Molecular Mechanisms of Antibiotic Resistance in Diarrheagenic Escherichia coli Isolated from the Pediatric Department Zagazig University Hospitals
Nagwa Shawky1, Ghada El-Akad2, Eman El-Moghazy3, Youmna Montaser4 and Rania Ahmed Ghonaim5
1Professor of Clinical Pathology, Department of Clinical Pathology, Zagazig University Hospitals, Egypt
2Assistant Professor of Clinical Pathology, Department of Clinical Pathology, Zagazig University Hospitals, Egypt
3Professor of Pediatric, Department of Pediatric, Zagazig University Hospitals, Egypt
4Master of Clinical Pathology, Department of Clinical Pathology, Zagazig University Hospitals, Egypt
5Assistant Professor of Clinical Pathology, Department of Clinical Pathology, Zagazig University Hospitals, Egypt
*Corresponding Author: Rania Ahmed Ghonaim, Assistant Professor of Clinical Pathology, Department of Clinical Pathology, Zagazig University Hospitals, Egypt.
May 15, 2022; Published: July 21, 2022
Background: Diarrhea is considered the second most common cause of mortality in infants worldwide, however due to its neglected clinical manifestations, labor-intensive microbiological diagnosis and epidemiology, it is still a common problem.
The Aim of this Work: Performing multiplex PCR assay to detect the main pathotypes of DEC. Detect the resistance of DEC to beta lactam antibiotics and the molecular mechanism responsible for this resistance.
Patient and Method: All stool samples were plated and the yielded bacterial isolates were identified as E. coli using Maldi-Tof (Vitac MS). The identified E. coli strains were then exposed to Multiplex PCR to identify the DEC strains genotypically. DEC strains were tested for their antibiotic susceptibility by Vitec-MS and then evaluated for the presence of TEM and SHV genes by conventional PCR.
Results: DEC represented 56 out of 196 E. coli strains (28.5%). The most sensitive antibiotics were Imipenem and Aztreonam (96.5% and 89.3% respectively), while the most resistant antibiotics were Amoxicillin and Unasyn showing resistance of (91.1% and 78.6% respectively). TEM gene was positive in 28.6% of cases, while SHV gene was positive in 7.1% of cases..
Limitations for the Study: Including cases above or below the required age. The child has any disease other than diarrhea. The required organism to be tested is E. coli.
Conclusion: DEC patho-type distribution was, ETEC: 37.5%, EAEC: 30.4% and EPEC: 32.6%. The most sensitive antibiotics were IPM and ATM (96.5% and 89.3% respectively), while the most resistance antibiotics were AMC and SAM (91.1% and 78.6% respectively). TEM gene was positive in 28.6% of cases and SHV gene was positive in 7.1% of cases.
Keywords: Antibiotics; Resistance; IPM; ATM; AMC; SAM; TEM Gene; SHV Gene; PCR
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