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1.
Food Microbiol ; 85: 103280, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31500706

RESUMEN

Listeria monocytogenes causes severe diseases in humans, including febrile gastroenteritis and systemic infections that has a high mortality despite antibiotic treatment. This pathogen may cause massive outbreaks associated to the consumption of contaminated food products, which highlight its importance in public health. In the last decade, L. monocytogenes has emerged as a foodborne pathogen of major importance in Chile. A previous work showed that in Chile during 2008 and 2009, L. monocytogenes serotypes 1/2a, 1/2b and 4b were the most frequently identified in food and clinical strains. Here we report the molecular characterization of L. monocytogenes strains isolated from 2008 to 2017 in the country. Our results indicate that serotypes 1/2a, 1/2b and 4b continue to be the most commonly found in food products. In addition, we identify persistent and widespread PFGE subtypes. This study reports ten years of epidemiological surveillance ofL. monocytogenes in Chile.


Asunto(s)
Monitoreo Epidemiológico , Microbiología de Alimentos , Enfermedades Transmitidas por los Alimentos/epidemiología , Listeria monocytogenes/genética , Listeriosis/epidemiología , Chile/epidemiología , Recuento de Colonia Microbiana , ADN Bacteriano/genética , Brotes de Enfermedades , Enfermedades Transmitidas por los Alimentos/microbiología , Gastroenteritis/epidemiología , Gastroenteritis/microbiología , Variación Genética , Humanos , Listeria monocytogenes/patogenicidad , Productos de la Carne/microbiología , Epidemiología Molecular , Salud Pública , Serogrupo , Serotipificación , Factores de Virulencia/genética
2.
BMC Infect Dis ; 19(1): 1018, 2019 Dec 02.
Artículo en Inglés | MEDLINE | ID: mdl-31791267

RESUMEN

BACKGROUND: Although, India has made steady progress in reducing deaths in children younger than 5 years, the proportional mortality accounted by diarrhoeal diseases still remains high. The present hospital based cross sectional study was carried out to understand the prevalence of various bacterial pathogens associated with the diarrhoea cases in under 5 years age group. METHODS: During, 1st September, 2015 to 30th November 2017, all the childhood diarrhoea cases (≤5 yrs) of SCB Medical College in Odisha, India were included in the study. Stool samples were collected and processed for the isolation of causative bacterial pathogen and the isolated bacterial pathogens were subjected to antibiotic sensitivity testing, molecular analysis of drug resistance. Clinical and demographic data were collected and analyzed. RESULTS: Three hundred twenty patients were enrolled in the study during the study period from whom 82 bacterial isolates were obtained indicating a proportional causality of 25.6% for bacterial diarrhoea among children in this region. Entero toxigenic E.coli (ETEC) accounted for majority of the cases and and more than 50% of the strains were found to be multi-drug resistant (resistant to more than 3 class of antibiotics). More than 50% of the strains were resistant to current choice of treatment like ciprofloxacin, ofloxacin and ceftriaxone and 2.4% being resistant to Imipenem. ESBL production was also observed in some of the strains and one isolate harboured the NDM-1 gene. Fluoroquinolone resistance was found to be linked with multiple mutations in the QRDR region followed by PMQR determinants. CONCLUSION: The current study, to the best of our knowledge is first of its kind which demonstrated the etiology of bacterial diarrhoea in children less than 5 years old and identified diarrheogenic E. coli as the predominant enteropathogen in Odisha. Majority of the isolates being multi-drug resistance calls for a continuous surveillance system in the region which will be helpfulin identifying emerging resistance pattern and for developing suitable intervention stategies.


Asunto(s)
Infecciones Bacterianas/diagnóstico , Infecciones Bacterianas/microbiología , Diarrea/diagnóstico , Diarrea/etiología , Farmacorresistencia Microbiana/genética , Tipificación Molecular/métodos , Antibacterianos/uso terapéutico , Infecciones Bacterianas/tratamiento farmacológico , Infecciones Bacterianas/epidemiología , Preescolar , Ciprofloxacino/uso terapéutico , Estudios Transversales , Diarrea/epidemiología , Diarrea/microbiología , Farmacorresistencia Microbiana/efectos de los fármacos , Escherichia coli/aislamiento & purificación , Infecciones por Escherichia coli/diagnóstico , Infecciones por Escherichia coli/epidemiología , Infecciones por Escherichia coli/microbiología , Femenino , Fluoroquinolonas/uso terapéutico , Gastroenteritis/diagnóstico , Gastroenteritis/tratamiento farmacológico , Gastroenteritis/epidemiología , Gastroenteritis/microbiología , Humanos , India/epidemiología , Lactante , Recién Nacido , Masculino , Pruebas de Sensibilidad Microbiana , Técnicas de Diagnóstico Molecular/métodos , Prevalencia , Centros de Atención Terciaria
3.
Artículo en Inglés | MEDLINE | ID: mdl-31610774

