Isolation and Antibiotic Susceptibility Pattern of Escherichia Coli Isolates from Stools of Diarrhoiec Children below 5 Years in Zaria, Nigeria.
Abstract
E.coli has become widespread in distribution and recognised both as harmless commensal and a versatile pathogen. It has emerged as an important cause of diarrhoea illness with diverse phenotypes and pathogenicic mechanisms.
E. coli and other members of the family enterobacteriaceae are well known to develop or acquire resistance to a variety of antibiotics by different mechanisms.
Seventy (70) isolates of Escherichia coli from stool of diarrhoeic children below five (5) years of age with suspected gastrointestinal infections attending two hospitals and a primary health care centre in Zaria were screened for their susceptibility to a panel of nine commonly used antibiotics by the disc diffusion method.
Escherichia coli isolates which were resistant to multiple antibiotics and showed minimum inhibitory concentration between 20 – 100µg/ml against ciprofloxacin were used for conjugation studies.
Curing experiments of the transconjugants and resistant Escherichia coli isolates was carried out with acridine orange to determine if the resistant determinants were plamid mediated.
High level of resistance was observed to Amoxicillin (100%), Ampicillin (100%), Tetracycline (100%), Sulphamethoxazole/Trimethoprim (97.1%), Ceftazidime (88.6%), Cefuroxime (85.7%) while lower resistance were observed to Gentamicin (35.7%), Ciprofloxacin (40%) and Ceftriaxone (58.6%).
Sixteen isolates (22.9%) were found to be resistant to all the 9 antibiotics used. Sixty- eight isolates (97.1%) were identified as being resistant to multiple antibiotics since they were simultaneously resistant to at least three different antibiotics with seventeen (17) different phenotypic patterns.
The multiple antibiotic resistance indices (MARI) for the MAR isolates was found to be high, between 0.3 to 1.0 suggesting that the isolates originated from an environment where antibiotics were often used.
Plasmid DNA analysis on thirty-five resistant isolates showed 11 plasmid band sizes with molecular weights ranging from 2800 bp to > 5000 bp.
Three isolates were found to harbour the IncK epidemiologic plasmid encoding gene for the blaCTX-M of the ESBLs and nineteen resistant isolates were also found to harbour the gyrB gene.
Introduction
Background Of Study
Diarrhoea is defined as the passage of three or more loose or liquid stools per day or more frequent passage than is normal for the individual (WHO, 2009).
Diarrhoeal disease has been reported to be a leading cause of morbidity and mortality in children and there are about two billion cases of diarrhoeal disease worldwide (WHO, 2009).
Out of the 1.5 million children reported to have been killed by diarrhoeal disease in 2004, 80% were below two years (WHO, 2009).
In children below five years, diarrhoeal disease has been described to be the second leading cause of death after pneumonia (Kosek et al., 2003).
In developing countries, children under three years old have been reported to experience an average of three episodes of diarrhoea every year.
Each episode of diarrhoea deprives the child of the nutrition necessary for growth and as a result, diarrhoea has been reported to be a major cause of malnutrition, and malnourished children are predisposed to falling ill due to diarrhoea (WHO, 2012).
The highest age-mortality rate (8.5 children per 1000/year) occurs in children under 1 year of life (Kosek et al., 2003).
Improvement in sanitation, nutrition, education and early access to oral rehydration therapy among other measures has been reported to lower the fatality of severe acute infectious diarrhoea from 4.6 million in 1982 to an estimated 1.5–2.5 million in 2010 (Black et al., 2010; O’Ryan et al., 2010).
However, diarrhoea remains the second most common cause of death in children under 5 years of age worldwide according to the Global Burden Disease Report of the WHO (Boschi-Pinto et al., 2008; Kosek et al., 2003).
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