Atypical enteropathogenic <i>E. coli</i> as a cause of pediatric diarrhea

Diarrhogenic Escherichia coli (DEC) is the second most important cause for mortality and morbidity among children. Among the DEC, enteropathogenic E.coli (EPEC) has become the major cause for diarrhea in children less than five years of age. Serotyping helps in determining the pathotype but is cumbersome, expensive and has lot of cross reactions. In this regard, Polymerase chain reaction (PCR) is a reliable and rapid tool for its identification than serotyping. Aim: This study was conducted to detect Enteropathogenic Escherichia coli (EPEC) using PCR from stool samples of children less than 5 years with diarrhea. Discussion: EPEC is an important causative agent of infant diarrhea in developing countries. In this study we found that EPEC was the most important cause of diarrhea among children which outnumbered rotavirus. Among the other pathogens detected Y.enterocolitica was more common than Shigella and Salmonella. This could be due to the use of the PCR in case of Yersinia. PCR based detection would increase the yield of the enteropathogens in diarrhea patients and with a reduced turnaround time compared to that of culture. Among the EPEC, atypical EPEC was more common than the typical EPEC. Atypical EPEC has been recently documented in a few studies to be more commonly associated with paediatric diarrhea than the typical EPEC. Usually the atypical strains possess eaeA gene rather than bfpA gene, contrarily, we noted that 4 strains had only eaeA while 14 had only bfpA.