RESUMEN

An outbreak of Salmonella enterica serovar Typhimurium with closely related Multiple Locus Variable-number Tandem Repeat Analysis (MLVA) patterns was detected by routine surveillance by the Australian Capital Territory Health Protection Service in May 2018. The outbreak consisted of three cases in 2018 (MLVA 03-10-10-09-496) and one in 2016 (MLVA 03-10-09-09-496), who reported eating home-cooked eggs from the same local producer. Environmental investigations found significant problems with egg cleaning, hand hygiene and documentation of food safety procedures on farm. Environmental samples collected from the farm were found to have the same MLVA pattern as the 2018 cases. Although poor farm practices most likely led to contamination of the eggs, this outbreak highlights the need for consumer education about safe handling of eggs in the home.


Asunto(s)
Huevos/microbiología , Infecciones por Salmonella/epidemiología , Infecciones por Salmonella/microbiología , Adolescente , Adulto , Territorio de la Capital Australiana/epidemiología , Niño , Brotes de Enfermedades , Monitoreo del Ambiente , Femenino , Microbiología de Alimentos , Gastroenteritis/epidemiología , Gastroenteritis/microbiología , Humanos , Masculino , Persona de Mediana Edad , Repeticiones de Minisatélite , Salud Pública , Salmonella typhimurium , Serogrupo , Adulto Joven
4.
Artículo en Inglés | MEDLINE | ID: mdl-31522662

RESUMEN

A cluster of gastrointestinal illness was detected following receipt of a complaint of becoming ill after a multi-course dinner at a restaurant in Canberra, Australian Capital Territory (ACT), Australia. The complaint led to an investigation by ACT Health. Food samples retained by the restaurant for microbiological analysis returned an unsatisfactory level of Bacillus cereus in beef (19,000 colony forming units/gram [cfu/g]) and a satisfactory level in arancini (50 cfu/g). These positive samples underwent whole genome sequencing and genes encoding diarrhoeal toxins were detected with no laboratory evidence of the emetic toxin. No stool specimens were collected. A cohort study was undertaken and 80% (33/41) of patrons took part in a structured interview. There was no significant difference in age or sex between those ill and not ill. Due to universal exposure most foods were unable to be statistically analysed and no significant results were found from the food history. The ill cohort diverged into two distinct groups based on incubation period and symptoms suggesting this outbreak involved B. cereus intoxication with both diarrhoeal and potentially emetic toxins. Some hygiene practices during food preparation were noted to be inadequate and heating and cooling procedures were unverified when questioned. A combination of the incubation periods and symptom profile, food laboratory evidence, and genomic sequencing of the B. cereus diarrhoeal gene suggest a probable aetiology of B. cereus intoxication. Public health action included the restaurant rectifying hygiene practices and documenting heating/cooling procedures.


Asunto(s)
Bacillus cereus/aislamiento & purificación , Toxinas Bacterianas/toxicidad , Brotes de Enfermedades , Enfermedades Transmitidas por los Alimentos/epidemiología , Gastroenteritis/epidemiología , Carne Roja/microbiología , Animales , Territorio de la Capital Australiana/epidemiología , Bacillus cereus/genética , Bovinos , Estudios de Cohortes , Diarrea/epidemiología , Diarrea/microbiología , Diarrea/mortalidad , Eméticos , Femenino , Contaminación de Alimentos , Enfermedades Transmitidas por los Alimentos/microbiología , Enfermedades Transmitidas por los Alimentos/mortalidad , Gastroenteritis/microbiología , Gastroenteritis/mortalidad , Humanos , Masculino , Restaurantes , Estudios Retrospectivos , Encuestas y Cuestionarios
5.
Rev Med Suisse ; 15(661): 1574-1577, 2019 Sep 04.
Artículo en Francés | MEDLINE | ID: mdl-31496191

RESUMEN

Gastroenteritis due to non-typhoidal Salmonella (NTS) is usually considered as a benign infection. NTS can nevertheless cause severe diseases with high mortality. Invasive NTS infections may present as bacteremia without other manifestations, particularly in immunocompromised hosts. They may also correspond to extra-digestive infections in various body sites. Patients with cardiovascular diseases are at risk for endovascular infections, aortitis being the most frequent. These infections are difficult to diagnose and require surgery.


