Antimicrobial susceptibility profile of enterotoxigenic and enteropathogenic Escherichia coli isolates obtained from fecal specimens of children with acute diarrhea / Perfil de suscetibilidade a drogas antimicrobianas de amostras de Escherichia coli enterotoxigênica e enteropatogênica isoladas de espécimes fecais de crianças com doença diarreica aguda

ABSTRACT Among the diseases which etiopathogenesis is associated with Escherichia coli, acute diarrhea stands out. Studies on the characterization of the antimicrobial susceptibility profile contribute to the selection of appropriate empirical antimicrobial therapy. In this study, the antimicrobial susceptibility profile of 98 enterotoxigenic E. coli (ETEC) and enteropathogenic E. coli (EPEC) strains isolated from fecal specimens of children with acute diarrhea was evaluated. The resistance rates to ampicillin, sulfamethoxazole/trimethoprim, amoxicillin/clavulanate, and nalidixic acid were high, ranging from 34.7% to 10.2%. The result of this research recommends the use of cefotaxime and ceftriaxone for the empirical treatment of children with acute diarrhea which the etiology suggested is ETEC or EPEC.

RESUMO Entre as doenças cuja etiopatogenia está associada à Escherichia coli, destaca-se a doença diarreica aguda. Estudos que visam à caracterização do perfil de suscetibilidade antimicrobiana contribuem para o delineamento de antibioticoterapia empírica eficaz. Neste estudo, foi avaliado o perfil de suscetibilidade a antimicrobianos de 98 amostras de E. coli enterotoxigênica (ETEC) e E. coli enteropatogênica (EPEC) isoladas de crianças com doença diarreica. As frequências de resistência a ampicilina, sulfametoxazol-trimetoprima, amoxicilina-clavulanato e ácido nalidíxico foram elevadas, variando entre 34,7% e 10,2%. Esta pesquisa recomenda o emprego de cefotaxima e ceftriaxona para o tratamento empírico de crianças com quadro de diarreia cuja etiologia sugerida seja ETEC ou EPEC.

Distribution of vacA genotypes in Helicobacter pylori strains isolated from Brazilian adult patients with gastritis, duodenal ulcer or gastric carcinoma.

This PCR-based analysis is the first molecular epidemiological study in Brazil testing Helicobacter pylori cagA and vacA distribution in adults with gastric complaints, that includes a large number of carcinoma patients. Multiple-strain infection was identified in 11/13.4% patients. vacA s1-m1 and cagA(+) genotypes were the most common in patients with a non-mixed infection. All vacA s1 strains were s1b, so subtyping s1 strains was not useful. vacA s1b-m1 and cagA(+) strains were associated with higher prevalence of peptic ulcer and gastric carcinoma than vacA s2-m2 and cagA(-) ones. In conclusion, cagA and vacA genotyping may have clinical relevance in Brazil.