule Hora town, West Guji, Ethiopia. Front Public Health, 12, 1398264.
Belina, D., Gobena, T., Kebede, A., Chimdessa, M., & Hald, T. (2024). Genotypic antimicrobial resistance profiles of diarrheagenic Escherichia coli and nontyphoidal Salmonella strains isolated from children with diarrhea and their exposure environments in Ethiopia. Infection and Drug Resistance, 17, 4955–4972.
Bizot, E., Bonacorsi, S., Labé, P., Pinhas, Y., Cointe, A., Ferroni, A., Cohen, J. F., Lécuyer, H., & Toubiana, J. (2025). Use of gastrointestinal syndromic multiplex molecular assays and detection of Escherichia coli pathotypes in pediatric wards. Journal of Clinical Microbiology, 63(4), e0107324.
Brubaker, J., Zhang, X., Bourgeois, A.L., Harro, C., Sack, D.A., & Chakraborty, S. (2021). Intestinal and systemic inflammation induced by symptomatic and asymptomatic enterotoxigenic E. coli infection and impact on intestinal colonization and ETEC specific immune responses in an experimental human challenge model. Gut Microbes, 13(1), 1891852.
Bywater, A., Dintwe, G., Alexander, K. A., & Ponder, M. A. (2024). Characterization of diarrheagenic Escherichia coli and Salmonella enterica from produce in the Chobe District of Botswana. Journal of Food Protection, 87(10), 100351.
Chercos, D. H., Wafula, S. T., Lusingu, J. P. A., Minja, D. T. R., Gesase, S., Mbwana, J. R., Schotte, U., May, J., Mardeis, L., Jaeger, A., Rojak, S., Lamshöft, M., Kaseka, J., Lorenz, E., Frickmann, H., & Dekker, D. (2024). Epidemiology and multiple colonization of gastrointestinal pathogens in rural Tanzanian children with and without diarrhea: A case-control study. PLoS One, 19(6), e0305469.
Dikoumba, A. C., Mbehang Nguema, P. P., Oyaba Yinda, L. E. D., Lendamba, R. W., Obague Mbeang, J. C., Ndong Atome, G. R., Zinga Koumba, C. R., Godreuil, S., & Onanga, R. (2024). Characterization of extended-spectrum beta-lactamase-producing Escherichia coli in diarrhoeal faeces from 0 to 5-year-old children attending public hospitals in Franceville, Gabon. Antibiotics, 13(11), 1059.
Fernández Fellenz, D., Ruiz, J. M., Etcheverría, A. I., Colello, R., Velez, M. V., Sanz, M. E., Sparo, M. D., Lissarrague, S., Pereyra, J., Zanelli, G., & Padola, N. L. (2025). Detection of EPEC and STEC strains isolated from children with diarrhea in Argentina. Revista Argentina de Microbiología, 57(1), 59–62.
Glassman, H., Suttorp, V., White, T., Ziebell, K., Kearney, A., Bessonov, K., Li, V., & Chui, L. (2021). Clinical outcomes and virulence factors of Shiga toxin-producing Escherichia coli (STEC) from Southern Alberta, Canada, from 2020 to 2022. Pathogens, 13(10), 822.
Jones, A., Ahmed, S. M., Platts-Mills, J. A., Kotloff, K. L., Levine, A. C., Nelson, E. J., Pavia, A. T., Khan, A. I., & Leung, D. T. (2024). Etiology of severely dehydrating diarrheal illness in infants and young children residing in low- and middle-income countries. Open Forum Infectious Diseases, 11(11), ofae619.
Kralicek, S. E., Sitaraman, L. M., Kuprys, P. V., Harrington, A. T., Ramakrishna, B., Osman, M., & Hecht, G. A. (2022). Clinical manifestations and stool load of atypical enteropathogenic Escherichia coli infections in United States children and adults. Gastroenterology, 163(5), 1321–1333.
Machado Ribeiro, T. R., Salgaço, M. K., Adorno, M. A. T., da Silva, M. A., Piazza, R. M. F., Sivieri, K., & Moreira, C. G. (2021). Human microbiota modulation via QseC sensor kinase mediated in the Escherichia coli O104:H4 outbreak strain infection in microbiome model. BMC Microbiology, 21(1), 163.
Martínez-Oliveros, Y. P., Rita-Iotti, L., Sánchez, B. F., Eiros, J. M., & de Frutos, M. (2025). Distribución de patotipos de Escherichia coli diarreagénica en población pediátrica y perfil de sensibilidad antibiótica en el área de salud de Valladolid Oeste (ASVAO) [Distribution of diarrheagenic Escherichia coli pathotypes in the pediatric population and antibiotic susceptibility profile in the Valladolid Oeste health area (ASVAO)]. Revista Española de Quimioterapia, 38(2), 129–132.
