Escherichia coli Clonal Variability Based on Genetic Diversity Pattern with Enterobacterial Repetitive Intergenic Consensus-Polymerase Chain Reaction Methods for Traveler’s Diarrhea Cases in Bali


  • I Dewa Made Sukrama Department of Clinical Microbiology, Faculty of Medicine, Universitas Udayana, Bali, Indonesia
  • Komang Januartha Putra Pinatih Department of Clinical Microbiology, Faculty of Medicine, Universitas Udayana, Bali, Indonesia
  • Made Agus Hendrayana Department of Clinical Microbiology, Faculty of Medicine, Universitas Udayana, Bali, Indonesia
  • Burhannuddin Rasyid Department of Medical Laboratory Technology, Polytechnic of Health Denpasar, Bali, Indonesia
  • Ni Luh Putu Harta Wedari Clinical Microbiology Specialist Program, Faculty of Medicine, Universitas Udayana, Sanglah General Hospital, Bali, Indonesia



Escherichia coli, Genetic diversity, ERIC-PCR, Traveller’s Diarrhea


BACKGROUND: Bali is a favorite tourism destination in the world. As a major tourist destination, the incidence of illness that afflicts tourists greatly affects the image of tourism. Diarrhea is a health problem that is most often experienced and is a major obstacle for foreign tourists when traveling, especially to Bali. Escherichia coli (E. coli) bacteria cause diarrhea more often than viruses in some developing countries. Genetic differences can affect the characteristics of E. coli, especially in relation to the medical field.

AIM: We would like to assess the genetic diversity of the different pathogenic E. coli from various clinical isolates including those from traveler’s diarrhea in Bali, Indonesia.

MATERIALS AND METHODS: One of the molecular techniques used in this study is to use enterobacterial repetitive intergenic consensus-polymerase chain reaction (ERIC-PCR). The sample in this study was the feces of foreign tourists with traveler’s diarrhea in Bali. This study carried out research procedures in the form of Isolation of E. coli genome DNA from culture, amplification of E. coli 16S rRNA encoding genes, sequencing of E. coli 16S rRNA encoding genes, phylogenetic tree construction, and then analysis of E. coli genetic diversity with ERIC-PCR sequences.

RESULTS: The results showed that the ERIC-PCR method was more discriminatory than other methods to analyze the genetic diversity of E. coli from fecal samples of patients with traveler’s diarrhea. It was found that clonal variability based on the genetic similarity of all sample E. coli isolates varied from 0% to 100%.

CONCLUSIONS: This shows that the source of transmission and the strains of E. coli that cause it comes from diverse populations.


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Pratiwi A. Popular Destinations in Tourism: Case Study of TripAdvisor. 3rd International Conference on Vocational Higher Education (ICVHE 2018). Advances in Social Science, Education and Humanities Research; 2020. p. 426. DOI:

Velyniawati P, Dewantari NM, Suarjana IM. Tingkat penerimaan wisatawan asing terhadap makanan tradisional Bali. Jurnal Ilmu Gizi. 2015;6:58-65.

BPS Provinsi Bali. Jumlah wisatawan asing ke Bali menurut bulan 1982-20182019. Available from: [Last accessed on 2022 Feb 07].

Wahyuni NW, Wirawan IM, Hendrayana MA. Risks factors for diarrhea among travellers visiting Bali. Public Health Prev Med Arch. 2019;2:121-6. DOI:

Steffen R. Epidemiology of travellers’diarrhea. J Travel Med. 2017;24:2016-9. DOI:

Trisdayanti NP, Sawitri AA, Sujaya IN. Hygiene, sanitation and potential existence of virulent genes of E. coli in lawar Bali in Kuta. Public Health Prev Med Arch. 2015;3(2):124-32. DOI:

Jiang, ZD, DuPont, HL. Etiology of travellers’ diarrhea. J Travel Med. 2017;24(1):S13-6. DOI:

Toma C, Yan L, Higa N, Nakasone N, Chinen I, Baschkier A, et al. Multiplex PCR assay for identification of human diarrheagenic Escherichia coli. J Clin Microbiol. 2003;41(6):2669-71. PMid:12791900 DOI:

