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INTERNATIONAL JOURNAL OF PHARMACEUTICAL RESEARCH

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Published by : Advanced Scientific Research
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0975-2366
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IJPR 9[3] July - September 2017 Special Issue

July - September 9[3] 2017

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Prevalence of Enterotoxigenic Bacteroides Fragilis in Children Less than 5 Years of Age with Diarrhea in Iraq

Author: , , HASAN ABD ALI KHUDHAIR
Abstract: Bacteroides (B) fragilis is anaerobic bacilli with pale reddish color when stained with gram stain and one of the microflora members of the individual digestive system and female reproductive track. Bacteroides fragilis regarded as one of the causative agents of endogenous diarrheal disorder by synthesis of exotoxin. Current research was aimed to evaluate the enterotoxigenic B. fragilis (ETBF) bacteria as one of the etiological pathogens of diarrheal disease in pediatric group and to study the antibiotics susceptibility pattern for certain antibiotics in these isolates. One hundred and fifty stool samples were obtained from pediatric patients with acute diarrhea under 5 years during the period of from September 2019 to April 2020. All subjects were underwent primary stool culture and biochemical tests for detection and presumptive diagnosis of B. fragilis. Molecular technology was used for diagnosis of non-enterotoxigenic B. fragilis (NTBF) and ETBF by detection of neuraminidase and Bacteroides fragilis toxin (bft) genes, respectively. All B. fragilis isolates were evaluated for their antimicrobial susceptibility and biofilm production. Recent research findings revealed that the percent of B. fragilis infection within pediatric patients was (10%) and the prevalence of ETBF isolates as a cause of diarrheal illness in 2.7% of total clinical samples. For antibiotics susceptibility, the B. fragilis isolates revealed higher resistance for ampicillin (93.3%) and amoxicillin (73.3%), moderate resistance for cefotetan (46.7%), cefotaxime (40%), ceftriaxone (33.3%) and clindamycin (33.3%) and low resistance for cefoxitin (26.7%), doripenem (20%), meropenem (13.3%), ertapenem (13.3%), piperacillin/tazobactam (6.7%), ampicillin-sulbactam (6.7%), imipenem (6.7%), moxifloxacin (6.7%), metronidazole (6.7%) and ticarcillin-clavulanate (0%). The synthesis of biofilm was statistically highest in ETBF group in comparison to NTBF group. Furthermore, antibiotics resistance was statistically highest in isolates with higher biofilm level than those with weak and/or moderate levels. Finally, B. fragilis isolates were consistent with a significant elevation in beta (ß)-lactamase production. The conclusion of this study referred to that ETBF is member of the diarrheal diseases causative factors in pediatric people but it is not the major agents. Tricarcillin-clavulanate, metronidazole, moxifloxacin, piperacillin/tazobactam, imipenem and ampicillin-sulbactam antibiotics are effective antibiotics against B. fragilis isolates.
Keyword: Bacteroides Fragilis Bft Gene and Diarrheal Diseases.
DOI: https://doi.org/10.31838/ijpr/2020.12.03.369
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