RESUMEN
OBJECTIVES: To determine if the Vibrio parahaemolyticus O3:K6 global pandemic clone has spread into Peru. METHODS: A collection of 100 V. parahaemolyticus strains isolated from diarrhea cases in Peru were serotyped for O:K antigens and genotyped for the presence of the species-specific toxR gene and for the tdh and trh genes. In addition, the group-specific PCR (GS-PCR) and PCR for the presence of the open reading frame ORF8 of the filamentous phage f237 was performed to determine the pandemic status of the strains. RESULTS: Fifty strains of V. parahaemolyticus in this collection were identified as pandemic strains. Forty-six ORF8 and GS-PCR positive strains were identical to the global pandemic clone O3:K6, while four strains that also possessed the pandemic genotype and were ORF8 and GS-PCR positive belonged to serotypes O3:K68, O3:K58 and OUT (untypable):K6. One of the O3:K6 strains was isolated in 1996, indicating that the pandemic strain was present in Peru at about the same time that it caused the first outbreak in Calcutta in February 1996. CONCLUSIONS: Based on this first report in Peru of such strains, we recommend including V. parahaemolyticus in the differential diagnosis of the etiologic agents for diarrhea in this part of the world.
Asunto(s)
Diarrea/microbiología , Brotes de Enfermedades , Vibriosis/microbiología , Vibrio parahaemolyticus/clasificación , Proteínas Bacterianas/genética , Proteínas de Unión al ADN/genética , Diagnóstico Diferencial , Diarrea/epidemiología , Proteínas Hemolisinas/genética , Humanos , Perú/epidemiología , Reacción en Cadena de la Polimerasa/métodos , Técnica del ADN Polimorfo Amplificado Aleatorio , Factores de Transcripción/genética , Vibriosis/epidemiología , Vibrio parahaemolyticus/genética , Vibrio parahaemolyticus/aislamiento & purificaciónRESUMEN
Objetivos. Determinar las características epidemiológicas y clínicas de la gastroenteritis causada por Vibrio parahaemolyticus del grupo pandémico en el Perú. Materiales y métodos. Se examinó las historias clínicas y registros de laboratorio de cien casos de gastroenteritis en los cuales se aisló V. parahaemolyticus del grupo pandémico y no pandémico. Se recolectó información epidemiológica y clínica y se realizó el análisis estadístico de los datos para evaluar si la gravedad de la enfermedad se asoció con la presencia de las cepas del grupo pandémico. Resultados. Se logró colectar información epidemiológica en 85 por ciento de los casos e información clínica sólo en 37 por ciento de los casos, principalmente de los hospitalizados. Los casos del grupo pandémico tuvieron una mayor probabilidad de tener deposiciones líquidas (96,3 por ciento frente a 62,5 por ciento, p<0,05), presentar deshidratación moderada o grave (100 por ciento frente a 60 por ciento, p<0,05) y requerir atención hospitalaria (98 por ciento frente a 42,9 por ciento, p<0,0001). Fue más probable aislar una cepa pandémica en personas de 30 o más años de edad (63 por ciento frente a 39,5 por ciento, p<0,05). Conclusiones. El Vibrio parahaemolyticus del grupo pandémico causa enfermedad gastrointestinal de mayor gravedad que las cepas no pandémicas, con mayor probabilidad de requerir atención hospitalaria. Basados en este reporte, se recomienda incluir la identificación de V. parahaemolyticus en el diagnóstico etiológico de agentes causantes de gastroenteritis grave en el sistema de salud del Perú.
Objective. To determine the epidemiological and clinic characteristics of gastroenteritis caused by Vibrio parahaemolyticus strains of the pandemic group in Peru. Material and methods. Clinical and laboratory records were searched in 100cases of gastroenteritis caused by V parahaemolyticus, either of the pandemic or non pandemic group. Clinical and epidemiological data were collected and statistical analysis was done to evaluate if the severity of illness was associated with the pandemic group. Results. Epidemiological data were collected in 85 per cent of cases, and clinical data were only available in 37 per cent of cases, mainly on those hospitalized. Cases associated with the pandemic strains had a higher probability of liquid stools (96.3 per cent vs. 62.5 per cent, p<0.05), moderate or severe dehydration (100 per cent vs. 60 per cent, p<0.05), and hospital care (98 per cent vs. 42.9 per cent, p<0.0001). Cases aged thirty or older were associated with the pandemic strains (63 per cent vs. 39.5 per cent, p<0.05). Conclusions. Vibrio parahaemolyticus of the pandemic group causes more severe gastrointestinal disease than none pandemic strains, with higher probability of requiring hospital care. Based on this report, it is advisable to include the identification of V. parahaemolyticus in the etiological diagnosis of agents causing severe gastroenteritis in the Peruvian health system.