Tapia-Pastrana Gabriela, Rojas-Bautista Metztli, Hernández-Pérez Pilar, Santiago-Martínez Olegario, Gómez-Rodríguez Lucía C, Terrazas-Luna Víctor M, Montes-Yedra Jacobo, Bautista-Avendaño Alfonso A, García-López Eduardo S, Leon-Sicairos Nidia, Angulo-Zamudio Uriel A, Canizalez-Roman Adrian
Laboratorio de Investigación Biomédica, Hospital Regional de Alta Especialidad de Oaxaca, Servicios de Salud, IMSS-Bienestar, Oaxaca, Mexico.
Facultad de Ciencias Químicas de la Universidad Autónoma Benito Juárez de Oaxaca, Oaxaca de Juarez, Oaxaca, Mexico.
PLoS One. 2024 Mar 12;19(3):e0300304. doi: 10.1371/journal.pone.0300304. eCollection 2024.
Diarrheagenic E. coli (DEC) strains are one of the most important etiology factors causing diarrhea in children worldwide, especially in developing countries. DEC strains have characteristic virulence factors; however, other supplemental virulence genes (SVG) may contribute to the development of diarrhea in children. Therefore, this study aimed to determine the prevalence of DEC in children with diarrhea in southwestern Mexico and to associate childhood symptoms, SVG, and pathotypes with diarrhea-causing DEC strains. DEC strains were isolated from 230 children with diarrhea aged 0-60 months from the state of Oaxaca, southwestern Mexico; clinical data were collected, and PCR was used to identify SVG and pathotypes. Antibiotic resistance profiling was performed on DEC strains. 63% of samples were DEC positive, single or combined infections (two (21%) or three strains (1.3%)) of aEPEC (51%), EAEC (10.2%), tEPEC (5.4%), DAEC (4.8%), ETEC (4.1%), EIEC (1.4%), or EHEC (0.7%) were found. Children aged ≤ 12 and 49-60 months and symptoms (e.g., fever and blood) were associated with DEC strains. SVG related to colonization (nleB-EHEC), cytotoxicity (sat-DAEC and espC-tEPEC), and proteolysis (pic-aEPEC) were associated with DECs strains. E. coli phylogroup A was the most frequent, and some pathotypes (aEPEC-A, DAEC-B), and SVG (espC-B2, and sat-D) were associated with the phylogroups. Over 79% of the DEC strains were resistant to antibiotics, and 40% were MDR and XDR, respectively. In conclusion aEPEC was the most prevalent pathotype in children with diarrhea in this region. SVG related to colonization, cytotoxicity, and proteolysis were associated with diarrhea-producing DEC strains, which may play an essential role in the development of diarrhea in children in southwestern Mexico.
致泻性大肠杆菌（DEC）菌株是全球范围内导致儿童腹泻的最重要病因之一，在发展中国家尤为如此。DEC菌株具有特征性毒力因子；然而，其他补充毒力基因（SVG）可能也会导致儿童腹泻。因此，本研究旨在确定墨西哥西南部腹泻儿童中DEC的流行情况，并将儿童症状、SVG和致病型与导致腹泻的DEC菌株相关联。从墨西哥西南部瓦哈卡州230名0至60个月大的腹泻儿童中分离出DEC菌株；收集临床数据，并使用聚合酶链反应（PCR）来鉴定SVG和致病型。对DEC菌株进行抗生素耐药性分析。63%的样本DEC呈阳性，发现了产肠毒素性大肠杆菌（aEPEC，占51%）、肠集聚性大肠杆菌（EAEC，占10.2%）、紧密黏附性大肠杆菌（tEPEC，占5.4%）、弥漫黏附性大肠杆菌（DAEC，占4.8%）、产毒性大肠杆菌（ETEC，占4.1%）、侵袭性大肠杆菌（EIEC，占1.4%）或肠出血性大肠杆菌（EHEC，占0.7%）的单一或混合感染（两种菌株（21%）或三种菌株（1.3%））。年龄≤12个月和49至60个月的儿童以及症状（如发热和便血）与DEC菌株有关。与定植相关的SVG（nleB - EHEC）、细胞毒性相关的SVG（sat - DAEC和espC - tEPEC）以及蛋白水解相关的SVG（pic - aEPEC）与DEC菌株有关。大肠杆菌A系统发育群最为常见，一些致病型（aEPEC - A、DAEC - B）和SVG（espC - B2和sat - D）与系统发育群有关。超过79%的DEC菌株对抗生素耐药，分别有40%为多重耐药（MDR）和广泛耐药（XDR）。总之，aEPEC是该地区腹泻儿童中最常见的致病型。与定植、细胞毒性和蛋白水解相关的SVG与导致腹泻的DEC菌株有关，这可能在墨西哥西南部儿童腹泻的发生中起重要作用。
