Abstract:
Background: Escherichia coli O157:H7 is one of the most potent, and zoonotic pathogen emerged as a cause
of food borne infection. In under-five children, it causes from mild diarrhea to hemolytic uremic syndrome
and even leading to death. Its magnitude was reported up to 39.3% in abroad and 14% in Ethiopia. However,
in Ethiopia where; childhood diarrhea is endemic, an alarming rate of insanitary conditions, and close
reservoir animals to human interaction, there is no robust information on its epidemiology. Hence, the study
was meant to estimate the magnitude, assess the associated factors and drug susceptibility pattern of the
isolates among under-five children with acute diarrhea in Haramaya Hospital and Hiwot-Fana Specialized
University Hospital, Ethiopia.
Methods: A Hospital based cross-sectional study design was carried out from January to March 2018 on 365
under-five children recruited by using consecutive sampling technique. A pretested structured questionnaire
was used to collect potential factors. Both the data and stool samples were collected by trained laboratory
technicians. Stool specimens were processed by using enrichment, differential and selective medium
following manufacturer’s instruction. E. coliO157:H7 latex test (Oxoid, England) was then used for
confirmation. Disk diffusion technique was used for antibiotic susceptibility test of 10 antimicrobials. Crude
and adjusted odds ratio was determined and p< 0.05 was used as statistically significant.
Results: The magnitude of E. coli O157:H7 was found to be 15.3% (95% CI: 11.8- 19.5). Of the isolates,
58.93 % (95% CI: 45.0 -71.9) exhibited multidrug resistance. Higher resistance was seen against Ampicillin
(92.9%) whereas sensitivity to ciprofloxacin (87.5%). Among the factors studied; rural residence (AOR=3.75,
95% CI: 1.26-11.20), under cocked meat consumption (AOR = 3.95, 95% CI: 1.23-12.67), raw vegetable
and/or fruit juice consumption (AOR 3.37, 95% CI: 1.32-8.62), bloody diarrhea (AOR 4.42, 95% CI: 1.78-
10.94), household with 3-4 under-five children (AOR 7.16, 95% CI: 2.90-17.70), presence of diarrhea in a
household (AOR 4.22, 95% CI: 1.84-12.69), animal ownership (AOR 3.87, 95% CI: 1.48-10.12) and mothers
with no formal education (AOR 3.14, 95% CI: 1.05-9.42) were found to be an independent predictors of
childhood E. coli O157:H7.
Conclusion: High magnitude of E. coli O157:H7 compounded by an alarming emerging resistance was seen
against quinolones (norfloxacin and nalidixic acid) and gentamycin. Most infections originate from
consumption of raw foods and drinks which presumably contaminated with farm animals coupled with
substandard hand hygiene practice in house hold. Thus, mother’s education on child care and household
sanitation together with preventive hygienic measures associated with animal manure in rural resident
children is recommended
