Prevalence of Escherichia coli O157:H7 among pediatric diarrheal cases in Misurata, Libya

Abstract

Background: Escherichia coli O157:H7 is a major pathogen transmitted through food; it is associated with severe stomach illnesses such as bleeding in the intestines and kidney failure due to destruction of red blood cells (HUS). Even though this organism plays a critical role in clinical settings, many labs do not identify it on a regular basis. Aims: This study aimed to determine the prevalence of E. coli O157:H7 among children with diarrhea in Misurata, Libya.
Methods: A cross-sectional study was conducted in 2024 on 124 children aged five days to thirteen years admitted to Misurata Central Hospital. Specimens were collected from stool samples and rectal swabs. Initial isolation was performed using Sorbitol MacConkeخy (SMAC) agar to identify sorbitol non-fermenting isolates, followed by biochemical identification. Molecular confirmation was performed using polymerase chain reaction (PCR) to detect stx1 and stx2 genes.
Results: Four isolates (3.2%) were sorbitol-negative, of which only one (0.8%) was confirmed as E. coli O157:H7. The confirmed case was a 26-month-old boy presenting with severe diarrhea and dehydration. Statistical analysis revealed a significant difference between observed and expected regional prevalence.
Conclusion: Although the prevalence of E. coli O157:H7 was low, its potential to cause severe disease highlights the need for improved diagnostic strategies, including molecular methods, as well as strengthened surveillance systems and public health interventions in Libya.