Asunto(s)
Aortitis/microbiología , Infecciones por Salmonella/microbiología , Salmonella/patogenicidad , Anciano , Bacteriemia/microbiología , Enfermedades Cardiovasculares/microbiología , Gastroenteritis/microbiología , Humanos
6.
BMC Infect Dis ; 19(1): 630, 2019 Jul 17.
Artículo en Inglés | MEDLINE | ID: mdl-31315581

RESUMEN

BACKGROUND: In hospitalised patients with diarrhoea a positive campylobacter stool Polymerase Chain Reaction (PCR) test with negative culture results as well as Enteropathogenic Escherichia coli (EPEC) positive stool PCRs, challenges the clinician and may lead the unexperienced clinician astray. The aim of the study was to elucidate the clinical significance of positive Campylobacter and/or EPEC test results in hospitalised patients with diarrhoea. METHODS: We conducted a retrospective case-case study. Case groups with 1) EPEC only and 2) EPEC in combination with any other pathogen in the PCR multiplex array, 3) PCR positive/culture negative Campylobacter, and 4) PCR positive/culture positive Campylobacter were compared. Medical records were reviewed and cases classified according to pre-specified clinical criteria as infectious gastroenteritis or non-infectious causes for diarrhoea. We analyzed the association between laboratory findings (the 4 subgroups) and the pre-specified clinical classification. We further sequenced culture negative campylobacter samples and tested EPEC for bundle forming pilus A (bfpA) gene, distinguishing typical from atypical EPEC. RESULTS: A total of 291 patients were included, 169 were PCR positive for Campylobacter and 122 for EPEC. For both pathogens, co-infections were more common in culture negative/PCR positive samples than in culture positive samples. Clinical characteristics differed significantly in and between groups. Campylobacter culture positive patients had very high prevalence of characteristics of acute infectious gastroenteritis, whereas patients with PCR positive test results only often had an alternative explanation for their diarrhoea. Culture positives were almost exclusively C. jejuni/coli, whereas in culture negatives, constituting a third of the total PCR positives, C. concisus was the most frequent species. The vast majority of EPEC only positives had documented non-infectious factors that could explain diarrhoea. The EPEC co-infected group mimicked the culture positive campylobacter group, with most patients fulfilling the infectious gastroenteritis criteria. CONCLUSIONS: In hospitalised patients, positive PCR results for campylobacter and EPEC should be interpreted in a clinical context after evaluation of non-infectious diarrhoea associated conditions, and cannot be used as a stand-alone diagnostic tool.


Asunto(s)
Escherichia coli Enteropatógena/genética , Infecciones por Escherichia coli/microbiología , Heces/microbiología , Reacción en Cadena de la Polimerasa Multiplex/métodos , Anciano , Técnicas Bacteriológicas , Campylobacter/genética , Campylobacter/patogenicidad , Diarrea/microbiología , Escherichia coli Enteropatógena/aislamiento & purificación , Infecciones por Escherichia coli/epidemiología , Femenino , Gastroenteritis/epidemiología , Gastroenteritis/microbiología , Hospitalización/estadística & datos numéricos , Humanos , Masculino , Persona de Mediana Edad , Noruega/epidemiología , Estudios Retrospectivos
7.
Nutrients ; 11(7)2019 Jun 27.
Artículo en Inglés | MEDLINE | ID: mdl-31252646

RESUMEN

Citrus flavanones, with hesperidin and naringin as the most abundant representatives, have various beneficial effects, including anti-oxidative and anti-inflammatory activities. Evidence also indicates that they may impact the intestinal microbiome and are metabolized by the microbiota as well, thereby affecting their bioavailability. In this review, we provide an overview on the current evidence on the intestinal fate of hesperidin and naringin, their interaction with the gut microbiota, and their effects on intestinal barrier function and intestinal inflammation. These topics will be discussed as they may contribute to gastrointestinal health in various diseases. Evidence shows that hesperidin and naringin are metabolized by intestinal bacteria, mainly in the (proximal) colon, resulting in the formation of their aglycones hesperetin and naringenin and various smaller phenolics. Studies have also shown that citrus flavanones and their metabolites are able to influence the microbiota composition and activity and exert beneficial effects on intestinal barrier function and gastrointestinal inflammation. Although the exact underlying mechanisms of action are not completely clear and more research in human subjects is needed, evidence so far suggests that citrus flavanones as well as their metabolites have the potential to contribute to improved gastrointestinal function and health.


Asunto(s)
Bacterias/metabolismo , Citrus/metabolismo , Colon/metabolismo , Flavanonas/metabolismo , Frutas/metabolismo , Gastroenteritis/prevención & control , Microbioma Gastrointestinal , Hesperidina/metabolismo , Absorción Intestinal , Intestino Delgado/metabolismo , Animales , Bacterias/efectos de los fármacos , Disponibilidad Biológica , Colon/efectos de los fármacos , Colon/microbiología , Flavanonas/administración & dosificación , Gastroenteritis/metabolismo , Gastroenteritis/microbiología , Microbioma Gastrointestinal/efectos de los fármacos , Hesperidina/administración & dosificación , Humanos , Absorción Intestinal/efectos de los fármacos , Intestino Delgado/efectos de los fármacos , Intestino Delgado/microbiología
8.
Emerg Microbes Infect ; 8(1): 827-840, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31169073

