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Ayesha Masood
Dr Bushra Adeel
Sehr Syed
Muhammad Qasim Ali
Asif Hanif
Dr. Syed Zeeshan Haider Naqvi
Hafiza Ayesha Andleeb
Dr Amina Mahmood
Dr. Fatima Masood
Dr. Izah Tahir


Diarrhea, Diarrheagenic Escherichia coli (DEC), Multiplex PCR, Infection.


Background: Diarrhea is a ruling general health issue in developing countries. The prevailing rate of diarrhea in individuals below the age of 5 years is increasing every year. The current study aims to find out the prevalence of Escherichia coli strains causing diarrhoea in off-springs and children of 5 years or below in the region of Lahore, Pakistan. The purpose of this study is to reveal the underline cause of diarrhoea in children and to monitor the anti-microbial treatment of the children.   

Material and Methods: Over the course of 9 months, samples were obtained from the Medical Center for Children and Sir Ganga Ram Hospital in Lahore. Participating children were less than 5 years old and were having diarrhea. For determining the prevalence of Diarrheagenic Escherichia coli (DEC) among children aged five and under, a total of 268 rectal swab specimens were collected from kids who were ill with diarrhoea. All specimens were received in sterile containers and cultured. Standard biochemical assays were used for identifying E. coli. Confirmed E. coli samples were further studied using multiplex PCR for identification of its particular genes by amplification of toxic genes. Pearson correlation analysis was done for the present study.

Results: 146 out of 268 samples were derived as positive for E. coli. 36 % isolates had the entero-aggressive (EAEC) pathogenic gene. EAEC revealed 10 % co-infection with entero-hemorrhagic E. coli (EHEC). Enteropathogenic (EPEC) virulent gene was found in 19% of total samples that were observed positive for E. coli. Older Escherichia coli (DEC) strains had a stronger negative correlation with age groups, suggesting that lower-aged infants may have more chances of getting the strains.

Conclusion: The current study found that EAEC is significantly linked to diarrheal disease in children under the age of 5 years. The present study reveals strain-specific analysis of diarrheagenic E. coli at a molecular level by multiplex PCR plays a pivotal role in finding out the prevalence of E. coli strains at a regional level. Moreover, the current study will also play a positive role in the anti-microbial monitoring of diarrheal patients, with a focus on the increased prevailing ratio of the disease. To the best of our knowledge, this is a foremost report from Punjab Pakistan that enlists isolated EAEC, EHEC and EPEC genes in the region.

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