الفهرس 
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Abstract
Introduction: EPEC belongs to a family of Gram-negative pathogens that cause attaching and effacing (A/E) lesions. EPEC strains do not produce enterotoxins which are two types heat-stable (ST) and heat labile (LT) also they are not invasive, EPEC were discovered in 1940s and were demonstrated to be major cause of diarrhea in first months of life, including non epidemic and epidemic diarrhea. The aim of work: Estimate percentage of cases of diarrhea caused by Enteropathogenic E.coli among those caused by diarrheagenic E.coli in children under 5 years in Children Hospital Mansoura University.Biofilm formation for isolated strains.Study the relation between the Bfp adhesions and EspA filament containing strains and the severity of diarrhea. Research Plan: This study was conducted over the period from September 2015 to April 2016.The study concluded 103 patients attended to Mansoura University Children Hospital (MUCH), Faculty of Medicine, Mansoura city, Dakahlia governorate, Egypt. The age of the studied group ranged from 2-60 months (mean=34.88 months, SD ± 17.469). There was 49(47.6 %) male child and 54 (52.4%) female child. The samples were sent in clean containers containing no disinfectant to Medical Diagnostic and Infection Control Unit (MDICU), Medical Microbiology and Immunology department, Faculty of Medicine, Mansoura University, Dakahlia governorate, Egypt for processing and examination. Results: Of 103 clinically examined children, 50 E.coli isolates were isolated, 16 (32%) were EPEC and 34 (68%) were non-EPEC. There is a statistically significant difference (P=0.003) in biofilm formation according to serological test, all serologically positive EPEC (n=16, 100 %) samples had shown growth and were biofilm producers as they produced biofilm in the four time point 3h, 6h, 9h, 24h , 17 non EPEC samples (50%) had shown growth and were biofilm producers. Conclusion: There is a statistically significant difference between the biofilm producer isolates and the biofilm non producer isolates which is, P = 0.007 with the resistance to antibiotic ceftazidime (CAZ), P=0.014 with ceftriaxone (CRO), p=0.012 with meronem (MEM) and p=0.003 with amoxilline (AX).