Background The importance of diarrhoeagenic Escherichia coli (DEC) infections in the Arabian Gulf including Kuwait is not known. The prevalence of DEC (enterotoxigenic [ETEC], enteropathogenic [EPEC], enteroinvasive [EIEC], enterohemorrhagic [EHEC] and enteroaggregative [EAEC]) was studied in 537 children ≤ 5 years old hospitalised with acute diarrhoea and 113 matched controls from two hospitals during 2005–07 by PCR assays using E. coli colony pools. Results The prevalence of DEC varied from 0.75% for EHEC to 8.4% for EPEC (mostly atypical variety) in diarrhoeal children with no significant differences compared to that in control children (P values 0.15 to 1.00). Twenty-seven EPEC isolates studied mostly belonged to non-traditional serotypes and possessed β and θ intimin subtypes. A total of 54 DEC isolates from diarrhoeal children and 4 from controls studied for antimicrobial susceptibility showed resistance for older antimicrobials, ampicillin (0 to 100%), tetracycline (33 to 100%) and trimethoprim (22.2 to 100%); 43.1% of the isolates were multidrug-resistant (resistant to 3 or more agents). Six (10.4%) DEC isolates produced extended spectrum β-lactamases and possessed genetic elements (blaCTX-M, blaTEM and ISEcp1) associated with them. Conclusion We speculate that the lack of significant association of DEC with diarrhoea in children in Kuwait compared to countries surrounding the Arabian Gulf Region may be attributable to high environmental and food hygiene due to high disposable income in Kuwait.
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机译：背景技术在包括科威特在内的阿拉伯海湾，腹泻性大肠杆菌（DEC）感染的重要性尚不清楚。研究了DEC的患病率（肠毒素[ETEC]，肠致病性[EPEC]，肠浸润性[EIEC]，肠出血性[EHEC]和肠凝集性[EAEC]），对537名≤5岁住院急性腹泻的儿童和来自两家医院的113名对照进行了研究在2005-07年间，使用大肠杆菌菌落库进行PCR分析。结果腹泻儿童的DEC患病率从EHEC的0.75％到EPEC（主要是非典型品种）的8.4％不等，与对照组的儿童相比无显着差异（P值为0.15至1.00）。研究的二十七种EPEC分离株大多属于非传统血清型，并具有β和θ内膜素亚型。从腹泻儿童中分离出的54份DEC分离物和从对照中研究的4份对抗生素敏感性的对照显示对较老的抗生素，氨苄青霉素（0至100％），四环素（33至100％）和甲氧苄啶（22.2至100％）有抗药性; 43.1％的分离株具有多重耐药性（对3种或更多种药物有耐药性）。六个（10.4％）DEC分离物产生了广谱的β-内酰胺酶，并具有与之相关的遗传元件（bla CTX-M ，bla TEM 和ISEcp1）。结论我们推测，与阿拉伯海湾地区周边国家相比，科威特儿童的DEC与腹泻缺乏明显联系，这可能归因于科威特可支配收入较高，环境和食品卫生状况良好。
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