RESUMEN

Campylobacter showae a bacterium historically linked to gingivitis and periodontitis, has recently been associated with inflammatory bowel disease and colorectal cancer. Our aim was to generate genome sequences for new clinical C. showae strains and identify functional properties explaining their pathogenic potential. Eight C. showae genomes were assessed, four strains isolated from inflamed gut tissues from paediatric Crohn's disease patients, three strains from colonic adenomas, and one from a gastroenteritis patient stool. Genome assemblies were analyzed alongside the only 3 deposited C. showae genomes. The pangenome from these 11 strains consisted of 4686 unique protein families, and the core genome size was estimated at 1050 ± 15 genes with each new genome contributing an additional 206 ± 16 genes. Functional assays indicated that colonic strains segregated into 2 groups: adherent/invasive vs. non-adherent/non-invasive strains. The former possessed Type IV secretion machinery and S-layer proteins, while the latter contained Cas genes and other CRISPR associated proteins. Comparison of gene profiles with strains in Human Microbiome Project metagenomes showed that gut-derived isolates share genes specific to tongue dorsum and supragingival plaque counterparts. Our findings indicate that C. showae strains are phenotypically and genetically diverse and suggest that secretion systems may play an important role in virulence potential.


Asunto(s)
Infecciones por Campylobacter/microbiología , Campylobacter/genética , Genoma Bacteriano , Proteínas Bacterianas/genética , Campylobacter/clasificación , Campylobacter/aislamiento & purificación , Campylobacter/patogenicidad , Enfermedad de Crohn/microbiología , Gastroenteritis/microbiología , Genómica , Humanos , Fenotipo , Filogenia , Virulencia , Factores de Virulencia/genética
9.
Lett Appl Microbiol ; 69(3): 190-197, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31220348

RESUMEN

This research aims to compare the culturing conditions for enterohepatic Helicobacter, evaluating culture media, incubation atmosphere and susceptibility to antimicrobials used to generate selective conditions. Four common media for the closely related genus Campylobacter (Columbia, Bolton, Brucella and CCDA agar), as well as the need for hydrogen in the microaerobic incubation atmosphere, were evaluated. Serial dilutions of 13 strains belonging to six species (H. apodemus, H. bilis, H. canicola, H. canis, H. equorum and Helicobacter sp.) were inoculated in each media and incubated at 37°C for 48 to 96 h using CampyGen (OXOID) and gaseous exchange (including hydrogen) in parallel. Columbia or Brucella agars were the most appropriate for culturing EHH (P < 0·05). However, there was no significant difference between the atmospheres evaluated (P = 0·13). In addition, minimal inhibitory concentration for six antibiotics showed that all isolates were resistant to trimethoprim, whereas for the rest of the antibiotics (cephalothin, cefoperazone, cefsulodin, teicoplanin and vancomycin) the inhibition range was between 8 and 64 µg ml- 1 . Our findings suggest that Columbia or Brucella media, regardless of the use of hydrogen, can be used for the EHH isolation. In addition, the concentration of antibiotics included in commercial campylobacteria supplements is suitable for EHH species recovery. SIGNIFICANCE AND IMPACT OF THE STUDY: Enterohepatic Helicobacter (EHH) infections have been associated with several diseases in humans such as acute gastroenteritis, inflammatory bowel disease and hepatobiliary diseases. Although they are frequently detected in clinical samples by molecular methods, only occasionally they are isolated using culture conditions described for the taxonomic related pathogen Campylobacter sp. This is because the optimal conditions for the isolation of EHH have not yet been described, which results in an underestimation of the prevalence and clinical importance of these emerging pathogens. Therefore, this study provides insight for culturing EHH species.


Asunto(s)
Agar/química , Antibacterianos/farmacología , Medios de Cultivo/química , Helicobacter/crecimiento & desarrollo , Helicobacter/metabolismo , Campylobacter/crecimiento & desarrollo , Gastroenteritis/microbiología , Helicobacter/clasificación , Infecciones por Helicobacter/tratamiento farmacológico , Humanos , Pruebas de Sensibilidad Microbiana
10.
Iran J Kidney Dis ; 13(3): 139-150, 2019 05.
Artículo en Inglés | MEDLINE | ID: mdl-31209187

