Molecular Characterization And Antibiogram Of Diarrheagenic And Non-Diarrheagenic Escherichia Coli Isolated From Pediatric Patients Of Lahore, Pakistan

Abstract

Gastrointestinal disturbances, specifically diarrhea, represent a prevalent health concern, with a recognized association with an elevated susceptibility to stunting. This study provides a comprehensive analysis of biological samples collected from various hospitals, highlighting Mayo Hospital, Lahore, as the major contributor. The study encompasses both genders, with 43.9% males and 56.1% females. Age-wise distribution reveals 31.9%, 26.4%, 25%, and 16.7% for individuals below 2, 2-3, 3-4, and 4-5 years, respectively. Subjects were categorized into Group A (Diarrheagenic) and Group B (non-diarrheagenic), each constituting 50% of the total. PCR screenings focused on identifying E. coli pathotypes, emphasizing stx1, stx2, and eae primers for specific gene detection. Three E. coli strains were identified, with three assigned to O121:H19, two to O148:H8, and others denoted as ONT: HNT. DEC strains from diarrhea patients exhibited higher res[1]istance to AMP (69.4%) and AMC (80.6%) compared to those aged 3 years. Detection of EAEC revealed 60% with the aggR gene, and 53.3% characterized as multivirulent isolates. Different E. coli pathotypes (ETEC, EIEC, EPEC, EHEC, and EAEC) exhibited a clonal nature with unique O and O:H serotypes. Virulence factors fell into colonization factors or secreted toxins, emphasizing diverse mechanisms contributing to diarrheal infections. Non-diarrheagenic E. coli constituted 34% of studied strains, while 15.9% were identified as DEC through PCR analysis. Prevalent DEC pathotypes in both groups included AEPEC (6.11%), tEAEC (9.7%), ETEC (8.9%), DAEC (5.3%), and EIEC (5.6%). Clinical management and public health initiatives can benefit from these results, which can help in the creation of more precise plans to avoid and cure diarrhea caused by E. coli. The dynamic nature of E. coli pathotypes and the ways in which they interact with host variables in different population’s call for more investigation