The Detection of Escherichiacoli O157: H7 Infections in Children Less than Five Years with Acute Diarrhea

Background: Diarrhea is a leading cause of morbidity and mortality in children aged less than five years. Escherichia coli O157: H7 is a highly pathogenic subgroup of Shiga toxin-producing E. coli (STEC) that causes severe human bloody diarrhea and hemolytic uremic syndrome. Objectives: To determine the rates of detection of E. coli O157: H7 infections in children less than five years of age and to assess the clinical and laboratory criteria of E. coli O157: H7 associated diarrhea. Patients and Method: Across sectional prospective, hospital-based study was carried out on children with acute diarrhea visiting the outpatientclinics at Children Welfare Teaching Hospital, AL-Kadhymia Pediatric Hospital and AL-Elweya Pediatric Hospital in Baghdad during the period from Sep. to Dec. 2015. E.coli O157: H7 antigen in fecal samples taken from children with acute diarrhea were detected by immunochromatographic assay (ICA). Results: Escherichia coli O157: H7 antigen was detected in 43/94(45.7%) of fecal samples for children with diarrhea. 55.8% of children with positive stool samples were females and 44.2% were males with a female to male ratio of 1.3:1. Children with acute diarrhea due to E. coli O157: H7 were younger (mean age 17.19 ± 9.572 months) than those without E. coli O157: H7 infection (mean age 30.63 ±19.815 months) and the difference is highly significant. Fever and vomiting were symptoms shared by all the studied children regardless of their E.coli O157: H7 infections. Significant associations between bloody diarrhea, pus and red blood cells in stools and E. coli O157: H7 infections were noted. Conclusions: E. coli O157: H7 infectionwas a common cause of gastroenteritisin children less than five years in Baghdad.Mainly among infants and young children who presented with acute bloody diarrhea, microscopic pus and red blood cells in their stools