Evaluation of C-Reactive Protein in Iraqi Children Presented with Acute Enteropathogenic Escherichia Coli Associated Diarrhea with Special Emphasis to Age and Gender
AbstractBackground and Objectives: The aim is to determine the role of Enteropathogenic Escherichia coli (EPEC) serotypes (O111, O55, O26, O86, O119, O127, O114, and O142) in C- reactive protein (CRP) level in acute diarrhea among children; to determine the possible effect of age and gender in CRP level. Methods: Culture of stool samples from 64 children in MacConkey agar for primary isolation of E.coli and confirmed via API20E . Sero-grouping of E.coli performed via specific antisera . CRP detected by latex agglutination. Results: In this study, 64 children with diarrhea were involved. The mean age was 2.92 years. Males represent 34/64, 53.1%. The range of CRP level 12-96 mg/dl. EPEC1 and EPEC3 not detected. EPEC2 detected among 14/64, 21.9% and EPEC4 in 18.8%. Among the age group ˂1 year, EPEC2 detected in 9.38%, with mean CRP level 12mg/dl; 3.13%, 48 mg/dl 6.25% . EPEC4 detected in 2/64, 3.13%, with mean CRP level 12mg/dl. Age group 1-4 year, EPEC2 detected in 6/64 , 9.38% , with mean CRP level 24mg/dl. EPEC4 detected in 6/64, 9.38%; with mean CRP level 12mg/dl, 24mg/dl, 48mg/dl 3.13% in each. Among the age group 4.1-8 year, EPEC4 detected in 4/64 ,6.25% , with CRP mean level 48 mg/dl. EPEC not detected in 8˃ years age group .EPEC2 detected in male 28/64 , 43.75% and the CRP level range from 12-96mg/dl .EPEC2 detected in 22/64 females, 34.38% , CRP level range from 12-96mg/dl . No significant difference or correlation between gender and CRP level detected. EPEC4 detected in males 26/64 , 40.63% , CRP level range from 12-96mg/dl . EPEC4 detected in 26/64 females , 40.63% , CRP level range from 12-96mg/dl . No significant difference or correlation between gender and CRP level was detected. EPEC2 and CRP level significantly correlated with patients age . while infection with EPEC2 inversely correlated EPEC4. No significant correlation between gender and EPEC serotypes. Conclusion: Although EPEC2 and EPEC4 frequently detected in diarrhea cases of 1-8 years old, only EPEC2 positively correlated with age. Even with a fluctuation in CRP level, it was positively correlated with age and not correlated with EPEC serotypes and gender.
Trung NV: Children’s Diarrhea in Hanoi, Vietnam Importance of Enteric Pathogens .phD thesis. In: . sweden karolinska university 2005.
Estrada-Garcia T, Lopez-Saucedo C, Thompson-Bonilla R, Abonce M, Lopez-Hernandez D, Santos JI, Rosado JL, DuPont HL, Long KZ: Association of diarrheagenic Escherichia coli pathotypes with infection and diarrhea among Mexican children and association of atypi-cal enteropathogenic E. coli with acute diarrhea. Journal of clinical microbiology 2009, 47(1):93-98.
Ali AI, Abood WN: Possible correlation between O-antigen serogroup of Enteropathogenic/Enteroinvasive E. coli and co infection with Giardia G. lamblia and Entamoeba histolytica as a possible pathological strategy for acute diarrhea among chil-dren of Baghdad governorate. Diyala Journal for pure science 2010, 6(1):206-226.
Behiry I, Abada E, Ahmed E, Labeeb R: Enteropathogenic Escherichia coli associated with diarrhea in children in Cairo, Egypt. The Scientific World Journal 2012, 11:2613-2619.
Donnenberg M, Finlay BB: Combating enteropathogenic Escherichia coli (EPEC) infections: the way forward. Trends in microbiology 2013, 21(7):317-319.
Thompson D PM, Wood SP The physiological structure of human C-reactive protein and its complex with phosphocholine". . Structure 1999, 7(2):169-177.
Eagan D, Gonzales M, Tarumi T, Tanaka H, Stautberg S, Haley A: Elevated serum C-reactive protein relates to increased cerebral myoinositol levels in middle-aged adults. Cardiovas-cular psychiatry and neurology 2012, .
Vandepitte JVE, Kraesten;Rohner, Patrick;Piot, Peter;Heuck, CC;: Basic laboratory proce-dures in clinical bacteriology: World Health Organization; 2003.
Biomerieux api 20E In.: www.Biomerieux.com ,France.
Bio-RAD-France: trivalent E.coli antisera In.: http://www.bio-rad.com.
Statens serum i: E. coli antisera for in vitro diagnostic use. In.: http://www.ssi.dk.
SPINREACT: Qualitative determination of C-Reactive Protein (CRP),CRP-Latex Slide agglutination avaibable from:www.spinreact.com
Taniuchi M, Sobuz S, Begum S, Platts-Mills J, Liu J, Yang Z, Wang X-Q, Petri W, Haque R, Houpt E: Etiology of diarrhea in Bangladeshi infants in the first year of life analyzed using molecular methods. Journal of Infectious Diseases 2012, 208(11):1794-1802.
AIA AL-Ezzy WA: Immuno-Microbiological Diagnosis of Co-Infections with Rota Virus, Giardia lamblia, Entamoeba histolytica And Salmonella enterica As A Possible Pathological Strategy For Acute Diarrhea Among Iraqi Children. International Journal of Advanced Research 2013, 1:216-224.
Nhampossa T, Mandomando I, Acacio S, Quintأ³ L, Vubil D, Ruiz J, Nhalungo D, Sacoor C, Nhabanga A, Nhacolo A: Diarrheal Disease in Rural Mozambique: Burden, Risk Factors and Etiology of Diarrheal Disease among Children Aged 0â€“59 Months Seeking Care at Health Facilities. PLOS ONE 2015:1-19.
Chen C-C, Chang C-J, Lin T-Y, Lai M-W, Chao H-C, Kong M-S: Usefulness of fecal lactoferrin in predicting and monitoring the clinical severity of infectious diarrhea. World journal of gastroenterology: WJG 2011, 17(37):4218.
AlAyed M, Asaad A, Mahdi A, Qureshi M: Aetiology of acute gastroenteritis in children in Najran region, Saudi Arabia. Journal of Health Specialties 2013, 1(2):84.
Nhampossa T, Mandomando I, Acacio S, Quint L, Vubil D, Ruiz J, Nhalungo D, Sacoor C, Nhabanga A, Nhacolo A: Diarrheal Disease in Rural Mozambique: Burden, Risk Factors and Etiology of Diarrheal Disease among Children Aged 0â€“59 Months Seeking Care at Health Facilities. 2015.
Behiry IA, Emad ;Ahmed, Entsar ;Labeeb, Rania ;: Enteropathogenic Escherichia coli associ-ated with diarrhea in children in Cairo, Egypt. The Scientific World Journal 2012, 11:2613-2619.
Dahifar H, Ghorbani A, Ghods M: Isolated and non-isolated enteric pathogens in children with diarrhea and related laboratory characteristics. Medical Journal of The Islamic Repub-lic of Iran (MJIRI) 2008, 22(1):40-46.
Nweze E: Virulence properties of diarrheagenic E. coli and etiology of diarrhea in infants, young children and other age groups in southeast, Nigeria. American-Eurasian Journal of Scientific Research 2009, 4(3):173-179.
Adugna A, Kibret M, Abera B, Nibret E, Adal M: Antibiogram of E. coli serotypes isolated from children aged under five with acute diarrhea in Bahir Dar town. African Health Sci-ences 2015, 15(2):656-664.
Galadima MK, OO;: Bacteria agents of Diarrhoea in Children Aged 0-5 Years, in Minna, Ni-ger State, Nigeria. Int J Curr Microbiol App Sci 2014, 3(6):1048-1054.
Alikhani MY, Mirsalehian A, Fatollahzadeh B, Pourshafie MR, Aslani MM: Prevalence of enteropathogenic and Shiga toxin-producing Escherichia coli among children with and without diarrhoea in Iran. Journal of health, population, and nutrition 2007, 25(1):88.
Kandakai-Olukemi Y, Mawak J, Onojo M: Isolation of Enteropathogenic Escherichia coli from Children with Diarrhoea Attending the National Hospital in Abuja, Nigeria. 2009.
Al-Ezzy AIA, Abood WN, Hussein RA: C-Reactive Protein as an Immunopathological Prog-nostic Marker for Giardia Lamblia and Entamoeba Histolytica Associated Diarrhea among Children of Baghdad Governorate. Journal of Biology, Agriculture and Healthcare 2015, 5(3):28-32.
Kabayiza J-C: Acute gastroenteritis in Rwandan children under five years of age investigat-ed by real-time PCR. University of Gothenburg 2014.
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