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RÉSUMÉ
Objectif. La présente étude avait pour objectif de déterminer la prévalence des gènes de virulence d’Escherichia coli au cours des gastro-entérites aiguës chez les enfants de moins de 5 ans. Matériels et Méthodes. Nous avons mené une étude transversale prospective descriptive, de Novembre 2018 à Févier 2019 au laboratoire de biologie de l’Hôpital National de Niamey. Ont été inclus tous les enfants de moins de 5 ans chez qui une coproculture a été réalisée. Les selles ont été ensemencées sur la gélose EMB et l’identification d’E. coli a été réalisée avec les galeries API 10 S de Biomerieux®. Une PCR en uniplexe avec les différentes amorces ciblant les gènes de virulence nous a permis de caractériser les différents pathotypes. Résultats. Au total, 279 patients ont été inclus. L’âge moyen des sujets était de 18,36±12,4 mois. Nous avions observé une distribution E. coli plus ou moins constante en fonction de l’âge. Nous avons détecté quatre gènes de virulence d’E. coli dans 55 échantillons des 279 patients inclus (19,7%). Les prévalences d'EPEC, d'EHEC, d'EAEC, d'EIEC étaient respectivement de 0,7%, 1,1%, 2,9% et 6,1%, tandis que celles des infections mixtes étaient de 6,8% pour EIEC+EAEC, 0,7% pour EIEC+EHEC, 0,4% pour EPEC+EIEC et 1,1% pour EPEC+EIEC+EAE. Aucune souche disposant d’ETEC et de DAEC n'a été isolée. Conclusion. Cette étude nous a permis d’établir la distribution des gènes de virulence d’E. coli isolés chez les enfants de moins de 5 ans au cours des gastro-entérites à l’HNN. Au regard du taux de mortalité élevé lié aux diarrhées, il est nécessaire de rendre systématique la recherche d’E coli devant toute gastro-entérite d’origine infectieuse.
ABSTRACT
Objective. The objective of our study was to determine the prevalence of Escherichia coli virulence genes during acute gastroenteritis in children less than 5 years of age. Methodology. We conducted a cross sectional descriptive prospective study from November 2018 to February 2019 in the biology laboratory of the Niamey National Hospital. All children aged 5 years or less who had a coproculture were included. The stool was streaked on the EMB agar and identification of E. coli was produced with API 10 S galleries in Biomerieux®. A uniplex PCR with the different primers targeting the virulence genes allowed us to characterize the different pathotypes. Results. A total of 279 patients were included in our study. The mean age of the cohort was 18.36 ± 12.4 months. We had observed a more or less constant distribution of E. coli according to age. We had detected four virulence genes from E. coli in 55 samples of the 279 patients included (19.7%). Prevalence of EPEC, EHEC, EAEC, EIEC were 0.7%, 1.1%, 2.9% and 6.1%, respectively, while those of mixed infections were 6, 8% for EIEC + EAEC, 0.7% for EIEC + EHEC, 0.4% for EPEC + EIEC and 1.1% for EPEC + EIEC + EAE. No strain with ETEC and DAEC had been isolated. Conclusion. This study allowed us to establish the distribution of E. virulence genes. E coli isolated from children less than 5 years of age during NHN gastroenteritis. In view of the high mortality rate linked to diarrhea, it is more than necessary to make the search for E coli systematic in the face of any gastroenteritis of infectious origin.
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References
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- Liu L, Oza S, Hogan D, Perin J, Rudan I, Lawn JE, Cousens S, Mathers C, Black RE. Global, regional, and national causes of child mortality in 2000–13, with projections to inform post-2015 priorities: an updated systematic analysis. The Lancet. 2015;385(9966):430‑40.
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- Mariani-Kurkdjian P, Bonacorsi S. Diagnostic des infections à Escherichia coli entérohémorragique. Revue Francophone des Laboratoires. 2016 ;( 486):45‑52.
- Moyo SJ, Maselle SY, Matee MI, Langeland N, Mylvaganam H. Identification of diarrheagenic Escherichia coli isolated from infants and children in Dar es Salaam, Tanzania. BMC Infectious Diseases. 2007; 7(1)92
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- Nguyen TV, Le Van P, Le Huy C, Gia KN, Weintraub A. Detection and Characterization of Diarrheagenic Escherichia coli from Young Children in Hanoi, Vietnam. Journal of Clinical Microbiology. 2005; 43(2):755‑60.
- Cerna JF, Nataro JP, Estrada-Garcia T. Multiplex PCR for Detection of Three Plasmid-Borne Genes of Enteroaggregative Escherichia coli Strains. Journal of Clinical Microbiology. 2003; 41(5):2138‑40.
- Medeiros P, Bolick DT, Roche JK, Noronha F, Pinheiro C, Kolling GL, Lima A, Guerrant RL. The micronutrient zinc inhibits EAEC strain 042 adherence, biofilm formation, virulence gene expression, and epithelial cytokine responses benefiting the infected host. Virulence. 2013;4(7):624‑33.
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References
Titilawo Y, Obi L, Okoh A. Occurrence of virulence gene signatures associated with diarrhoeagenic and non-diarrhoeagenic pathovars of Escherichia coli isolates from some selected rivers in South-Western Nigeria. BMC Microbiology. 2015; 15(204):1-14
Lanata CF, Fischer-Walker CL, Olascoaga AC, Torres CX, Aryee MJ, Black RE, for the Child Health Epidemiology Reference Group of the World Health Organization and UNICEF. Global Causes of Diarrheal Disease Mortality in Children <5 Years of Age: A Systematic Review. Sestak K, éditeur. PLoS ONE. 2013;8(9):e72788.
