Related Experiment Videos
Enterotoxigenic Escherichia coli associated diarrhea: the clinical pattern in Khmer children
Insights
Enterotoxigenic Escherichia coli (ETEC) causes severe diarrhea in Khmer children, leading to dehydration and complications. Antibiotic resistance is common in ETEC strains, highlighting the need for effective treatment strategies.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Diarrhea remains a significant health concern in children globally.
- Enterotoxigenic Escherichia coli (ETEC) is a common bacterial cause of diarrheal diseases.
Purpose of the Study:
- To investigate the clinical features and outcomes of ETEC-associated diarrhea in hospitalized Khmer children.
- To assess the antibiotic resistance patterns of ETEC isolates.
Main Methods:
- A comparative study of 16 children with ETEC diarrhea and 132 controls.
- Clinical data including stool frequency, dehydration severity, lethargy, and complications were recorded.
- Antibiotic resistance of isolated ETEC strains was determined.
Main Results:
- Children with ETEC infections presented with more frequent loose stools, severe dehydration, and lethargy.
- ETEC-associated diarrhea was linked to a higher incidence of complications, including hypotension and hypovolemic shock.
- A high prevalence (75%) of multidrug-resistant ETEC was observed.
- Seasonal distribution of ETEC showed a bimodal pattern.
Conclusions:
- ETEC is a prevalent cause of severe diarrhea in Khmer children.
- The high rate of antibiotic resistance in ETEC isolates poses a treatment challenge.
- Prompt recognition and management of ETEC infections are crucial to reduce morbidity and mortality.
Abstract:
One hundred and fourty eight children with diarrhea of less than 1 week duration, admitted to hospital, were studied. Sixteen cases with enterotoxigenic Escherichia coli (ETEC) associated diarrhea and 132 cases from whom ETEC was not isolated were compared. Age, nutritional status and duration of illness were similar in both groups. Children with ETEC infections passed more loose stools (P = 0.006), were more severely dehydrated (P = 0.0007) and were more lethargic (P = 0.04) on admission than children without ETEC infections. Complications were more often observed in the ETEC group. Six children with ETEC infections had severe hypotension and required intravenous rehydration therapy (P = 0.005). Four of them developed hypovolaemic shock (P = 0.002). Multiple antibiotic resistance was observed in 75% of ETEC isolated from children with diarrhea. Seasonal variation of ETEC shows a bimodal distribution before and after the rainy season. Concomitant infections were diagnosed in 71% of children, 66% got antibiotic treatment and 93% received oral rehydration solution (ORS). Two children died during hospitalization. Case fatality rate was 1.35 per cent. The findings of this study indicate that ETEC is a common cause of diarrhea in Khmer children and can cause severe disease.