Paper Information

Journal:   IRANIAN JOURNAL OF PUBLIC HEALTH   JULY 2014 , Volume 43 , Number 7; Page(s) 947 To 960.
 
Paper: 

ETIOLOGY OF ACUTE DIARRHEA IN TUNISIAN CHILDREN WITH EMPHASIS ON DIARRHEAGENIC ESCHERICHIA COLI: PREVALENCE AND IDENTIFICATION OF E. COLI VIRULENCE MARKERS

 
 
Author(s):  BEN SALEM BEN NEJMA IMEN*, HASSINE ZAAFRANE MOUNA, HASSINE FREDJ, SDIRI LOULIZI KHIRA, BEN SAID MONCEF, AOUNI MAHJOUB, RIDHA MZOUGHI
 
* LABORATORY OF INFECTIOUS DISEASES AND BIOLOGICAL AGENTS, FACULTY OF PHARMACY, UNIVERSITY OF MONASTIR, TU-5000 MONASTIR, TUNISIA
 
Abstract: 

Background: Diarrheal diseases can be caused by viral, bacterial and parasitic infections. This paper provides a preliminary image of diarrhea with regards to etiology and epidemiologic factors in Tunisian children less than five years of age.
Methods: Overall, 124 diarrhoeal stools were collected from patients suffering from acute diarrhea and 54 stool samples from healthy children. All stools were examined for the presence of enteric pathogens.
Results: In diarrheagenic children, 107 pathogenic bacteria were isolated (12 Salmonella spp. (9.7%) and 95 diarrheagenicEscherichia coli strains (76.6%): 29 enteroaggregative E.coli (EAEC) (23.4%), 15 enteroinvasive E.coli (EIEC) (12.1%), 17 enteropathogenicE.coli (EPEC) (13.7%), 26 enterotoxigenic E.coli (ETEC) (21%) and 2 enterohemoragicE.coli (EHEC) (1.6%). However, in the control group, 23 pathogenic E.coli strains were isolated (42.6%): 8 EAEC (14.8%), 12 EIEC (22.2%) and 3 EPEC (5.5%). Among diarrheagenicE.coli (DEC), only ETEC strains were significantly recovered from diarrheagenic children than from healthy controls (P<0.0003). Group A rotavirus was identified in 33.9% (n=42) of diarrheagenic children and in 11.1% among the control group (n=6).
Concerning norovirus, 8.9% (n=11) of the samples collected from diarrheagenic children and 9.2% (n=5) from the control group were positive. The prevalence of rotaviruses andSalmonella spp were also significantly higher in patients with diarrhea than in controls (P=0.002 and P<0.019, respectively). Finally, enteropathogenic parasites (Entamoeba coliand cryptosporidium Oocystes) were isolated from 4.8% and 9.2% of diarrheagenic and control children, respectively.
Conclusion: These results provide baseline data about the relative importance of different enteropathogens in Tunisian children.

 
Keyword(s): ENTERIC PATHOGENS, ESCHERICHIA COLI, DIARRHEA, CHILDREN, DIAGNOSIS, TUNISIA
 
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