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Investigation of the Domestic Reservoirs of Diarrheagenic Escherichia coli in Diarrhea Case Households of Urban Bangladesh

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Abstract

This study collected rectal swabs from diarrheal patients and in-house environmental samples from low-income households in Dhaka City, Bangladesh, over a 4-month period and investigated these to determine the domestic transmission pathways of Escherichia coli-associated diarrhea. The environmental samples included swabs from four frequently touched surfaces, drinking water and food. Both the rectal swabs and environmental samples were examined for virulence genes characteristic of diarrheagenic E. coli pathotypes by PCR. In addition, each sample was cultured for E. coli, and the strains were analyzed for virulence profile and subjected to multilocus sequence typing (MLST). The results showed that 31% (73 of 233) of all samples including rectal swabs and household samples were positive for one or more of the diarrheagenic E. coli virulence factors. PCR analyses showed that 28% (10/36) of the rectal swabs, 43% (58/136) of household swabs, 9% (3/32) of the food, and 7% (2/29) of the water samples were positive for various virulence genes. 6 Out of the 36 rectal swab samples and associated household samples were shown to have similar E. coli pathotypic genes, and the drinking vessel surface was identified as the major source of contamination. EAEC and CTEC were the most commonly identified pathotypes in the cultured isolates. The phylogenetic tree constructed by MLST data showed that the diarrheagenic isolates were clustered in several diversified lineages. This study supports the hypothesis that there are high-risk hotspots, particularly those surfaces associated with food consumption, for diarrheagenic E. coli contamination within the household environments of Bangladesh.

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Acknowledgements

This study was solely funded by the Danish International Development Agency (DANIDA)-Project Grant No. 12-040KU. We thank all the field staffs and our study participants from Arichpur for enduring and helping in sample collection from their households. We acknowledge editage English editing service for the professional English proof-reading of the manuscript.

Funding

This study was carried out as a part of a Danish Government (DANIDA) Funded Research Project ‘Combating Cholera Caused by Climate Change’ (C5) (Grant No. 12-040KU) in Bangladesh. The funder has no role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript.

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Authors and Affiliations

  1. Department of Microbiology, University of Dhaka, Dhaka, 1000, Bangladesh

    Zenat Zebin Hossain, Rokaia Sultana & Anowara Begum

  2. Department of Public Health, University of Copenhagen, Copenhagen, Denmark

    Zenat Zebin Hossain & Peter Kjær Mackie Jensen

  3. Institute of National Analytical Research and Service, Bangladesh Council of Scientific and Industrial Research, Dhaka, Bangladesh

    Rokaia Sultana

  4. Copenhagen Centre for Disaster Research, Global Health Section, University of Copenhagen, Copenhagen, Denmark

    Peter Kjær Mackie Jensen

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  1. Zenat Zebin Hossain
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Contributions

ZZH conceived and designed the study, performed laboratory analyses and was a major contributor in writing the manuscript. RS carried out laboratory experiments, analyzed the results and contributed in writing. AB and PKMJ participated in the supervision and coordination of the project. All authors read and approved the final manuscript.

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Correspondence to Zenat Zebin Hossain.

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Conflict of interest

None declared.

Ethical Approval

The study (Research protocol# PR-14006) was approved by the Ethical Review Committee (ERC) of International Centre for Diarrheal Disease Research, Bangladesh (ICDDR, B) and Faculty of Biological Science, University of Dhaka.

Informed Consent

Informed consents were taken from the household caretakers at the time of enrolment in the study. Patients or their guardian were also asked for written consent before rectal swab collection.

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Hossain, Z.Z., Sultana, R., Begum, A. et al. Investigation of the Domestic Reservoirs of Diarrheagenic Escherichia coli in Diarrhea Case Households of Urban Bangladesh. Curr Microbiol 78, 2534–2547 (2021). https://doi.org/10.1007/s00284-021-02506-9

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