جستجوی مقالات مرتبط با کلیدواژه « escherichia coli » در نشریات گروه « پزشکی »

 Escherichia coli is one of the main causes of various diseases worldwide, whose multidrug-resistant strains have caused many public health problems by producing extended-spectrum β-lactamases (ESBLs). The resistance rate varies in different regions. Thus, it is necessary to identify ESBL-producing strains in each region and their antibiotic sensitivity in order to find appropriate treatment options. Hence, the present study aimed to detect the ESBL-producing E. coli strains and their antimicrobial susceptibility pattern in Tabriz, Iran.

 This study was conducted at the Imam Reza Hospital in Tabriz from November 20, 2022, to April 20, 2023. A total of 400 E. coli isolates were collected from different clinical specimens. Antimicrobial susceptibility testing was performed by the disk diffusion method. ESBL-producing isolates were detected by the double-disc synergy test method according to the Clinical and Laboratory Standards Institute (CLSI) guidelines.

 Out of 400 E. coli isolates, 211 (52.75%) were obtained from females, and 189 (47.25%) belonged to males. The mean age of patients was 52.1±27.9 years. Overall, 279 (69.75%) were confirmed as ESBL producers. These producers were mainly recovered from outpatients. The highest antibiotic resistance was observed to ceftriaxone (86.25%) and tetracycline (80.75%), and the least antibiotic resistance was related to imipenem (8%) and amikacin (16.25%), respectively. The rate of antibiotic resistance among ESBL producers was higher than among non-ESBLs.

 The present study reported a high prevalence of ESBL-producing E. coli among patients referring to Imam Reza hospital in Tabriz. Carbapenems, aminoglycosides, and nitrofurantoins were confirmed as the most efficient drugs for these bacteria, whereas cephalosporins, fluoroquinolones, and sulfonamides were the least effective agents.

To explore the prevalence and characteristics of secondary bacterial infections among patients suffering from mucormycosis following COVID-19 infection.

We conducted a cross-sectional, retrospective analysis from March 2020 to April 2022 at Imam Khomeini Hospital Complex in Tehran. The study included patients with histopathologically confirmed mucormycosis and documented secondary bacterial infections. We extracted and analyzed data from hospital records using SPSS software, version 26.

The study comprised 27 patients, with a predominance of females (70.4%) and an average age of 56 years. The majority of these patients (63%) had pre-existing diabetes mellitus. The severity of their COVID-19 infections varied. Treat- ment regimens included immunosuppressive drugs and antibiotics. Rhinocerebral mucormycosis was the most common form observed. The predominant secondary infections involved the urinary tract, respiratory system, bloodstream (bacteremia), and soft tissues, with resistant strains of Acinetobacter baumannii, Escherichia coli, and Klebsiella pneumoniae being the most frequently identified microorganisms. Notably, cases of bacteremia and pneumonia exhibited a higher mortality rate. Ultimately, 55.6% of patients were discharged, while 44.4% succumbed to their infections.

Patients recovering from COVID-19 with mucormycosis are significantly susceptible to secondary bacterial infections, particularly those with diabetes mellitus or those undergoing immunosuppressive therapy. Such infections com- pound the morbidity and mortality risks in this vulnerable patient cohort.

 Drymaria cordata is used traditionally against hyperglycemia. In this research the methanol (DCM), hexane (DCH), and water (DCW) extracts of D. cordata were investigated for their metabolite profiling, antioxidant, antibacterial, and carbohydrate hydrolyzing enzyme inhibitory activities.

 The antidiabetic activities of the extracts were investigated using the α-amylase and α-glucosidase (carbohydrate-hydrolyzing enzymes) inhibition assays and yeast glucose uptake assays. Antibacterial investigation of D. cordata extracts was done against methicillin-resistant Staphylococcus aureus (MRSA) and β-lactam-resistant Escherichia coli. The zone of inhibition and minimum inhibitory concentration (MIC) were observed.

 GC-MS metabolite profiling revealed the presence of stearyl aldehyde, henicosanal, glycidyl palmitate, eicosane, phytol, octacosanal, and neophytadiene. The DCM extract had a higher phenolic (168.19 ± 3.34 mg gallic acid equivalent/g), flavonoid (843 ±11.55 mg rutin equivalents/g), and ferric reducing potential (556.083 ± 6.51 mg ascorbic acid equivalent/g) than the DCH and DCW extracts. Also, DCM showed its greatest scavenging activity with a minimum IC50 value using the ABTS assay. DCM extract had the highest zone of inhibition and lowest MIC value against E. coli and S. aureus. Carbohydrate-hydrolyzing enzymes were inhibited, with DCM extract having minimum IC50 values of 714.66 µg/ml and 508.94 µg/ml. Yeast glucose uptake assays confirmed the highest efficacy of DCM extract for glucose uptake by yeast cells.