RESUMEN

Shiga toxin induced Escherichia Coli (STEC) is associated with chronic kidney disease or neurologic disability. The aim of this study is to determine the prevalence of STEC identified in human studies in Iran. Search engines of PubMed, EMBASE, OVID, SCOPUS, Web of Science, Google Scholar, IranMedex, MagIran, SID and ganj.irandoc were used. All human studies with stool or rectal swap samples evaluated for STEC and the outcome of HUS in Iran, which had been published between 1985 and 2017, were included. Chi-square and I2 statistic tests were applied to assess between-studies heterogeneity. Pooled prevalence and odd ratio were calculated using random effect models. A total of 30 articles containing 23379 samples were included for the final analysis. The design of study was cross sectional in 16, case control in 13 and one was cohort. The pooled prevalence of STEC was 7% (95% CI, 5 - 11; I2 = 98.3%). In subgroup analysis, the pooled prevalence was 8% (95% CI, 4 - 13; I2 = 97.55%) in children but 4% (95% CI, 2 - 7; I2 = 97.66%) in adults. The odds of patients with diarrhea having had STEC were 7.06 times the odds of healthy subjects (pooled OR = 7.06, 95% CI: 3.66-13.61). Patients with bloody diarrhea less likely to have positive STEC than patients with non-bloody diarrhea (pooled OR = 0.33, 95% CI: 0.10-1.02). STEC was prevalent in diarrheic patients and the rate increased in recent years. The highest contamination was seen in East-South of Iran. Public health intervention is mandatory to eliminate it effectively.


Asunto(s)
Infecciones por Escherichia coli/epidemiología , Gastroenteritis/epidemiología , Síndrome Hemolítico-Urémico/epidemiología , Escherichia coli Shiga-Toxigénica/aislamiento & purificación , Diarrea/diagnóstico , Diarrea/epidemiología , Diarrea/microbiología , Infecciones por Escherichia coli/diagnóstico , Infecciones por Escherichia coli/microbiología , Heces/microbiología , Gastroenteritis/diagnóstico , Gastroenteritis/microbiología , Síndrome Hemolítico-Urémico/diagnóstico , Síndrome Hemolítico-Urémico/microbiología , Humanos , Irán/epidemiología , Prevalencia
11.
PLoS Genet ; 15(6): e1008233, 2019 06.
Artículo en Inglés | MEDLINE | ID: mdl-31233504

RESUMEN

Pathogenic Salmonella strains that cause gastroenteritis are able to colonize and replicate within the intestines of multiple host species. In general, these strains have retained an ability to form the rdar morphotype, a resistant biofilm physiology hypothesized to be important for Salmonella transmission. In contrast, Salmonella strains that are host-adapted or even host-restricted like Salmonella enterica serovar Typhi, tend to cause systemic infections and have lost the ability to form the rdar morphotype. Here, we investigated the rdar morphotype and CsgD-regulated biofilm formation in two non-typhoidal Salmonella (NTS) strains that caused invasive disease in Malawian children, S. Typhimurium D23580 and S. Enteritidis D7795, and compared them to a panel of NTS strains associated with gastroenteritis, as well as S. Typhi strains. Sequence comparisons combined with luciferase reporter technology identified key SNPs in the promoter region of csgD that either shut off biofilm formation completely (D7795) or reduced transcription of this key biofilm regulator (D23580). Phylogenetic analysis showed that these SNPs are conserved throughout the African clades of invasive isolates, dating as far back as 80 years ago. S. Typhi isolates were negative for the rdar morphotype due to truncation of eight amino acids from the C-terminus of CsgD. We present new evidence in support of parallel evolution between lineages of nontyphoidal Salmonella associated with invasive disease in Africa and the archetypal host-restricted invasive serovar; S. Typhi. We hypothesize that the African invasive isolates are becoming human-adapted and 'niche specialized' with less reliance on environmental survival, as compared to gastroenteritis-causing isolates.


Asunto(s)
Evolución Biológica , Gastroenteritis/genética , Infecciones por Salmonella/genética , Salmonella typhimurium/genética , África/epidemiología , Biopelículas/crecimiento & desarrollo , Niño , Gastroenteritis/epidemiología , Gastroenteritis/microbiología , Humanos , Filogenia , Polimorfismo de Nucleótido Simple/genética , Infecciones por Salmonella/microbiología , Infecciones por Salmonella/transmisión , Salmonella typhimurium/patogenicidad , Transactivadores/genética
12.
Semin Diagn Pathol ; 36(3): 187-192, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-31036328

RESUMEN

Knowledge of the pathogenic roles of certain bacterial agents in gastroenteritis has been growing over the past few decades. With the increasing use of multiplex molecular-based syndromic stool pathogen panels, the roles of Plesiomonas shigelloides and some of the diarrheagenic pathotypes of Escherichia coli (enterotoxigenic E. coli [ETEC], enteropathogenic E. coli [EPEC], enteroinvasive E. coli [EIEC], and enteroaggregative E. coli [EAEC]) have been better understood. Although not currently targeted on Food and Drug Administration (FDA)-cleared commercial multiplex stool panels, Aeromonas has also emerged as a possible cause of bacterial gastroenteritis. The clinical presentation, pathophysiology, and diagnostic approaches to these pathogens in stool specimens are reviewed. Variability in inclusion of these pathogens on multiplex molecular panels and difficulties in detection by stool culture techniques utilized by clinical microbiology laboratories have contributed to an unclear understanding of the pathogenic role of several of these pathogens. Nonetheless, most evidence points towards a clear pathogenic role for P. shigelloides and ETEC, and possibly EPEC and EIEC. The contribution of Aeromonas spp. and EAEC to bacterial gastroenteritis has not been fully established. Further studies of pathogenicity of these pathogens are needed.


