Isolation of Enteropathogenic Escherichia coli from Children with Diarrhoea Attending the National Hospital in Abuja, Nigeria

Background:: Diarrhoeal diseases remain one of the leading causes of childhood morbidity
and mortality in most developing countries, with enteropathogenic Escherichia coli (EPEC)
being one of the most important aetiologic agents of infantile diarrhoea in many of these
countries.

Objective:: To determine the prevalence of EPEC in children (0-24 months) with diarrhoea.

Methods:: One hundred stool samples from children with diarrhoea attending the National
Hospital in Abuja, Nigeria were analysed for the presence of EPEC using standard bacteriological
methods. Isolates were also subjected to antimicrobial testing using the disc diffusion
method.

Results:: Fifteen (15.00%) samples were positive for EPEC. The highest number of isolates
was recovered from the 6-12 months age group with 10 (20.41%) in total. No isolates were
recovered from the 0-5 months age group or from exclusively breast fed children, however,
nine (19.15%) children receiving mixed feeding and six (33.33%) children who were not
being breast-fed tested positive for EPEC, and the difference was found to be statistically
significant (P<0.05). The highest number of isolates, eight (53.33%), belonged to those in
the poly 1 sero-group with serotypes O1, O26, O86a, O111, O119, O127 and O128. Fourteen
(93.33%) of the isolates were sensitive to norfloxacin, 13 (86.67%) each to ofloxacin and
colistin, 11 (73.33%) to nalidixic acid, 10 (66.67%) to cefuroxime, two (13.33%) to cotrimoxazole,
and one (6.67%) to tetracycline. None of the isolates were found to be sensitive to
ampicillin or chloramphenicol.

Conclusion:: This study has shown that multidrug resistant EPEC is associated with infantile
diarrhoea in Abuja, Nigeria. To address this issue, antibiotic therapy should take into consideration
the susceptibility pattern of the pathogen. In addition, the incidence of EPEC in children
can be traced primarily to faulty weaning practices and/or poor personal hygiene.