Antimicrobial multiresistance of enterotoxigenic and enteropathogenic escherichia Coli detected in clinical specimens by polymerase chain reaction

Introduction: Increasing antimicrobial resistance of enteric pathogens has attractedattention mainly in developing countries where the prevalence of acute diarrheal diseasecontinues to be major cause of mortality and morbidity. Diarrheagenic pathotypes of E.coli, enterotoxigenic (ETEC) and enteropathogenic (EPEC) are associated with this disease.Objective: To determine antimicrobial susceptibility of enterotoxigenic and enteropathogenicEscherichia coli in clinical samples from patients with diarrhea.Material and methods: Fifty eight strains of E. coli isolated from children under five years,and forty five from adults were analyzed by PCR; we used disk diffusion method to evaluateantimicrobial susceptibility to 12 antibiotics in both, typified pathotypes and strains of E.coli without any of the tested genes (E. coli SNG).Results: Enteropathogenic Escherichia coli was found in 41% of samples andenterotoxigenic Escherichia coli in 37%; the former predominating in strains isolatedfrom adults (42%) and the last in strains isolated from infants (43%). The most commonresistance markers were carbenicillin (83%), ampicillin (70%) and trimethoprimsulfamethoxazole(49%). We found a high percentage of strains (87%) resistant to at leastone antibiotic and multiresistance of three to six antibiotics was found in 62%.In strains isolated from children, multiresistance was found in 63% and 52% for EPEC andETEC, and strains isolated from adults 53% and 71% respectively.Conclusion: Strains of E. coli showed similar resistance profiles, predominatingmultiresistance in EPEC, ETEC and E. coli SNG (four antibiotics), reflecting frequent exposureof enteropathogens to antibiotics, so increasing resistance reduce effectiveness of availableantimicrobials.RESUMEN:Introducción: la creciente resistencia antimicrobiana de patógenos entéricos hallamado la atención principalmente en países en vías de desarrollo, donde la prevalenciade enfermedades diarreicas agudas sigue causando grandes índices de mortalidad ymorbilidad. Los patotipos diarrogénicos de E.coli: EPEC y ETEC se encuentran asociadosa este tipo de enfermedades.Objetivo: determinar la susceptibilidad antimicrobiana de los patogrupos EPEC y ETECen muestras clínicas de pacientes con cuadro diarreico.Material y métodos: mediante la técnica de PCR se caracterizaron 58 cepas de E.coliaisladas de ni os menores a cinco a os y en 45 cepas de adultos, se utilizó la técnicade difusión en disco para evaluar la susceptibilidad antimicrobiana a doce antibióticostanto en los patotipos tipificados como en las cepas E.coli sin ninguno de los