Asunto(s)
Aeromonas/aislamiento & purificación , Infecciones Bacterianas/patología , Enfermedades Transmisibles Emergentes/patología , Diarrea/patología , Escherichia coli/aislamiento & purificación , Gastroenteritis/patología , Plesiomonas/aislamiento & purificación , Infecciones Bacterianas/diagnóstico , Enfermedades Transmisibles Emergentes/diagnóstico , Enfermedades Transmisibles Emergentes/microbiología , Diarrea/diagnóstico , Diarrea/microbiología , Heces/microbiología , Gastroenteritis/diagnóstico , Gastroenteritis/microbiología , Humanos
13.
Artículo en Inglés | MEDLINE | ID: mdl-31083597

RESUMEN

Shiga toxin-producing Escherichia Coli (STEC) infections routinely run as a common gastroenteritis, but in many cases they may evolve towards hemolytic uremic syndrome (HUS). HUS is a rare disease characterized by microangiopathic hemolytic anemia, thrombocytopenia, and acute renal failure. Gut microorganisms have a fundamental impact on human physiology, because they modulate normal intestinal functions and play a pivotal role in influencing the local and systemic immune responses. Despite surveillance established in many countries and major progresses in the understanding of STEC-HUS mechanisms, no specific treatment is currently available. Targeting the gut microbiota could represent a new potential therapeutic strategy in STEC infection. In this paper, we reviewed the current knowledge about microbiota characteristics of patients with STEC infections, as well as in vitro and in vivo evidence of probiotic supplementation in managing STEC gastroenteritis and in HUS onset prevention.


Asunto(s)
Infecciones por Escherichia coli/tratamiento farmacológico , Gastroenteritis/tratamiento farmacológico , Microbioma Gastrointestinal , Síndrome Hemolítico-Urémico/tratamiento farmacológico , Probióticos/uso terapéutico , Escherichia coli Shiga-Toxigénica/fisiología , Infecciones por Escherichia coli/epidemiología , Infecciones por Escherichia coli/microbiología , Gastroenteritis/complicaciones , Gastroenteritis/epidemiología , Gastroenteritis/microbiología , Síndrome Hemolítico-Urémico/epidemiología , Síndrome Hemolítico-Urémico/microbiología , Humanos , Incidencia
15.
Artículo en Inglés | MEDLINE | ID: mdl-31091403

RESUMEN

Salmonella Hessarek is an uncommon serotype in Australia. We report on the investigation of a protracted outbreak of 25 cases of S. Hessarek gastroenteritis in which cases were defined as any laboratory confirmed case of Salmonella Hessarek notified to the South Australian Communicable Disease Control Branch from 1st March 2017 to 3 July 2018. We conducted a descriptive case series investigation interviewing all cases and 17 (68%) reported consuming brand X free-range eggs. Four samples of one-dozen brand X eggs were cultured for the presence of Salmonella spp. One out of the four samples returned positive for S. Hessarek in the contents of the eggs; Salmonella was not present in any of the whole egg rinses of the four samples. The high proportion of cases reporting the consumption of brand X free-range eggs and the isolation of S. Hessarek from sampling four dozen brand X eggs is an unusually strong signal implicating brand X eggs as the source of this outbreak. From a public health perspective, it is important to understand the behaviour of S. Hessarek including its ability to be present in the content of eggs and further research is recommended. The findings in this investigation into a rare Salmonella serotype highlight the need for continuous monitoring of the epidemiology of Salmonella in Australia including the epidemiology of egg-associated Salmonella outbreaks of human disease.


Asunto(s)
Brotes de Enfermedades , Huevos/microbiología , Microbiología de Alimentos , Gastroenteritis/epidemiología , Intoxicación Alimentaria por Salmonella/epidemiología , Salmonella/aislamiento & purificación , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Femenino , Gastroenteritis/microbiología , Humanos , Lactante , Masculino , Persona de Mediana Edad , Intoxicación Alimentaria por Salmonella/microbiología , Australia del Sur/epidemiología , Adulto Joven
16.
PLoS Pathog ; 15(4): e1007745, 2019 04.
Artículo en Inglés | MEDLINE | ID: mdl-31009517

