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Global Prevalence of Yersinia enterocolitica in Cases of Gastroenteritis: A Systematic Review and Meta-Analysis. Int J Microbiol 2021; 2021:1499869. [PMID: 34512763 PMCID: PMC8433020 DOI: 10.1155/2021/1499869] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 08/15/2021] [Accepted: 08/23/2021] [Indexed: 11/18/2022] Open
Abstract
The prevalence of Yersinia enterocolitica in gastroenteritis is often underestimated. It relates considerably to morbidity and medical expenses around the world. Understanding the cause of gastroenteritis leads to making the appropriate treatment decisions. We systematically searched PubMed, Science Direct, Embase, and Scopus to identify all published studies between Jan. 1, 2000, and Dec. 31, 2019, to assess the prevalence of Y. enterocolitica in gastroenteritis patients. A total of 5039 articles were identified that lead to the extraction of data from 47 of them. The pooled prevalence of Y. enterocolitica in cases of gastroenteritis was estimated as 1.97% (1.32–2.74%) in the culture method and 2.41% (1.07–4.22%) in the molecular method. Among the biotypes of Y. enterocolitica, 1A (62.48%) and 1B (2.14%) had the most and least prevalence, respectively. Serotype O3 Y. enterocolitica with 39.46% had the highest and O5,27 with 0.0% had the least prevalence in gastroenteritis cases. In conclusion, the findings of this systematic review show that Y. enterocolitica is prevalent in gastroenteritis in all age groups. Serotypes O3 and O9 of Y. enterocolitica had the highest prevalence and O5,27 had the least prevalence in diarrheal patients. The prevalence of Y. enterocolitica was similar in both gender and different seasons. It should be noted that to determine the role of the organism, more studies are needed especially in food-borne diseases.
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Vergadi E, Maraki S, Dardamani E, Ladomenou F, Galanakis E. Polymicrobial gastroenteritis in children. Acta Paediatr 2021; 110:2240-2245. [PMID: 33755990 DOI: 10.1111/apa.15854] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Revised: 03/09/2021] [Accepted: 03/22/2021] [Indexed: 01/17/2023]
Abstract
AIM Co-infections with viral and bacterial enteropathogens often augment severity of diarrhoea, however, there is limited evidence on the clinical importance of bacterial enteric co-infections. We investigated the rate, type and impact of bacterial enteropathogens and their associations in children with gastroenteritis. METHODS Retrospective cohort study that included children 0-18 years old with acute bacterial diarrhoea during a 27-year period (1993-2019), in Crete, Greece. Differences in clinical characteristics and pathogen associations were investigated between single and multiple infections. RESULTS Two or more bacteria were isolated in stool culture in 53 out of 1932 children (2.74%). Patients with co-infections were younger (p 0.0001) and had higher hospitalisation rates (p 0.03). Escherichia coli (E. coli) was the most prevalent pathogen associated with co-infections, in particular the E. coli enteropathogenic strains O127 and O111 (p 0.001), and Salmonella spp the least (p 0.001). Co-occurrence analysis revealed two positively associated pathogen pairs, E. coli with Campylobacter spp and E. coli (p 0.001) with Salmonella spp (p 0.04). CONCLUSION Bacterial enteropathogen co-infection was most common with E. coli strains and related to higher hospitalisation rates and younger age.
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Affiliation(s)
- Eleni Vergadi
- Department of Paediatrics, University General Hospital of Heraklion, Medical School University of Crete Heraklion Crete Greece
| | - Sofia Maraki
- Department of Microbiology University General Hospital of Heraklion Heraklion Crete Greece
| | - Evangelia Dardamani
- Department of Paediatrics, University General Hospital of Heraklion, Medical School University of Crete Heraklion Crete Greece
| | - Fani Ladomenou
- Department of Paediatrics Venizeleion General Hospital of Heraklion Heraklion Crete Greece
| | - Emmanouil Galanakis
- Department of Paediatrics, University General Hospital of Heraklion, Medical School University of Crete Heraklion Crete Greece
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Molina NB, Oderiz S, Vescina C, Córdoba A, Basualdo JÁ, Sparo MD. [First report of diarrheagenic Escherichia coli in pediatric outpatient population with diarrhea in La Plata, Argentina]. Rev Argent Microbiol 2021; 54:15-21. [PMID: 33875293 DOI: 10.1016/j.ram.2021.02.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 11/11/2020] [Accepted: 02/12/2021] [Indexed: 11/30/2022] Open
Abstract
Diarrheagenic Escherichia coli is a heterogeneous group of strains that presents various virulence factors and causes different diarrheal syndromes. The most studied pathotypes are enteropathogenic Escherichia coli (EPEC), enterotoxigenic Escherichia coli (ETEC), enteroaggregative Escherichia coli (EAEC), enteroinvasive Escherichia coli (EIEC) and Shiga toxin-producing Escherichia coli (STEC). The objective was to estimate the frequency of infection of diarrheagenic E. coli pathotypes in children with diarrhea, attended at the Sor María Ludovica Hospital in La Plata, Argentina, during the period May-October 2017. E. coli pathotypes were detected by molecular amplification of eight characteristic virulence genes. The feces of 211 children (76% under 5 years) were studied. Infection with diarrheagenic E. coli was detected in 12.3% of the samples. The pathotypes were EAEC (10.43%), ETEC (1.42%, all of them positive for thermolabile toxin), EPEC (0.95%) and STEC (0.47%, positive for Shiga toxin 2). The EAEC pathotype was prevalent in children of all age groups, while ETEC, EPEC and STEC were only observed in children under 5 years of age. This study constitutes the first report of diarrheagenic Escherichia coli detection in an outpatient pediatric population with diarrhea from La Plata, using molecular amplification techniques. Broader future studies, including the characterization of the isolates with the largest number of genes, asymptomatic controls, different times of the year and population from different geographic areas will be necessary to clarify the relevance of diarrheagenic E. coli infection in children from Argentina.
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Affiliation(s)
- Nora Beatriz Molina
- Centro Universitario de Estudios Microbiológicos y Parasitológicos (CUDEMYP)-CIC, Universidad Nacional de La Plata, La Plata, Argentina.
| | - Sebastián Oderiz
- Sala de Microbiología, Hospital Interzonal de Niños Sor María Ludovica, La Plata, Argentina
| | - Cecilia Vescina
- Sala de Microbiología, Hospital Interzonal de Niños Sor María Ludovica, La Plata, Argentina
| | - Alejandra Córdoba
- Centro Universitario de Estudios Microbiológicos y Parasitológicos (CUDEMYP)-CIC, Universidad Nacional de La Plata, La Plata, Argentina
| | - Juan Ángel Basualdo
- Centro Universitario de Estudios Microbiológicos y Parasitológicos (CUDEMYP)-CIC, Universidad Nacional de La Plata, La Plata, Argentina
| | - Mónica Delfina Sparo
- Centro Universitario de Estudios Microbiológicos y Parasitológicos (CUDEMYP)-CIC, Universidad Nacional de La Plata, La Plata, Argentina
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Caffarena RD, Casaux ML, Schild CO, Fraga M, Castells M, Colina R, Maya L, Corbellini LG, Riet-Correa F, Giannitti F. Causes of neonatal calf diarrhea and mortality in pasture-based dairy herds in Uruguay: a farm-matched case-control study. Braz J Microbiol 2021; 52:977-988. [PMID: 33575990 PMCID: PMC7877513 DOI: 10.1007/s42770-021-00440-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 02/02/2021] [Indexed: 01/08/2023] Open
Abstract
Neonatal calf diarrhea (NCD) and mortality cause significant losses to the dairy industry. The preweaning dairy calf mortality risk in Uruguay is high (15.2%); however, causes for these losses are largely unknown. This study aimed to assess whether various pathogens were associated with NCD and death in Uruguayan dairy calves and whether these infections, diarrhea, or deaths were associated with the failure of transfer of passive immunity (FTPI). Contemporary diarrheic (n = 264,) and non-diarrheic (n = 271) 1- to 30-day-old calves from 27 farms were sampled. Feces were analyzed by antigen-capture ELISA for Cryptosporidium spp., rotavirus, bovine coronavirus, and Escherichia coli F5+, RT-PCR for bovine astrovirus (BoAstV), and bacterial cultures for Salmonella enterica. Blood/serum was analyzed by RT-PCR or antigen-capture ELISA for bovine viral diarrhea virus (BVDV). Serum of ≤ 8-day-old calves (n = 95) was assessed by refractometry to determine the concention of serum total proteins (STP) as an indicator of FTPI. Whether the sampled calves died before weaning was recorded. At least one pathogen was detected in 65.4% of the calves, and this percentage was significantly higher in diarrheic (83.7%) versus non-diarrheic (47.6%) calves. Unlike the other pathogens, Cryptosporidium spp. and rotavirus were associated with NCD. Diarrheic calves, calves infected with any of the pathogens, and calves infected with rotavirus had significantly lower concentrations of STP. Diarrheic calves had higher chances of dying before weaning than non-diarrheic calves. Diarrheic calves infected with S. enterica were at increased risk of mortality. Controlling NCD, salmonellosis, cryptosporidiosis, and rotavirus infections, and improving colostrum management practices would help to reduce calf morbi-mortality in dairy farms in Uruguay.
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Affiliation(s)
- Rubén Darío Caffarena
- Plataforma de Investigación en Salud Animal, Instituto Nacional de Investigación Agropecuaria (INIA) Estación Experimental La Estanzuela, Colonia, Uruguay. .,Departamento de Patología y Clínica de Rumiantes y Suinos, Facultad de Veterinaria, Universidad de la República (UdelaR), Montevideo, Uruguay.
| | - María Laura Casaux
- Plataforma de Investigación en Salud Animal, Instituto Nacional de Investigación Agropecuaria (INIA) Estación Experimental La Estanzuela, Colonia, Uruguay
| | - Carlos Omar Schild
- Plataforma de Investigación en Salud Animal, Instituto Nacional de Investigación Agropecuaria (INIA) Estación Experimental La Estanzuela, Colonia, Uruguay
| | - Martín Fraga
- Plataforma de Investigación en Salud Animal, Instituto Nacional de Investigación Agropecuaria (INIA) Estación Experimental La Estanzuela, Colonia, Uruguay
| | - Matías Castells
- Plataforma de Investigación en Salud Animal, Instituto Nacional de Investigación Agropecuaria (INIA) Estación Experimental La Estanzuela, Colonia, Uruguay.,Laboratorio de Virología Molecular, Centro Universitario Regional (CENUR) Litoral Norte, Universidad de la República (UdelaR), Salto, Uruguay
| | - Rodney Colina
- Laboratorio de Virología Molecular, Centro Universitario Regional (CENUR) Litoral Norte, Universidad de la República (UdelaR), Salto, Uruguay
| | - Leticia Maya
- Laboratorio de Virología Molecular, Centro Universitario Regional (CENUR) Litoral Norte, Universidad de la República (UdelaR), Salto, Uruguay
| | - Luis Gustavo Corbellini
- Plataforma de Investigación en Salud Animal, Instituto Nacional de Investigación Agropecuaria (INIA) Estación Experimental La Estanzuela, Colonia, Uruguay.,Departamento de Medicina Veterinária Preventiva, Laboratório de Epidemiologia Veterinária (Epilab), Faculdade de Veterinária, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brasil
| | - Franklin Riet-Correa
- Plataforma de Investigación en Salud Animal, Instituto Nacional de Investigación Agropecuaria (INIA) Estación Experimental La Estanzuela, Colonia, Uruguay.,Programa de Pós Graduação em Ciência Animal nos Trópicos, Faculdade de Veterinária, Universidade Federal da Bahia, Ondina, Salvador, BA, Brasil
| | - Federico Giannitti
- Plataforma de Investigación en Salud Animal, Instituto Nacional de Investigación Agropecuaria (INIA) Estación Experimental La Estanzuela, Colonia, Uruguay.
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García A, Fox JG. A One Health Perspective for Defining and Deciphering Escherichia coli Pathogenic Potential in Multiple Hosts. Comp Med 2021; 71:3-45. [PMID: 33419487 PMCID: PMC7898170 DOI: 10.30802/aalas-cm-20-000054] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 08/17/2020] [Accepted: 09/19/2020] [Indexed: 11/05/2022]
Abstract
E. coli is one of the most common species of bacteria colonizing humans and animals. The singularity of E. coli 's genus and species underestimates its multifaceted nature, which is represented by different strains, each with different combinations of distinct virulence factors. In fact, several E. coli pathotypes, or hybrid strains, may be associated with both subclinical infection and a range of clinical conditions, including enteric, urinary, and systemic infections. E. coli may also express DNA-damaging toxins that could impact cancer development. This review summarizes the different E. coli pathotypes in the context of their history, hosts, clinical signs, epidemiology, and control. The pathotypic characterization of E. coli in the context of disease in different animals, including humans, provides comparative and One Health perspectives that will guide future clinical and research investigations of E. coli infections.
