[Molecular characterization of diarrheagenic Escherichia coli from an outpatient pediatric population with diarrhea attended in two hospitals from Buenos Aires, Argentina]. / Caracterización molecular de Escherichia coli diarreogénica proveniente de población pediátrica ambulatoria con diarrea, atendida en dos hospitales de Buenos Aires, Argentina.

Diarrheagenic Escherichia coli comprises a heterogeneous group of pathotypes or pathogenic variants that share phenotypic characteristics with marked differences in virulence genes, colonization sites, pathogenesis, clinical presentation, and epidemiology of infection. The most studied pathotypes are Shiga toxin-producing E.coli (STEC), enterotoxigenic E.coli (ETEC), enteropathogenic E.coli (EPEC), enteroaggregative E.coli (EAEC), and enteroinvasive E.coli (EIEC). The objective of the study was to characterize the isolates of diarrheagenic E.coli from an outpatient pediatric population with diarrhea attended in two public hospitals from Buenos Aires, Argentina. Diarrheagenic E.coli pathotypes were investigated by amplifying characteristic virulence gene fragments: intimin (eae), heat-labile toxin (lt), heat-stable toxins (stp, sth), invasion plasmid antigen H (ipaH), transcriptional activator R (aggR) and Shiga toxins (stx1, stx2). Molecular subtyping of isolates was performed using PFGE (XbaI). Diarrheagenic E.coli was detected in 14% (84/601) of cases. The EAEC pathotype was prevalent, while ETEC, STEC, EPEC and EIEC were found in a lower proportion. EAEC isolates exhibited a high degree of genetic diversity. All pathotypes were found in children under 5years of age, while only EAEC, EIEC and ETEC were detected in the older population. Future studies that include the characterization of isolates from a greater number of genes and populations from other geographical areas will be necessary to determine the relevance of diarrheagenic E.coli in Argentina.

[First report of diarrheagenic Escherichia coli in pediatric outpatient population with diarrhea in La Plata, Argentina]. / Primer reporte de Escherichia coli diarreogénica en población pediátrica ambulatoria con diarrea atendida en la ciudad de La Plata, Argentina.

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.

Caracterización molecular de Escherichia coli diarreogénica proveniente de población pediátrica ambulatoria con diarrea, atendida en dos hospitales de Buenos Aires, Argentina / Molecular characterization of diarrheagenic Escherichia coli from an outpatient pediatric population with diarrhea attended in two hospitals from Buenos Aires, Argentina

Resumen Escherichia coli diarreogénica abarca un grupo heterogéneo de patotipos o variantes patogénicas que comparten características fenotípicas con marcadas diferencias en genes de virulencia, sitios de colonización, patogenia, presentación clínica y epidemiología de la infección. Los patotipos más estudiados son E.coli productora de toxina Shiga (STEC), E.coli enterotoxigénica (ETEC), E.coli enteropatogénica (EPEC), E.coli enteroagregativa (EAEC) y E.coli enteroinvasiva (EIEC). El objetivo del estudio fue caracterizar los aislamientos de E.coli diarreogénica provenientes de población pediátrica ambulatoria con diarrea, atendida en dos hospitales públicos de Buenos Aires, Argentina. Los patotipos de E.coli diarreogénica se investigaron mediante la amplificación de fragmentos de genes de virulencia característicos: intimina (eae), toxina termolábil (lt), toxinas termoestables (stp, sth), antígeno plasmídico de invasiónH (ipaH), activador transcripcional R (aggR) y toxinas Shiga (stx1, stx2). La subtipificación molecular de aislamientos se realizó mediante PFGE (XbaI). E.coli diarreogénica fue detectada en el 14% (84/601) de los casos. El patotipo EAEC fue prevalente, mientras que ETEC, STEC, EPEC y EIEC fueron hallados en menor proporción. Los aislamientos de EAEC presentaron un alto grado de diversidad genética. Todos los patotipos fueron hallados en niños menores de 5años, mientras que solamente EAEC, EIEC y ETEC fueron detectados en población de mayor edad. Futuros estudios que incluyan la caracterización de aislamientos a partir de un mayor número de genes y población de otras áreas geográficas serán necesarios para determinar la relevancia de E.coli diarreogénica en Argentina.

