Pervasiveness of diarrheagenic E. coli pathotypes and Salmonella species among gastroenteritis patients in some selected pastoral hinterlands of the Amathole district municipality, Eastern Cape, South Africa

Background: Diarrhea as the consequence of gastroenteritis is one of the most significant causes of infant's deaths across the world. Over 700 000 child loses occur each year as a result of gastroenteritis infection. This study aimed at elucidating potential bacterial aetiological agents of diarrhoea within the selected rural settlements of Amathole District Municipality, Eastern Cape, South Africa. Standard culture-based methods and Polymerase chain reaction techniques were employed for the detection, isolation and validation of diarrheagenic E. coli (DEC) pathotypes and Salmonella species from diarrheal stool samples. Results: A total of 208 (64%) isolates were positively affirmed by conventional Polymerase Chain Reaction as Diarrheagenic E. coli (DEC) and were further delineated into 4 DEC pathotypes and an additional 116 (36%) isolates were confirmed as Non-diarrheagenic E. coli. Among the confirmed DEC pathotypes, Enterotoxigenic E. coli (ETEC) (51%) was the most prevalent followed by Diffusely adherent E. coli DAEC (18%), Enteroaggregative E. coli (EAEC) (16%) and Enteropathogenic E. coli (EPEC) (15%). Subsequently; 62 (23%) of 263 Salmonella phenotypic isolates were also confirmed by conventional Polymerase Chain Reaction (PCR) using genus specific primer sets. Though sought; no presumptive isolates of Campylobacter species were detected from the diarrheal stool samples obtained in the study region. Conclusion: The findings of this study elucidated bacterial pathogens co-infection of DEC and Salmonella species among diarrheal stool specimens, accentuating a significant public health concern.