Brugère H, Auvray F, Mariani-Kurkdjian P, King L A, Loukiadis E. E. coli producteurs de shigatoxines (STEC) : définitions, virulence et propriétés des souches entérohémorragiques (EHEC). Bulletin épidémiologique, santé animale et alimentation no 50/Spécial Risques alimentaires microbiologiques, P23-28
Liu L, Oza S, Hogan D, Perin J, Rudan I, Lawn JE, Cousens S, Mathers C, Black RE. Global, regional, and national causes of child mortality in 2000–13, with projections to inform post-2015 priorities: an updated systematic analysis. The Lancet. 2015;385(9966):430‑40.
Vidal M, Kruger E, Duran C, Lagos R, Levine M, Prado V, Toro C, Vidal R. Single Multiplex PCR Assay To Identify Simultaneously the Six Categories of Diarrheagenic Escherichia coli Associated with Enteric Infections. Journal of Clinical Microbiology. 2005;43(10):5362‑5.
GermanP Y, Bouguenec CL. Diagnostic des Escherichia coli agents de diarrhée chez I’homme. Revue Francophone des Laboratoires. 2008; (398):67‑76.
Mariani-Kurkdjian P, Bonacorsi S. Diagnostic des infections à Escherichia coli entérohémorragique. Revue Francophone des Laboratoires. 2016 ;( 486):45‑52.
Moyo SJ, Maselle SY, Matee MI, Langeland N, Mylvaganam H. Identification of diarrheagenic Escherichia coli isolated from infants and children in Dar es Salaam, Tanzania. BMC Infectious Diseases. 2007; 7(1)92
Dias R.C., Dos Santos B.C., Dos Santos L.F., Vieira M.A., Yamatogi R.S., Mondelli A.L., Sadatsune T., Sforcin J.M., Gomes T.A., Hernandes R.T. Diarrheagenic Escherichia coli pathotypes investigation revealed atypical enteropathogenicE. coli as putative emerging diarrheal agents in children living in Botucatu, São Paulo State, Brazil.APMIS. 2016;124(4):299-308.
Bonkoungou IJO, Lienemann T, Martikainen O, Dembelé R, Sanou I, Traoré AS, Siitonen A, Barro N, Haukka K. Diarrhoeagenic Escherichia coli detected by 16-plex PCR in children with and without diarrhoea in Burkina Faso. Clinical Microbiology and Infection. 2012;18(9):901‑6.
Okeke IN, Lamikanra A, Ck HS, Kaper JB. Characterization of Escherichia coli Strains from Cases of Childhood Diarrhea in Provincial Southwestern Nigeria. J Clin Microbiol. 2000;38:6.
Nweze E. Aetiology of Diarrhoea and Virulence Properties of Diarrhoeagenic Escherichia coli among Patients and Healthy Subjects in Southeast Nigeria. Journal of Health, Population and Nutrition. 2010; 28(3): 245-252.
Iijima Y, Oundo JO, Hibino T, Saidi SM, Hinenoya A, Osawa K, Shirakawa T, Osawa R, Yamasaki S. High Prevalence of Diarrheagenic Escherichia coli among Children with Diarrhea in Kenya. Japanese Journal of Infectious Diseases. 2017;70(1):80‑3.
Rappelli P, Folgosa E, Solinas ML, DaCosta JL, Pisanu C, Sidat M, Melo J, Cappuccinelli P, Colombo MM. Pathogenic enteric Escherichia coli in children with and without diarrhea in Maputo, Mozambique. FEMS Immunology & Medical Microbiology. 2005;43(1):67‑72.
Somda NS, Bonkoungou OJI, Zongo C, Kpoda DS, Tapsoba F, Bassolé IHN, Traoré Y, Savadogo A. Prevalence of Escherichia coli virulence genes in patients with diarrhoea in Ouagadougou, Burkina Faso. African Journal of Clinical and Experimental Microbiology. 2017; 18(4):179.
Nejma IBS-B, Zaafrane MH, Sdiri-Loulizi K, Said MB, Aouni M. Etiology of Acute Diarrhea in Tunisian Children with Emphasis on Diarrheagenic Escherichia coli: Prevalence and Identification of E. coli Virulence Markers. 2014;43:14.
Rajendran P, Ajjampur SSR, Chidambaram D, Chandrabose G, Thangaraj B, Sarkar R, Samuel P, Deva Prasanna Rajan DP, Kang G. Pathotypes of diarrheagenic Escherichia coli in children attending a tertiary care hospital in South India. Diagnostic Microbiology and Infectious Disease. 2010;68(2):117‑22.
Nyanga PL, Onyuka J, Webale MK, Were T, Budambula V. Escherichia coli pathotypes and Shigella sero-groups in diarrheic children in Nairobi city, Kenya. Gastroenterol Hepatol Bed Bench 2017;10(3):220-228.
Nguyen TV, Le Van P, Le Huy C, Gia KN, Weintraub A. Detection and Characterization of Diarrheagenic Escherichia coli from Young Children in Hanoi, Vietnam. Journal of Clinical Microbiology. 2005; 43(2):755‑60.
Cerna JF, Nataro JP, Estrada-Garcia T. Multiplex PCR for Detection of Three Plasmid-Borne Genes of Enteroaggregative Escherichia coli Strains. Journal of Clinical Microbiology. 2003; 41(5):2138‑40.
Medeiros P, Bolick DT, Roche JK, Noronha F, Pinheiro C, Kolling GL, Lima A, Guerrant RL. The micronutrient zinc inhibits EAEC strain 042 adherence, biofilm formation, virulence gene expression, and epithelial cytokine responses benefiting the infected host. Virulence. 2013;4(7):624‑33.
Beutin L, Fach P. Detection of Shiga Toxin-Producing Escherichia coli from Nonhuman Sources and Strain Typing. Microbiology Spectrum. 2014; 2(3).EHEC-0001-2013.