 Drymaria cordata, especially DCM, has the potential to be considered an effective phytopharmaceutical drug for the treatment of oxidative stress, bacterial infections, and type 2 diabetes.

Investigating multidrug resistance and TEM and SHV broad-spectrum beta-lactamase genes in Escherichia coli bacteria isolated from patients with urinary tract infections is very useful to improve the treatment of infection and prevent the failure of treatment of urinary tract infections.The aim of this study was to investigate multidrug resistance and TEM and SHV broad-spectrum beta-lactamase genes in Escherichia coli bacteria isolated from patients with urinary tract infections.

In this study, 188 strains of Escherichia coli, which cause urinary tract infections in Alborz province, were studied. Urine samples were cultured on EMB and Blood Agar media. Differential tests were performed for final identification. ESBL-producing strains were identified, PCR was performed to survey the abundance of ESBL-producing genes.

Based on the results of the disk diffusion and Double-disk synergy testS, 82 (43.6%) strains were determined as the final producer of ESBL. out of these isolates, the frequency of SHV, TEM, and CTX genes measured 64.3%, 55.9%, and 21.4%, respectively. These results showed that 12 (14.28%) of Escherichia coli isolated have all genes, 26 (30.95%) had 2 genes and 36 (42.85%) had one gene.

According to the results, it was found that imipenem with the lowest resistance is the best drug in the treatment, and carbapenems are the best drug for treating diseases caused by Escherichia coli. The results of the current study may be useful in replacing ESBL enzyme resistance screening with more modern sensitivity measurement methods such as MIC and Etest.

The widespread use of antibiotics for growth promotion or therapeutic purposes in poultry farming has led to increased antibiotic resistance. Escherichia coli is one of the gastrointestinal bacteria capable of transferring resistance genes and causing antibiotic resistance in humans and poultry. Evaluating antibiotic resistance in poultry flocks can provide researchers with a clear picture of the health status of poultry flocks and the human community. 

This study was conducted on 60 broiler chicken flocks aged 1 to 28 days. These flocks had no history of antibiotic use. In the laboratory, after necropsy, sampling was carried out from five chicken pieces in each flock. After confirming the diagnosis and purification of E. coli using biochemical methods, antibiotic sensitivity testing against 19 antibiotics was performed using the disc diffusion method, following the CLSI guidelines. 

Out of 300 samples collected, 270 (90%) isolates of E. coli were obtained. In this study, the sensitivity of antibiotics was as follows: fosfomycin (100%), lincomycin (94.81%), neomycin (48.52%), amoxicillin (48.15%), norfloxacin (41.48%), thiamphenicol (38.52%), enrofloxacin (38.52%), sulfamethoxazole (36.66%), florfenicol (31.85%), tilmycosin (31.85%), danofloxacin (30%), flumequine (25.19%), difloxacin (21.85%), chlortetracycline (16.66%), trimethoprim (16.66%), doxycycline (11.85%), erythromycin (10%), tylosin (1.48%), and colistin (0%). Additionally, resistance was observed only against tylosin (91.85%). No multiple resistance was observed among the isolated strains, and at least sensitivity to two antibiotics was detected in all samples. 

The findings of this research indicate that the level of antibiotic resistance in broiler chicken flocks at young ages in the Kermanshah region is low. However, the sensitivity rate to 17 antibiotics is less than 50%, demonstrating a relatively high level of sensitivity in poultry at these ages.

Uropathogenic Escherichia coli is one of the most important causes of urinary tract infections. These strains possess various virulence factors, including adhesins, toxins, and iron acquisition systems. Virulence genes are situated on mobile genetic elements or in specific regions of the chromosome known as pathogenicity islands. In this study, 375 clinical samples from male and female patients suspected of having urinary tract infections were collected in the hospitals of Dhi Qar, Iraq, during the period from June 1, 2019, to November 1, 2019. Following the collection of 100 samples, bacterial isolation, DNA extraction, and antibiotic sensitivity tests were conducted using the disc diffusion method with the selected antibiotics. The presence of papC, aer, fimH, hly, cnf-1, and afa class genes was investigated using multiplex PCR. The results indicated that the highest frequency among the genes was associated with the fim gene (98%). The aer, papC, cnf-1, hly, and afa genes were also detected, with frequencies of 52%, 30%, 18%, 13%, and 11%, respectively. Additionally, the highest resistance and sensitivity among UPEC isolates were observed for amoxicillin (82.37%) and amikacin (92.35%) antibiotics, respectively.