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Key Words
- aa, aggregative adherence
- a/e, attaching and effacing
- aepec, atypical epec
- afa, afimbrial adhesin
- aida-i, adhesin involved in diffuse adherence
- aiec, adherent invasive e. coli
- apec, avian pathogenic e. coli
- atcc, american type culture collection
- bfp, bundle-forming pilus
- cd, crohn disease
- cdt, cytolethal distending toxin gene
- clb, colibactin
- cnf, cytotoxic necrotizing factor
- cs, coli surface (antigens)
- daec, diffusely adhering e. coli
- db, dutch belted
- eae, e. coli attaching and effacing gene
- eaec, enteroaggregative e. coli
- eaf, epec adherence factor (plasmid)
- eahec, entero-aggregative-hemorrhagic e. coli
- east-1, enteroaggregative e. coli heat-stable enterotoxin
- e. coli, escherichia coli
- ed, edema disease
- ehec, enterohemorrhagic e. coli
- eiec, enteroinvasive e. coli
- epec, enteropathogenic e. coli
- esbl, extended-spectrum β-lactamase
- esp, e. coli secreted protein
- etec, enterotoxigenic e. coli
- expec, extraintestinal pathogenic e. coli
- fyua, yersiniabactin receptor gene
- gi, gastrointestinal
- hly, hemolysin
- hus, hemolytic uremic syndrome
- ibd, inflammatory bowel disease
- la, localized adherence
- lee, locus of enterocyte effacement
- lpf, long polar fimbriae
- lt, heat-labile (enterotoxin)
- mlst, multilocus sequence typing
- ndm, new delhi metallo-β-lactamase
- nzw, new zealand white
- pap, pyelonephritis-associated pilus
- pks, polyketide synthase
- sfa, s fimbrial adhesin
- slt, shiga-like toxin
- st, heat-stable (enterotoxin)
- stec, stx-producing e. coli
- stx, shiga toxin
- tepec, typical epec
- upec, uropathogenic e. coli
- uti, urinary tract infection
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Affiliation(s)
- Alexis García
- Molecular Sciences Research Center, University of Puerto Rico, San Juan, Puerto Rico; Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, Massachusetts; Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, Massachusetts;,
| | - James G Fox
- Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, Massachusetts
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Caffarena RD, Meireles MV, Carrasco-Letelier L, Picasso-Risso C, Santana BN, Riet-Correa F, Giannitti F. Dairy Calves in Uruguay Are Reservoirs of Zoonotic Subtypes of Cryptosporidium parvum and Pose a Potential Risk of Surface Water Contamination. Front Vet Sci 2020; 7:562. [PMID: 32974408 PMCID: PMC7473207 DOI: 10.3389/fvets.2020.00562] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 07/15/2020] [Indexed: 12/19/2022] Open
Abstract
Cryptosporidium parvum, a major cause of diarrhea in calves, is of concern given its zoonotic potential. Numerous outbreaks of human cryptosporidiosis caused by C. parvum genetic subtypes are reported yearly worldwide, with livestock or water being frequently identified sources of infection. Although cryptosporidiosis has been reported from human patients in Uruguay, particularly children, epidemiologic information is scant and the role of cattle as reservoirs of zoonotic subtypes of C. parvum has not been explored. In this study, we aimed to (a)-identify C. parvum subtypes infecting dairy calves in Uruguay (including potentially zoonotic subtypes), (b)-assess their association with calf diarrhea, (c)-evaluate their spatial clustering, and (d)-assess the distance of infected calves to surface watercourses draining the farmlands and determine whether these watercourses flow into public water treatment plants. Feces of 255 calves that had tested positive for Cryptosporidium spp. by antigen ELISA were selected. Samples had been collected from 29 dairy farms in seven Uruguayan departments where dairy farming is concentrated and represented 170 diarrheic and 85 non-diarrheic calves. Selected samples were processed by nested PCRs targeting the 18S rRNA and gp60 genes followed by sequencing to identify C. parvum subtypes. Of seven C. parvum subtypes detected in 166 calves, five (identified in 143 calves on 28/29 farms) had been identified in humans elsewhere and have zoonotic potential. Subtype IIaA15G2R1 was the most frequent (53.6%; 89/166), followed by IIaA20G1R1 (24.1%; 40/166), IIaA22G1R1 (11.4%; 19/166), IIaA23G1R1 (3.6%; 6/166), IIaA17G2R1 (3%; 5/166), IIaA21G1R1 (2.4%; 4/166), and IIaA16G1R1 (1.8%; 3/166). There were no significant differences in the proportions of diarrheic and non-diarrheic calves infected with any of the C. parvum subtypes. Two spatial clusters were detected, one of which overlapped with Uruguay's capital city and its main water treatment plant (Aguas Corrientes), harvesting surface water to supply ~1,700,000 people. Infected calves on all farms were within 20–900 m of a natural surface watercourse draining the farmland, 10 of which flowed into six water treatment plants located 9–108 km downstream. Four watercourses flowed downstream into Aguas Corrientes. Calves are reservoirs of zoonotic C. parvum subtypes in Uruguay and pose a public health risk.
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Affiliation(s)
- Rubén Darío Caffarena
- Instituto Nacional de Investigación Agropecuaria (INIA), Plataforma de Investigación en Salud Animal, Estación Experimental INIA La Estanzuela, Colonia, Uruguay.,Facultad de Veterinaria, Universidad de la República, Montevideo, Uruguay
| | | | - Leonidas Carrasco-Letelier
- Instituto Nacional de Investigación Agropecuaria (INIA), Programa de Producción y Sustentabilidad Ambiental, Estación Experimental INIA La Estanzuela, Colonia, Uruguay
| | - Catalina Picasso-Risso
- Facultad de Veterinaria, Universidad de la República, Montevideo, Uruguay.,Department of Veterinary Population Medicine, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN, United States
| | | | - Franklin Riet-Correa
- Instituto Nacional de Investigación Agropecuaria (INIA), Plataforma de Investigación en Salud Animal, Estación Experimental INIA La Estanzuela, Colonia, Uruguay
| | - Federico Giannitti
- Instituto Nacional de Investigación Agropecuaria (INIA), Plataforma de Investigación en Salud Animal, Estación Experimental INIA La Estanzuela, Colonia, Uruguay
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Wang R, Deng Y, Deng Q, Sun D, Fang Z, Sun L, Wang Y, Gooneratne R. Vibrio parahaemolyticus Infection in Mice Reduces Protective Gut Microbiota, Augmenting Disease Pathways. Front Microbiol 2020; 11:73. [PMID: 32082289 PMCID: PMC7002474 DOI: 10.3389/fmicb.2020.00073] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 01/14/2020] [Indexed: 12/30/2022] Open
Abstract
Vibrio parahaemolyticus (Vp), a major food-borne pathogen, is responsible for severe infections such as gastroenteritis and septicemia, which may be accompanied by life-threatening complications. While studies have evaluated factors that affect the virulence of the pathogen, none have investigated the interaction of Vp with gut microbiota. To address this knowledge gap, we compared the effect of Vp on gut bacterial community structure, immunity, liver and kidney function, in pseudo germ-free (PGF) mice and normal (control) mice. Significant damage to the ileum was observed in normal mice compared with the PGF mice. The inflammatory factors IL-1β, IL-6, and TNF-α in normal mice were ∼2.5-fold higher than in the PGF mice, and liver (ALT, AST, ALP) and kidney (BUN) function indices were ∼1.6-fold higher. The Vp infection substantially reduced species composition and richness of the gut microbial communities. In particular, there was a shift in keystone taxa, from protective species of genera Bacteroides, Lactobacillus, Bifidobacterium, and Akkermansia in the gut of control mice to opportunistic pathogens Enterobacteriaceae, Proteus, Prevotella, and Sutterella in Vp-infected mice, thus affecting microbiota-related biological functions in the mice. Specifically, pathways involved in infectious diseases and ion channels were significantly augmented in infected mice, while the pathways involved in metabolism, digestion and cell growth declined. We propose that the normal mice are more prone to Vp infection because of the alteration in gut-microbe-mediated functions. All these effects reduce intestinal resistance, with marked damage to the gut lining and pathogen leakage into the blood culminating in liver and kidney damage. These findings greatly advance our understanding of the mechanisms underlying interactions between Vp, the gut microbiota and the infected host.
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Affiliation(s)
- Rundong Wang
- College of Food Science and Technology, Guangdong Ocean University, Guangdong Provincial Key Laboratory of Aquatic Product Processing and Safety, Key Laboratory of Advanced Processing of Aquatic Products of Guangdong Higher Education Institution, Zhanjiang, China.,School of Chemistry and Chemical Engineering, Key Laboratory of Clean Energy Materials Chemistry of Guangdong Higher Education Institutes, Lingnan Normal University, Zhanjiang, China
| | - Yijia Deng
- College of Food Science and Technology, Guangdong Ocean University, Guangdong Provincial Key Laboratory of Aquatic Product Processing and Safety, Key Laboratory of Advanced Processing of Aquatic Products of Guangdong Higher Education Institution, Zhanjiang, China
| | - Qi Deng
- College of Food Science and Technology, Guangdong Ocean University, Guangdong Provincial Key Laboratory of Aquatic Product Processing and Safety, Key Laboratory of Advanced Processing of Aquatic Products of Guangdong Higher Education Institution, Zhanjiang, China
| | - Dongfang Sun
- College of Food Science and Technology, Guangdong Ocean University, Guangdong Provincial Key Laboratory of Aquatic Product Processing and Safety, Key Laboratory of Advanced Processing of Aquatic Products of Guangdong Higher Education Institution, Zhanjiang, China
| | - Zhijia Fang
- College of Food Science and Technology, Guangdong Ocean University, Guangdong Provincial Key Laboratory of Aquatic Product Processing and Safety, Key Laboratory of Advanced Processing of Aquatic Products of Guangdong Higher Education Institution, Zhanjiang, China
| | - Lijun Sun
- College of Food Science and Technology, Guangdong Ocean University, Guangdong Provincial Key Laboratory of Aquatic Product Processing and Safety, Key Laboratory of Advanced Processing of Aquatic Products of Guangdong Higher Education Institution, Zhanjiang, China
| | - Yaling Wang
- College of Food Science and Technology, Guangdong Ocean University, Guangdong Provincial Key Laboratory of Aquatic Product Processing and Safety, Key Laboratory of Advanced Processing of Aquatic Products of Guangdong Higher Education Institution, Zhanjiang, China
| | - Ravi Gooneratne
- Department of Wine, Food and Molecular Biosciences, Faculty of Agriculture and Life Sciences, Lincoln University, Lincoln, New Zealand
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Peirano V, Bianco MN, Navarro A, Schelotto F, Varela G. Diarrheagenic Escherichia coli Associated with Acute Gastroenteritis in Children from Soriano, Uruguay. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2018; 2018:8387218. [PMID: 30515254 PMCID: PMC6234443 DOI: 10.1155/2018/8387218] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 09/07/2018] [Accepted: 10/04/2018] [Indexed: 02/04/2023]
Abstract
INTRODUCTION Acute diarrheal disease still deserves worldwide attention due to its high morbidity and mortality, especially in developing countries. While etiologic determination is not mandatory for management of all individual cases, it is needed for generating useful epidemiologic knowledge. Diarrheagenic Escherichia coli (DEC) are relevant enteropathogens, and their investigation requires specific procedures to which resources and training should be dedicated in reference laboratories. METHODOLOGY Following the hypothesis that enteric pathogens affecting children in towns located in the interior of Uruguay may be different from those found in Montevideo, we conducted a diagnostic survey on acute diarrheal disease in 83 children under 5 years of age from populations in the south of the country. RESULTS DEC pathotypes were the only bacterial pathogens found in diarrheal feces (20.48%), followed by rotavirus (14.45%) and enteric adenovirus (4.81%). Atypical EPEC (aEPEC) was the most frequent DEC pathotype identified, and unexpectedly, it was associated with bloody diarrheal cases. These patients were of concern and provided with early consultation, as were children who presented with vomiting, which occurred most frequently in rotavirus infections. aEPEC serotypes were diverse and different from those previously reported in Montevideo children within the same age group and different from serotypes identified in regional and international studies. Enteroinvasive (EIEC) O96 : H19, associated with large outbreaks in Europe, was also isolated from two patients. Antibiotic susceptibility of pathogenic bacteria identified in this study was higher than that observed in previous national studies, which had been mainly carried out in children from Montevideo. CONCLUSION The reduced number of detected species, the marked prevalence of aEPEC, the scarce resistance traits, and the diverse range of serotypes in the virulent DEC identified in this study confirm that differences exist between enteropathogens affecting children from interior towns of Uruguay and those circulating among children in Montevideo.
