Acta Scientific Microbiology (ISSN: 2581-3226)

Research Article Volume 5 Issue 8

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.

Received: 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


  1. Adrian Canizalez-Roman., et al. “Surveillance od Diarrheagenic Escherichia coli Strains Isolated from Diarrheal cases from children, Adults and Elderly at Northwest of Mexico”. Frontiers in Microbiology 10 (2016): 3389.
  2. Yin W., et al. “Novel plasmid-mediated colistin resistance gene mcr-3 in Escherichia coli”. MBio 8.3 (2017): e00543-e00617.
  3. French GL. “The continuing crisis in antibiotic resistance”. International Journal of Antimicrobial Agents 3653 (2010): 53-57.
  4. Huang S., et al. “Detection of common diarrhea-causing pathogens in Northern Taiwan by multiplex polymerase chain reaction”. Medicine23 (2018).
  5. Dan Wu., et al. “Antimicrobial Resistance Analysis of Clinical Escherichia coli Isolates in Neonatal Ward”. Frontiers in Pediatrics 9 (2021): 670470.
  6. Hazen T H., et al. “Refining the pathovar paradigm via phylogenomics of the attaching and effacing Escherichia coli”. Proceedings of the National Academy of Sciences31 (2013): 12810-12815.
  7. Chao A W., et al. “Clinical features and molecular epidemiology of diarrheagenic Escherichia coli pathotypes identified by fecal gastrointestinal multiplex nucleic acid amplification in patients with cancer and diarrhea”. Diagnostic Microbiology and Infectious Disease3 (2017): 235-240.
  8. Gomes T., et al. “Diarrheagenic Escherichia coli”. Brazilian Journal of Microbiology 47 (2016): 3-30.
  9. Stefan Surzycki. “Basic Techniquesin Molecular Biology”. Springer Lab Manuals (2000).
  10. Boom R., et al. “Rapid and Simple method for purification of nucleic acids”. Journal of Clinical Microbiology3 (1990): 495.
  11. Viljoen Gerrit J., et al. “Molecular Diagnostic PCR HandBook” (2005).
  12. Diallo A., et al. “Management of childhood diarrhea by healthcare professionals in low income countries: An integrative review”. International Journal of Nursing Studies 66 (2017): 82-92.
  13. Shane A., et al. “Infectious Diseases Society of America clinical practice guidelines for the diagnosis and management of infectious diarrhea”. Clinical Infectious Diseases12 (2017): e45-e80.
  14. Thakur N., et al. “Molecular characterization of diarrheagenic Escherichia coli pathotypes: Association of virulent genes, serogroups and antibiotic resistance among moderate‐to‐severe diarrhea patients”. Journal of Clinical Laboratory Analysis (2018): 1-11.
  15. Allam A., et al. “Rapid Diagnosis and Characterization of Diarrheagenic Escherichia coli In Egyptian Children Using Multiplex PCR”. Egyptian Journal of Medical Microbiology3 (2006): 523-529.
  16. Raghavan P R., et al. “Diarrheagenic Escherichia coli infections among the children of Andaman Islands with special reference to pathotype distribution and clinical profile”. Journal of Epidemiology and Global Health4 (2017): 305-308.
  17. Shabana I., et al. “Molecular studies on diarrhea-associated Escherichia coli isolated from humans and animals in Egypt”. Veterinary Microbiology3-4 (2013): 532-539.
  18. Alikhani M Y., et al. “Prevalence and antibiotic resistance patterns of diarrheagenic Escherichia coli isolated from adolescents and adults in Hamedan, Western Iran”. Iranian Journal of Microbiology1 (2013): 42.
  19. Mandal A., et al. “Molecular Epidemiology of Extended-Spectrum β-Lactamase-Producing Escherichia coli Pathotypes in Diarrheal Children from Low Socioeconomic Status Communities in Bihar, India: Emergence of the CTX-M Type”. Infectious Diseases Research and Treatment 10 (2017).