RESUMEN

The mechanisms by which the gut luminal environment is disturbed by the immune system to foster pathogenic bacterial growth and survival remain incompletely understood. Here, we show that STAT2 dependent type I IFN signaling contributes to the inflammatory environment by disrupting hypoxia enabling the pathogenic S. Typhimurium to outgrow the microbiota. Stat2-/- mice infected with S. Typhimurium exhibited impaired type I IFN induced transcriptional responses in cecal tissue and reduced bacterial burden in the intestinal lumen compared to infected wild-type mice. Although inflammatory pathology was similar between wild-type and Stat2-/- mice, we observed decreased hypoxia in the gut tissue of Stat2-/- mice. Neutrophil numbers were similar in wild-type and Stat2-/- mice, yet Stat2-/- mice showed reduced levels of myeloperoxidase activity. In vitro, the neutrophils from Stat2-/- mice produced lower levels of superoxide anion upon stimulation with the bacterial ligand N-formylmethionyl-leucyl-phenylalanine (fMLP) in the presence of IFNα compared to neutrophils from wild-type mice, indicating that the neutrophils were less functional in Stat2-/- mice. Cytochrome bd-II oxidase-mediated respiration enhances S. Typhimurium fitness in wild-type mice, while in Stat2-/- deficiency, this respiratory pathway did not provide a fitness advantage. Furthermore, luminal expansion of S. Typhimurium in wild-type mice was blunted in Stat2-/- mice. Compared to wild-type mice which exhibited a significant perturbation in Bacteroidetes abundance, Stat2-/- mice exhibited significantly less perturbation and higher levels of Bacteroidetes upon S. Typhimurium infection. Our results highlight STAT2 dependent type I IFN mediated inflammation in the gut as a novel mechanism promoting luminal expansion of S. Typhimurium.


Asunto(s)
Disbiosis/inmunología , Gastroenteritis/inmunología , Inflamación/inmunología , Interferón Tipo I/inmunología , Factor de Transcripción STAT2/fisiología , Infecciones por Salmonella/inmunología , Salmonella typhimurium/inmunología , Animales , Células Cultivadas , Disbiosis/metabolismo , Disbiosis/patología , Femenino , Gastroenteritis/metabolismo , Gastroenteritis/microbiología , Gastroenteritis/patología , Inflamación/metabolismo , Inflamación/microbiología , Inflamación/patología , Interferón Tipo I/metabolismo , Intestinos/inmunología , Intestinos/microbiología , Intestinos/patología , Ratones , Ratones Endogámicos C57BL , Ratones Noqueados , Neutrófilos/inmunología , Neutrófilos/metabolismo , Neutrófilos/microbiología , Neutrófilos/patología , Factor de Transcripción STAT1/fisiología , Infecciones por Salmonella/metabolismo , Infecciones por Salmonella/microbiología , Infecciones por Salmonella/patología
17.
Int J Infect Dis ; 83: 83-85, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-30986543

RESUMEN

OBJECTIVES: In this study we investigated an outbreak of Vibrio cholera O1 Ogawa serotype, occurred during December 2014 in Kudat district, situated in Sabah state of the Malaysian part of Borneo. METHODS: Active case detection and contact tracing were done at respective localities by house to house survey. Passive case detection was done among acute gastroenteritis patients attended at various health facilities. To determine the source, samples from food, water and environment were taken. A case control study was also done to determine the risk factors. RESULTS: A total of 44 symptomatic and 34 asymptomatic cases from 19 localities were investigated. 39 cases were detected through passive case detection. Median age of cases was 23 years. All cases belonged to serogroup O1 and Ogawa serotype. The epidemiological investigation of time, place, and person identified that V. cholerae cross-transmission might have occurred in two fish markets and the fish-loading port. Circumstantial evidences indicated that cholera was possibly transmitted through contaminated sea foods. CONCLUSIONS: We concluded that the life-style of Sea Gypsies is a challenge in cholera control; therefore vaccination might be an effective way to mitigate cholera in an outbreak prone area like Kudat.


Asunto(s)
Cólera/epidemiología , Brotes de Enfermedades , Alimentos Marinos/microbiología , Migrantes , Vibrio cholerae , Adolescente , Adulto , Borneo/epidemiología , Estudios de Casos y Controles , Cólera/etiología , Femenino , Gastroenteritis/epidemiología , Gastroenteritis/microbiología , Humanos , Malasia/epidemiología , Masculino , Persona de Mediana Edad , Factores de Riesgo , Serogrupo , Encuestas y Cuestionarios , Adulto Joven
18.
Diagn Microbiol Infect Dis ; 95(1): 10-14, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31029490

RESUMEN

Though the FilmArray GI Panel has a reported aggregate specificity and reproducibility of >97% and > 99%, respectively, the reproducibility is less understood in clinical practice. We measured the reproducibility of positive results for low-prevalence pathogens. Samples with positive results for selected targets were repeated using a different FilmArray module. Overall, 331 of 373 (89%) results were reproducible. Giardia lamblia (57/57, 100%), Cryptosporidium spp. (61/63, 97%), Cyclospora cayetanensis (34/35, 97%), Plesiomonas shigelloides (17/18, 94%), and Rotavirus A (76/77, 99%) were highly reproducible, while Adenovirus F40/41 (38/54, 70%), Vibrio spp. (8/10, 80%), V. cholerae (3/8, 37.5%), and Yersinia enterocolitica (36/50, 72%) were poorly reproducible. Review of 38 patients with nonreproducible results showed that 19 (50%) had evidence of gastroenteritis and only 6 (16%) had possible infection with the organism that showed a nonreproducible result. Higher false-positive rates with certain targets on FAGP emphasize the need for diagnostic stewardship.