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Affiliation(s)
- Vivian Peirano
- Bacteriology and Virology Department, Hygiene Institute, Medicine Faculty, Universidad de la República, Uruguay
- Mercedes Hospital Laboratory, State Health Services Administration (ASSE), Uruguay
| | - María Noel Bianco
- Bacteriology and Virology Department, Hygiene Institute, Medicine Faculty, Universidad de la República, Uruguay
| | - Armando Navarro
- Public Health Department, Medicine Faculty, UNAM (Universidad Nacional Autónoma de Mexico), Mexico City, Mexico
| | - Felipe Schelotto
- Bacteriology and Virology Department, Hygiene Institute, Medicine Faculty, Universidad de la República, Uruguay
| | - Gustavo Varela
- Bacteriology and Virology Department, Hygiene Institute, Medicine Faculty, Universidad de la República, Uruguay
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Abstract
CONTEXT Cryptosporidium spp. is a zoonotic infection, now being recognized as a significant cause of diarrhea in both immunocompetent and immunocompromised hosts. However, there still exist significant knowledge gaps in its estimated global burden, epidemiology, diagnosis and management. EVIDENCE ACQUISITION A semi-systematic search was performed across PubMed to select studies on epidemiological burden of cryptosporidium diarrhea using the following keywords- ['crytosporidiosis' OR 'cryptosporidium'] AND ['diarrhea' OR 'diarrhoea']. Articles were included if participants were 'Humans', belonged to pediatric (0-18 y) age group, and were published after 1990. The results were compiled separately for acute and persistent diarrhea. RESULTS Cryptosporidium spp is commonly detected in stools of both cases (acute/ persistent diarrhea) and asymptomatic controls. The prevalence is higher in children with diarrhea than non-diarrheal controls (1.7-35% vs 0.3-15%); varying widely across different studies. The positivity rate is higher in younger children (<2 years) suffering from diarrhea. The main symptoms associated with cryptosporidiosis include fever, vomiting and abdominal pain with propensity for prolonged duration of diarrhea. It predisposes to malnutrition, which is also a risk factor for cryptosporidiosis. The prevalence is higher in HIV positive patients; certain socio-demographic factors play a more important role than mere geographical distribution for infection. CONCLUSION The high positivity rates during both acute and persistent diarrhea highlights the need to suspect this infection even in immunocompetent children.
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Gomes TAT, Elias WP, Scaletsky ICA, Guth BEC, Rodrigues JF, Piazza RMF, Ferreira LCS, Martinez MB. Diarrheagenic Escherichia coli. Braz J Microbiol 2016; 47 Suppl 1:3-30. [PMID: 27866935 PMCID: PMC5156508 DOI: 10.1016/j.bjm.2016.10.015] [Citation(s) in RCA: 233] [Impact Index Per Article: 29.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Accepted: 10/27/2016] [Indexed: 12/22/2022] Open
Abstract
Most Escherichia coli strains live harmlessly in the intestines and rarely cause disease in healthy individuals. Nonetheless, a number of pathogenic strains can cause diarrhea or extraintestinal diseases both in healthy and immunocompromised individuals. Diarrheal illnesses are a severe public health problem and a major cause of morbidity and mortality in infants and young children, especially in developing countries. E. coli strains that cause diarrhea have evolved by acquiring, through horizontal gene transfer, a particular set of characteristics that have successfully persisted in the host. According to the group of virulence determinants acquired, specific combinations were formed determining the currently known E. coli pathotypes, which are collectively known as diarrheagenic E. coli. In this review, we have gathered information on current definitions, serotypes, lineages, virulence mechanisms, epidemiology, and diagnosis of the major diarrheagenic E. coli pathotypes.
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Affiliation(s)
- Tânia A T Gomes
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Microbiologia, Imunologia e Parasitologia, São Paulo, SP, Brazil.
| | - Waldir P Elias
- Instituto Butantan, Laboratório de Bacterologia, São Paulo, SP, Brazil
| | - Isabel C A Scaletsky
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Microbiologia, Imunologia e Parasitologia, São Paulo, SP, Brazil
| | - Beatriz E C Guth
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Microbiologia, Imunologia e Parasitologia, São Paulo, SP, Brazil
| | - Juliana F Rodrigues
- Universidade de São Paulo, Instituto de Ciências Biomédicas, Departamento de Microbiologia, São Paulo, SP, Brazil
| | - Roxane M F Piazza
- Instituto Butantan, Laboratório de Bacterologia, São Paulo, SP, Brazil
| | - Luís C S Ferreira
- Universidade de São Paulo, Instituto de Ciências Biomédicas, Departamento de Microbiologia, São Paulo, SP, Brazil
| | - Marina B Martinez
- Universidade de São Paulo, Faculdade de Ciências Farmacêuticas, Departamento de Análises Clínicas e Toxicológicas, São Paulo, SP, Brazil
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Zheng S, Yu F, Chen X, Cui D, Cheng Y, Xie G, Yang X, Han D, Wang Y, Zhang W, Chen Y. Enteropathogens in children less than 5 years of age with acute diarrhea: a 5-year surveillance study in the Southeast Coast of China. BMC Infect Dis 2016; 16:434. [PMID: 27544130 PMCID: PMC4992557 DOI: 10.1186/s12879-016-1760-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 08/07/2016] [Indexed: 05/29/2023] Open
Abstract
Background Diarrhea is the second most common cause of death among children less than 5 years of age worldwide. The etiological agents of diarrhea in the southeast coastal area of China were studied from July 2009 to December 2014. Methods A total of the 2318 patients were enrolled in this study and examined for the presence of viruses, bacteria, and parasites. Multiplex real-time PCR was used for the detection of diarrheagenic Escherichia.coli (DEC). DEC strains were tested for susceptibility to a panel of 20 antibiotics using the Kirby-Bauer disc-diffusion method. Results Of the 2318 children with diarrhea, 962 (41.5 %) were positive for at least one pathogen. Rotavirus, human calicivirus (HucV), and DEC were predominant, with detection rates of 19.1 % (443), 17.7 % (411), and 7.6 % (177), respectively. The prevalences of various pathogens in patients of different ages and in different seasons were not the same. The resistance rates of 177 strains of DEC to ampicillin, tetracycline, and cefazolin were 93.2 %, 60.0 %, and 57.7 %, respectively. Conclusions Rotavirus, HucV, and DEC were the main pathogens associated with diarrhea in Zhejiang, China. DEC possessed high levels of antibiotic resistance. Increased monitoring of etiological agents of diarrhea is necessary.
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Affiliation(s)
- Shufa Zheng
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, No. 79, Qingchun Road, Hangzhou, 310003, People's Republic China.,Key Laboratory of Clinical In Vitro Diagnostic Techniques of Zhejiang Province, No. 79, Qingchun Road, Hangzhou, 310003, People's Republic China
| | - Fei Yu
- Key Laboratory of Clinical In Vitro Diagnostic Techniques of Zhejiang Province, No. 79, Qingchun Road, Hangzhou, 310003, People's Republic China
| | - Xiao Chen
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, No. 79, Qingchun Road, Hangzhou, 310003, People's Republic China.,Key Laboratory of Clinical In Vitro Diagnostic Techniques of Zhejiang Province, No. 79, Qingchun Road, Hangzhou, 310003, People's Republic China
| | - Dawei Cui
- Key Laboratory of Clinical In Vitro Diagnostic Techniques of Zhejiang Province, No. 79, Qingchun Road, Hangzhou, 310003, People's Republic China
| | - Yongzhang Cheng
- Center of Clinical Laboratory, Affiliated Children's Hospital, School of Medicine, Zhejiang University, No. 57, Zhuganxiang Road, Hangzhou, 310052, People's Republic China
| | - Guoliang Xie
- Key Laboratory of Clinical In Vitro Diagnostic Techniques of Zhejiang Province, No. 79, Qingchun Road, Hangzhou, 310003, People's Republic China
| | - Xianzhi Yang
- Key Laboratory of Clinical In Vitro Diagnostic Techniques of Zhejiang Province, No. 79, Qingchun Road, Hangzhou, 310003, People's Republic China
| | - Dongsheng Han
- Department of Clinical Laboratory, Northern Jiangsu People's Hospital, No. 98, Nantong West Road, Yangzhou, 225001, People's Republic China
| | - Yiyin Wang
- Key Laboratory of Clinical In Vitro Diagnostic Techniques of Zhejiang Province, No. 79, Qingchun Road, Hangzhou, 310003, People's Republic China
| | - Wen Zhang
- Key Laboratory of Clinical In Vitro Diagnostic Techniques of Zhejiang Province, No. 79, Qingchun Road, Hangzhou, 310003, People's Republic China
| | - Yu Chen
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, No. 79, Qingchun Road, Hangzhou, 310003, People's Republic China. .,Key Laboratory of Clinical In Vitro Diagnostic Techniques of Zhejiang Province, No. 79, Qingchun Road, Hangzhou, 310003, People's Republic China.
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12
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Rahimi E, Shirazi F, Khamesipour F. Isolation and Study of the Antibiotic Resistance Properties ofShigellaSpecies in Meat and Meat Products. J FOOD PROCESS PRES 2016. [DOI: 10.1111/jfpp.12947] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Ebrahim Rahimi
- Department of Food Hygiene, Faculty of Veterinary Medicine, Shahrekord Branch; Islamic Azad University; Shahrekord Iran
| | - Farzaneh Shirazi
- Department of Food Science and Technology, Faculty of Agriculture, Shahrekord Branch; Islamic Azad University; Shahrekord Iran
| | - Faham Khamesipour
- Cellular and Molecular Research Center; Sabzevar University of Medical Sciences; Sabzevar Iran
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Khosravi AD, Khaghani S, Sheikh AF, Ahmadzadeh A, Shamsizadeh A. Prevalence of Escherichia coli O157:H7 in Children with Bloody Diarrhea Referring to Abuzar Teaching Hospital, Ahvaz, Iran. J Clin Diagn Res 2016; 10:DC13-5. [PMID: 26894066 DOI: 10.7860/jcdr/2016/16689.7134] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 11/16/2015] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Escherichia coli O157: H7 are recognized as important aetiological agents of diarrhea in children, particularly in developed countries. AIM The aim of the study was to determine the rates of detection of E. coli O157: H7strains among children in Ahvaz, Iran. MATERIALS AND METHODS From June 2010 to December 2010, 137 diarrheal stool samples of children were collected. E.coli was identified by standard microbiological techniques. O157 or O157:H7 subtypes discerned by serological tests. RESULTS Of the 137 E. coli isolates, enteropathogens were found in 53 (38.7%) of the patients as follow: Shigella spp. (75.5%), EPEC (enteropathogenic E. coli) (16.9%), Campylobacter spp. (3.8%) and Salmonella spp. (3.8%). None of the isolated E. coli was O157:H7 serotype. CONCLUSION This shows that non-O157:H7 E. coli are the major cause of paediatric infections in this region of Iran.
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Affiliation(s)
- Azar Dokht Khosravi
- Professor, Department of Microbiology, School of Medicine & Health Research Institute, Infectious and Tropical Diseases Research Center , Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Soheila Khaghani
- Research Assistant, Health Research Institute, Infectious and Tropical Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences , Ahvaz, Iran
| | - Ahmad Farajzadeh Sheikh
- Associate Professor, Department of Microbiology, Ahvaz Jundishapur University of Medical Sciences , Ahvaz, Iran
| | - Ali Ahmadzadeh
- Professor, Department of Pediatric, School of Medicine, Ahvaz Jundishapour University of Medical Sciences , Ahvaz, Iran
| | - Ahmad Shamsizadeh
- Professor, Department of Pediatric, School of Medicine, Ahvaz Jundishapour University of Medical Sciences , Ahvaz, Iran
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Ianiro G, Delogu R, Baba M, Oderinde BS, Dawurung J, Ruggeri FM, Fiore L. Molecular characterization of group A rotavirus strains detected in children with diarrhea admitted to Nigerian hospitals in 2013. Arch Virol 2015; 160:1511-7. [PMID: 25772575 DOI: 10.1007/s00705-015-2389-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2014] [Accepted: 02/28/2015] [Indexed: 11/28/2022]
Abstract
Group A rotaviruses (RVA) are the leading cause of acute gastroenteritis (AGE) in children worldwide and cause up to 455,000 deaths annually, mostly in developing countries. During 2013, 66 RVAs from children with AGE admitted to four Nigerian hospitals were investigated. The G3P[6], G1P[8] and G2P[4] genotypes predominated. The VP7 and/or VP4 genes of 18 G3P[6]/[8]/[4], six G2P[4], three G12P[8]/[4], and two G1P[8] RVA strains were sequenced. The G3P[6] strains belonged to lineage G3-III and were different from G3 strains widespread in Asia. Phylogenetic analysis revealed substantial sequence conservation, suggesting continuing evolution and genomic reassortment but no zoonotic RVA transmission from animals.
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Affiliation(s)
- Giovanni Ianiro
- Istituto Superiore di Sanità, V.le Regina Elena, 299, 00161, Rome, Italy
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15
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Enteropathogens associated with acute diarrhea in children from households with high socioeconomic level in uruguay. Int J Microbiol 2015; 2015:592953. [PMID: 25861274 PMCID: PMC4377524 DOI: 10.1155/2015/592953] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Revised: 02/25/2015] [Accepted: 02/28/2015] [Indexed: 01/11/2023] Open
Abstract
Infectious diarrhea, a common disease of children, deserves permanent monitoring in all social groups. To know the etiology and clinical manifestations of acute diarrhea in children up to 5 years of age from high socioeconomic level households, we conducted a descriptive, microbiological, and clinical study.
