ABSTRACT
Background: Enteroaggregative Escherichia coli (EAEC) is increasingly associated with domestically acquired diarrheal episodes in high-income countries, particularly among children. However, its specific role in endemic diarrhea in this setting remains under-recognized and information on molecular characteristics of such EAEC strains is limited. We aimed to investigate the occurrence of EAEC in patients with non-travel related diarrhea in Spain and molecularly characterize EAEC strains associated with illness acquired in this high-income setting. Methods: In a prospective multicenter study, stool samples from diarrheal patients with no history of recent travel abroad (n = 1,769) were collected and processed for detection of EAEC and other diarrheagenic E. coli (DEC) pathotypes by PCR. An additional case-control study was conducted among children ≤5 years old. Whole-genome sequences (WGS) of the resulting EAEC isolates were obtained. Results: Detection of DEC in the study population. DEC was detected in 23.2% of patients aged from 0 to 102 years, with EAEC being one of the most prevalent pathotypes (7.8%) and found in significantly more patients ≤5 years old (9.8% vs. 3.4%, p < 0.001). Although not statistically significant, EAEC was more frequent in cases than in controls. WGS-derived characterization of EAEC isolates. Sequence type (ST) 34, ST200, ST40, and ST10 were the predominant STs. O126:H27, O111:H21, and O92:H33 were the predominant serogenotypes. Evidence of a known variant of aggregative adherence fimbriae (AAF) was found in 89.2% of isolates, with AAF/V being the most frequent. Ten percent of isolates were additionally classified as presumptive extraintestinal pathogenic E. coli (ExPEC), uropathogenic E. coli (UPEC), or both, and belonged to clonal lineages that could be specifically associated with extraintestinal infections. Conclusion: EAEC was the only bacterial enteric pathogen detected in a significant proportion of cases of endemic diarrhea in Spain, especially in children ≤5 years old. In particular, O126:H27-ST200, O111:H21-ST40, and O92:H33-ST34 were the most important subtypes, with all of them infecting both patients and asymptomatic individuals. Apart from this role as an enteric pathogen, a subset of these domestically acquired EAEC strains revealed an additional urinary/systemic pathogenic potential.
ABSTRACT
We identified the mucus-activatable Shiga toxin genotype stx2d in the most common hemolytic uremic syndrome-associated Escherichia coli serotype, O157:H7. stx2d was detected in a strain isolated from a 2-year-old boy with bloody diarrhea in Spain, and whole-genome sequencing was used to confirm and fully characterize the strain.
Subject(s)
Escherichia coli Infections/metabolism , Escherichia coli Infections/microbiology , Escherichia coli O157/classification , Escherichia coli O157/genetics , Genotype , Mucus/metabolism , Shiga Toxin/genetics , Child, Preschool , Escherichia coli O157/pathogenicity , Genome, Bacterial , Hemolytic-Uremic Syndrome/metabolism , Hemolytic-Uremic Syndrome/microbiology , Humans , Male , Serogroup , Spain , Virulence Factors/geneticsABSTRACT
Introducción Se estudiaron los grupos genéticos (genotipos) de Giardia duodenalis circulantes en las áreas sanitarias de 2 hospitales de Zaragoza y León (España).Métodos Se genotiparon 211 muestras de Giardia mediante PCR del gen tpi. Resultados El genotipo B fue más prevalente tanto en Zaragoza (84,7%) como en León (95,1%). Los restantes aislados fueron identificados como AII+B. Conclusiones Predominó G. duodenalis genotipo B en Zaragoza y León, con aumento de su prevalencia en Zaragoza respecto a estudios anteriores (AU)
Objectives To study Giardia duodenalis assemblages circulating in the health areas of two hospitals in Zaragoza and León (Spain).Method sA total of 211 stool samples with Giardia were genotyped by PCR of the tpi gene. Results Assemblage B was the most prevalent, both in Zaragoza (84,7%) and León (95,1%). The remaining isolates were identified as AII+B. Conclusions We detected the spread of G. duodenalis assemblage B in Zaragoza and in León, with an increase in its prevalence in Zaragoza compared to previous studies (AU)
Subject(s)
Humans , Giardiasis/epidemiology , Giardia/genetics , Genotype , Parasite Egg Count , Age DistributionABSTRACT
OBJECTIVES: To study Giardia duodenalis assemblages circulating in the health areas of two hospitals in Zaragoza and León (Spain). METHODS: A total of 211 stool samples with Giardia were genotyped by PCR of the tpi gene. RESULTS: Assemblage B was the most prevalent, both in Zaragoza (84,7%) and León (95,1%). The remaining isolates were identified as AII+B. CONCLUSIONS: We detected the spread of G. duodenalis assemblage B in Zaragoza and in León, with an increase in its prevalence in Zaragoza compared to previous studies.
