title: Role of Enterotoxigenic Bacteroides fragilis in Children Less Than 5 Years of Age With Diarrhea in Tabriz, Iran.
abstract: BACKGROUND
  Diarrhea is the most frequent health problem among children in developing countries. Defining the etiology of acute diarrhea is critical to disease therapy and prevention. Some anaerobic bacteria such as Enterotoxigenic Bacteroides fragilis (ETBF) strains cause diarrheal disease by production of enterotoxin in children less than 5 years old.
  
  
  OBJECTIVE
  This study aimed to evaluate the prevalence of ETBF among common bacteria and viruses causing diarrhea in children aged less than five years.
  
  
  METHODS
  One hundred diarrheal stools were cultured for detection of aerobic and anaerobic pathogen bacteria by direct plating on selective media and antibiotic susceptibility tests were performed according to clinical and laboratory standards institute (CLSI) guidelines on isolates of ETBF. The enterotoxigenic gene among B. fragilis isolates was also investigated using the polymerase chain reaction (PCR) method. Detection of viral pathogens was carried out using the latex agglutination test.
  
  
  RESULTS
  Ten B. fragilis were isolated from 100 diarrheal fecal specimens. All isolates were susceptible to metronidazole, while 10% were susceptible to clindamycin. Four (40%) ETBF were isolated. Rotaviruses (57.2%) and adenoviruses (18.6%) were the most frequently detected etiological agents.
  
  
  CONCLUSIONS
  ETBF is one of the etiological agents that may cause diarrhea in children but it is not the commonest of them. Metronidazole is still an effective antibiotic against B. fragilis. Viruses are the most important etiological agents of diarrhea in children less than 5 years of age.
authors.affiliation: Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, IR Iran; Department of Bacteriology and Virology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, IR Iran.
authors.forename: Mohammad Taghi
authors.initials: MT
authors.lastname: Akhi
authors.affiliation: Department of Bacteriology and Virology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, IR Iran.
authors.forename: Sirus
authors.initials: S
authors.lastname: Jedari Seifi
authors.affiliation: Paramedical Faculty, Tabriz University of Medical Sciences, Tabriz, IR Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Asgharzadeh
authors.affiliation: Department of Bacteriology and Virology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, IR Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Ahangarzadeh Rezaee
authors.affiliation: Department of Pediatrics, Tabriz Children's Hospital, Tabriz University of Medical Sciences, Tabriz, IR Iran.
authors.forename: Shahram
authors.initials: S
authors.lastname: Abdoli Oskuei
authors.affiliation: Department of Bacteriology and Virology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, IR Iran.
authors.forename: Tahereh
authors.initials: T
authors.lastname: Pirzadeh
authors.affiliation: Department of Bacteriology and Virology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, IR Iran.
authors.forename: Mohammad Yousef
authors.initials: MY
authors.lastname: Memar
authors.affiliation: Department of Bacteriology and Virology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, IR Iran.
authors.forename: Naser
authors.initials: N
authors.lastname: Alizadeh
authors.affiliation: Department of Bacteriology and Virology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, IR Iran.
authors.forename: Hasan
authors.initials: H
authors.lastname: Seifi Yarijan Sofla
keywords: Adenovirus; Bacteroides fragilis; Diarrhea; PCR; Rotavirus; Susceptibility Pattern