Stools from 59 children with acute community-acquired diarrhea were examined, and their parents were interviewed concerning symptoms and signs. Rotavirus, adenovirus, and norovirus were detected by commercially available qualitative immunochromatographic lateral flow rapid tests. Salmonella, Campylobacter, Yersinia, and Shigella were investigated by standard bacteriological methods and diarrheagenic E. coli by PCR assays. We identified a potential enteric pathogen in 30 children. The most frequent causes of diarrhea were enteropathogenic E. coli (EPEC), viruses, Campylobacter, Salmonella, and Shiga-toxin-producing E. coli (STEC). Only 2 patients showed mixed infections. Our data suggest that children with viral or Campylobacter diarrhea were taken to the hospital earlier than those infected with EPEC. One child infected with STEC O26 developed “complete” HUS.
The microbiological results highlight the importance of zoonotic bacteria such as atypical EPEC, Campylobacter, STEC, and Salmonella as pathogens associated with acute diarrhea in these children. The findings also reinforce our previous communications about the regional importance of non-O157 STEC strains in severe infant food-borne diseases.
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Tort LFL, Victoria M, Lizasoain A A, Castells M, Maya L, Gómez MM, Arreseigor E, López P, Cristina J, Leite JPG, Colina R. Molecular epidemiology of group a rotavirus among children admitted to hospital in Salto, Uruguay, 2011-2012: First detection of the emerging genotype G12. J Med Virol 2015; 87:754-63. [DOI: 10.1002/jmv.24123] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2014] [Indexed: 12/13/2022]
Affiliation(s)
| | - Matías Victoria
- Molecular Virology Laboratory, North Regional; University of Republic; Salto Uruguay
| | - Andrés Lizasoain A
- Molecular Virology Laboratory, North Regional; University of Republic; Salto Uruguay
| | - Matías Castells
- Molecular Virology Laboratory, North Regional; University of Republic; Salto Uruguay
| | - Leticia Maya
- Molecular Virology Laboratory, North Regional; University of Republic; Salto Uruguay
| | - Mariela Martínez Gómez
- Laboratory of Comparative and Environmental Virology; Oswaldo Cruz Institute; Rio de Janeiro Brazil
| | | | - Patricia López
- Pediatric Unit of Regional Public Hospital; Salto Uruguay
| | - Juan Cristina
- Molecular Virology Laboratory, Faculty of Sciences; University of Republic; Montevideo Uruguay
| | | | - Rodney Colina
- Molecular Virology Laboratory, North Regional; University of Republic; Salto Uruguay
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Ogunshe A, Adinmonyema P. Evaluation of bacteriostatic potency of expired oral paediatric antibiotics and implications on infant health. Pan Afr Med J 2014; 19:378. [PMID: 25977741 PMCID: PMC4427466 DOI: 10.11604/pamj.2014.19.378.2156] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2012] [Accepted: 07/06/2013] [Indexed: 11/25/2022] Open
Abstract
Introduction In spite of significant risks, as well as non-clinical importance due to loss of potency, stiff penalties against administration of expired medications are still not appropriately enforced by health policy makers in many developing countries, possibly because of little evidence to support that expired medications are hazardous. The purpose of this study therefore, was to investigate the effect of expiration dates on in vitro bacteriostatic potentials of oral paediatric antibiotics. Methods Comparative bacteriostatic potentials of 31 expired and seven corresponding unexpired oral paediatric antibiotics were determined on infantile diarrhoeagenic bacteria, using a modification of agar well-diffusion method. Results Verall total percentage in vitro resistance rates against expired and unexpired paediatric antibiotics respectively were - E. coli (≤100% vs. ≤15.9%), Klebsiella pneumoniae (≤100% vs. ≤31.3%), Proteus mirabilis (≤91.7% vs. ≤41.7%) and Staphylococcus aureus (≤100% vs. ≤18.2%). Resistance rates of 45.5-55.8% (sulfamethoxazole + trimethoprim 5), 39.5-63.6% (amoxycillin 6), 46.5-54.5% (cotrimoxazole 7), 37.5-63.6% (ampicillin + cloxacillin 18), and higher resistance rates of ≥75.0-100% were exhibited towards remaining expired antibiotics. Higher total resistance and multiple antibiotic resistance (MAR) rates were also recorded against expired antibiotics (45.2-93.5%) compared to unexpired antibiotics (28.6-57.2%), except for few strains of E. coli and Proteus mirabilis. Furthermore, unexpired paediatric antibiotics exhibited wider zones of inhibition towards the test diarrhoeagenic bacteria (≥25.0 mm diameter). Conclusion This study provided preliminary microbiological results on the appreciable reduction in in vitro bacteriostatic potentials, as well as higher resistance and multiple antibiotic resistance rates among expired oral paediatric antibiotics on infantile diarrhoeagenic bacteria. Apart from less-efficacy, administration of expired antibiotics can lead to increased antibiotic resistance and clinical treatment failure, as well as adverse drug reactions.
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Affiliation(s)
- Adenike Ogunshe
- Applied Microbiology and Infectious Diseases, Department of Microbiology, Faculty of Science, University of Ibadan, Ibadan, Nigeria
| | - Patience Adinmonyema
- Applied Microbiology and Infectious Diseases, Department of Microbiology, Faculty of Science, University of Ibadan, Ibadan, Nigeria
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Vasco G, Trueba G, Atherton R, Calvopiña M, Cevallos W, Andrade T, Eguiguren M, Eisenberg JNS. Identifying etiological agents causing diarrhea in low income Ecuadorian communities. Am J Trop Med Hyg 2014; 91:563-9. [PMID: 25048373 PMCID: PMC4155560 DOI: 10.4269/ajtmh.13-0744] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2013] [Accepted: 06/16/2014] [Indexed: 12/26/2022] Open
Abstract
Continued success in decreasing diarrheal disease burden requires targeted interventions. To develop such interventions, it is crucial to understand which pathogens cause diarrhea. Using a case-control design we tested stool samples, collected in both rural and urban Ecuador, for 15 pathogenic microorganisms. Pathogens were present in 51% of case and 27% of control samples from the urban community, and 62% of case and 18% of control samples collected from the rural community. Rotavirus and Shigellae were associated with diarrhea in the urban community; co-infections were more pathogenic than single infection; Campylobacter and Entamoeba histolytica were found in large numbers in cases and controls; and non-typhi Salmonella and enteropathogenic Escherichia coli were not found in any samples. Consistent with the Global Enteric Multicenter Study, focused in south Asia and sub-Saharan Africa, we found that in Ecuador a small group of pathogens accounted for a significant amount of the diarrheal disease burden.
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Affiliation(s)
- Gabriela Vasco
- Microbiology Institute, Universidad San Francisco de Quito, Quito, Ecuador; Centro de Biomedicina, Universidad Central del Ecuador, Quito, Ecuador; Department of Epidemiology, University of Michigan, Ann Arbor, Michigan; Centro de Salud de Guamaní, Ministerio de Salud Pública, Quito, Ecuador
| | - Gabriel Trueba
- Microbiology Institute, Universidad San Francisco de Quito, Quito, Ecuador; Centro de Biomedicina, Universidad Central del Ecuador, Quito, Ecuador; Department of Epidemiology, University of Michigan, Ann Arbor, Michigan; Centro de Salud de Guamaní, Ministerio de Salud Pública, Quito, Ecuador
| | - Richard Atherton
- Microbiology Institute, Universidad San Francisco de Quito, Quito, Ecuador; Centro de Biomedicina, Universidad Central del Ecuador, Quito, Ecuador; Department of Epidemiology, University of Michigan, Ann Arbor, Michigan; Centro de Salud de Guamaní, Ministerio de Salud Pública, Quito, Ecuador
| | - Manuel Calvopiña
- Microbiology Institute, Universidad San Francisco de Quito, Quito, Ecuador; Centro de Biomedicina, Universidad Central del Ecuador, Quito, Ecuador; Department of Epidemiology, University of Michigan, Ann Arbor, Michigan; Centro de Salud de Guamaní, Ministerio de Salud Pública, Quito, Ecuador
| | - William Cevallos
- Microbiology Institute, Universidad San Francisco de Quito, Quito, Ecuador; Centro de Biomedicina, Universidad Central del Ecuador, Quito, Ecuador; Department of Epidemiology, University of Michigan, Ann Arbor, Michigan; Centro de Salud de Guamaní, Ministerio de Salud Pública, Quito, Ecuador
| | - Thamara Andrade
- Microbiology Institute, Universidad San Francisco de Quito, Quito, Ecuador; Centro de Biomedicina, Universidad Central del Ecuador, Quito, Ecuador; Department of Epidemiology, University of Michigan, Ann Arbor, Michigan; Centro de Salud de Guamaní, Ministerio de Salud Pública, Quito, Ecuador
| | - Martha Eguiguren
- Microbiology Institute, Universidad San Francisco de Quito, Quito, Ecuador; Centro de Biomedicina, Universidad Central del Ecuador, Quito, Ecuador; Department of Epidemiology, University of Michigan, Ann Arbor, Michigan; Centro de Salud de Guamaní, Ministerio de Salud Pública, Quito, Ecuador
| | - Joseph N S Eisenberg
- Microbiology Institute, Universidad San Francisco de Quito, Quito, Ecuador; Centro de Biomedicina, Universidad Central del Ecuador, Quito, Ecuador; Department of Epidemiology, University of Michigan, Ann Arbor, Michigan; Centro de Salud de Guamaní, Ministerio de Salud Pública, Quito, Ecuador
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Khan S, Singh P, Ansari M, Asthana A. Isolation of Shigella species and their resistance patterns to a panel of fifteen antibiotics in mid and far western region of Nepal. ASIAN PACIFIC JOURNAL OF TROPICAL DISEASE 2014. [DOI: 10.1016/s2222-1808(14)60309-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Khan S, Singh P, Asthana A, Ansari M. Magnitude of drug resistant shigellosis in Nepalese patients. IRANIAN JOURNAL OF MICROBIOLOGY 2013; 5:334-8. [PMID: 25848501 PMCID: PMC4385157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND AND OBJECTIVES Shigella plays an important role as a causative organism of acute gastroenteritis, in children and others. Rapid emergence of antibiotic resistance warrants continuous monitoring of susceptibility pattern of bacterial isolates. We report here our findings about Shigella spp. isolates and their drug resistance patterns in Nepalese patients. MATERIALS AND METHODS The study was conducted on 507 Nepalese patients with acute gastroenteritis attending outpatient and inpatient departments of Nepalgunj Medical college and teaching Hospital, Banke, Nepal from September 2011 to April 2013. Stool specimens were processed for isolation and identification of Shigella species following the standard microbiological methods while the disc diffusion test was used to determine antimicrobial resistance patterns of the recovered isolates at the central Laboratory of Microbiology. RESULTS Sixty nine isolates were identified as Shigella species. S. flexneri, S. dysenteriae, S. boydii and S. sonnei accounted, respectively, for 42.03%, 27.54%, 21.74% and 8.70% of the total number of Shigella isolates. Resistance to nalidixic acid (95.65%), ampicillin (85.51%), co-trimoxazole (82.61%) and ciprofloxacin (47.83%) was observed. Among 69 isolates, 29 (42.03%) were from children aged 1-10 years and this group was statistically significant (P < 0.05), compared to the other age groups. CONCLUSIONS The study revealed endemicity of shigellosis with S. flexneri as the predominant serogroup in Nepalese patients. Children were at a higher risk of severe shigellosis. Nalidixic acid, ampicillin, co-trimoxazole and ciprofloxacin should not be used empirically as the first line drugs in treatment of shigellosis. Continuous local monitoring of resistance patterns is necessary for the appropriate selection of empirical antimicrobial therapy.
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Affiliation(s)
- Salman Khan
- Department of Microbiology, Nepalgunj Medical College, Nepal
| | - Priti Singh
- Department of Biochemistry, Nepalgunj Medical College, Nepal
| | - Asnish Asthana
- Department of Microbiology, Neta ji Subhash Chandra bose subharti Medical College, Swami Vivekanand Subharti University, India
| | - Mukhtar Ansari
- Department of Pharmacology, National Medical College, Nepal
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Hernandez-Doria JD, Sperandio V. Nutrient and chemical sensing by intestinal pathogens. Microbes Infect 2013; 15:759-64. [PMID: 23850657 PMCID: PMC3803155 DOI: 10.1016/j.micinf.2013.06.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2013] [Revised: 06/27/2013] [Accepted: 06/28/2013] [Indexed: 02/08/2023]
Abstract
Pathogenic gut bacteria, such as those comprising the Enterobacteriaceae family, have evolved sophisticated virulence mechanisms, including nutrient and chemical sensing, to escape host defense strategies and produce disease. In this review we describe the mechanisms utilized by the enteric pathogen enterohemorrhagic Escherichia coli (EHEC) O157:H7 to achieve successful colonization of its mammalian host.
