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1.
Nat Commun ; 12(1): 765, 2021 02 03.
Artigo em Inglês | MEDLINE | ID: mdl-33536414

RESUMO

Chickens are the most common birds on Earth and colibacillosis is among the most common diseases affecting them. This major threat to animal welfare and safe sustainable food production is difficult to combat because the etiological agent, avian pathogenic Escherichia coli (APEC), emerges from ubiquitous commensal gut bacteria, with no single virulence gene present in all disease-causing isolates. Here, we address the underlying evolutionary mechanisms of extraintestinal spread and systemic infection in poultry. Combining population scale comparative genomics and pangenome-wide association studies, we compare E. coli from commensal carriage and systemic infections. We identify phylogroup-specific and species-wide genetic elements that are enriched in APEC, including pathogenicity-associated variation in 143 genes that have diverse functions, including genes involved in metabolism, lipopolysaccharide synthesis, heat shock response, antimicrobial resistance and toxicity. We find that horizontal gene transfer spreads pathogenicity elements, allowing divergent clones to cause infection. Finally, a Random Forest model prediction of disease status (carriage vs. disease) identifies pathogenic strains in the emergent ST-117 poultry-associated lineage with 73% accuracy, demonstrating the potential for early identification of emergent APEC in healthy flocks.


Assuntos
Infecções por Escherichia coli/prevenção & controle , Escherichia coli/genética , Evolução Molecular , Genoma Bacteriano/genética , Doenças das Aves Domésticas/prevenção & controle , Animais , Galinhas , Escherichia coli/classificação , Escherichia coli/patogenicidade , Infecções por Escherichia coli/diagnóstico , Infecções por Escherichia coli/microbiologia , Genes Bacterianos , Variação Genética , Estudo de Associação Genômica Ampla/métodos , Genótipo , Humanos , Filogenia , Doenças das Aves Domésticas/diagnóstico , Doenças das Aves Domésticas/microbiologia , Virulência/genética
2.
BMJ Case Rep ; 14(1)2021 Jan 27.
Artigo em Inglês | MEDLINE | ID: mdl-33504527

RESUMO

The clinical manifestation of Escherichia coli could vary from asymptomatic bacteraemia to systemic bloodstream infection and meningitis. We describe an unusual course of E. coli infection in twins, emphasising commencement of appropriate antimicrobial therapy. A set of male dichorionic diamniotic twins were delivered at 34 weeks of gestation by caesarian section. Pregnancy was complicated by diabetes, pre-eclampsia and cholestasis. Antenatal ultrasounds noted a congenital pulmonary airway malformation in twin A. Following delivery, twin A developed respiratory distress, but twin B was asymptomatic. Partial septic work-up at admission in the neonatal intensve care unit was done. Twin A's blood culture grew E. coli, while twin B's blood culture was negative. Twin A was treated with 7 days of intravenous antibiotics. At 11 days of age, twin B acutely developed a scrotal swelling. On suspicion of testicular torsion, he was taken for urgent surgery, which revealed a scrotal abscess positive for E. coli The scrotum was irrigated and successfully treated with 4 weeks of antibiotics. Both twins were doing well at 3 months of follow-up.


Assuntos
Abscesso/diagnóstico , Bacteriemia/diagnóstico , Doenças em Gêmeos/diagnóstico , Infecções por Escherichia coli/diagnóstico , Pneumonia Bacteriana/diagnóstico , Síndrome do Desconforto Respiratório do Recém-Nascido/diagnóstico , Abscesso/terapia , Antibacterianos/uso terapêutico , Bacteriemia/tratamento farmacológico , Cesárea , Pressão Positiva Contínua nas Vias Aéreas , Doenças em Gêmeos/terapia , Infecções por Escherichia coli/terapia , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Masculino , Sepse Neonatal/diagnóstico , Sepse Neonatal/terapia , Pneumonia Bacteriana/terapia , Síndrome do Desconforto Respiratório do Recém-Nascido/terapia , Escroto , Gêmeos , Adulto Jovem
3.
BMJ Case Rep ; 14(1)2021 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-33431529

RESUMO

Abdominoperineal excision of rectum (APER) is one of the widely used surgical procedures to treat low rectal cancer, benign conditions like Crohn's proctitis with anal involvement and as a salvage procedure for anal cancer. Perineal wound infection is a well-recognised complication following such major surgery. Occurrence of appendicitis in a few weeks' time following such a major surgery is uncommon. However, here we present a rare case report of perforated appendicitis presenting as persistent perineal discharge in an elderly man, following laparoscopic APER for a low rectal tumour. To our knowledge, this is the first time such a rare clinical presentation of appendicitis is reported in the history of medical literature. Through this case report, we aim to highlight the importance of considering such an uncommon presentation in patients with perineal discharge, following APER.


Assuntos
Abscesso/diagnóstico , Apendicite/complicações , Infecções por Escherichia coli/diagnóstico , Perfuração Intestinal/diagnóstico , Infecção Pélvica/diagnóstico , Complicações Pós-Operatórias/diagnóstico , Protectomia/efeitos adversos , Abscesso/etiologia , Abscesso/cirurgia , Adenocarcinoma/diagnóstico , Adenocarcinoma/patologia , Adenocarcinoma/cirurgia , Idoso , Apendicectomia , Apendicite/diagnóstico , Apendicite/cirurgia , Diagnóstico Diferencial , Escherichia coli/isolamento & purificação , Infecções por Escherichia coli/etiologia , Infecções por Escherichia coli/cirurgia , Humanos , Perfuração Intestinal/etiologia , Perfuração Intestinal/cirurgia , Masculino , Infecção Pélvica/etiologia , Infecção Pélvica/cirurgia , Períneo/microbiologia , Períneo/patologia , Períneo/cirurgia , Complicações Pós-Operatórias/etiologia , Complicações Pós-Operatórias/cirurgia , Neoplasias Retais/diagnóstico , Neoplasias Retais/patologia , Neoplasias Retais/cirurgia , Reto/patologia , Reto/cirurgia
4.
Biosens Bioelectron ; 171: 112753, 2021 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-33120235

RESUMO

A polyethyleneimine (PEI)-assisted copper in-situ growth (CISG) strategy was proposed as a controlled signal amplification strategy to enhance the sensitivity of gold nanoparticle-based lateral flow sensors (AuNP-LFS). The controlled signal amplification is achieved by introducing PEI as a structure-directing agent to regulate the thermodynamics of anisotropic Cu nanoshell growth on the AuNP surface, thus controlling shape and size of the resultant AuNP@Cu core-shell nanostructures and confining free reduction and self-nucleation of Cu2+ for improved reproducibility and decreased false positives. The PEI-CISG-enhanced AuNP-LFS showed ultrahigh sensitivities with the detection limits of 50 fg mL-1 for HIV-1 capsid p24 antigen and 6 CFU mL-1 for Escherichia coli O157:H7. We further demonstrated its clinical diagnostic efficacy by configuring PEI-CISG into a commercial AuNP-LFS detection kit for SARS-CoV-2 antibody detection. Altogether, this work provides a reliable signal amplification platform to dramatically enhance the sensitivity of AuNP-LFS for rapid and accurate diagnostics of various infectious diseases.


Assuntos
Técnicas Biossensoriais/métodos , Cobre/química , Infecções por Coronavirus/diagnóstico , Infecções por Escherichia coli/diagnóstico , Ouro/química , Infecções por HIV/diagnóstico , Pneumonia Viral/diagnóstico , Betacoronavirus/isolamento & purificação , Técnicas Biossensoriais/instrumentação , Técnicas de Laboratório Clínico , Desenho de Equipamento , Escherichia coli O157/isolamento & purificação , Proteína do Núcleo p24 do HIV/análise , HIV-1/isolamento & purificação , Humanos , Limite de Detecção , Nanopartículas Metálicas/química , Nanopartículas Metálicas/ultraestrutura , Oxirredução , Pandemias , Polietilenoimina/química , Fitas Reagentes/análise
5.
Arch Gerontol Geriatr ; 93: 104315, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33310397

RESUMO

OBJECTIVE: To investigate risk factors for Escherichia coli (E. coli) bloodstream infection (BSI) in older patients and the diagnostic accuracy of laboratory parameters. METHODS: The electronic medical records of patients aged 60 years and above who were admitted with a serious condition were extracted. Propensity score matching (PSM) was used to ensure that the included patients had similar baseline clinical features. Multiple regression analysis was used to identify risk factors for E. coli BSI and extended-spectrum ß-lactamase (ESBL)-producing E. coli BSI. Receiver operating characteristic (ROC) curve analysis was performed to determine the diagnostic utility of relevant laboratory indicators. RESULTS: After PSM, 508 patients were included: 254 patients with E. coli BSI and 254 control patients. Bile duct stone (adjusted odds ratio [aOR] 5.131), kidney stone (aOR 3.678), and urinary system infection (aOR 3.173) were independent risk factors for E. coli BSI. Prior exposure to cephems (aOR 3.782) and drainage tube placement (aOR 2.572) were independent risk factors for ESBL-producing E. coli BSI. Serum procalcitonin (PCT) yielded the highest area under the curve (0.783) and the best cut-off value (1.3 ng/ml). CONCLUSION: Bile duct stone, kidney stone, and urinary system infection must be detected and treated early, in order to prevent E. coli BSI in older patients. Further, administration of cephems and invasive procedures must be undertaken with caution, in order to reduce the risk of BSI with ESBL-producing E. coli. Finally, serum PCT level has potential as diagnostic marker for E. coli BSI in older individuals.