Unfortunately, infectious diseases are still one of the most important health problems around the world. The resistance of pathogenic bacteria to several drugs is an important and growing problem in the treatment of infectious diseases and hospital infections. It seems necessary to identify new compounds that have inhibitory or lethal effects on this bacterium. That's why we decided antimicrobial efficacy. The newly synthesized compound (2-methyl-1,3-dioxo-',11',2',3',5',6',7'a,7-octahydrospiro] inden-'2,3-pyrrolizidine 2-carboxylate (5) on Staphylococcus aureus and Escherichia coli bacteria.

At first, synthesized of methyl'2-methyl-1,3-dioxo-1',1',2',3',5',6', 7',7'a, -octahydrospiro] inden-'2,3-pyrrolizidine 2- Carboxylate was prepared by green chemistry method and with the help of microwave in one pot. Microbial culture media containing control bacteria of Staphylococcus aureus and Escherichia coli were prepared and concentrations of 70 to 110 Landa of the above compound were added to the samples. The antimicrobial property of the samples was determined after 3 days using the disk diffusion method and broth micro dilution method was determined, as well as the minimum inhibitory concentration and bacterial lethality of the samples.

The minimum inhibitory concentration and bacterial lethality in the above combination against the same standard strain of Escherichia coli bacteria was obtained at the rate of 12.5 μg/mL. The minimum inhibitory and lethal concentration of methyl methacrylate compound against the standard strain of Staphylococcus aureus bacteria was 12.5 and 25 μg/mL, respectively.

The use of the above combination was effective in controlling and inhibiting the tested bacteria.

 Catheter-associated urinary tract infections (CAUTIs) are prevalent among intensive care unit (ICU) patients and pose significant health risks. The causative agent, Escherichia coli, is commonly associated with these infections.

 The primary objective of our study was to evaluate various risk factors associated with CAUTIs. Additionally, we investigated the capacity of E. coli to form biofilms and the presence of virulence genes in these infections.

 We conducted a prospective study involving 204 patients admitted to ICUs with indwelling urinary catheters who subsequently developed CAUTIs. The isolated pathogen in all cases was E. coli. We subjected the isolated E. coli strains to microbiological analyses, including biofilm formation assays and polymerase chain reaction (PCR) for detecting virulence genes (pap-C, fim-H, sfa, afa, hylA, and cnf1).

 Our findings revealed that 111 out of 204 isolated E. coli strains (54.4%) could form biofilms in vitro. Among the detected virulence genes, fim-H was the most frequently observed (32.4%), followed by pap-C (14.2%), sfa (12.3%), and afa1 (11.3%). The least frequently detected genes were cnf1 (3.9%) and hylA (2.5%). Notably, there was a significant association between the presence of fim-H, pap-C, afa1, and hylA genes and the ability of E. coli to form biofilms (P = 0.001, P = 0.001, P = 0.04, P = 0.046, respectively).
Regarding the timing of CAUTIs, most cases occurred 7 - 10 days after catheter insertion (48.53%), followed by 3 - 6 days after insertion (45.59%). The least frequent occurrence was after 10 days from catheter insertion (5.86%). Early presence of CAUTIs (within 3 - 6 days) was significantly associated with diabetes mellitus (DM) and post-operative complications (both with P = 0.046). Furthermore, we observed a significant increase in the presence of the cnf1 gene in cases of early CAUTIs (3 - 6 days after catheter insertion, P = 0.001).

 Our study highlights the importance of understanding the risk factors, virulence genes, and biofilm formation capacity in E. coli-related CAUTIs. These findings may guide preventive strategies and improve patient outcomes.

