[Distribution of capsular types and antimicrobial susceptibility of Streptococcus agalactiae causing infections in Argentina]. / Distribución de tipo capsular y sensibilidad antimicrobiana de Streptococcus agalactiae productores de infecciones en Argentina.

Streptococcus agalactiae is an endogenous bacterium that has emerged in the last 20 years as an etiological agent in both neonatal and perinatal infections, and in immunocompromised patients. The differentiation of the capsular polysaccharide, the presence of surface proteins c, X, R, and molecular methods allow classification in serotypes and genotypes. This identification is a useful tool for epidemiological purposes and virulence studies in this bacterium. The objective of this work was to study the serotypes and the antimicrobial susceptibility of isolates recovered from invasive diseases in different areas of Argentina. In the analyzed sample a fair predominance of Ia and III serotypes was recovered, followed by II and IV serotypes. All the isolates were found to be sensitive to penicillin. A 6% of resistance to erythromycin and a 4.5% to clindamycin were detected. In three of the isolates, constitutive MLS phenotype (resistance to macrolides, lincosamins and streptogramins) was founded, while in the remaining one, inducible MLS phenotype was detected. These results stress the importance of conducting a surveillance of the prevalent serotypes in our country with the goal of future prevention of this disease with an effective vaccine. The knowledge of the antimicrobial susceptibility profile will be also important to obtain therapeutic success in the treatment.

Distribución de tipo capsular y sensibilidad antimicrobiana de Streptococcusagalactiae productores de infecciones en Argentina / Distribution of capsular types and antimicrobial susceptibility of Streptococcus agalactiae causing infections in Argentina

Streptococcus agalactiae es una bacteria colonizante que ha emergido en los últimos años como causante de infecciones neonatales, perinatales y en pacientes con compromiso inmunológico. La caracterización del polisacárido capsular, de las proteínas de superficie (c, X, R), así como el análisis de marcadores moleculares, permiten su clasificación en serotipos y genotipos. Esto resulta de utilidad para fines epidemiológicos y para estudios de virulencia de la bacteria. El objetivo de este trabajo fue conocer los serotipos prevalentes y la sensibilidad antimicrobiana de aislamientos provenientes de procesos infecciosos en pacientes de distintas zonas de Argentina. En la muestra analizada se obtuvo predominio de los serotipos Ia y III, seguido de II y IV. Todas las cepas resultaron sensibles a penicilina. Se observó 6% de resistencia a eritromicina y 4,5% a clindamicina. En 3 de las cepas se detectó fenotipo MLS (resistencia a macrólidos, lincosaminas y estreptograminas) constitutiva y en una cepa, resistencia MLS inducible. Los resultados logrados en este estudio destacan la importancia de efectuar un relevamiento de los serotipos más frecuentes en nuestro país en vistas a la prevención de esta infección con una vacuna que realmente sea eficaz, como así también el conocimiento de la sensibilidad antimicrobiana para lograr éxito terapéutico en los tratamientos.

Streptococcus agalactiae is an endogenous bacterium that has emerged in the last 20 years as an etiological agent in both neonatal and perinatal infections, and in immunocompromised patients. The differentiation of the capsular polysaccharide, the presence of surface proteins c, X, R, and molecular methods allow classification in serotypes and genotypes. This identification is a useful tool for epidemiological purposes and virulence studies in this bacterium. The objective of this work was to study the serotypes and the antimicrobial susceptibility of isolates recovered from invasive diseases in different areas of Argentina. In the analyzed sample a fair predominance of Ia and III serotypes was recovered, followed by II and IV serotypes. All the isolates were found to be sensitive to penicillin. A 6% of resistance to erythromycin and a 4.5% to clindamycin were detected. In three of the isolates, constitutive MLS phenotype (resistance to macrolides, lincosamins and streptogramins) was founded, while in the remaining one, inducible MLS phenotype was detected. These results stress the importance of conducting a surveillance of the prevalent serotypes in our country with the goal of future prevention of this disease with an effective vaccine. The knowledge of the antimicrobial susceptibility profile will be also important to obtain therapeutic success in the treatment.

Distribución de tipo capsular y sensibilidad antimicrobiana de Streptococcus agalactiae productores de infecciones en Argentina. / [Distribution of capsular types and antimicrobial susceptibility of Streptococcus agalactiae causing infections in Argentina]

Streptococcus agalactiae is an endogenous bacterium that has emerged in the last 20 years as an etiological agent in both neonatal and perinatal infections, and in immunocompromised patients. The differentiation of the capsular polysaccharide, the presence of surface proteins c, X, R, and molecular methods allow classification in serotypes and genotypes. This identification is a useful tool for epidemiological purposes and virulence studies in this bacterium. The objective of this work was to study the serotypes and the antimicrobial susceptibility of isolates recovered from invasive diseases in different areas of Argentina. In the analyzed sample a fair predominance of Ia and III serotypes was recovered, followed by II and IV serotypes. All the isolates were found to be sensitive to penicillin. A 6

of resistance to erythromycin and a 4.5

to clindamycin were detected. In three of the isolates, constitutive MLS phenotype (resistance to macrolides, lincosamins and streptogramins) was founded, while in the remaining one, inducible MLS phenotype was detected. These results stress the importance of conducting a surveillance of the prevalent serotypes in our country with the goal of future prevention of this disease with an effective vaccine. The knowledge of the antimicrobial susceptibility profile will be also important to obtain therapeutic success in the treatment.

