Correlation between Escherichia coli resistant gene isolated from stool samples of children under five years and that from consumed water

Diarrheagenic Escherichia coli (DEC) causes enteric infections and diarrhea, especially in young children. Kenya reports around 2.6 million cases and 7,000 deaths annually due to diarrhea. Antibiotic-resistant DEC strains are a significant public health concern, complicating treatment. The objective...

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Main Authors: Titus Suge, Dennis Magu, Peter Wanzala
Format: Article
Language:English
Published: Elsevier 2023-11-01
Series:Scientific African
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2468227623003927
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author Titus Suge
Dennis Magu
Peter Wanzala
author_facet Titus Suge
Dennis Magu
Peter Wanzala
author_sort Titus Suge
collection DOAJ
description Diarrheagenic Escherichia coli (DEC) causes enteric infections and diarrhea, especially in young children. Kenya reports around 2.6 million cases and 7,000 deaths annually due to diarrhea. Antibiotic-resistant DEC strains are a significant public health concern, complicating treatment. The objective of this research was to correlate children's water consumption and antimicrobial-resistant DEC development. The study sampled 1124 children under five with diarrhea in Nakuru, Kenya, using a case-control design. Among 384 eligible children, 192 cases showed Amoxicillin-resistant DEC. Water samples from households were collected and analyzed for DEC presence. The samples were filtered, plated onto MacConkey agar, and subcultured onto Eosin Methylene Blue agar for further analysis. The DEC pathotypes were identified based on morphological and biochemical characteristics, and antibiotic resistance was assessed using the Kirby-Bauer disk diffusion method. The study revealed a strong correlation of 11.613 (95 % Confidence Interval [CI]: 6.495–20.765, p-value: 0.000) between microbial burden in vended water (water sold by vendors) used by different households consumption and antimicrobial resistance in DEC. Water sources showed a high prevalence of DEC, primarily Enteroaggregative, enteropathogenic, enterotoxigenic, and enteroinvasive E. coli. DEC isolates also exhibited varying antibiotic resistance, and genes like blaCTX-M, blaTEM, and blaSHV were identified using PCR. The Spearman correlation coefficient was one, showing that resistance genes in water and stool were perfectly correlated. The study emphasizes the significance of improving water quality, hygiene, and antibiotic-resistant bacteria control to prevent and manage DEC and infectious diseases in Kenya. To combat outbreaks, effective surveillance and rapid reaction procedures are essential. The findings help to shape public health policies and initiatives.
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spelling doaj.art-68a9b9df4a7941668d9729a0dba009872023-12-02T07:06:23ZengElsevierScientific African2468-22762023-11-0122e01937Correlation between Escherichia coli resistant gene isolated from stool samples of children under five years and that from consumed waterTitus Suge0Dennis Magu1Peter Wanzala2Department of Environmental Health and Disease Control, School of Public Health, Jomo Kenyatta University of Agriculture and Technology, P.O. Box 62000-00200, Nairobi, Kenya; Department of Pharmacology & Pharmacognosy, Kabarak University, Private Bag-20157, Nakuru, Kenya; Corresponding author at: Department of Environmental Health and Disease Control, School of Public Health, Jomo Kenyatta University of Agriculture and Technology, P.O. Box 62000-00200 Kenya, Nairobi, Kenya.Department of Environmental Health and Disease Control, School of Public Health, Jomo Kenyatta University of Agriculture and Technology, P.O. Box 62000-00200, Nairobi, KenyaCenter for Public Health Research, Kenya Medical Research Institute, Centre for Public Health Research, Nairobi, KenyaDiarrheagenic Escherichia coli (DEC) causes enteric infections and diarrhea, especially in young children. Kenya reports around 2.6 million cases and 7,000 deaths annually due to diarrhea. Antibiotic-resistant DEC strains are a significant public health concern, complicating treatment. The objective of this research was to correlate children's water consumption and antimicrobial-resistant DEC development. The study sampled 1124 children under five with diarrhea in Nakuru, Kenya, using a case-control design. Among 384 eligible children, 192 cases showed Amoxicillin-resistant DEC. Water samples from households were collected and analyzed for DEC presence. The samples were filtered, plated onto MacConkey agar, and subcultured onto Eosin Methylene Blue agar for further analysis. The DEC pathotypes were identified based on morphological and biochemical characteristics, and antibiotic resistance was assessed using the Kirby-Bauer disk diffusion method. The study revealed a strong correlation of 11.613 (95 % Confidence Interval [CI]: 6.495–20.765, p-value: 0.000) between microbial burden in vended water (water sold by vendors) used by different households consumption and antimicrobial resistance in DEC. Water sources showed a high prevalence of DEC, primarily Enteroaggregative, enteropathogenic, enterotoxigenic, and enteroinvasive E. coli. DEC isolates also exhibited varying antibiotic resistance, and genes like blaCTX-M, blaTEM, and blaSHV were identified using PCR. The Spearman correlation coefficient was one, showing that resistance genes in water and stool were perfectly correlated. The study emphasizes the significance of improving water quality, hygiene, and antibiotic-resistant bacteria control to prevent and manage DEC and infectious diseases in Kenya. To combat outbreaks, effective surveillance and rapid reaction procedures are essential. The findings help to shape public health policies and initiatives.http://www.sciencedirect.com/science/article/pii/S2468227623003927DECWater samplesAntimicrobial resistanceMorbidityExtended-spectrum beta-lactamases (ESBLS)
spellingShingle Titus Suge
Dennis Magu
Peter Wanzala
Correlation between Escherichia coli resistant gene isolated from stool samples of children under five years and that from consumed water
Scientific African
DEC
Water samples
Antimicrobial resistance
Morbidity
Extended-spectrum beta-lactamases (ESBLS)
title Correlation between Escherichia coli resistant gene isolated from stool samples of children under five years and that from consumed water
title_full Correlation between Escherichia coli resistant gene isolated from stool samples of children under five years and that from consumed water
title_fullStr Correlation between Escherichia coli resistant gene isolated from stool samples of children under five years and that from consumed water
title_full_unstemmed Correlation between Escherichia coli resistant gene isolated from stool samples of children under five years and that from consumed water
title_short Correlation between Escherichia coli resistant gene isolated from stool samples of children under five years and that from consumed water
title_sort correlation between escherichia coli resistant gene isolated from stool samples of children under five years and that from consumed water
topic DEC
Water samples
Antimicrobial resistance
Morbidity
Extended-spectrum beta-lactamases (ESBLS)
url http://www.sciencedirect.com/science/article/pii/S2468227623003927
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