Estudo da prevalência de Escherichia coli diarreiogênica em crianças do Oeste Paulista.

Abstract

Diarrheal disease is a major public health problem, affecting mainly children living in development areas in Brazil, such as urban, rural and peri-rural areas. The West Paulista region has a still weak urbanization index, yet it lacks adequate sanitation for the population. Some strains of Escherichia coli colonize the gastrointestinal tract and are responsible for causing diarrhea, being called E. coli diarreiogenicas (DEC). Escherichia coli can be classified into seven categories according to the virulence profile and the clinical syndromes they cause, namely, enteropathogenic E. coli (EPEC); Enteroaggregative E. coli (EAEC); E. coli producing Toxin Shiga (STEC); E. coli enterohemorrágica (EHEC), E. coli enterotoxigenic (ETEC) as well as E. coli enteroinvasiva (EIEC) and diffuse adherent E. coli (DAEC). This study aimed to verify the prevalence of earning DEC in children, determining them as to the pathotype and resistance to antimicrobial drugs. A higher prevalence of EPEC was observed, present in 10% of the main ones; followed by STEC with 8% and finally EAEC with 6% and hybrid EPEC-a / EAEC-t with 2%. However, the presence of ETEC and EIEC pathotypes was not observed in these regions. The resistance profile to antimicrobial drugs was verified using the agar diffusion method for the following antimicrobials: ampicillin (10 μg), amoxicillin - clavulanic acid (30 μg), cefazolin (30 μg), cefuroxime (30 μg), cefotaxime (30 μg), cefepime (30 μg), imipenem (10 μg), gentamicin (10 μg), tobramycin (10 μg), ciprofloxacin (5 μg) and cotrimoxazole (25 μg). The data demonstrate a high frequency of choice resistant to the antimicrobials ampicillin and cefuroxime. On the other hand, only 1 isolate from this group was resistant to the bactericidal effects of imipenem. In addition, 54% of those tested are resistant simultaneously to 3 or more tested antimicrobials and 32% are multidrug-resistant. The data are of clinical and epidemiological importance, since they demonstrate intrinsic characteristics of DEC in children in this region that has never been studied.