title: The prevalence and molecular typing of enterotoxigenic Escherichia coli strains isolated from diarrheic stools in Malatya, Turkey.
abstract: This study was performed from June 2002 to November 2003 year in Malatya, eastern Turkey. Stools of 172 diarrheic patients and 90 healthy controls were analysed for enterotoxigenic Escherichia coli (ETEC). Heat-labile (LT) and heat-stable (ST) toxins were investigated by passive latex agglutination and enzyme immunoassay, respectively. Nine ETEC strains were isolated from 172 diarrheic stools (5.2%). Seven of the ETEC strains (10.1%) were isolated from 69 children in the 0-5 year age group. Two of these pediatric isolates were ST positive (2.9%) and five were LT positive (7.2%). ETEC was not isolated in the 6-18 year age group. Two ST producing E. coli strains were detected in diarrheic adult patients (> 18 years). In the 90 controls, two ETEC strains were detected (2.2%). One of them was a LT producer (1.1%) and the other was a ST producer (1.1%). E. coli strains producing both toxins simultaneously were not observed. ETEC positivity was higher in the diarrheic group than in the control group but statistically not significant (p > 0.05). The rate of resistance among ETEC strains to cefuroxime axetil, ampicillin, piperacillin, and trimethoprim-sulfamethoxazole was 72.7%, 54.5%, 45.5%, and 36.4%, respectively whereas the resistance rate to the same antibiotics in non-ETEC strains was 14%, 62%, 54%, and 66%, respectively. All ETEC isolates were intermediately resistant to cephalothin and fully susceptible to other antibiotics tested. Typing of the ETEC strains was done by arbitrary primed polymerase chain reaction (AP-PCR). Only two LT strains of the 11 typed strains had a unique profile. The remaining nine were mixed LT and ST strains and divided into two groups. The first group had three strains having a similarity coefficient ranging from 70-90%. The other one had six strains, five of them were similar and one was subtype isolate. It can be concluded that ETEC strains might be considerably important enteropathogens especially in pediatric patients in the 0-5 year age group. High clonal relation indicated that ETEC strains were epidemiologically related.
authors.affiliation: Department of Medical Microbiology, Faculty of Medicine, Inonu University, Malatya, Turkey.
authors.forename: Ibrahim Halil
authors.initials: IH
authors.lastname: Ozerol
authors.forename: Mehmet Refik
authors.initials: MR
authors.lastname: Bayraktar
authors.forename: Latife
authors.initials: L
authors.lastname: Iseri
authors.forename: Barifl
authors.initials: B
authors.lastname: Otlu
authors.forename: Riza
authors.initials: R
authors.lastname: Durmaz
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001427:Bacterial Toxins / Q000032:analysis*; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D016172:DNA Fingerprinting; D004269:DNA, Bacterial / Q000032:analysis / Q000302:isolation & purification; D003967:Diarrhea / Q000453:epidemiology / Q000382:microbiology*; D024881:Drug Resistance, Bacterial; D004768:Enterotoxins / Q000032:analysis*; D004926:Escherichia coli / Q000145:classification / Q000235:genetics / Q000302:isolation & purification / Q000472:pathogenicity*; D004927:Escherichia coli Infections / Q000453:epidemiology / Q000382:microbiology*; D029968:Escherichia coli Proteins / Q000032:analysis*; D005243:Feces / Q000382:microbiology*; D005838:Genotype; D006801:Humans; D007124:Immunoenzyme Techniques; D007223:Infant; D007231:Infant, Newborn; D007841:Latex Fixation Tests; D008826:Microbial Sensitivity Tests; D017720:Molecular Epidemiology; D016133:Polymerase Chain Reaction; D014421:Turkey / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents; D001427:Bacterial Toxins; D004269:DNA, Bacterial; D004768:Enterotoxins; D029968:Escherichia coli Proteins; C034151:heat stable toxin (E coli); C027538:heat-labile enterotoxin, E coli