 Bacterial infections are the most frequently occurring infections in pets. Escherichia coli (E. coli) and Klebsiella pneumoniae (K. pneumoniae) have been recognized as two opportunistic pathogens that are prevalent in pets. The aforementioned organisms play a vital role in the development and propagation of infections that affect the urinary tract, respiratory system, and gastrointestinal tract. The growing emergence of multidrug resistance among the bacteria is a global concern. The investigation of antibiotic resistance and genotypic characterization of Extended- spectrum β-lactamases (ESBLs) and Metallo - β - lactamase (MBL) - producing Enterobacteriaceae (CPE) in companion animals in Iran has been infrequently documented. The aim of this study was to identify the phenotypic and genotypic characterization of ESBL and MBL - producing Escherichia coli and Klebsiella pneumoniae strains that were isolated from dogs and cats stool.

 A total of 65 stool samples of dogs and cats were collected from five veterinary hospitals between February to August 2022. The antimicrobial susceptibility test (AST) was evaluated by using disk diffusion according to The Clinical and Laboratory Standards Institute guidelines (CLSI). The detection of ESBLs and MBLs producing isolates was performed by Combination Disk Diffusion Test (CDDT). The presence of blaCTXM, blaTEM,blaSHV, blaNDM, blaVIM, blaIMP genes was detected by PCR technique.

 Among 65 samples, 24 E. coli and 6 K. pneumoniae strains were identified. According to our findings, the most effective antibiotics against bacterial isolates were piperacillin - tazobactam imipenem and meropenem, respectively. The prevalence of ESBL and MBL was found to be 66.66% and 0%, respectively. The PCR assay revealed the presence of blaCTXM-15, blaTEM, blaSHV, blaIMP genes 28, 28, 18, 1 number, respectively. Whereas blaNDM, and blaVIM genes were not detected.

 The increasing prevalence of antibiotic resistance genes is a significant concern in the field of medicine. The excessive utilization of antibiotics may lead to the acquisition of genes that contribute to resistance.

 The urgent need for antimicrobial research to address the escalating global challenge of β-lactam antibiotic resistance, particularly in Escherichia coli-induced urinary tract infections (UTI), is underscored by the increasing resistance to ciprofloxacin in Latin America. This issue has led to a heightened dependence on alternative therapeutics, such as cephalosporins. The identification of extended-spectrum β-lactamase (ESBL)-producing E. coli, notably the O25b-ST131 clone, adds complexity to UTI management. The prevalence of ESBL-producing E. coli varies globally due to factors including regional antimicrobial usage practices.

 The goal of this study was to identify and molecularly characterize ESBL-producing E. coli isolates to identify the pandemic O25b-ST131 clone related to UTIs in one healthcare institution in Mexico.

 Bacterial species identification and antibiotic susceptibility tests were performed using the VITEK 2. The ESBL genes were identified using polymerase chain reaction (PCR). The E. coli genotyping was carried out by the phylogenetic group analysis and the O25b-ST131 identification.

 A total of 86 unique E. coli isolates were confirmed as ESBL, and 75% were obtained from UTIs. The most prevalent β-lactamase genes were blaCTX-M (66%), blaTEM (8.1%), blaCTX-M/SHV (5.8%), blaCTX-M/TEM (4.6%), and blaSHV (2.3%). The B2 phylogroup was most prominent (54.4%), with 46.5% identified as a globally pandemic O25b-ST131 clone. No evident relationship was observed using random amplified polymorphic DNA (RAPD) between nosocomial and community-acquired infections in ESBL-producing E. coli isolates.

 The obtained findings highlight the significance of monitoring molecular epidemiology in antibiotic resistance profiles of the O25b-ST131 E. coli clone.

Multi-drug-resistant pathogens pose a significant threat as they can rapidly spread, leading to severe healthcare-associated invasive infections. In developing countries, diarrheagenic Escherichia coli (DEC) is a major bacterial pathogen responsible for causing diarrhea. However, the outbreak of resistant strains has made the treatment of DEC infections much more challenging. This study aimed to investigate the relationship between antibiotic resistance genes and other virulence categories in E. coli strains that cause diarrhea, particularly DEC.

The phylogenetic grouping was defined using PCR and multi-locus sequence type (MLST) methods.

Among the isolates analyzed, 14 were identified as resistant and were classified into eight distinct sequence types: ST3, ST53, ST77, ST483, ST512, ST636, ST833, and ST774, indicating genetic diversity among the resistant strains. Certain sequence types, notably ST512 and ST636, were found to be associated with multiple antibiotic resistance in DEC. Regarding antibiotic susceptibility, strains showed the highest resistance to amoxicillin, suggesting that this antibiotic may not be effective in treating DEC infections. On the other hand, the isolates demonstrated susceptibility to amikacin and chloramphenicol, implying that these antibiotics could be more suitable treatment options for DEC infections.