Jafari A, Aslani M, Bouzari S. Escherichia coli: A brief review of diarrheagenic pathotypes and their role in diarrheal disease in Iran. Iran J Microbiol. 2012;4(3):102-17. PMid:23066484

Akondi KB, Lakshmi VV. Emerging trends in genomic approaches for microbial bioprospecting. OMICS. 2013;17(2):61-70. PMid:23308385 DOI:

Park YS, Lee S, Sharma A. Molecular typing tools for identifying and characterizing lactic acid bacteria: A review. Food Sci Biotechnol. 2020;29:1301-18. PMid:32995049 DOI:

A’yun Q. Profil genetik Escherichia coli yang diisolasi dari tempe berdasarkan Enterobacterial Repetitive Intergenic Consensus- Polymerase Chain Reaction (ERIC-PCR). Tesis Magister Sains Pada Program Studi Mikrobiologi Sekolah Pascasarjana Institut Pertanian Bogor; 2015.

Srinivasan R, Karaoz U, Volegova M, MacKichan J, Maeda MK, Miler S, et al. Use of 16S rRNA gene for identification of a broad range of clinically relevant bacterial pathogens. PLoS One. 2015;10(2):e0117617. PMid:25658760 DOI:

Madigan MT, Martinko JM, Parker J. Brock, the Biology of Microorganisms. 9th ed. Upper Saddle River, New Jersey: Pearson Prentice Hall; 2000.

Ludwig, W, Klenk HP. Overview: A phylogenetic backbone and taxonomic framework for procaryotic systematics. In: Boone DR, Castenholz RW, editors. The Archaea and the Deeply Branching and Phototrophic Bacteria. In: Garrity GM, editor. Bergey’s Manual of Systematic Bacteriology. 2nd ed. New York: Springer- Verlag; 2001. p. 49-65. DOI:

Case RJ, Boucher Y, Dahllof I, Holmstrom C, Doolittle WF, Kjelleberg S. Use of 16S rRNA and rpoB genes as molecular markers for microbial ecology studies. Appl Environ Microbiol. 2007;73(1):278-88. PMid:17071787 DOI:

Clarridge JE 3rd. Impact of 16S rRNA gene sequence analysis for identification of bacteria on clinical microbiology and infectious diseases. J Clin Microbiol. 2004;17(4):840-62. PMid:15489351 DOI:

Moore ER, Mihaylova SA, Vandamme P, Kriscevsky M. Microbial systematics and taxonomy: Relevance for a microbial commons. Res Microbiol. 2010;161(6):430-8. PMid:20670913 DOI:

Drancourt M, Bollet C, Carlioz A, Martelin R, Gayral JP, Raoult D. 16S ribosomal DNA sequence analysis of a large collection of environmental and clinical unidentifiable bacterial isolates. J Clin Microbiol. 2000;38:3623-30. PMid:11015374 DOI:

Mahapatro G, Mishra D, Shaw K, Mishra S, Jena T. Phylogenetic tree construction for DNA sequences using clustering methods. Procedia Eng. 2012;38:1362-6. DOI:

Johnson JS, Spakowicz DJ, Hong BY, Petersen LM, Demkowicz P, Chen L, et al. Evaluation of 16S rRNA gene sequencing for species and strain-level microbiome analysis. Nat Commun. 2019;10(1):5029. PMid:31695033 DOI:

Roberfroid S, Vanderleyden J, Steenackers H. Gene expression variability in clonal populations: causes and consequences. Crit Rev Microbiol. 2016;42(6):969-84. 841X.2015.1122571 PMid:26731119 DOI:




How to Cite

Sukrama IDM, Pinatih KJP, Hendrayana MA, Rasyid B, Wedari NLPH. Escherichia coli Clonal Variability Based on Genetic Diversity Pattern with Enterobacterial Repetitive Intergenic Consensus-Polymerase Chain Reaction Methods for Traveler’s Diarrhea Cases in Bali. Open Access Maced J Med Sci [Internet]. 2022 Mar. 30 [cited 2023 Mar. 22];10(A):752-60. Available from: