%0 Journal Article %T Etiology of acute diarrhea in children and adults in Tunis, Tunisia, with emphasis on diarrheagenic Escherichia coli: prevalence, phenotyping, and molecular epidemiology. %+ Laboratoire de Contrôle des Eaux et Denrées Alimentaires, Institut Pasteur de Tunis %+ Institut Pasteur de Tunis %+ Laboratoire de Parasitologie Médicale, Biotechnologies et Biomolécules (LR11IPT06) %+ Centre National de Greffe de la Moëlle osseuse Tunis (CNGMO) %A Al-Gallas, Nazek %A Bahri, Olfa %A Bouratbeen, Aida %A Ben Haasen, Assia %A Ben Aissa, Ridha %Z This work was conducted in the Laboratoire de Contrôle des Eaux et Denrées Alimentaires de l’Institut Pasteur de Tunis in Tunis, Tunisia. The American Society of Tropical Medicine and Hygiene (ASTMH) assisted with publication expenses %< avec comité de lecture %@ 0002-9637 %J American Journal of Tropical Medicine and Hygiene %I American Society of Tropical Medicine and Hygiene %V 77 %N 3 %P 571-582 %8 2007-09-01 %D 2007 %R 10.4269/ajtmh.2007.77.571 %M 17827382 %Z Life Sciences [q-bio] %Z Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology %Z Life Sciences [q-bio]/Santé publique et épidémiologieJournal articles %X A total of 271 stool specimens were collected from children (diarrheagenic, n = 115 and control, n = 54) and adults (diarrheagenic, n = 73 and control, n = 29) from Tunis, Tunisia, and processed to detect bacterial enteropathogens, parasites, and viruses. Diarrheagenic Escherichia coli (DEC) were identified by their virulence genes (polymerase chain reaction) and adherence patterns (tissue culture assays). The most frequently isolated enteric pathogens from diarrheagenic children were enterotoxigenic E. coli (ETEC, 32.3%), enteroaggregative E. coli (EAEC, 11.3%), enteroinvasive E. coli (EIEC, (11.3%), adenovirus (10.4%), enterohemorrhagic E. coli (EHEC, 10.4%), and Salmonella spp. (9.5%). For children in the control group, ETEC (37%), EAEC (15%), EHEC (11.1%), and typical enteropathogenic E. coli (EPEC, 11.1%) were the most common enteric pathogens. In adults in the diarrheagenic group, Salmonella spp. (34.2%), ETEC (12.3%), adenovirus (7%), and Shigella spp. (4%) were the most common enteric pathogens. In adults in the control group, ETEC (31%) was the most common enteric pathogen. Multiple pathogens were recovered from 22% of the diarrheagenic children and 7% of the diarrheagenic adults. Escherichia coli strains showed high resistance rates to tetracycline, streptomycin, and beta-lactams. The most frequent combinations were ETEC-rotavirus and ETEC-adenovirus. Pulsed-field gel electrophoresis for DEC indicated a large number of DEC clones (five major clones) persistent in the community reservoir for a considerable period of time that caused diarrhea in the population. This suggests the confluence of small epidemics by clonally related DEC strains circulating in this region. %G English %2 https://riip.hal.science/pasteur-01375250/document %2 https://riip.hal.science/pasteur-01375250/file/Etiology%20of%20Acute%20Diarrhea.pdf %L pasteur-01375250 %U https://riip.hal.science/pasteur-01375250 %~ RIIP %~ SANTE_PUB_INSERM %~ RIIP_TUNIS