Andes virus associated with hantavirus pulmonary syndrome in northern Argentina and determination of the precise site of infection.

Hantavirus pulmonary syndrome (HPS) has been documented in the Salta and Jujuy provinces of northern Argentina since 1991 and 1997, respectively, accounting for almost 50% of the cases of HPS reported in this country. Andes (AND) virus, specifically the AND virus Nort lineage, was previously associated with human disease in this region. Genetic analysis of viral medium RNA segments obtained from 18 HPS cases showed the existence of three AND virus Nort sublineages co-circulating in these two provinces. They showed a nucleotide sequence diversity of up to 11.1% between the sublineages. The putative site of infection of one of these cases (Sal3/97) was determined. A 100% nucleotide sequence identity was observed between the viral sequence found in patient Sal3/97 and in two virus-positive Oligoryzomys chacoensis captured in the same place where the case lived and worked. These results indicated the putative site of infection and identified this rodent species as the source of infection.

Casos de gastroenteritis asociados a Vibrio cholerae no O1 en Orán, Salta / Non- O group 1 Vibrio cholerae gastroenteritis in Oran, Salta

Entre febrero de 1992 y 1995 se detectaron 41 casos de gastroenteritis asociada a Vibrio cholerae no O1 en Orán, Salta. La frecuencia de aislamiento fue del 0,9 o/o, entre los casos de diarrea. El 51,2 o/o de los casos correspondió a mayores de 15 años y el 60,9, al sexo masculino. Todos los pacientes tuvieron diarrea, en 24 (58,5 o/o) fue líquida y en 6 (14,5 o/o) con aspecto coleriforme. Diez (24,4 o/o) de los pacientes presentaron vómitos y 12 (29,3 o/o) deshidratación leve o moderada. Seis pacientes pediátricos, desnutridos de 2§ y 3§ grado, que presentaron diarrea de más de una semana de evolución y deshidratación moderada, requirieron hospitalización durante 7 días. Durante el primer brote, en un paciente se aisló simultáneamente V. cholerae no O1 y Shigella flexneri y en el cuarto brote en otro se detectó la asociación V. cholerae no O1 y Salmonella subespecie IV 50: b:-. Una mujer de 72 años falleció durante el segundo brote. El cuadro clínico estuvo caracterizado por diarrea líquida, vómitos, fiebre y deshidratación moderada. De su coprocultivo se recuperó V. cholerae O5 negativo para los siguientes factores de virulencia: toxina de cólera (CT), enterotoxina termoestable, hemolisina (El Tor) y hemaglutinina asociadas a células resistentes a D-manosa y L-fucosa. La caracterización bioquímica de los 41 aislamientos correspondió a V. cholerae con serología negativa para los serogrupos O1 y O139. Ningún aislamiento produjo CT. El 19,5 o/o presentó resistencia a la ampiclina y 4,9 o/o, a trimetoprimasulfametoxazol. La vigilancia activa de las diarreas en Orán, ha demostrado que V. cholerae no O1 no es un agente causal importante de las mismas

Casos de gastroenteritis asociados a Vibrio cholerae no O1 en Orán, Salta / Non- O group 1 Vibrio cholerae gastroenteritis in Oran, Salta

Entre febrero de 1992 y 1995 se detectaron 41 casos de gastroenteritis asociada a Vibrio cholerae no O1 en Orán, Salta. La frecuencia de aislamiento fue del 0,9 o/o, entre los casos de diarrea. El 51,2 o/o de los casos correspondió a mayores de 15 años y el 60,9, al sexo masculino. Todos los pacientes tuvieron diarrea, en 24 (58,5 o/o) fue líquida y en 6 (14,5 o/o) con aspecto coleriforme. Diez (24,4 o/o) de los pacientes presentaron vómitos y 12 (29,3 o/o) deshidratación leve o moderada. Seis pacientes pediátricos, desnutridos de 2º y 3º grado, que presentaron diarrea de más de una semana de evolución y deshidratación moderada, requirieron hospitalización durante 7 días. Durante el primer brote, en un paciente se aisló simultáneamente V. cholerae no O1 y Shigella flexneri y en el cu

[Cases of gastroenteritis associated to Vibrio cholerae no 01 in Oran, Salta]. / Casos de gastroenteritis asociados a Vibrio cholerae no O1 en Orán, Salta.