Asunto(s)
Gastroenteritis/diagnóstico , Técnicas de Diagnóstico Molecular/métodos , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Animales , Bacterias/genética , Bacterias/aislamiento & purificación , Niño , Preescolar , Reacciones Falso Positivas , Heces/microbiología , Heces/parasitología , Heces/virología , Femenino , Hongos/genética , Hongos/aislamiento & purificación , Gastroenteritis/microbiología , Gastroenteritis/parasitología , Gastroenteritis/virología , Humanos , Lactante , Masculino , Persona de Mediana Edad , Reacción en Cadena de la Polimerasa Multiplex/normas , Parásitos/genética , Parásitos/aislamiento & purificación , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Adulto Joven
19.
Indian J Gastroenterol ; 38(2): 134-142, 2019 04.
Artículo en Inglés | MEDLINE | ID: mdl-30949908

RESUMEN

BACKGROUND AND AIM: Post-infection irritable bowel syndrome (PI-IBS) can occur following acute gastroenteritis (AGE). This study was designed to evaluate the incidence and risk factors of PI-IBS following AGE and to validate a PI-IBS risk score. METHODS: This prospective study was performed between September 2014 and October 2016 on AGE patients by documenting their AGE severity and following up after 3 and 6 months to study the development of IBS (ROME III criteria). The risk score was calculated for all the subjects, and its discrimination ability was tested. RESULTS: Out of 136 hospitalized AGE patients, 35 developed PI-IBS after 6 months. The factors associated with PI-IBS were younger age, longer duration of AGE, anxiety, depression, abdominal pain, bloody stool, vomiting, fever, family history of IBS, and positive stool culture (univariate analysis); however, on multivariate analysis, younger age (adjusted odds ratio [AOR] 0.5; p 0.03), prolonged duration of AGE (AOR 8.6; p 0.01), and abdominal cramps (AOR 2.1; p 0.02) were the independent factors influencing its occurrence. PI-IBS occurred even after infection with Vibrio cholerae. The PI-IBS risk score was significantly higher in patients who developed PI-IBS (72.4 ± 14.48 vs. 31.56 ± 20.4, p-value < 0.001); score > 50 had a sensitivity and specificity of 91.4% and 84.2%, respectively. CONCLUSION: One fourth of AGE patients developed PI-IBS after 6 months. Factors influencing its development were younger age, long duration of AGE, and abdominal pain. The PI-IBS risk score had good predictive accuracy in our population.


Asunto(s)
Gastroenteritis/complicaciones , Síndrome del Colon Irritable/epidemiología , Síndrome del Colon Irritable/etiología , Enfermedad Aguda , Factores de Edad , Infecciones por Escherichia coli , Femenino , Gastroenteritis/microbiología , Humanos , Incidencia , India/epidemiología , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Riesgo , Factores de Riesgo , Factores de Tiempo , Vibrio
20.
Antonie Van Leeuwenhoek ; 112(8): 1199-1211, 2019 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-30877501

RESUMEN

The Gram-negative marine bacterium Vibrio parahaemolyticus has been identified as a major cause of bacterial food poisoning in China. Here, the population structure and genetic diversity of V. parahaemolyticus from Weihai, a coastal city in China, was studied by the multi-locus sequence typing (MLST) method. In this survey, we isolated 40 strains including environmental and clinical samples of patients with acute gastroenteritis or diarrhea; isolates from other countries were also included for comparison. DnaSP Version5, START V2, eBURST version3 and Mega 6 were used to analyse the data. We found that ST3 and ST332 were the most prevalent clones and that they were closely associated with acute diarrhoeal diseases. These STs showed a low dN/dS ratio and significant linkage disequilibrium. All isolates were divided into four clonal complexes, six groups and nine singletons, showing a high degree of genetic diversity. 18 STs, mostly from environmental isolates, were recognised by the MLST analysis for the first time. In conclusion, ST3 and ST332 were the epidemic STs in the coastal area. ST332 might be a region-specific ST, which needs to be confirmed by further analysis. Thus, the long-term monitoring of V. parahaemolyticus plays an important role in preventing and controlling the transmission between environment and people in Weihai.


Asunto(s)
Gastroenteritis/microbiología , Variación Genética , Tipificación de Secuencias Multilocus , Agua de Mar/microbiología , Vibriosis/microbiología , Vibrio parahaemolyticus/clasificación , Vibrio parahaemolyticus/aislamiento & purificación , China , Genotipo , Humanos , Vibrio parahaemolyticus/genética
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