title: Comparative analysis of virulence determinants, antibiotic susceptibility patterns and serogrouping of atypical enteropathogenic Escherichia coli versus typical enteropathogenic E. coli in India.
abstract: The epidemiology of enteropathogenic Escherichia coli (EPEC) and the significance of isolation of atypical EPEC (aEPEC) in childhood diarrhoea have not been well studied in an Indian context. A comparative study was undertaken to investigate virulence determinants, antibiotic susceptibility patterns and serogrouping of typical EPEC (tEPEC) versus aEPEC causing diarrhoea in children. A total of 400 prospective and 500 retrospective E. coli isolates were included. PCR was performed for eae, bfpA, efa, nleB, nleE, cdt, ehxA and paa genes. The Clinical and Laboratory Standards Institute's disc diffusion test was used to determine the antimicrobial susceptibility. Phenotypic screening of extended spectrum β-lactamases (ESBLs), AmpC and Klebsiella pneumoniae carbapenemase (KPC) production, and molecular detection of bla(NDM-1), bla(VIM), bla(CTX-M-15), bla(IMP) and bla(KPC) were performed. aEPEC (57.6 %) were more common as compared with tEPEC (42.3 %). The occurrence of virulence genes was observed to be three times higher in aEPEC as compared with tEPEC, efa1 (14.7 % of aEPEC, 4 % of tEPEC) being the most common. Most of the isolates did not belong to the classical EPEC O-serogroups. The highest resistance was observed against amoxicillin (93.22 %) followed by quinolones (83 %), cephalosporins (37.28 %), cotrimoxazole (35.59 %) and carbapenems (30.5 %). Overall equal numbers of aEPEC (41.17 %) and tEPEC (40 %) were observed to be multidrug-resistant. Fifteen EPEC strains demonstrated presence of ESBLs, five produced AmpC and four each produced metallo-β-lactamases and KPC-type carbapenemases; eight, seven and one isolate(s) each were positive for bla(VIM), bla(CTX-M-15) and bla(NDM-1), respectively. Here, to the best of our knowledge, we report for the first time on carbapenem resistance and the presence of bla(NDM-1) and bla(CTX-M-15) in EPEC isolates from India.
authors.affiliation: Enteric Laboratory, Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
authors.forename: Supriya
authors.initials: S
authors.lastname: Malvi
authors.affiliation: Enteric Laboratory, Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
authors.forename: Suma
authors.initials: S
authors.lastname: Appannanavar
authors.affiliation: Enteric Laboratory, Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
authors.forename: Balvinder
authors.initials: B
authors.lastname: Mohan
authors.affiliation: Enteric Laboratory, Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
authors.forename: Harsimran
authors.initials: H
authors.lastname: Kaur
authors.affiliation: Enteric Laboratory, Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
authors.forename: Neha
authors.initials: N
authors.lastname: Gautam
authors.affiliation: Advanced Pediatric Centre, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
authors.forename: Bhavneet
authors.initials: B
authors.lastname: Bharti
authors.affiliation: National Salmonella and Escherichia Centre, Central Research Institute, Kasauli 173204, India.
authors.forename: Yashwant
authors.initials: Y
authors.lastname: Kumar
authors.affiliation: Enteric Laboratory, Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
authors.forename: Neelam
authors.initials: N
authors.lastname: Taneja
mesh_terms: D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004279:DNA, Viral / Q000235:genetics; D003967:Diarrhea / Q000453:epidemiology / Q000382:microbiology*; D054308:Enteropathogenic Escherichia coli / Q000145:classification / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification*; D004927:Escherichia coli Infections / Q000453:epidemiology / Q000382:microbiology*; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008826:Microbial Sensitivity Tests; D016133:Polymerase Chain Reaction; D011446:Prospective Studies; D012189:Retrospective Studies; D065288:Serogroup; D037521:Virulence Factors / Q000235:genetics*; D001618:beta-Lactamases / Q000032:analysis
chemical_list: D000900:Anti-Bacterial Agents; D004279:DNA, Viral; D037521:Virulence Factors; D001618:beta-Lactamases