The findings underscore the importance of promptly identifying antibiotic resistance patterns and their correlation with specific pathogenic virulence categories, as this knowledge can aid in selecting the most appropriate antibiotics for treating DEC infections. Considering the antibiotic resistance profiles and associated resistance genes is crucial in managing and containing diarrheal outbreaks and in selecting effective antibiotic therapies for DEC infections.

Antibiotic resistance within the poultry sector presents a considerable health concern due to treatment inefficacy and resistance transmission to humans and the environment. The investigation of plasmid-mediated quinolone resistance (PMQR) in Escherichia coli, acknowledged for its role in advancing resistance, remains inadequately studied in Iranian poultry. This study aimed to evaluate PMQR gene prevalence as well as to determine correlation between resistance phenotype and genotype in E. coli obtained from poultry colibacillosis.

A collection of 100 E. coli isolates from the viscera of broilers suspected to colibacillosis was assessed. Using the Kirby-Bauer disk diffusion method, antimicrobial susceptibility tests were conducted for ofloxacin, nalidixic acid, levofloxacin, ciprofloxacin, and ampicillin. Additionally, PCR was employed to screen for qnrS, qnrB, and aac(6)Ib-cr genes.

Among the analyzed E. coli isolates, 51% demonstrated resistance to at least one of the tested antibiotics, with 17% exhibiting resistance to four different antibiotics. Nalidixic acid displayed the highest resistance rate at 48%, while ampicillin had the lowest at 16%. PMQR genes were detected in 28% of the E. coli isolates, with aac(6′)-Ib-cr being the most prevalent at 14%, followed by qnrB in 13%, and qnrS in 7%.

The study underscores the vital need for careful antibiotic usage in poultry to curb the emergence of antibiotic-resistant bacteria. The results illuminate the prevalence of PMQR genes and their association with resistance trends in Iranian poultry, forming a pivotal basis for forthcoming approaches to combat antibiotic resistance within the poultry sector.

Escherichia coli is a significant causative agent of bloodstream infections (BSIs). Aminoglycoside antibiotics play a crucial role in treating severe infections such as sepsis and pneumonia. However, resistance to these antibiotics often occurs due to the production of aminoglycoside-modifying enzymes (AMEs). This study was conducted to assess antimicrobial susceptibility patterns against various aminoglycosides and to determine the prevalence of common AME genes in E. coli strains isolated from BSIs.

Sixty-five E. coli isolates were obtained from blood samples in a referral hospital in Tehran, Iran. The susceptibility patterns of aminoglycosides were determined using disk diffusion method and AMEs genes were investigated using PCR assay.

Resistance to aminoglycosides was observed in 64.6% (42/65) of the isolates. The most frequent resistance rate was found for kanamycin (44.6%) and gentamicin (38.5%), followed by tobramycin (29.2%) and amikacin (4.6%). The most frequent AME gene was aac(3)-IVa, which detected in 49.2% isolates, followed by aac(6)-Ib (40%), aac(3)-IIa (32.3%), and ant(2)-Ia (30.8%), respectively.

Athough the findings of this survey are based on specimens collected from a single hospital, our study shows that the high prevalence of aminoglycoside resistance is primarily attributed to the presence of the aac(3)-Iva, aac(6)-Ib and aac(3)-IIa genes. The low rate of resistance to amikacin makes this antibiotic a good candidate for treatment of BSIs due to E. coli.