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Affiliation(s)
- Juan D. Hernandez-Doria
- Departments of Microbiology and Biochemistry, University of Texas Southwestern Medical Center, 75390-9048 Dallas, Texas USA
| | - Vanessa Sperandio
- Departments of Microbiology and Biochemistry, University of Texas Southwestern Medical Center, 75390-9048 Dallas, Texas USA
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Sousa MÂB, Mendes EN, Collares GB, Péret-Filho LA, Penna FJ, Magalhães PP. Shigella in Brazilian children with acute diarrhoea: prevalence, antimicrobial resistance and virulence genes. Mem Inst Oswaldo Cruz 2013; 108:30-5. [PMID: 23440111 PMCID: PMC3974317 DOI: 10.1590/s0074-02762013000100005] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2012] [Accepted: 08/22/2012] [Indexed: 11/30/2022] Open
Abstract
Diarrhoeal disease is still considered a major cause of morbidity and mortality among children. Among diarrhoeagenic agents, Shigella should be highlighted due to its prevalence and the severity of the associated disease. Here, we assessed Shigella prevalence, drug susceptibility and virulence factors. Faeces from 157 children with diarrhoea who sought treatment at the Children's Hospital João Paulo II, a reference children´s hospital in Belo Horizonte, state of Minas Gerais, Brazil, were cultured and drug susceptibility of the Shigella isolates was determined by the disk diffusion technique. Shigella virulence markers were identified by polymerase chain reaction. The bacterium was recovered from 10.8% of the children (88.2% Shigella sonnei). The ipaH, iuc, sen and ial genes were detected in strains isolated from all shigellosis patients; set1A was only detected in Shigella flexneri. Additionally, patients were infected by Shigella strains of different ial, sat, sen and set1A genotypes. Compared to previous studies, we observed a marked shift in the distribution of species from S. flexneri to S. sonnei and high rates of trimethoprim/sulfamethoxazole resistance.
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Affiliation(s)
- Mireille Ângela Bernardes Sousa
- Departamento de Microbiologia, Instituto de Ciências Biológicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
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Filip R, Chihu-Amparan L, Coman G, Velázquez ME, Silva J. Molecular Characterization of β-lactam Resistance ofSalmonellaIsolates from Pediatric Patients in Romania. J Chemother 2013; 16:337-42. [PMID: 15332707 DOI: 10.1179/joc.2004.16.4.337] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
The molecular characterization of 16 clinical isolates of Salmonella enterica (14 serotype Typhimurium and 2 serotype Kingston) obtained between January and June 1999 from feces of children hospitalized in Iasi, Romania were genotypically compared by pulse field gel electrophoresis of XbaI restricted bacterial DNA. The majority of the clinical isolates (12/16) belonged to cluster A and (4/16) to unrelated strains, correlating to the OMP profile. Two major different patterns of beta-lactamases were identified: the first with pI of 5.4, 8.2 in 6/16 strains and the second with pI of 5.4 in 5/16. The blaTEM beta-lactamase was identified in 14/16 of the clinical isolates and the blaSHV-5 gene in one strain. We concluded that extended spectrum beta-lactamase (ESBL) with pIs of 8.2 was the most frequent enzyme produced by serotype Typhimurium isolates which were related.
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Affiliation(s)
- R Filip
- Department of Microbiology, Faculty of Medicine, University of Medicine and Pharmacy Gr.T. Popa Iasi, Romania
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Gonzales L, Joffre E, Rivera R, Sjöling Å, Svennerholm AM, Iñiguez V. Prevalence, seasonality and severity of disease caused by pathogenic Escherichia coli in children with diarrhoea in Bolivia. J Med Microbiol 2013; 62:1697-1706. [PMID: 23851188 DOI: 10.1099/jmm.0.060798-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The prevalence of infection caused by different categories of diarrhoeagenic E. coli (DEC) strains, including enteroaggregative (EAEC), enteropathogenic (EPEC), enterotoxigenic (ETEC), enteroinvasive (EIEC) and enterohaemorrhagic (EHEC) E. coli, in children who suffered from diarrhoea (n = 3943) or did not have diarrhoea (n = 1026) were analysed in two areas in Bolivia over a period of 4 years. We also analysed the seasonality of DEC infections and severity of diarrhoea in children with DEC infection and compared antibiotic resistance in DEC strains isolated from children with and without diarrhoea. Stool samples were analysed for the presence of DEC by culturing followed by PCR. The most prevalent DEC categories in samples from the children were: EAEC (11.2 %); ETEC (6.6 %); EPEC (5.8 %); and EIEC and EHEC (<1 %). DEC strains were isolated significantly more often from diarrhoea cases (21.6 %) than from controls (17.6 %; P = 0.002). The number of children with diarrhoea associated with EAEC, EPEC and ETEC infections peaked in the Bolivian winter (April-September), although the proportion of DEC-positive stool samples was higher during the warm rainy season (October-March). High levels of antibiotic resistance were detected among the DEC strains. In particular, resistance to tetracycline and sulfamethoxazole-trimethoprim was significantly higher in strains isolated from individuals with diarrhoea than in samples from controls. The severity of disease in children infected with EAEC, EPEC and ETEC varied from mild to severe diarrhoea, although disease severity did not differ significantly between the different DEC categories. ETEC, EPEC and EAEC are commonly found in Bolivia and may cause severe disease in children.
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Affiliation(s)
- Lucia Gonzales
- Instituto de Biología Molecular y Biotecnología, Universidad Mayor de San Andrés, Facultad de Ciencias Puras y Naturales, Campus Universitario Cota-Cota, Calle 27 s/n La Paz, Bolivia.,Department of Microbiology and Immunology, Institute of Biomedicine, University of Gothenburg, Box 435, 405 30 Gothenburg, Sweden
| | - Enrique Joffre
- Instituto de Biología Molecular y Biotecnología, Universidad Mayor de San Andrés, Facultad de Ciencias Puras y Naturales, Campus Universitario Cota-Cota, Calle 27 s/n La Paz, Bolivia.,Department of Microbiology and Immunology, Institute of Biomedicine, University of Gothenburg, Box 435, 405 30 Gothenburg, Sweden
| | - Rosario Rivera
- Instituto de Biología Molecular y Biotecnología, Universidad Mayor de San Andrés, Facultad de Ciencias Puras y Naturales, Campus Universitario Cota-Cota, Calle 27 s/n La Paz, Bolivia
| | - Åsa Sjöling
- Department of Microbiology and Immunology, Institute of Biomedicine, University of Gothenburg, Box 435, 405 30 Gothenburg, Sweden
| | - Ann-Mari Svennerholm
- Department of Microbiology and Immunology, Institute of Biomedicine, University of Gothenburg, Box 435, 405 30 Gothenburg, Sweden
| | - Volga Iñiguez
- Instituto de Biología Molecular y Biotecnología, Universidad Mayor de San Andrés, Facultad de Ciencias Puras y Naturales, Campus Universitario Cota-Cota, Calle 27 s/n La Paz, Bolivia
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Fletcher SM, McLaws ML, Ellis JT. Prevalence of gastrointestinal pathogens in developed and developing countries: systematic review and meta-analysis. J Public Health Res 2013; 2:42-53. [PMID: 25170480 PMCID: PMC4140330 DOI: 10.4081/jphr.2013.e9] [Citation(s) in RCA: 85] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2013] [Accepted: 05/14/2013] [Indexed: 12/13/2022] Open
Abstract
ABSTRACT Diarrhoeal illness is a leading cause of child mortality and morbidity worldwide. There are no precise or current estimates of the types and prevalence of pathogens associated with diarrheal illnesses in developed and developing settings. This systematic review assessed data from 60 studies published in the English language from five developing regions and developed countries worldwide to provide regional estimates of enteric pathogens affecting children. The random-effect method was used to establish the weighted average prevalence of pathogens in adults and children for each region. Significantly more pathogens were reported by studies from developing regions compared with Organisation for Economic Co-operation and Development countries (P<0.016). The identification rates of pathogens from community based and hospital based studies were similar (58.5% and 58.1% respectively, P<0.619). The overall detection of enteric pathogens in developing countries was higher in adults (74.8%; 95% CI 63.1-83.8%) compared with children (56.7%; 95% CI 53.0-60.4%) (P<0.001). Rotavirus was the most frequently detected pathogen in all regions with the highest rate, 24.8% (95% CI 18.0-33.1%), detected in the developed countries. This systematic review is the first to provide an estimate of the prevalence of enteric pathogens associated with diarrhoeal illnesses in adults and children in developed and developing settings. While pathogen detection rate is greater in developing regions the consistently high prevalence of rotavirus in both developed and developing settings underscores the urgent need for access to rotavirus vaccines. Increased travel between developing and developed countries increases disease risk, and hence developed countries have a vested interest in supporting vaccine accessibility in developing settings.
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Affiliation(s)
- Stephanie M. Fletcher
- The iThree Institute and School of Medical and Molecular Biosciences, University of Technology, Sydney
| | | | - John T. Ellis
- The iThree Institute and School of Medical and Molecular Biosciences, University of Technology, Sydney
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Bhavnani D, Goldstick JE, Cevallos W, Trueba G, Eisenberg JNS. Synergistic effects between rotavirus and coinfecting pathogens on diarrheal disease: evidence from a community-based study in northwestern Ecuador. Am J Epidemiol 2012; 176:387-95. [PMID: 22842722 PMCID: PMC3499114 DOI: 10.1093/aje/kws220] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2011] [Accepted: 02/17/2012] [Indexed: 12/12/2022] Open
Abstract
In developing countries where diarrheal disease is a leading cause of morbidity and mortality in children under 5 years of age, enteric coinfection is common. There is little understanding, however, of the biologic interaction between coinfecting pathogens. The authors investigated the potential for synergistic interaction between coinfecting pathogens on diarrhea pathogenesis using an epidemiologic framework. They conducted community-based, case-control studies in 22 communities in northwestern Ecuador between 2003 and 2008. Risk ratios of diarrhea associated with single infections and coinfections were estimated. Interaction between coinfecting pathogens was assessed through departure from risk ratio additivity and multiplicativity after adjustment for age. On the additive scale, the authors found departure from the null value of 0 for rotavirus-Giardia coinfections (interaction contrast ratio = 8.0, 95% confidence interval: 3.1, 18.9) and for rotavirus-Escherichia coli coinfections (interaction contrast ratio = 9.9, 95% confidence interval: 2.6, 28.4). On the multiplicative scale, they found departure from the value of 1 for rotavirus-Giardia coinfections (multiplicative interaction = 3.6, 95% confidence interval: 1.3, 8.7). This research provides epidemiologic evidence for synergism between rotavirus and other enteric pathogens. During coinfection, the pathogenic potential of each organism appears to be enhanced. The potential for pathogenesis to be more severe in the presence of a rotavirus coinfection amplifies the need for rotavirus vaccination.
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Affiliation(s)
| | | | | | | | - Joseph N. S. Eisenberg
- Correspondence to Dr. Joseph N. S. Eisenberg, M5065 SPH II, Department of Epidemiology, University of Michigan School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109-2029 (e-mail: )
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Sinha A, SenGupta S, Guin S, Dutta S, Ghosh S, Mukherjee P, Mukhopadhyay AK, Ramamurthy T, Takeda Y, Kurakawa T, Nomoto K, Nair GB, Nandy RK. Culture-independent real-time PCR reveals extensive polymicrobial infections in hospitalized diarrhoea cases in Kolkata, India. Clin Microbiol Infect 2012; 19:173-80. [PMID: 22268636 DOI: 10.1111/j.1469-0691.2011.03746.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Culture-independent identification of diarrhoeal aetiological agents was performed using DNA harvested from diarrhoeal stool specimens with SYBR-Green-based real-time PCR targeting Vibrio cholerae, Vibrio parahaemolyticus, Campylobacter spp., Shigella spp. and three different pathotypes of diarrhoeagenic Escherichia coli. Conventional culture-dependent methods detected bacterial enteropathogens in 68 of 122 diarrhoeal stool specimens. Of 68 specimens, 59 (86.8%) had a single pathogen and the remaining nine (13.2%) had polymicrobial infections with multiple pathogens. Re-analysis of the 68 specimens by culture-independent real-time PCR methods showed that 25 (36.8%) specimens contained single pathogen and 43 (63.2%) specimens contained mixed infections with multiple pathogens. The prevalence of such high levels of polymicrobial infections would not have been detected without using real-time PCR. Culture-dependent analysis assigned 54 of the 122 selected archived specimens as 'no known aetiology'. However, re-analysis of these samples by real-time PCR showed the presence of single or multiple pathogens among 34 (63%) of these specimens. Estimation of relative pathogen load by real-time PCR in the stool specimens indicated that the inability of conventional culture-dependent methods to detect the pathogens was related to lower colony-forming units of the pathogen, as reflected by lower C(t) values. Detection of high levels of polymicrobial infection by real-time PCR indicates that in the settings like Kolkata and its surroundings, where cholera and other enteric diseases are endemic, the concept of one pathogen one disease might need to be re-evaluated.
