Abstract:
Diarrhoea is among the leading causes of childhood morbidity and
mortality worldwide. Diarrheagenic Escherichia coli (DEC) are responsible
for 30% to 40% of acute diarrhea and chronic episodes in children in
developing countries. This study sought to elucidate genotypic diversity and
virulence markers of Diarrheagenic Escherichia coli associated with
diarrhoea among HIV seropositive and seronegative children aged below
five in Western Kenya. A total of 105 diarrheagenic E coli isolates obtained
from children aged below five years with diarrhoea admitted at Moi
Teaching and Referral Hospital , Kenya, were subjected to multiplex PCR
using seven sets of primers. The study revealed that 36 (34.2%) pathotypes
were identified as; EHEC 4 (11.1%), ETEC 2 (5.6%), EAEC 21 (58.3%),
EIEC 3 (8.3%) and EPEC 6 (16.7%), EAEC. Seven virulence genes were
identified including EHEC shigatoxin genes, stx1 (0 vs 100%) and stx2 (0 vs
100%), ETEC heat labile, elt (0 vs 100%), and heat stable toxin, est (0 vs
100%), EPEC, bfp (33.3% vs 66.7%), EAEC, aatA (71.4% vs 28.6%) and
EIEC ipaH (66.7% vs 33.3%) among isolates from HIV seropositive and
negative cases respectively. EPEC and ETEC were significantly associated
with acute diarrhoea episodes in HIV negative cases while EAEC was predominantly linked to persistent diarrhoea with higher incidence in HIV
seropositive than seronegative cases, (p<0.05). There was a significant
difference in the expression of virulence genes in relation to age.