  20. Dhaka P., et al. “Genetic diversity and antibiogram profile of diarrhoeagenic Escherichia coli pathotypes isolated from human, animal, foods and associated environmental sources”. Infection Ecology and Epidemiology1 (2016): 31055.
  21. Mohammadalipour Z., et al. “High Frequency of Class 2 and 3 Integrons Related to Drug-Resistance in Clinical Isolates of Diarrheagenic coli in Iran”. Novelty in Biomedicine 5.1 (2017): 30-36.
  22. Kanyina E. “Characterization and antimicrobial susceptibility pattern of diarrheagenic Coli in thika level 5 hospital. Nairobi. Kenya”. (2017): 31.
  23. Soltan Dallal M M., et al. “Prevalence of blaCTX-M, blaSHV and blaTEM β-Lactamase Genes Among Escherichia coli Isolates in Foodborne Outbreak in Iran”. International Journal of Enteric Pathogens2 (2018): 48-52.
  24. Al-Dulaimi T H., et al. “Molecular characterization and antibiotic susceptibility of diarrheagenic Escherichia coli from Children”. Medical Journal of Babylon2 (2015): 541-550.
  25. Croxen MA., et al. “Advances in understanding enteric pathogenic Escherichia coli”. Clinical Microbiology Reviews 26 (2013): 822-880.
  26. Maysaa El SZ E., et al. “Molecular Detection of blaTEM and blaSHF in Diarrhoegenic Escherichia coli Isolated from Egyptian Children”. International Journal of Microbiology and Advanced Immunology 1 (2015): 49-54.
  27. Xu Y., et al. “Occurrence of multidrug-resistant and ESBL-producing atypical enteropathogenic Escherichia coli in China”. Gut Pathogens1 (2018): 8.
  28. Muringani BN., et al. “β-lactamase Genes Produced by coli Isolated from Water and Stool Samples in Mthata Region Eastern Cape Province of South Africa”. EC Microbiology 3.5 (2016): 548-552.
  29. Memariani M., et al. “Occurrence of SHV, TEM and CTX-M β-lactamase genes among enteropathogenic Escherichia coli strains isolated from children with diarrhea”. Jundishapur Journal of Microbiology4 (2015).
  30. Singh T., et al. “Distribution of Integrons and Phylogenetic Groups among Enteropathogenic Escherichia coli Isolates from Children< 5 Years of Age in Delhi, India”. Frontiers in Microbiology 8 (2017): 561.
  31. Bai L., et al. “Prevalence and Molecular Characteristics of Extended-Spectrum β-Lactamase Genes in Escherichia coli Isolated from Diarrheic Patients in China”. Frontiers in Microbiology 8 (2017): 144.
  32. El-Sharif A and Ali R. “Molecular detection of TEM-Type beta. lactamase producing Escherichia coli from diarrheic Egyptian children”. Archives of Clinical Microbiology 5 (2012).
  33. Kargar M., et al. “Multiplex PCR assay for rapid determination of bla TEM, bla SHV and bla CTX-M genes in diarrheagenic Escherichia coli isolated from Iran, Shiraz”. International Journal of Infectious Diseases 15 (2011): S47-S48.
  34. Chen Y., et al. “Serotypes, genotypes and antimicrobial resistance patterns of human diarrhoeagenic Escherichia coli isolates circulating in southeastern China”. Clinical Microbiology and Infection 1 (2014): 52-58.
  35. Benjelloun Touimi Ghita., et al. “Molecular Serotyping and Antibiotic Resistance Patterns of Escherichia coli Isolated in Hospital Catering Service in Morocco”. International Journal of Microbiology (2020).


Citation: Rania Ahmed Ghonaim., et al. “Molecular Mechanisms of Antibiotic Resistance in Diarrheagenic Escherichia coli Isolated from the Pediatric Department Zagazig University Hospitals". Acta Scientific Microbiology 5.8 (2022): 97-103.


Copyright: © 2022 Rania Ahmed Ghonaim., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Acceptance rate30%
Acceptance to publication20-30 days

Indexed In

News and Events

  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is June 25, 2024.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue"
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.

Contact US