INVESTIGATING AND CO EXISTENCE OF SALMONELA AND E. COLI IN DIARRHEA PATIENT

Background: Diarrheal diseases and reproductive disorders such as abortion remain critical public health concerns, particularly in low-resource settings. Salmonella spp. and Escherichia coli (E. coli) are significant enteric pathogens not only causing gastrointestinal illness but also implicated in systemic infections with potential reproductive consequences. Co-infections, antimicrobial resistance, and the diagnostic challenges related to reproductive outcomes emphasize the need for integrated clinical and laboratory surveillance. Objective: To evaluate the clinical relevance of Salmonella and E. coli co-infections in diarrhea patients, and to determine the diagnostic performance of RBPT, ELISA, and PCR tests in predicting abortion outcomes. Methods: A cross-sectional study was conducted involving 200 diarrheic patients, from whom stool samples were collected for microbiological identification of Salmonella and E. coli, followed by antibiotic susceptibility testing. Additionally, 165 serum samples were analyzed using Rose Bengal Plate Test (RBPT), Enzyme-Linked Immunosorbent Assay (ELISA), and Polymerase Chain Reaction (PCR) to detect reproductive tract infections. Statistical analysis included Pearson correlation and linear regression to assess associations between diagnostic results and abortion cases. Results: Among 200 stool samples, E. coli was isolated in 25 cases (12.5%), Salmonella in 18 (9.0%), and co-infection in 7 (3.5%). Co-infections were predominantly associated with raw vegetable consumption and watery stool (p = 0.025, p = 0.005, respectively). High antibiotic resistance was observed in co-infected isolates, particularly to streptomycin (85.7%) and ampicillin (71.4%). In reproductive analysis, RBPT (r = 0.099), ELISA (r = 0.045), and PCR (r = 0.045) showed no significant correlation with abortion cases (p > 0.05). Linear regression revealed RBPT did not significantly predict abortion outcomes (R² = 0.002, p = 0.567); ELISA and PCR were excluded due to multicollinearity.