Multidrug-resistant Escherichia coli and Staphylococcus aureus are frequent culprits of severe healthcare-associated infections and have been identified as significant pollutants in hospital settings. The research into plasmids as potential carriers for transferring new resistance genes among clinical pathogens has been quite constrained. This study was conducted to determine the extent of multidrug resistance and the presence of plasmids in E. coli and S. aureus isolates derived from wastewater effluents at healthcare institutions in Lafia, Nigeria. A total of 231 effluent samples were collected from different units within the healthcare facilities and bacterial identification performed using standard CLSI identification techniques. Phenotypic multidrug resistance was analyzed using the Kirby-Bauer disc diffusion method while plasmid DNA was extracted by alkaline lysis and separated using 0.8% agarose gel electrophoresis. A total of 167 (72.3%) and 175 (75.6%) samples were positive for E. coli and S. aureus, respectively. Both E. coli and S. aureus exhibited the greatest resistance to amoxicillin, with resistance rates of 79.0% and 66.3%, respectively. Conversely, the lowest resistance was observed for levofloxacin (26.3%) and cotrimoxazole (25.1%) in E. coli and S. aureus, respectively. The study did not find any significant correlation between the phenotypic antibiotic resistance profiles of the isolates and different wastewater discharge points (P > 0.05). Out of the total isolates, 77 (46.1%) of E. coli and 51 (29.1%) of S. aureus were resistant to all tested antibiotics. A majority of these isolates exhibited multiple antibiotic resistance index (MARI) values greater than 0.5, with 87.4% of E. coli and 80.6% of S. aureus demonstrating multidrug resistance. Plasmid analysis for E. coli indicated that the largest proportion of the selected isolates (46.7%) carried double plasmids with sizes ranging from 1500 to 6000 base pairs (bp), and 6.7% had no plasmids. In the case of S. aureus, 53.3% of the isolates harbored a single plasmid with a size of 7500 bp, while 46.7% had no plasmids. The wastewater discharged from healthcare facilities in the examined community was found to be significantly contaminated with multidrug-resistant organisms carrying plasmids with resistance genes.

Several prominent bacterial species known to induce diarrhea in human hosts encompass Escherichia coli, Escherichia albertii, Escherichia fergusonii, and various Shigella spp. Given that these organisms contribute to the burden of food-borne illness, it is essential to rapidly and correctly identify them in a clinical laboratory or food microbiology unit to prevent their transmission and spread. These pathogens are often mistakenly identified because of their genetic and phenotypic similarities. Phenotypic tests are not highly discriminatory and are time-consuming. Whole-genome sequencing is expensive and unavailable in most clinical laboratories.

To simplify their rapid detection, we improved an available multiplex polymerase chain reaction (PCR) assay targeting three species-specific primers, including Eco (the main target for E. coli identification), Ealb (specific for E. albertii), and Efer (specific for E. fergusonii), by adding ipaH and lacY to additionally discriminate between the highly similar Shigella spp. and enteroinvasive E. coli (EIEC) organisms. Primers were tested on 65 defined isolates, including E. coli (n=29), Shigella spp. (n=26), E. fergusonii (n=1), E. albertii (n=1), and other Enterobacterales (n=8).

All examined E. coli yielded two amplicons of the expected size (Eco and lacY), except for EIEC, which had three bands (Eco, lacY, and ipaH). All Shigella spp. yielded two amplicons (Eco and ipaH). E. fergusonii had only one band (Efer), and E. albertii also yielded one band (Ealb). Other Enterobacterales that were tested for validation did not demonstrate a product, except for Klebsiella pneumoniae and Klebsiella oxytoca (both lacY).

The assay was shown to be a way forward for rapid, specific, and cost-effective primary discrimination of these important or emerging enteropathogens that can be used in clinical and research laboratories.

Water and foodborne disease outbreaks continually present formidable challenges to healthcare systems, leading to morbidity, mortality, and substantial economic losses. Investigating and reporting these outbreaks play a pivotal role in effectively controlling and mitigating future occurrences. This study endeavors to scrutinize an outbreak of water contamination in Mariyanaj, Hamadan, Iran, employing the World Health Organization’s (WHO’s) comprehensive 10-step framework.

In this descriptive study, we meticulously adhered to the WHO outbreak investigation and reporting guidelines, systematically progressing through each step to investigate and report the outbreak. Symptom/exposure samples, involving two samples per symptomatic individual, were collected and sent to the Center for Disease Control’s laboratory for examination. Additionally, we executed a case-control study (Step 7) to discern the root cause of the outbreak.

The outbreak affected 919 individuals among 12115 residents of Mariyanaj city, with a male prevalence of 57.7%. The most impacted age group was 10-14 years. Predominant symptoms included abdominal pain, nausea, and vomiting. Through meticulous field investigations and the case-control study, the contaminated water source was identified. Human samples exhibited Escherichia coli and norovirus as the most prevalent pathogens, with E. coli also detected in water samples.

Despite advancements in outbreak investigation and reporting systems, the utilization of a standardized step-by-step approach proves more effective in identifying and managing outbreaks. The consistent monitoring of drinking water quality, particularly in times of water crises, emerges as a crucial factor in significantly preventing waterborne diseases.