ESBL and Integron Profiles in Pediatric EPEC/STEC

Area of Science:

• Microbiology
• Infectious Diseases
• Public Health

Background:

• Diarrheagenic Escherichia coli (DEC) is a primary cause of pediatric diarrhea in low- and middle-income countries.
• Antimicrobial resistance, including extended-spectrum β-lactamase (ESBL) production, complicates treatment.
• This study focused on DEC pathotypes, resistance, ESBL, and integron carriage in Egyptian children.

Purpose of the Study:

• To investigate the prevalence of DEC pathotypes in children with acute diarrhea in Mansoura, Egypt.
• To determine antimicrobial resistance patterns, ESBL production, and integron carriage among E. coli isolates.
• To understand the associations between these factors.

Main Methods:

• 120 children with acute diarrhea were enrolled, with stool samples cultured for E. coli.
• Phenotypic antibiotic susceptibility testing and ESBL detection were performed.
• Polymerase chain reaction (PCR) assays identified DEC pathotypes and class I/II integrons.

Main Results:

• E. coli was isolated from 50% of children; Shiga toxin-producing E. coli (STEC) and typical enteropathogenic E. coli (tEPEC) were predominant.
• High resistance rates were observed for amoxicillin/clavulanic acid, cefadroxil, and ampicillin.
• ESBL production (41.7%) and class I/II integrons (51.7%/16.7%) were prevalent, with strong associations between integrons and STEC/tEPEC.

Conclusions:

• DEC, particularly STEC and tEPEC, is a significant cause of pediatric diarrhea in Egypt.
• High antimicrobial resistance, ESBL production, and integron carriage highlight the need for surveillance and control.
• Urgent implementation of surveillance programs, antimicrobial stewardship, and infection control is crucial to limit resistance spread in pediatric populations.