Prevalence and Antimicrobial Resistance of Enterohemorrhagic Escherichia coli (Ecoli.0157) in Children under Five Years Old with Diarrhea at Enugu State University Teaching Hospital (ESUT)

Escherichia coli (E. coli) is a leading cause of diarrhoea in low- and middle-income nations, particularly among children under the age of five. This study aimed to determine the prevalence of Enterohemorrhagic E coli (E coli 0157) and the antimicrobial susceptibility in children less than five years old in Enugu State University of Science and Technology Teaching Hospital. The study employed a mixed cross-sectional design which was carried out from October-November 2024 Esuth Teaching Hospital. Ethical considerations were met before 83 stool samples were collected from eligible children, and questionnaires administered. Samples were cultured on Coliform chromogenic (E coli 0157) agar and antimicrobial susceptibility testing were done using the Kirby- Bauer Disk Diffusion Method. The findings revealed a prevalence of 15 out of 83 participants (18%) for E. coli O157, with a slightly higher prevalence in females (21%) than males (15%). The most affected age group was children aged 1-2 years (46.7%). Vomiting was reported in 57% of cases, fever in 23%, abdominal pain in 64%, and dehydration in 58%, with 85.5% presenting loose or watery stools and semi-formed stools (14.5%). Antimicrobial susceptibility testing indicated that while several strains were sensitive to antibiotics there was significant resistance to some. The study found an 18% prevalence of E. coli O157 in children under 5 in Enugu, Nigeria, with higher rates in females and the 1-2 age group. Also susceptibility studies showed significant rate of resistance in amoxicillin, nitrofurantoin and streptomycin drugs. Poor sanitation and hygiene were linked to infections. Antimicrobial resistance was also shown to be prevalent. The outcome of the study indicate a key relationship between sex and prevalence of the disease as well as the relative epidemiological predispositions. In conclusion, the study underscores the urgent need for improved public health initiatives focused on sanitation and hygiene practices to mitigate E. coli infections, alongside continuous monitoring of antimicrobial resistance patterns to inform treatment protocols.