Objective: Diarrhea-causing Escherichia coli (E. coli) is a significant etiological agent that is always evolving due to its genomic plasticity, necessitating its routine surveillance. However, diarrheagenic E. coli (DEC) among Ghanaian students remains uncharacterized. This current study focused on characterizing the DEC pathotypes recovered from the stool samples of students with and without diarrhea seeking health care from the Ashanti region of Ghana.

Patients and Methods: There were 119 students who participated in this research. A structured questionnaire was utilized to gather the data. E. coli was isolated from participant stool samples using a biochemical method. DEC was distinguished from the E. coli isolates using a two-multiplex Polymerase Chain Reaction (PCR).

Results: The study detected all the five main pathotypes of DEC with the enterotoxigenic E. coli (ETEC), which elaborate only heat-labile enterotoxin gene, elt, or heat-stable enterotoxin gene, still being most frequent. When comparing individuals with diarrhea to those without it, it was shown that ETEC with simply elt or stla was statistically significantly lower in cases of diarrhea. In general, there was no statistically significant difference in the likelihood of any pathotype producing diarrhea between students who experienced diarrhea and those who did not.

Conclusions: The study has provided insight into the five main pathotypes of diarrheagenic E. coli among students in the Ashanti region of Ghana, which calls for monitoring by public health authorities. This current study suggests that more research be done in this field on the host immunological response to DEC infection.