Morita, D., & Kuroda, T. (2025). Recent antimicrobial resistance situation and mechanisms of resistance to key antimicrobials in enterotoxigenic Escherichia coli. Biological and Pharmaceutical Bulletin, 48(3), 222–229.
Okumu, N. O., Muloi, D. M., Moodley, A., Ochien'g, L., Watson, J., Kiarie, A., Ngeranwa, J. J. N., Cumming, O., & Cook, E. A. J. (2025). Epidemiology of antimicrobial-resistant diarrheagenic Escherichia coli pathotypes from children, livestock and food in Dagoretti South, Nairobi Kenya. International Journal of Antimicrobial Agents, 65(3), 107419.
Olayinka, A. A., Oginni-Falajiki, I. O., Okeke, I. N., & Aboderin, A. O. (2024). Diarrhoeagenic Escherichia coli associated with childhood diarrhoea in Osun State, Nigeria. BMC Infectious Diseases, 24(1), 928.
Sameer, M., Masood, A., Almutawea, L., Fox, G., Loni, R., Ahmed, A., Ben Turkia, H., Abdulsamad, M., & Mary, I. (2024). Gastrointestinal panel performance for the diagnosis of acute gastroenteritis in pediatric patients. Cureus, 16(6), e61979.
Schlosserová, K., Daniel, O., Labská, K., Jakubů, V., Stárková, T., Bílý, J., Dresler, J., Lang, C., Fruth, A., Flieger, A., Žemličková, H., Bielaszewska, M., & Havlíčková, M. (2024). Enteroaggregative Escherichia coli: Frequent, yet underdiagnosed pathotype among E. coli O111 strains isolated from children with gastrointestinal disorders in the Czech Republic. International Journal of Medical Microbiology, 316, 151628.
Seliga-Gąsior, D., Sokól-Leszczyñska, B., Krzysztoñ-Russjan, J., Wierzbicka, D., Stępieñ-Hołubczat, K., Lewandowska, P., Frankiewicz, E., Cacko, A., Leszczyñska, B., Demkow, U., & Podsiadły, E. (2024). Epidemiological characteristics of Shiga toxin-producing Escherichia coli responsible for infections in the Polish pediatric population. Polish Journal of Microbiology, 73(2), 177–187.
Tesfaw, G., Siraj, D. S., Abdissa, A., Jakobsen, R. R., Johansen, Ø. H., Zangenberg, M., Hanevik, K., Mekonnen, Z., Langeland, N., Bjørang, O., Safdar, N., Mapes, A. C., Kates, A., Krych, L., Castro-Mejía, J. L., & Nielsen, D. S. (2024). Gut microbiota patterns associated with duration of diarrhea in children under five years of age in Ethiopia. Nature Communications, 15(1), 7532.
Thystrup, C., Majowicz, S. E., Kitila, D. B., Desta, B. N., Fayemi, O. E., Ayolabi, C. I., Hugho, E., Buys, E. M., Akanni, G. B., Machava, N. E., Monjane, C., Hald, T., & Pires, S. M. (2024). Etiology-specific incidence and mortality of diarrheal diseases in the African region: A systematic review and meta-analysis. BMC Public Health, 24(1), 1864.
Usein, C. R., Oprea, M., Dinu, S., Popa, L. I., Cristea, D., Militaru, C. M., Ghiță, A., Costin, M., Popa, I. L., Croitoru, A., Bologa, C., & Rusu, L. C. (2024). Shiga toxin-producing Escherichia coli strains from Romania: A whole genome-based description. Microorganisms, 12(7), 1469.
Vusirikala, A., Yanshi, Robin, C., Rowell, S., Dabke, G., Fox, G., Bell, J., Manuel, R., Jenkins, C., Love, N. K., McCarthy, N., Sumilo, D., & Balasegaram, S. (2024). Facilitators and barriers to implementing successful exclusion among children with shiga toxin-producing Escherichia coli: A qualitative analysis of public health case management records. BMC Public Health, 24(1), 2272.
Wang, Z., Sun, M., Guo, S., Wang, Y., Meng, L., Shi, J., Geng, C., Han, D., Fu, X., Xue, J., Ma, H., & Liu, K. (2024). Detection of drug resistance in Escherichia coli from calves with diarrhea in the Tongliao Region: An analysis of multidrug-resistant strains. Frontiers in Veterinary Science, 11, 1466690.
Wolde, D., Eguale, T., Medhin, G., Haile, A.F., Alemayehu, H., Mihret, A., Pirs, M., Strašek Smrdel, K., Avberšek, J., Kušar, D., Cerar Kišek, T., Janko, T., Steyer, A., & Starčič Erjavec, M. (2024). Diarrheagenic Escherichia coli in stool specimens collected from patients attending primary healthcare facilities in Ethiopia: Whole-genome sequencing-based molecular characterization. International Journal of Molecular Sciences, 25(19), 10251.
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