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Affiliation(s)
- A Sinha
- National Institute of Cholera and Enteric Diseases, Kolkata, India
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Analysis of global transcriptional profiles of enterotoxigenic Escherichia coli isolate E24377A. Infect Immun 2012; 80:1232-42. [PMID: 22215741 DOI: 10.1128/iai.06138-11] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Enterotoxigenic Escherichia coli (ETEC) is an important pathogenic variant (pathovar) of E. coli in developing countries from a human health perspective, causing significant morbidity and mortality. Previous studies have examined specific regulatory networks in ETEC, although little is known about the global effects of inter- and intrakingdom signaling on the expression of virulence and colonization factors in ETEC. In this study, an E. coli/Shigella pan-genome microarray, combined with quantitative reverse transcriptase PCR (qRT-PCR) and RNA sequencing (RNA-seq), was used to quantify the expression of ETEC virulence and colonization factors. Biologically relevant chemical signals were combined with ETEC isolate E24377A during growth in either Luria broth (LB) or Dulbecco's modified Eagle medium (DMEM), and transcription was examined during different phases of the growth cycle; chemical signals examined included glucose, bile salts, and preconditioned media from E. coli/Shigella isolates. The results demonstrate that the presence of bile salts, which are found in the intestine and thought to be bactericidal, upregulates the expression of many ETEC virulence factors, including heat-stable (estA) and heat-labile (eltA) enterotoxin genes. In contrast, the ETEC colonization factors CS1 and CS3 were downregulated in the presence of bile, consistent with findings in studies of other enteric pathogens. RNA-seq analysis demonstrated that one of the most differentially expressed genes in the presence of bile is a unique plasmid-encoded AraC-like transcriptional regulator (peaR); other previously unknown genetic elements were found as well. These results provide transcriptional targets and putative mechanisms that should help improve understanding of the global regulatory networks and virulence expression in this important human pathogen.
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O'Ryan M, Lucero Y, O'Ryan-Soriano MA, Ashkenazi S. An update on management of severe acute infectious gastroenteritis in children. Expert Rev Anti Infect Ther 2010; 8:671-82. [PMID: 20521895 DOI: 10.1586/eri.10.40] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
This article focuses on clinical and diagnostic aspects relevant to severe acute infectious gastroenteritis in children and will update treatment strategies focused on, although not limited to, anti-infective therapy. For the purposes of this article we will consider severe acute infectious gastroenteritis as follows: watery diarrhea accompanied by, or at high risk for, moderate to severe dehydration due to abrupt onset of vomiting that reduces oral intake, and/or frequent emission of liquid stools, or moderate to severe dysenteric/bloody diarrhea with moderate to high-grade fever. The article will not include food poisoning associated with bacterial toxins and will only briefly discuss oral rehydration strategies and intravenous solutions. The article will also briefly discuss current preventive measures against rotavirus gastroenteritis through vaccination, a topic that has been extensively discussed elsewhere.
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Affiliation(s)
- Miguel O'Ryan
- Institute of Biomedical Sciences, Faculty of Medicine, University of Chile, Santiago, Chile.
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Diagnosis and prevalence of enteropathogenic bacteria in children less than 5 years of age with acute diarrhea in Tehran children's hospitals. J Infect 2009; 58:21-7. [DOI: 10.1016/j.jinf.2008.10.013] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2007] [Revised: 08/22/2008] [Accepted: 10/14/2008] [Indexed: 11/20/2022]
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Orrett FA. Prevalence of Shigella serogroups and their antimicrobial resistance patterns in southern Trinidad. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2008; 26:456-462. [PMID: 19069625 PMCID: PMC2740689 DOI: 10.3329/jhpn.v26i4.1889] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The serogroup distribution and antimicrobial susceptibility patterns of Shigella isolates obtained from stool specimens of persons with acute diarrhoea in community-based studies from southern Trinidad during 1997-2006 were reviewed. Of the 5,187 stool specimens, 392 (8%) were positive for Shigella organisms. From these 392 isolates, 88.8% were recovered from children aged >0-10 year(s). Shigella sonnei was the most frequently-isolated serogroup (75%), followed by S. flexneri (19%), S. boydii (4.1%), and S. dysenteriae (1.8%). S. flexneri was the major isolate among the >20-30 years age-group. The most common drug resistance among all age-groups was to ampicillin. All strains of S. flexneri, S. boydii, and S. dysenteriae were fully susceptible to aztreonam, gentamicin, and ciprofloxacin. S. sonnei, the most common species isolated, showed resistance to all antibiotics tested. The data showed that, throughout the study period, the resistance to commonly-used drugs was relatively low. Since resistance to several drugs seems to be emerging, continuous monitoring of resistance patterns is mandatory for the appropriate selection of empiric antimicrobial drugs in the therapy of suspected cases of shigellosis.
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Affiliation(s)
- Fitzroy A Orrett
- Department of Paraclinical Sciences, Unit of Pathology and Microbiology, Faculty of Medical Sciences, University of the West Indies, St. Augustine, Trinidad and Tobago.
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Koh H, Baek SY, Shin JI, Chung KS, Jee YM. Coinfection of viral agents in Korean children with acute watery diarrhea. J Korean Med Sci 2008; 23:937-40. [PMID: 19119432 PMCID: PMC2610655 DOI: 10.3346/jkms.2008.23.6.937] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2008] [Accepted: 05/02/2008] [Indexed: 11/25/2022] Open
Abstract
Currently, there are a few reports on viral coinfection that causes an acute watery diarrhea in Korean children. So, to evaluate the features of coinfectious viral agents in children with acute watery diarrhea, we enrolled 155 children with acute watery diarrhea from July 2005 to June 2006. Fecal samples were collected and evaluated for various viral infections such as rotavirus, norovirus, adenovirus and astrovirus. The mean (+/-standard deviation) age of the children was 2.71+/-2.37 yr. The detection rate of viral agents was most common in children between the ages of 1 and 3 yr. Rotavirus was detected in 63 children (41.3%), norovirus in 56 (36.2%), adenovirus in 11 (7.1%), and astrovirus in 1 (0.6%). Regarding rotavirus, there were 38 (60.3%) cases with monoinfection and 25 (39.7%) with coinfection. For norovirus, there were 33 (58.9%) cases with monoinfection and 23 (41.1%) with coinfection. Coinfection with rotavirus and norovirus was most common, and occurred in 20/155 cases (12.9%) including coinfection with adenovirus. So, rotavirus and norovirus were the most common coinfectious viral agents in our study population with acute watery diarrhea.
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Affiliation(s)
- Hong Koh
- Department of Pediatrics, Yonsei University College of Medicine, Severance Children's Hospital, Seoul, Korea
| | - Seoung Yon Baek
- Department of Pediatrics, Yonsei University College of Medicine, Severance Children's Hospital, Seoul, Korea
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Severance Children's Hospital, Seoul, Korea
| | - Ki Sup Chung
- Department of Pediatrics, Yonsei University College of Medicine, Severance Children's Hospital, Seoul, Korea
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Paniagua GL, Monroy E, García-González O, Alonso J, Negrete E, Vaca S. Two or more enteropathogens are associated with diarrhoea in Mexican children. Ann Clin Microbiol Antimicrob 2007; 6:17. [PMID: 18162140 PMCID: PMC2246149 DOI: 10.1186/1476-0711-6-17] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2007] [Accepted: 12/28/2007] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Diarrhoeal diseases constitute a major public health problem, particularly in the developing world, where the rate of mortality and morbidity is very high. The purpose of this study was to conduct a 2 years and 3 months study in order to determine the prevalence of five enteropathogen diarrheogenic agents in Mexico City. METHODS Faecal samples were obtained from 300 Mexican children diagnosed as positive for diarrhoea, aged > 2 to < 12 years old, and from 80 children matched for age but with no symptoms of the disease (control group). Two multiplex PCR were used to detect Escherichia coli, Salmonella spp., and Shigella spp. In addition, the two protozoan parasites Entamoeba histolytica/Entamoeba dispar and Giardia intestinalis were detected by conventional methods. RESULTS All diarrhoeal samples were positive for one or more enteropathogens. The most common enteropathogens in diarrhoeal samples were E. histolytica/E. dispar (70.3%), Salmonella (ohio 28.3%; typhimurium 16.3%; infantis 8%; anatum 0.6%; Newport 0.3%), G. intestinalis (33%), E. coli (ETEC 13.3%; EPEC 9.3%; VTEC 8.6%; EIEC 1%) and Shigella spp. (flexneri 1.6%, sonnei 1%). Infections by two (24%) three (16%) and four (12%) pathogens were observed. CONCLUSION This study revealed that 52% of the patients were infected by more than one enteropathogen, notably E. histolitica/E. dispar and Salmonella ohio. These results are useful for clinicians to improve the empiric treatment used in such cases.
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Affiliation(s)
- Gloria Luz Paniagua
- Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Avenida de Los Barrios, 1, Los Reyes Iztacala, Tlalnepantla, 54090, Estado de Mexico, Mexico.
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Abstract
Cryptosporidium is a coccidian protozoan parasite of the intestinal tract that causes severe and sometimes fatal watery diarrhea in immunocompromised patients, and self-limiting but prolonged diarrheal disease in immunocompetent individuals. It exists naturally in animals and can be zoonotic. Although cryptosporidiosis is a significant cause of diarrheal diseases in both developing and developed countries, it is more prevalent in developing countries and in tropical environments. We examined the epidemiology and disease burden of Cryptosporidium in Saudi Arabia and neighboring countries by reviewing 23 published studies of Cryptosporidium and the etiology of diarrhea between 1986 and 2006. The prevalence of Cryptosporidium infection in humans ranged from 1% to 37% with a median of 4%, while in animals it was different for different species of animals and geographic locations of the studies. Most cases of cryptosporidiosis occurred among children less than 7 years of age, and particularly in the first two years of life. The seasonality of Cryptosporidium varied depending on the geographic locations of the studies, but it was generally most prevalent in the rainy season. The most commonly identified species was Cryptosporidium parvum while C. hominis was detected in only one study from Kuwait. The cumulative experience from Saudi Arabia and four neighboring countries (Kuwait, Oman, Jordan and Iraq) suggest that Cryptosporidium is an important cause of diarrhea in humans and cattle. However, the findings of this review also demonstrate the limitations of the available data regarding Cryptosporidium species and strains in circulation in these countries.
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Affiliation(s)
- Mohammed Y Areeshi
- Department of Medical Microbiology, University of Liverpool, United Kingdom.
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Vieira N, Bates SJ, Solberg OD, Ponce K, Howsmon R, Cevallos W, Trueba G, Riley L, Eisenberg JNS. High prevalence of enteroinvasive Escherichia coli isolated in a remote region of northern coastal Ecuador. Am J Trop Med Hyg 2007; 76:528-33. [PMID: 17360879 PMCID: PMC2396511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023] Open
Abstract
Enteroinvasive Escherichia coli (EIEC) causes dysentery; however, it is less widely reported than other etiological agents in studies of diarrhea worldwide. Between August 2003 and July 2005, stool samples were collected in case-control studies in 22 rural communities in northwestern Ecuador. Infection was assessed by PCR specific for LT and STa genes of enterotoxigenic E. coli (ETEC), the bfp gene of enteropathogenic E. coli (EPEC), and the ipaH gene of both enteroinvasive E. coli and Shigellae. The pathogenic E. coli most frequently identified were EIEC (3.2 cases/100 persons) and Shigellae (1.5 cases/100 persons), followed by ETEC (1.3 cases/100 persons), and EPEC (0.9 case/100 persons). EIEC exhibited similar risk-factor relationships with other pathotypes analyzed but different age-specific infection rates. EIEC was the predominant diarrheagenic bacteria isolated in our community-based study, a unique observation compared with other regions of the world.
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Affiliation(s)
- Nadia Vieira
- Universidad San Francisco de Quito, Vía Interoceánica, Círculo Cumbayá, Quito, Ecuador
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Alikhani MY, Mirsalehian A, Fatollahzadeh B, Pourshafie MR, Aslani MM. Prevalence of enteropathogenic and shiga toxin-producing Escherichia coli among children with and without diarrhoea in Iran. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2007; 25:88-93. [PMID: 17615908 PMCID: PMC3013268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
The aim of the study was to determine the rates of detection of enteropathogenic Escherichia coli (EPEC) and Shiga toxin-producing E. coli (STEC) strains among children in two randomly-selected populations in Iran. In total, 1,292 randomly-selected faecal samples from children aged less than 10 years were screened for EPEC and STEC. Of the 1,292 cases participated in the study, 184 had diarrhoea, and 1,108 were healthy/asymptomatic children. The conventional culture method and slide agglutination with 12 different commercial EPEC antisera were used for the detection of EPEC. The colony sweep polymyxin-B extraction method, non-sorbitol fermentation (NSF) phenotype, and slide agglutination with O157: H7 antisera were used for the screening and detection of STEC. Of EPEC belonging to 11 different serogroups, 0111 and 0127 were most commonly found in 36.4% of the diarrhoeal cases and 7.2% of the asymptomatic children. A significant association (p<0.05) was found between isolation of EPEC and diarrhoea. 8.7% of the diarrhoeal cases and 2% of children without diarrhoea were infected with STEC, but none of the isolates belonged to the 0157:H7 serotype. A significant association (p<0.05) was found between STEC and diarrhoeal cases. Based on these findings, it can be concluded that different EPEC serogroups may be agents of endemic infantile diarrhoea, and STEC strains are an important enteropathogen among young children.
