Topic:

Pediatric and Perinatal Infections

Abstract No.:

ISE.106

Title:

Synergistic group A rotavirus {G12P[6]}  and  enteropathogenic  Escherichia coli {eaeA-β} diarrheal infection of a child from kashmir-india

Author(s):

I. Ahmad¹, S. Zafurullah², A. Afshan³; ¹SK University of Agricultural Sciences & Technology of Kashmir, Genetics & Biotechnology, Faculty of Fisheries, Kashmir, JAMMU & KASHMIR/IN, ²King Fahads Specialist Hospital, Dammam, Department of Pulmonory Medicine,Dammam, formerly Department of Gastroenterology, SK Institute of Medical Sciences, Soura, Srinagar, Kashmir-India-11, Dammam, DAMMAM/SA, ³King Fahads Specialist Hospital, Department of Anaesthesia and Critical care KFSH-Dammam, formerly Department of Paediatrics and Critical Crae SK Institute of Medical Sciences, Soura, Srinagar, Kashmir-India-11, Dammam, DAMMAM/SA

Abstract:

Background: Rotaviruses have been recognized as the major contributors of acute gastroenteritis in young children and are responsible for morbidity and mortality in children. Diarrhea causing Escherichia coli strains are the major pathogens associated with enteric disease worldwide. Among the six recognized patho-types of Escherichia coli, Enteropathogenic Escherichia coli are an important agent of pediatric diarrhea in both economically developed and underdeveloped countries. We reported a severe dehydrating diarrhea in a five month old male baby due to Group A rotavirus (G12P[6]) genotype co-infected with Enteropathogenic Escherichia coli (eaeA-β). The severe dehydrating diarrhea with hypovolemic shock was successfully treated with intravenous fluid rehydration and antibiotic therapy. Sequence analysis  from the neonatal strain indicated a high level of aminoacid homology (98-99%) to other G12 strains reported world wide, suggesting introduction of novel rotavirus strain serotype into the community. The subtyping of the eae-a gene revealed  typical  eaeA-β subtype. The present case appears to be the first report of dual infection in a child due to G12P[6] and  eaeA-β from India.
Methods: The samples were screened for genotypes of Escherchia coli and Rotavirus.Extraction of DNA from culture, screening and detection of stx1, stx2, eaeA, hlyA and lt virulence genes by PCR. Subtyping of eaeA gene, EAF and bfpA genes by PCR.Serogrouping of EPEC strain. Extraction of RNA, detection by RNA-PAGE and typing by Reverse transcription PCR.Nontypeable sample was subjected to sequencing.
Results: The results showed presence of EPEC with eaeA-β and rotavirus with G12P[6] specificity. The EPEC {eaeA-β} strain was non-motile with O9 serogroup, typical and harboured EAF plasmid.The phylogenetic analysis of VP7 gene sequence of G12 strains shows high degree of amino acid conservation with a South African strain and other globally reported strains. The dual infection was reported in a 5 month old male baby.The patient had a 3 days history of frequent diarrhea (watery) 20-25 episodes/day, fever, vomiting and abdominal pain. The patient was rehydrated, given antibiotics and treated successfully.
Conclusion: To our knowledge this appears to be first case report of severe dehydrating diahrrea due to G12P[6] & EPEC {eaeA- β} from this country.