Abstract Diarrheagenic Escherichia coli comprises a heterogeneous group of pathotypes or pathogenic variants that share phenotypic characteristics with marked differences in virulence genes, colonization sites, pathogenesis, clinical presentation, and epidemiology of infection. The most studied pathotypes are Shiga toxin-producing E.coli (STEC), enterotoxigenic E.coli (ETEC), enteropathogenic E.coli (EPEC), enteroaggregative E.coli (EAEC), and enteroinvasive E.coli (EIEC). The objective of the study was to characterize the isolates of diarrheagenic E.coli from an outpatient pediatric population with diarrhea attended in two public hospitals from Buenos Aires, Argentina. Diarrheagenic E.coli pathotypes were investigated by amplifying characteristic virulence gene fragments: intimin (eae), heat-labile toxin (lt), heat-stable toxins (stp, sth), invasion plasmid antigen H (ipaH), transcriptional activator R (aggR) and Shiga toxins (stx1, stx2). Molecular subtyping of isolates was performed using PFGE (XbaI). Diarrheagenic E.coli was detected in 14% (84/601) of cases. The EAEC pathotype was prevalent, while ETEC, STEC, EPEC and EIEC were found in a lower proportion. EAEC isolates exhibited a high degree of genetic diversity. All pathotypes were found in children under 5years of age, while only EAEC, EIEC and ETEC were detected in the older population. Future studies that include the characterization of isolates from a greater number of genes and populations from other geographical areas will be necessary to determine the relevance of diarrheagenic E.coli in Argentina.

Primer reporte de Escherichia coli diarreogénica en población pediátrica ambulatoria con diarrea atendida en la ciudad de La Plata, Argentina / First report of diarrheagenic Escherichia coli in pediatric outpatient population with diarrhea in La Plata, Argentina

Resumen Escherichia coli diarreogénica comprende un grupo heterogéneo de cepas que presentan diversos factores de virulencia y causan diferentes síndromes diarreicos. Los patotipos más estudiados son Escherichia coli enteropatogénica (EPEC), Escherichia coli enterotoxigé-nica (ETEC), Escherichia coli enteroagregativa (EAEC), Escherichia coli enteroinvasiva (EIEC) y Escherichia coli productora de toxina Shiga (STEC). El objetivo de este estudio fue estimar la frecuencia de infección de los diversos patotipos de E. coli diarreogénica en una población pediátrica ambulatoria con diarrea, atendida en el Hospital Sor María Ludovica de La Plata, Argentina, durante el período mayo-octubre de 2017. Los patotipos fueron detectados mediante la amplificación molecular de ocho genes de virulencia característicos. Se estudiaron las heces de 211 ninos (76% menores de 5 años). Se detectó infección con E. coli diarreogénica en el 12,3% (n = 26/211) de los niños con diarrea. Los patotipos identificados fueron EAEC, ETEC (todos lt positivos), EPEC y STEC (stx2 y eae positivos). El patotipo EAEC fue prevalente en todos los grupos etarios, mientras que los patotipos ETEC, EPEC y STEC solamente se observaron en niñnos menores de 5 anños. Este estudio constituye el primer reporte de detección por técnicas de amplificación molecular de Escherichia coli diarreogénica en una población pediátrica ambulatoria con diarrea, de la zona de La Plata. Se necesitan estudios más amplios que incluyan la caracterización de los aislamientos abarcando un mayor número de genes, controles asintomáticos, distintas épocas del ano y población de diversas áreas geográficas para esclarecer la relevancia de la infección por E. coli diarreogénica en niños de Argentina.

Abstract Diarrheagenic Escherichia coli is a heterogeneous group of strains that presents various virulence factors and causes different diarrheal syndromes. The most studied pat-hotypes 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 infec-tion 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 charac-terization 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.

Primer informe de celulitis cutánea por Erysipelothrix rhusiopathiae en dos trabajadores rurales / First report of cutaneous cellulitis caused by Erysipelothrix rhusiopathiae in two rural workers

Se informan dos casos de celulitis cutánea en trabajadores de un mismo criadero de aves a corral del área rural de la ciudad de Tandil, Argentina. En ambos pacientes fue identificado E. rhusiopathiae a partir de cultivos de muestras obtenidas por biopsia. La investigación del reservorio evidenció que en todas las muestras de las excretas de aves y en dos muestras de los residuos del alimento, se aisló E. rhusiopathiae con idéntico perfil bioquímico y de resistencia antimicrobiana al de las cepas aisladas de los dos casos clínicos. Si bien son necesarios estudios moleculares para establecer la relación epidemiológica entre las cepas aisladas de los pacientes y las del criadero, se puede inferir que la fuente de infección humana fue el criadero extensivo de aves de corral.

This report describes two cases of cutaneous cellulitis in workers at the same poultry farm in the rural area of Tandil, Argentina. In both patients E. rhusiopathiae was identified from culture samples obtained through biopsy. Investigation of the reservoir showed that, in all samples of fowl waste and in 2 samples of feed, E. rhusiopathiae was isolated with identical biochemical and antibiotic resistance profiles to those of the isolated strains in the case reports. Even though molecular analyses are required to establish an epidemiologic relation between the strains found in the patients and those on the farm, it can be inferred that the source of human infection was the extensive poultry farm.