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2020, Number 1

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Rev Cubana Med Trop 2020; 72 (1)

Diarrheagenic Escherichia coli: identification of pathotypes and antimicrobial resistance phenotypes in Cuban isolates

Águila SA, Rodríguez A, Fernández AA, Cruz IY, Bravo FL, Hernández MJL, Blanco S, Bebelagua D

Language: Spanish
References: 39
Page: 1-19
PDF size: 429.03 Kb.


ABSTRACT

Introduction: Acute diarrheal disease is a frequent cause of morbidity and mortality in developing countries. One of the leading causes is diarrheagenic Escherichia coli, which affects patients at extreme ages and with immunodeficiencies.
Objective: Identify the most active pathotypes of diarrheagenic Escherichia coli and the antimicrobial resistance phenotypes expressed by the prevailing pathotype.
Methods: A study was conducted from July 2012 to February 2014 of 184 isolates obtained from 15 provincial Hygiene, Epidemiology and Microbiology Centers in Cuba and the Isle of Youth. Identification of the genus, species and pathotypes was based on conventional and molecular diagnostic methods. Determination of antimicrobial susceptibility was performed by the Bauer-Kirby method in compliance with guidelines from the Clinical and Laboratory Standards Institute of 2013.
Results: A total 108 (58%) diarrheagenic Escherichia coli were identified. The following pathotypes were confirmed: Multiplex PCR 1 revealed 5 (6%) enteropathogenic, 4 (4%) enterotoxigenic and 0 (0%) enterohemorrhagic Escherichia coli. Multiplex PCR 2 found 72 (82%) enteroaggregative Escherichia coli, which was the prevailing type in the study. PCR (simple) detected 7 (8%) enteroinvasive Escherichia coli. 100% of the prevailing pathotype displayed resistance to at least one of the antimicrobials tested, a single resistance pattern to two antimicrobials, and nine multiresistance patterns.
Conclusions: The study showed the importance of the use of rapid molecular tests to confirm diarrheagenic E. coli pathotypes, which cause mild dehydration, serious complications and death. Identification could be done of the four most common pathotypes and enteroaggregative E. coli, the one with the highest incidence in the study population. The prevailing pathotype displayed high percentages of antimicrobial resistance to betalactams and good antimicrobial sensitivity to third-generation cephalosporins and aminoglycosides. The study contributed knowledge not revealed by previous research about Cuban isolates. Such information is considered to be highly valuable for clinicians, pediatricians and epidemiologists in the country.


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