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Affiliation(s)
- M Yousef Alikhani
- Microbiology Department, Faculty of Medicine, Hamadan University of Medical Science, Hamadan, Iran
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Bosilevac JM, Guerini MN, Brichta-Harhay DM, Arthur TM, Koohmaraie M. Microbiological characterization of imported and domestic boneless beef trim used for ground beef. J Food Prot 2007; 70:440-9. [PMID: 17340881 DOI: 10.4315/0362-028x-70.2.440] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The United States imports lean boneless beef trim from Australia (AUS), New Zealand (NZL), and Uruguay (URY) to meet demand for ground beef production. The reported incidence of and etiological agents responsible for foodborne diseases differ between these countries and the United States. Our objective was to determine whether current U.S. microbiological profiling adequately addresses the potential differences between foreign and domestic beef trim. We compared the hygienic status of imported and domestic (USA) beef trim by enumeration of aerobic bacteria, Enterobacteriaceae, coliforms, Escherichia coli, and Staphylococcus aureus. We also compared the prevalence of pathogens between imported and domestic samples by screening for the presence of Salmonella, Campylobacter spp., Listeria spp., and non-O157 Shiga toxin-producing E. coli (STEC). A total of 1,186 samples (487 USA, 220 AUS, 223 NZL, and 256 URY) of boneless beef trim were analyzed. Results of enumeration revealed significant differences between samples from all countries, with the lowest pathogen numbers in samples from AUS and the highest in samples from URY. Six Salmonella isolates (1 NZL, 1 URY, and 4 USA), 79 L. monocytogenes isolates (4 AUS, 5 NZL, 53 URY, and 17 USA), and 7 Campylobacter isolates (1 NZL, 1 URY, 5 USA) were found among the trim samples tested. Non-O157 STEC prevalence was 10% in NZL samples and about 30% in all of the other samples; 99 STEC strains were isolated. Serotyping of these isolates revealed that serotypes associated with hemolytic uremic syndrome were not different in prevalence between imported and domestic beef trim. Although it may be tempting to do so, these data cannot be used to compare the microbiological quality of beef trim between the countries examined. However, these results indicate that the current pathogen monitoring procedures in the United States are adequate for evaluation of imported beef trim.
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Affiliation(s)
- Joseph M Bosilevac
- U.S. Department of Agriculture, Agricultural Research Service, Roman L. Hruska U.S. Meat Animal Research Center, Clay Center, Nebraska 68933-0166, USA.
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Grotiuz G, Sirok A, Gadea P, Varela G, Schelotto F. Shiga toxin 2-producing Acinetobacter haemolyticus associated with a case of bloody diarrhea. J Clin Microbiol 2006; 44:3838-41. [PMID: 17021124 PMCID: PMC1594762 DOI: 10.1128/jcm.00407-06] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
We report the first Shiga toxin 2-producing Acinetobacter haemolyticus strain that was isolated from the feces of a 3-month-old infant with bloody diarrhea. Usual enteropathogenic bacteria were not detected. This finding suggests that any Shiga toxin-producing microorganism capable of colonizing the human gut may have the potential to cause illness.
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Affiliation(s)
- Germán Grotiuz
- Shiga Toxin-Producing E. coli Reference Laboratory, Department of Bacteriology and Virology, Institute of Hygiene, Av. Dr. Alfredo Navarro 3051, CP 11600, Montevideo, Uruguay
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39
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Alikhani MY, Mirsalehian A, Aslani MM. Detection of typical and atypical enteropathogenic Escherichia coli (EPEC) in Iranian children with and without diarrhoea. J Med Microbiol 2006; 55:1159-1163. [PMID: 16914644 DOI: 10.1099/jmm.0.46539-0] [Citation(s) in RCA: 50] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
The present study was performed to investigate the contribution of typical and atypical enteropathogenic Escherichia coli (EPEC) as a cause of infectious diarrhoea among children less than 10 years old in Iran. During the summer months, 247 specimens from children with diarrhoea and 1108 from asymptomatic children were analysed for the presence of EPEC and other bacterial pathogens. Potential enteric pathogens were identified in 140 cases of children with diarrhoea (56.7%). EPEC was the most frequently identified agent (111 cases), followed by Shiga toxin-producing E. coli (13), Shigella (9), Salmonella (6) and Aeromonas sp. (1). EPEC isolates were examined for the presence of eaeA, bfpA and stx genes by PCR. EPEC isolates were classified as typical (eaeA+ bfpA+) or atypical (eaeA+ bfpA-). Typical EPEC was diagnosed in 35 cases (11.8%), compared with 8 (0.4%) in the asymptomatic group (P<0.05). Atypical EPEC strains were isolated from 23 cases (9.3%), compared with 13 (1.2%) of the healthy control group (P<0.05). In conclusion, the data suggest that typical and atypical EPEC are an important cause of diarrhoea in Iranian children.
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Affiliation(s)
- M Yousef Alikhani
- Department of Microbiology, Faculty of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
- Department of Microbiology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Akbar Mirsalehian
- Department of Microbiology, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - M Mehdi Aslani
- Department of Microbiology, Institute Pasteur of Iran, 69 Pasteur Avenue, Tehran, Iran
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40
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Blanco M, Blanco JE, Dahbi G, Mora A, Alonso MP, Varela G, Gadea MP, Schelotto F, González EA, Blanco J. Typing of intimin (eae) genes from enteropathogenic Escherichia coli (EPEC) isolated from children with diarrhoea in Montevideo, Uruguay: identification of two novel intimin variants (μB and ξR/β2B). J Med Microbiol 2006; 55:1165-1174. [PMID: 16914645 DOI: 10.1099/jmm.0.46518-0] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
A total of 71 enteropathogenic Escherichia coli (EPEC) strains isolated from children with diarrhoea in Montevideo, Uruguay, were characterized in this study. PCR showed that 57 isolates carried eae and bfp genes (typical EPEC strains), and 14 possessed only the eae gene (atypical EPEC strains). These EPEC strains belonged to 21 O : H serotypes, including eight novel serotypes not previously reported among human EPEC in other studies. However, 72 % belonged to only four serotypes: O55 : H− (six strains), O111 : H2 (13 strains), O111 : H− (14 strains) and O119 : H6 (18 strains). Nine intimin types, namely, α1 (two O142 strains), β1 (29 strains, including 13 O111 : H2 and 14 O111 : H−), γ1 (three O55 : H− strains), θ (five strains, including three strains with H40 antigen), κ (two strains), ε1 (one strain), λ (one strain), μB (six strains of serotypes O55 : H51 and O55 : H−) and ξR/β2B (22 strains, including 18 O119 : H6) were detected among the 71 EPEC strains. The authors have identified two novel intimin genes (μB and ξR/β2B) in typical EPEC strains of serotypes O55 : H51/H− and O119 : H6/H−. The complete nucleotide sequences of the novel μB and ξR/β2 variant genes were determined. PFGE typing after XbaI DNA digestion was performed on 44 representative EPEC strains. Genomic DNA fingerprinting revealed 44 distinct restriction patterns and the strains were clustered in 12 groups. Only 15 strains clustered in six groups of closely related (similarity >85 %) PFGE patterns, suggesting the prevailing clonal diversity among EPEC strains isolated from children with diarrhoea in Montevideo.
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MESH Headings
- Adhesins, Bacterial/classification
- Adhesins, Bacterial/genetics
- Antigens, Bacterial/analysis
- Child
- Child, Preschool
- Cluster Analysis
- DNA Fingerprinting
- DNA, Bacterial/chemistry
- DNA, Bacterial/genetics
- Deoxyribonucleases, Type II Site-Specific
- Electrophoresis, Gel, Pulsed-Field
- Escherichia coli/classification
- Escherichia coli/genetics
- Escherichia coli/isolation & purification
- Escherichia coli Infections/microbiology
- Escherichia coli Proteins/classification
- Escherichia coli Proteins/genetics
- Genes, Bacterial
- Genotype
- Humans
- Molecular Sequence Data
- O Antigens/analysis
- Phylogeny
- Polymorphism, Restriction Fragment Length
- Sequence Analysis, DNA
- Sequence Homology, Amino Acid
- Serotyping
- Uruguay
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Affiliation(s)
- Miguel Blanco
- Laboratorio de Referencia de E. coli (LREC), Departamento de Microbioloxía e Parasitoloxía, Universidade de Santiago de Compostela, 27002 Lugo, Spain
| | - Jesús E Blanco
- Laboratorio de Referencia de E. coli (LREC), Departamento de Microbioloxía e Parasitoloxía, Universidade de Santiago de Compostela, 27002 Lugo, Spain
| | - Ghizlane Dahbi
- Laboratorio de Referencia de E. coli (LREC), Departamento de Microbioloxía e Parasitoloxía, Universidade de Santiago de Compostela, 27002 Lugo, Spain
| | - Azucena Mora
- Laboratorio de Referencia de E. coli (LREC), Departamento de Microbioloxía e Parasitoloxía, Universidade de Santiago de Compostela, 27002 Lugo, Spain
| | - María Pilar Alonso
- Unidade de Microbioloxía Clínica, Complexo Hospitalario Xeral-Calde, 27004 Lugo, Spain
- Laboratorio de Referencia de E. coli (LREC), Departamento de Microbioloxía e Parasitoloxía, Universidade de Santiago de Compostela, 27002 Lugo, Spain
| | - Gustavo Varela
- Departamento de Bacteriología y Virología, Instituto de Higiene, Facultad de Medicina, Universidad de la República, CP 11600 Montevideo, Uruguay
| | - María Pilar Gadea
- Departamento de Bacteriología y Virología, Instituto de Higiene, Facultad de Medicina, Universidad de la República, CP 11600 Montevideo, Uruguay
| | - Felipé Schelotto
- Departamento de Bacteriología y Virología, Instituto de Higiene, Facultad de Medicina, Universidad de la República, CP 11600 Montevideo, Uruguay
| | - Enrique A González
- Laboratorio de Referencia de E. coli (LREC), Departamento de Microbioloxía e Parasitoloxía, Universidade de Santiago de Compostela, 27002 Lugo, Spain
| | - Jorge Blanco
- Laboratorio de Referencia de E. coli (LREC), Departamento de Microbioloxía e Parasitoloxía, Universidade de Santiago de Compostela, 27002 Lugo, Spain
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Vu Nguyen T, Le Van P, Le Huy C, Nguyen Gia K, Weintraub A. Etiology and epidemiology of diarrhea in children in Hanoi, Vietnam. Int J Infect Dis 2006; 10:298-308. [PMID: 16458564 DOI: 10.1016/j.ijid.2005.05.009] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2005] [Revised: 05/17/2005] [Accepted: 05/31/2005] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES This paper provides a preliminary picture of diarrhea with regards to etiology, clinical symptoms, and some related epidemiologic factors in children less than five years of age living in Hanoi, Vietnam. METHODS The study population included 587 children with diarrhea and 249 age-matched healthy controls. The identification of pathogens was carried out by the conventional methods in combination with ELISA, immunoseparation, and PCR. The antibiotic susceptibility was determined by MIC following the NCCLS recommendations. RESULTS Of those with diarrhea, 40.9% were less than one year old and 71.0% were less than two years old. A potential pathogen was identified in 67.3% of children with diarrhea. They were group A rotavirus, diarrheagenic Escherichia coli, Shigella spp, and enterotoxigenic Bacteroides fragilis, with prevalences of 46.7%, 22.5%, 4.7%, and 7.3%, respectively. No Salmonella spp or Vibrio cholerae were isolated. Rotavirus and diarrheagenic E. coli were predominant in children less than two years of age, while Shigella spp, and enterotoxigenic B. fragilis were mostly seen in the older children. Diarrheagenic E. coli and Shigella spp showed high prevalence of resistance to ampicillin, chloramphenicol, and to trimethoprim/sulfamethoxazole. Children attending the hospitals had fever (43.6%), vomiting (53.8%), and dehydration (82.6%). Watery stool was predominant with a prevalence of 66.4%, followed by mucous stool (21.0%). The mean episodes of stools per day was seven, ranging from two to 23 episodes. Before attending hospitals, 162/587 (27.6%) children had been given antibiotics. Overall, more children got diarrhea in (i) poor families; (ii) families where piped water and a latrine were lacking; (iii) families where mothers washed their hands less often before feeding the children; (iv) families where mothers had a low level of education; (v) families where information on health and sanitation less often reached their households. CONCLUSIONS Group A rotavirus, diarrheagenic Escherichia coli, Shigella spp, and enterotoxigenic Bacteroides fragilis play an important role in causing diarrhea in children in Hanoi, Vietnam. Epidemiological factors such as lack of fresh water supply, unhygienic septic tank, low family income, lack of health information, and low educational level of parents could contribute to the morbidity of diarrhea in children.
