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Diarrheagenic Escherichia coli in Costa Rican children: a 9-year retrospective study

Cristian Pérez-Corrales1, Kevin Leandro-Sandí2

  • 1División de Diagnóstico Molecular, Laboratorio Clínico, Hospital Nacional de Niños "Dr. Carlos Sáenz Herrera", Caja Costarricense del Seguro Social, San José, Costa Rica. cperezc@ccss.sa.cr.

BMC Research Notes
|May 30, 2019
PubMed

Insights

Diarrheagenic Escherichia coli (DEC) prevalence in Costa Rican children varied annually, with enteroaggregative E. coli (EAEC) being most common. Higher rainfall reduced EAEC risk, while antimicrobial resistance was noted for certain antibiotics.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Public Health

Background:

  • Diarrheagenic Escherichia coli (DEC) is a significant cause of pediatric gastroenteritis globally.
  • Understanding local prevalence and risk factors is crucial for effective public health interventions.
  • Data on DEC in Costa Rican pediatric populations are limited.

Purpose of the Study:

  • To estimate the prevalence of DEC among children with diarrhea at a major Costa Rican hospital.
  • To investigate variations in DEC prevalence related to rainfall and coinfections.
  • To assess the antimicrobial resistance patterns of DEC isolates.

Main Methods:

  • Retrospective observational study analyzing 12,247 gastroenteritis records from January 2008 to December 2016.
  • Prevalence of different DEC pathotypes (EAEC, EPEC, EIEC) was determined.
  • Statistical analysis, including Generalized Additive Models (GAM), was used to explore associations with rainfall and coinfections.

Main Results:

  • Annual DEC prevalence ranged from 2.7% to 9.0%.
  • Enteroaggregative E. coli (EAEC) was the most prevalent pathotype (31%), followed by enteropathogenic E. coli (EPEC) (24%) and enteroinvasive E. coli (EIEC) (15%).
  • Increased rainfall (>200 mm/mo) was associated with a reduced probability of EAEC gastroenteritis (p=0.04). EPEC and Campylobacter spp. coinfections occurred in 10% of cases. Antimicrobial resistance was observed for ciprofloxacin (0.6%), trimethoprim/sulfamethoxazole (29%), and ampicillin (42%).

Conclusions:

  • DEC infections represent a notable burden in pediatric gastroenteritis in Costa Rica.
  • Environmental factors like rainfall may influence the epidemiology of specific DEC pathotypes.
  • Antimicrobial resistance in DEC isolates necessitates careful treatment guidelines and monitoring.
Abstract

Keywords:
ChildrenDiarrheagenic Escherichia coliGastroenteritis

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