Etiology of Acute Diarrhea in Tunisian Children with Emphasis on Diarrheagenic Escherichia coli: Prevalence and Identification of E. coli Virulence Markers

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TitreEtiology of Acute Diarrhea in Tunisian Children with Emphasis on Diarrheagenic Escherichia coli: Prevalence and Identification of E. coli Virulence Markers
Type de publicationJournal Article
Year of Publication2014
AuteursBen Nejma IBen Salem-, Zaafrane MHassine, Hassine F, Sdiri-Loulizi K, Ben Said M, Aouni M, Mzoughi R
JournalIRANIAN JOURNAL OF PUBLIC HEALTH
Volume43
Pagination947–960
Date PublishedJUL
Type of ArticleArticle
ISSN2251-6085
Mots-clésChildren, Diagnosis, Diarrhea, Enteric pathogens, Escherichia coli, Tunisia
Résumé

Background: Diarrheal diseases can be caused by viral, bacterial and parasitic infections. This paper provides a preliminary image of diarrhea with regards to etiology and epidemiologic factors in Tunisian children less than five years of age. Methods: Overall, 124 diarrhoeal stools were collected from patients suffering from acute diarrhea and 54 stool samples from healthy children. All stools were examined for the presence of enteric pathogens. Results: In diarrheagenic children, 107 pathogenic bacteria were isolated (12 Salmonella spp. (9.7%) and 95 diarrheagenic Escherichia coli strains (76.6%): 29 enteroaggregative E. coli (EAEC) (23.4%), 15 enteroinvasive E. coli (EIEC) (12.1%), 17 enteropathogenic E. coli (EPEC) (13.7%), 26 enterotoxigenic E. coli (ETEC) (21%) and 2 enterohemoragic E. coli (EHEC) (1.6%). However, in the control group, 23 pathogenic E. coli strains were isolated (42.6%): 8 EAEC (14.8%), 12 EIEC (22.2%) and 3 EPEC (5.5%). Among diarrheagenic E. coli (DEC), only ETEC strains were significantly recovered from diarrheagenic children than from healthy controls (P < 0.0003). Group A rotavirus was identified in 33.9% (n=42) of diarrheagenic children and in 11.1% among the control group (n=6). Concerning norovirus, 8.9% (n=11) of the samples collected from diarrheagenic children and 9.2% (n=5) from the control group were positive. The prevalence of rotaviruses and Salmonella spp were also significantly higher in patients with diarrhea than in controls (P=0.002 and P < 0.019, respectively). Finally, enteropathogenic parasites (Entamoeba coli and cryptosporidium Oocystes) were isolated from 4.8% and 9.2% of diarrheagenic and control children, respectively. Conclusion: These results provide baseline data about the relative importance of different enteropathogens in Tunisian children.