RESUMEN
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.
RESUMEN
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.