Forty-one sporadic cases of non-O group 1 Vibrio cholerae gastroenteritis were detected in Orán, Salta, between February 1992 and February 1995. The frequency of isolation was 0.9% of the diarrhea cases. Out of 41 patients, 21 (51.2%) were older than 15 years and 25 (60.9%) were male. All the patients had diarrhea, 24 (58.5%) had watery stools and 6 (14.6%) cholera-like diarrhea; 10 (24.4%) presented vomiting and 12 (29%) mild dehydration. Six malnourished children who suffered from diarrhea with moderate dehydration for more than a week, were hospitalized. V. cholerae non O1 and Shigella flexneri were isolated from one patient, during the first outbreak and V. cholerae non O1 and Salmonella IV 50:b:- were recovered simultaneously from another patient during the fourth outbreak. A 72 year old woman died during the second cholera outbreak. The symptoms were: watery diarrhea, vomiting, fever and mild dehydration. A strain of V. cholerae O5, that did not produce cholera toxin, heat-stable enterotoxin, Kanagawa-like hemolysin or verocitotoxin was detected. It was positive for El Tor hemolysin and D-mannose and L-fucose resistant cells-associated hemagglutinins. Among the 41 isolates studied, all were oxidase and indole positive, fermented glucose, saccharose and mannitol. They were all motile, produced lysine and ornithine decarboxylases but not arginine dihydrolase or hydrogen sulfide. They were sensitive to O129 vibriostatic compound. None of them belonged to O1 or O139 serogroup and they did not produce cholera troxin. Among the V. cholerae non O1 strains isolated, 9.5% were resistant to ampicillin and 4.9% to trimethoprim-sulfamethoxazole. Active surveillance had shown that V. cholerae non-O1 is not an important agent of diarrhea in Orán, Salta.

Nueva serovariedad mundial de Salmonella aislada de un caso de diarrea / A new serovar of Salmonella isolated from a case of diarrhea

Se informa el aislamiento por primera vez en el mundo, de una nueva serovariedad de Salmonella, a partir de heces de un niño con diarrea aguda en la ciudad de Orán, provincia de Salta. Por sus caracteres bioquímica fue obicada en la sub-especie IV, taxón 5, de acuerdo a la nomenclatura actual aceptada para el género, siendo su estructura antigénica 50:b:-(S IV 50:-)

Nueva serovariedad mundial de Salmonella aislada de un caso de diarrea / A new serovar of Salmonella isolated from a case of diarrhea

Se informa el aislamiento por primera vez en el mundo, de una nueva serovariedad de Salmonella, a partir de heces de un niño con diarrea aguda en la ciudad de Orán, provincia de Salta. Por sus caracteres bioquímica fue obicada en la sub-especie IV, taxón 5, de acuerdo a la nomenclatura actual aceptada para el género, siendo su estructura antigénica 50:b:-(S IV 50:-) (AU)

[New worldwide Salmonella serovar isolated in a case of diarrhea]. / Nueva serovariedad mundial de Salmonella aislada de un caso de diarrea.

The isolation of a new serovar of Salmonella from fecal material belonging to a child with acute diarrhea in the ville of Orán, province of Salta, is reported. Because of its biochemical characteristics it was classified within the sub-species IV, taxon 5, according to the present nomenclature for this genus, being its antigenic structure 50:b:-(S IV 50:b:-).

Nueva serovariedad mundial de Salmonella aislada de un caso de diarrea. / [New worldwide Salmonella serovar isolated in a case of diarrhea]

The isolation of a new serovar of Salmonella from fecal material belonging to a child with acute diarrhea in the ville of Orán, province of Salta, is reported. Because of its biochemical characteristics it was classified within the sub-species IV, taxon 5, according to the present nomenclature for this genus, being its antigenic structure 50:b:-(S IV 50:b:-).

Antimicrobial resistance among Salmonella isolates from hospitals in Rome.

The susceptibility to antimicrobial agents of 569 salmonella isolated collected in 1977-8 from patients in hospitals in Rome was tested. Fifty-nine per cent of all isolates were resistant to one or more antimicrobials. Resistance was most common to sulphathiazole, tetracycline, streptomycin, whereas colistin, gentamicin, tobramycin, trimethoprim-sulphamethoxazole and nalidixic acid were the most active in vitro. Multiple resistance was most frequently found in strains of Salmonella wien and S. typhimurium (94% and 38% respectively). A significant change in the resistance pattern of S. wien was observed between 1977 and 1978, with a significant increase of susceptibility to some antimicrobials in 1978. Twenty-one R-plasmids transmissible to E. coli K12 were derived from 46 resistant strains of S. typhimurum.