Prevalence and Antibiotic Resistance of Diarrheagenic Escherichia coli Isolated from Children Younge than 5 Years with Acute Gastroenteritis in Southeastern China

Acute gastroenteritis is a major public health problem worldwide and an important cause of morbidity and mortality, especially among children. Diarrheagenic Escherichia coli (DEC) are among the most important bacterial causes of childhood diarrhea. Our objectives were to determine the occurrence of diarrheagenic E. coli strains in stool samples from children under five years old and their drug susceptibility patterns. Stool specimens were collected from 462 children under 5 years visiting hospital due to acute gastroenteritis and from 478 healthy controls of similar age and gender. Pathogens were detected by using conventional culture techniques and polymerase chain reaction (PCR). The antimicrobial susceptibility of DEC was determined by disk diffusion. DEC was identified at a rate of 27.7% (n = 128) in diarrheic children and 13.2% (n = 63) in non-diarrheic children. Enteroaggregative (37.8%), enteropathogenic (23.6%), and enterotoxigenic E. coli (18.7%) were the most frequent pathotypes, followed by enterohemorrhagic (9.3%), enteroinvasive (6.2%), and diffusely adherent E. coli (4.4%). Most DEC strains isolated in this study were resistant to ampicillin, cefotaxime, tetracycline and cotrimoxazole (81.8, 72.9, 61.3, and 72.0% resistance, respectively). This study indicated that diarrheagenic Escherichia coli is an important cause of diarrhea in children younger than 5 years in southeastern China. A monitoring of drug susceptibility of DEC seems to be a critical issue in China.