Etiology of Acute Diarrhea in Tunisian Children With Emphasis on Diarrheagenic Escherichia Coli: Prevalence and Identification of E. Coli Virulence Markers

Background: diarrheal diseases can be caused by viral,bacterial and parasitic infections. this paper provides a preliminary image of diarrhea with regards to etiology and epidemiologic factors in tunisian children less than five years of age methods: overall,124 diarrhoeal stools were collected from patients suffering from acute diarrhea and 54 stool samples from healthy children. all stools were examined for the presence of enteric pathogens. results: in diarrheagenic children,107 pathogenic bacteria were isolated (12 salmonella spp. (9.7%) and 95 diarrheagenic escherichia coli strains (76.6%): 29 enteroaggregative e.coli (eaec) (23.4%),15 enteroinvasive e.coli (eiec) (12.1%),17 enteropathogenic e.coli (epec) (13.7%),26 enterotoxigenic e.coli (etec) (21%) and 2 enterohemoragic e.coli (ehec) (1.6%). however,in the control group,23 pathogenic e.coli strains were isolated (42.6%): 8 eaec (14.8%),12 eiec (22.2%) and 3 epec (5.5%). among diarrheagenic e.coli (dec),only etec strains were significantly recovered from diarrheagenic children than from healthy controls (p < 0.0003). group a rotavirus was identified in 33.9% (n=42) of diarrheagenic children and in 11.1% among the control group (n=6). concerning norovirus,8.9% (n=11) of the samples collected from diarrheagenic children and 9.2% (n=5) from the control group were positive. the prevalence of rotaviruses and salmonella spp were also significantly higher in patients with diarrhea than in controls (p = 0.002 and p < 0.019,respectively). finally,enteropathogenic parasites (entamoeba coli and cryptosporidium oocystes) were isolated from 4.8% and 9.2% of diarrheagenic and control children,respectively. conclusion: these results provide baseline data about the relative importance of different enteropathogens in tunisian children.