Ogunbiyi Tosin Segun, Fayemi Olanrewaju Emmanuel, Akanni Gabriel Bidemi, Ayolabi Christianah Idowu, Hald Tine
Department of Biological Sciences, Mountain Top University, Ibafo, 110106 Ogun State, Nigeria.
Department of Microbiology, University of Lagos, Akoka, 101017 Lagos State, Nigeria.
Pathogens. 2023 Nov 15;12(11):1358. doi: 10.3390/pathogens12111358.
Diarrheagenic (DEC) is one of the most common etiological agents of moderate-to-severe diarrhea in Low- and Middle-Income Countries (LMICs). Therefore, determining the source(s) of DEC in index cases and exposure environment is important for developing a prevention strategy. The current study aims to investigate the prevalence of DEC among children under 5 years and their exposure environment in Ogun State, Nigeria.
Samples from 228 diarrheic children and their exposure environment were collected and screened for . Bio-chemically compatible distinct colonies were molecularly characterized using a 7-virulence-gene multiplex PCR with virulence factors (VFs) indicative of four pathotypes of : enterotoxigenic (ETEC), verotoxigenic (VTEC), enteropathogenic (EPEC), and enteroinvasive (EIEC). Representative pathotypes were subjected to antimicrobial susceptibility and over-expressed efflux pump assays.
One or more VFs typical of specific pathotypes were detected in 25.9% (59/228) diarrhea cases consisting of ETEC (21.5%) and EPEC (0.4%), while hetero-pathogenic pathotypes were found in 4.0% of cases. Of the food sources, 27.9% (101/362) were positive for DEC, of which ETEC accounted for 21.0%, VTEC 1.9%, EPEC 0.6%, EIEC 0.6%, and hetero-pathogenic pathotypes were 3.9%. Furthermore, ETEC was the only pathotype detected in the wastewater (4/183). Interestingly, the consumption of street-vended foods was the most significant ( = 0.04) risk factor for DEC infection in the study area. A total of 73.3% of selected DEC pathotypes showed resistance to antimicrobials, while 27.5% demonstrated over-expression of efflux pump activity.
The high prevalence of ETEC across all sources and the occurrence of hetero-pathogenic DEC in diarrheic children and food sources emphasizes the importance of establishing a better strategy for the control and prevention of diarrhea among children in low- and medium-income households.
致泻性大肠埃希菌（DEC）是低收入和中等收入国家（LMICs）中重度腹泻最常见的病原体之一。因此，确定索引病例中DEC的来源和暴露环境对于制定预防策略很重要。本研究旨在调查尼日利亚奥贡州5岁以下儿童中DEC的流行情况及其暴露环境。
收集228例腹泻儿童及其暴露环境的样本并进行筛选。对生化特性兼容的不同菌落使用具有7种毒力基因的多重聚合酶链反应（PCR）进行分子特征分析，这些毒力因子（VFs）可指示DEC的四种致病型：产肠毒素性大肠埃希菌（ETEC）、产志贺毒素性大肠埃希菌（VTEC）、肠致病性大肠埃希菌（EPEC）和肠侵袭性大肠埃希菌（EIEC）。对代表性致病型进行药敏试验和外排泵过表达检测。
在25.9%（59/228）的腹泻病例中检测到一种或多种特定致病型的典型VFs，其中包括ETEC（21.5%）和EPEC（0.4%），而4.0%的病例中发现了异源致病型。在食物来源中，27.9%（101/362）的DEC呈阳性，其中ETEC占21.0%，VTEC占1.9%，EPEC占0.6%，EIEC占0.6%，异源致病型占3.9%。此外，ETEC是废水中唯一检测到的致病型（4/183）。有趣的是，在研究区域，食用街头售卖食品是DEC感染最显著（P = 0.04）的危险因素。总共73.3%的选定DEC致病型显示出对抗菌药物的耐药性，而27.5%表现出外排泵活性过表达。
ETEC在所有来源中的高流行率以及腹泻儿童和食物来源中异源致病型DEC的出现强调了为低收入和中等收入家庭儿童建立更好的腹泻控制和预防策略的重要性。
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