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Affiliation(s)
- Trung Vu Nguyen
- Department of Medical Microbiology, Hanoi Medical University, Hanoi, Vietnam
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42
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Dow MA, Tóth I, Malik A, Herpay M, Nógrády N, Ghenghesh KS, Nagy B. Phenotypic and genetic characterization of enteropathogenic Escherichia coli (EPEC) and entero-aggregative E. coli (EAEC) from diarrhoeal and non-diarrhoeal children in Libya. Comp Immunol Microbiol Infect Dis 2006; 29:100-13. [PMID: 16626804 DOI: 10.1016/j.cimid.2006.01.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2006] [Indexed: 11/27/2022]
Abstract
A total of 50 Escherichia coli strains isolated in a Libyan hospital (20 from children with diarrhoea and 30 from healthy children) were investigated for their pathotypes and virulence traits. Altogether nine eae-positive (enteropathogenic E. coli, EPEC) and nine aggR-positive (entero-aggregative E. coli, EAEC) strains were identified. Significantly (P=0.001) more EPEC strains were identified from diarrhoeal patients (n=8) than from healthy controls (n=1), while six EAEC strains were identified from diarrhoeal and three from healthy children. Typical (eae(+), EAF(+), bfp(+)) EPEC strains (n=6) belonged to classical EPEC serogroups O55, O114, O127 and showed localized adherence on Hela cells. EAEC strains revealed genetic heterogeneity but uniformly adhered to HeLa cultures in an entero-aggregative adherence pattern. Antibiotic resistance frequently, characterized the strains. Sixty-eight percentage of the strains were resistant against at least one antibiotic and 30% harbored a class 1 integron independently of their clinical background. This is the first report from North Africa demonstrating the significance of EPEC and EAEC.
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Affiliation(s)
- M A Dow
- Veterinary Medical Research Institute of the Hungarian Academy of Sciences, Budapest, Hungary
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43
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Garrido P, Blanco M, Moreno-Paz M, Briones C, Dahbi G, Blanco J, Blanco J, Parro V. STEC-EPEC oligonucleotide microarray: a new tool for typing genetic variants of the LEE pathogenicity island of human and animal Shiga toxin-producing Escherichia coli (STEC) and enteropathogenic E. coli (EPEC) strains. Clin Chem 2005; 52:192-201. [PMID: 16384888 DOI: 10.1373/clinchem.2005.059766] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Shiga toxin-producing Escherichia coli (STEC) and enteropathogenic E. coli (EPEC) are important emerging pathogens that can cause a severe and sometimes fatal illness. Differentiation of eae, tir, espA, espD, and espB gene variants of the locus of enterocyte effacement (LEE) pathogenicity island represents an important tool for typing in routine diagnostics as well as in pathogenesis, epidemiologic, clonal, and immunologic studies. METHODS Type-specific oligonucleotide microarrays and a PCR scheme were designed and constructed for the detection and typing of genetic variants of the LEE genes. Oligonucleotide probes were tested for their specificity against the corresponding type strain by microarray hybridization using fluorescent DNA, either PCR-amplified (single, multiplex, long-range), chromosomal, or amplified chromosomal DNA. RESULTS The PCR scheme and the oligonucleotide microarray allowed us to distinguish 16 variants (alpha1, alpha2, beta1, beta2, gamma1, gamma2/theta, delta/kappa, epsilon, zeta, eta, iota, lambda, mu, nu, xi, omicron) of the eae gene, 4 variants (alpha1, beta1, gamma1, gamma2/theta) of the tir gene, 4 variants (alpha1, beta1, beta2, gamma1) of the espA gene, 3 variants (alpha1, beta1, gamma1) of the espB gene, and 3 variants (alpha1, beta1, gamma1) of the espD gene. We found a total of 12 different combinations of tir, espA, espB, and espD genes among the 25 typed strains. CONCLUSIONS The PCR scheme and the oligonucleotide microarray described are effective tools to rapidly screen multiple virulence genes and their variants in E. coli strains isolated from human and animal infections. The results demonstrate the great genetic diversity among LEE genes of human and animal STEC and EPEC strains.
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Affiliation(s)
- Patricia Garrido
- Laboratorio de Ecología Molecular, Centro de Astrobiología (INTA-CSIC), Madrid, Spain
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44
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Vignoli R, Varela G, Mota MI, Cordeiro NF, Power P, Ingold E, Gadea P, Sirok A, Schelotto F, Ayala JA, Gutkind G. Enteropathogenic Escherichia coli strains carrying genes encoding the PER-2 and TEM-116 extended-spectrum beta-lactamases isolated from children with diarrhea in Uruguay. J Clin Microbiol 2005; 43:2940-3. [PMID: 15956426 PMCID: PMC1151943 DOI: 10.1128/jcm.43.6.2940-2943.2005] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We studied 13 extended-spectrum beta-lactamase (ESBL)-producing enteropathogenic Escherichia coli isolates from children suffering acute diarrhea in Uruguay. ESBL characterization in crude extracts showed a single band at pI 5.4. PCR amplification and sequencing data allowed identification of blaPER-2 and blaTEM-116. Retrospective analysis suggests that these strains were disseminated in the community, even if unnoticed, prior to their access to the hospital environment more than a decade ago.
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Affiliation(s)
- Rafael Vignoli
- Departamento de Bacteriología y Virología, Instituto de Higiene, Facultad de Medicina, Universidad de la República, 11600 Montevideo, Uruguay
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45
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Nguyen TV, Le Van P, Le Huy C, Gia KN, Weintraub A. Detection and characterization of diarrheagenic Escherichia coli from young children in Hanoi, Vietnam. J Clin Microbiol 2005; 43:755-60. [PMID: 15695676 PMCID: PMC548099 DOI: 10.1128/jcm.43.2.755-760.2005] [Citation(s) in RCA: 175] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Diarrhea continues to be one of the most common causes of morbidity and mortality among infants and children in developing countries. Escherichia coli is an emerging agent among pathogens that cause diarrhea. The development of a highly applicable technique for the detection of different categories of diarrheagenic E. coli is important. We have used multiplex PCR by combining eight primer pairs specific for enteroaggregative E. coli (EAEC), enteroinvasive E. coli (EIEC), enterohemorrhagic E. coli, enteropathogenic E. coli (EPEC), and enterotoxigenic E. coli (ETEC). This facilitates the identification of five different categories of diarrheagenic E. coli from stool samples in a single reaction simultaneously. The prevalences of diarrheagenic E. coli were 22.5 and 12% in the diarrhea group and the control group, respectively. Among 587 fecal samples from Vietnamese children under 5 years of age with diarrhea, this technique identified 132 diarrheagenic E. coli strains. This included 68 samples (11.6%) with EAEC, 12 samples (2.0%) with EIEC, 39 samples (6.6%) with EPEC, and 13 samples (2.2%) with ETEC. Among the 249 age-matched controls, 30 samples were positive for diarrheagenic E. coli. The distribution was 18 samples (7.2%) with EAEC, 11 samples (4.4%) with EPEC, and 1 sample (0.4%) with ETEC.
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Affiliation(s)
- Trung Vu Nguyen
- Department of Medical Microbiology, Hanoi Medical University, Hanoi, Vietnam
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46
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O’Ryan M, Prado V, Pickering LK. A millennium update on pediatric diarrheal illness in the developing world. ACTA ACUST UNITED AC 2005; 16:125-36. [DOI: 10.1053/j.spid.2005.12.008] [Citation(s) in RCA: 162] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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47
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Nimri LF, Elnasser Z, Batchoun R. Polymicrobial infections in children with diarrhoea in a rural area of Jordan. ACTA ACUST UNITED AC 2004; 42:255-9. [PMID: 15364112 DOI: 10.1016/j.femsim.2004.05.014] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2004] [Revised: 05/16/2004] [Accepted: 05/28/2004] [Indexed: 11/24/2022]
Abstract
Polymicrobial infections associated with diarrhoea are common in developing countries. Stool specimens were collected from 220 patient children and 100 controls. Potential pathogenic agents isolated from 143 (65%) children were identified by molecular and standard microbiological methods. Co-infections with two or more agents were detected in 50 (35%) cases. Escherichia coli, Shigella dysenteriae, Giardia and Entamoeba histolytica were found to be predominant. The etiologic agents could not be determined in 77 (35%) cases. The most significant risk factors were the age, the education level of the mother and the use of non-chlorinated water. The high infection rate of diarrhoeal diseases is a strong indication that these pathogens circulate easily through the population.
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Affiliation(s)
- Laila F Nimri
- Department of Medical Laboratory Sciences, Jordan University of Science and Technology, Irbid 22110, Jordan.
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48
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Nimri LF, Meqdam M. Enteropathogens associated with cases of gastroenteritis in a rural population in Jordan. Clin Microbiol Infect 2004; 10:634-9. [PMID: 15214876 DOI: 10.1111/j.1469-0691.2004.00891.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Stool specimens were collected from 180 patients belonging to a population of recently settled Bedouins in Jordan who presented with acute or persistent diarrhoea and other symptoms, and from 100 non-diarrhoeal controls. All samples were examined for parasites and bacterial pathogens by culture and PCR. Bacterial isolates were tested for their susceptibility to common antimicrobial agents. Pathogens and potential enteropathogens were identified from 140 (77.8%) of the patients, with more than one pathogen being recovered from 67 (37.2%) patients. Potentially pathogenic parasites were observed in 90 (50%) patients; those that were associated significantly with diarrhoea were Giardia lamblia, Blastocystis hominis, Cryptosporidium spp., Entamoeba histolytica and Cyclospora cayetanensis. Pathogenic bacteria were isolated from 72 (40%) patients, and, of these, 62.5% were resistant to at least one antibiotic, and 30.6% of these were multiresistant. Diarrhoeagenic Escherichia coli strains were found in 14.3% of the patients and 2.9% of the control subjects (not statistically significant). The most common enteropathogenic bacteria found were Shigella spp., Campylobacter jejuni and Yersinia enterocolitica. Unusual bacterial species were the predominant organisms recovered in a few cases and could represent a possible cause of diarrhoea. Overall, there was a high endemicity of diarrhoeal disease in the area studied. Risk factors that correlated significantly with contracting diarrhoea were socio-economic status, education, use of unchlorinated well or tank water, and a low level of personal hygiene.
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Affiliation(s)
- L F Nimri
- Department of Medical Laboratory Sciences, Jordan University of Science & Technology, Irbid, Jordan.
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Berois M, Libersou S, Russi J, Arbiza J, Cohen J. Genetic variation in the VP7 gene of human rotavirus isolated in Montevideo-Uruguay from 1996-1999. J Med Virol 2003; 71:456-62. [PMID: 12966554 DOI: 10.1002/jmv.10511] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The gene encoding the protein VP7 that induces the major neutralizing response has been sequenced from 34 human rotaviruses isolated from children with acute diarrhea in Montevideo (Uruguay) over a 4-year period (1996-1999). These sequences were analyzed and compared to representative corresponding sequences available on databases. In most years, serotype G1 was present as the single serotype, except in 1999 when serotypes G1 and G4 were present simultaneously. Two G1 VP7 lineages were identified. Serotype G2 was present in 1997. The G4 isolates are grouped with Argentine strains and emerged during 1998 in a recently defined sublineage. Neither serotype G3 nor the emerging serotype G9 were isolated during the study. Antigenic domains of isolates and of representative reference strains of each serotype were compared. Sequences of strains isolated during the same year, showed a high degree of homology among strains belonging to the same serotype.
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Affiliation(s)
- Mabel Berois
- UMR CNRS-INRA Virologie Moléculaire et Structurale, 1 Avenue de la Terrasse, 91198 Gif-sur-Yvette Cedex, France.
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50
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Abstract
Giardia lamblia (syn. G. duodenalis or G. intestinalis), the causative agent of giardiasis, is one of the most common causes worldwide of intestinal infections in humans. Symptomatic infection is characterized by diarrhoea, epigastric pain, nausea, vomiting, and weight loss, yet many infections are asymptomatic. The protozoan, unicellular parasite resides in the lumen and attaches to the epithelium and overlying mucus layers but does not invade the mucosa and causes little or no mucosal inflammation. Giardiasis is normally transient, indicating the existence of effective host defences, although re-infections can occur, which may be related to differences in infecting parasites and/or incomplete immune protection. Mucosal defences against Giardia must act in the small intestinal lumen in the absence of induction by classical inflammatory mediators. Secretory IgA antibodies have a central role in anti-giardial defence. B cell-independent mechanisms also exist and can contribute to eradication of the parasite, although their identity and physiological importance are poorly understood currently. Possible candidates are nitric oxide, antimicrobial peptides such as Paneth cell alpha-defensins, and lactoferrin. Elucidation of the key anti-giardial effector mechanisms will be important for selecting the best adjuvants in the rational development of vaccination strategies against Giardia.
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Affiliation(s)
- Lars Eckmann
- Department of Medicine, University of California, San Diego, La Jolla, California 92093, USA.
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