High prevalence of diarrheagenic Escherichia coli carrying toxin-encoding genes isolated from children and adults in southeastern Brazil

Background: Diarrheagenic Escherichia coli (DEC) are important bacterial causes of childhood diarrhea in Brazil, but its impact in adults is unknown. This study aimed at investigating DEC among children and adults living in endemic areas. Methods: A total of 327 stools specimens were collected from children (n = 141) and adults (n = 186) with diarrhea attending health centers. Diarrheagenic E. coli (DEC) were identified by their virulence genes (multiplex polymerase chain reaction) and HEp-2 cell adherence patterns. Results: DEC were detected in 56 (40%) children and 74 (39%) adultsenteroaggregative E. coli (EAEC) (23%) was the most prevalent pathotype, followed by diffusely adherent E. coli (DAEC) (13%), and occurred at similar frequencies in both diarrheal groups. Atypical enteropathogenic E. coli (aEPEC) strains were recovered more frequently from children (6%) than from adults (1%). Twenty-six percent of the EAEC were classified as typical EAEC possessing aggR gene, and carried the aap gene. EAEC strains carrying aggR-aap-aatA genes were significantly more frequent among children than adults (p < 0.05). DAEC strains possessing Afa/Dr. genes were detected from children (10%) and adults (6%). EAEC and DAEC strains harboring genes for the EAST1 (astA), Pet, Pic, and Sat toxins were common in both diarrheal groups. The astA and the porcine AE/associated adhesin (paa) genes were found in most of aEPEC strains. High levels of resistance to antimicrobial drugs were found among DAEC and aEPEC isolates. Conclusion: The results show a high proportion of EAEC and DAEC carrying toxin-encoding genes among adults with diarrhea.Foundation for Science and Technology of Victoria Municipality (FACITEC) of Espirito Santo State, BrazilUniv Fed Espirito Santo, Ctr Ciencias Saude, Dept Patol, Lab Virol & Gastrenterite Infecciosa, Ave Marechal Campos 1468, BR-29043900 Vitoria, ES, BrazilUniv Fed Espirito Santo, Nucleo Doencas Infecciosas, Dept Med Social, Ctr Ciencias Saude, Vitoria, ES, BrazilUniv Fed Sao Paulo, Dept Microbiol Imunol & Parasitol, Vitoria, ES, BrazilLab Cent Municipal, Vitoria, ES, BrazilUniv Fed Sao Paulo, Dept Microbiol Imunol & Parasitol, Vitoria, ES, BrazilWeb of Scienc