Assuntos
Bacteriemia , Infecções por Escherichia coli , Idoso , Antibacterianos/uso terapêutico , Bacteriemia/diagnóstico , Bacteriemia/tratamento farmacológico , Bacteriemia/epidemiologia , Escherichia coli , Infecções por Escherichia coli/diagnóstico , Infecções por Escherichia coli/tratamento farmacológico , Infecções por Escherichia coli/epidemiologia , Humanos , Estudos Retrospectivos , Fatores de Risco , beta-Lactamases
7.
Medicine (Baltimore) ; 99(28): e21113, 2020 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-32664134

RESUMO

RATIONALE: Emphysematous osteomyelitis is a rare disease caused by gas-forming bacteria. But only 45 cases have been reported in the literature since then. PATIENT CONCERNS: A 72-year-old female presented to our hospital with severe lower back pain that aggravated 4 days ago. DIAGNOSES: Computed tomography (CT) revealed intraosseous mottled air in the T12 and L1 vertebral bodies and epidural space. The enhanced T1 and T2 magnetic resonance imaging scans showed heterogeneous signal intensity of vertebral bodies, suggestive of emphysematous osteomyelitis. INTERVENTIONS: Surgery was performed to identify culture strains and to remove emphysematous lesions of the vertebral body using extensive transpedicular irrigation. OUTCOMES: Escherichia coli (E coli) was identified in the surgical specimen, and intravenous antibiotic therapy was continued with cefotaxime. The patient had a significant decrease in lower back pain after the surgery and the final CT scan before discharge revealed significantly decreased air at T12 and L1 vertebral bodies and no air density in the epidural space. LESSONS: We present a patient diagnosed with emphysematous osteomyelitis in vertebral bodies caused by E coli and successfully treated with surgical intervention.


Assuntos
Enfisema/diagnóstico , Infecções por Escherichia coli/diagnóstico , Vértebras Lombares , Osteomielite/diagnóstico , Doenças da Coluna Vertebral/diagnóstico , Vértebras Torácicas , Idoso , Enfisema/etiologia , Escherichia coli/isolamento & purificação , Infecções por Escherichia coli/complicações , Infecções por Escherichia coli/microbiologia , Feminino , Humanos , Imagem por Ressonância Magnética , Osteomielite/complicações , Doenças Raras , Doenças da Coluna Vertebral/complicações , Tomografia Computadorizada por Raios X
9.
Am J Trop Med Hyg ; 103(2): 696-703, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32458777

RESUMO

Despite the implementation of effective conjugate vaccines against the three main bacterial pathogens that cause meningitis, Streptococcus pneumoniae, Haemophilus influenzae type b (Hib), and Neisseria meningitidis serogroup A, the burden of meningitis in West Africa remains high. The relative importance of other bacterial, viral, and parasitic pathogens in central nervous system infections is poorly characterized. Cerebrospinal fluid (CSF) specimens were collected from children younger than 5 years with suspected meningitis, presenting at pediatric teaching hospitals across West Africa in five countries including Senegal, Ghana, Togo, Nigeria, and Niger. Cerebrospinal fluid specimens were initially tested using bacteriologic culture and a triplex real-time polymerase chain reaction (PCR) assay for N. meningitidis, S. pneumoniae, and H. influenzae used in routine meningitis surveillance. A custom TaqMan Array Card (TAC) assay was later used to detect 35 pathogens including 15 bacteria, 17 viruses, one fungus, and two protozoans. Among 711 CSF specimens tested, the pathogen positivity rates were 2% and 20% by the triplex real-time PCR (three pathogens) and TAC (35 pathogens), respectively. TAC detected 10 bacterial pathogens, eight viral pathogens, and Plasmodium. Overall, Escherichia coli was the most prevalent (4.8%), followed by S. pneumoniae (3.5%) and Plasmodium (3.5%). Multiple pathogens were detected in 4.4% of the specimens. Children with human immunodeficiency virus (HIV) and Plasmodium detected in CSF had high mortality. Among 220 neonates, 17% had at least one pathogen detected, dominated by gram-negative bacteria. The meningitis TAC enhanced the detection of pathogens in children with meningitis and may be useful for case-based meningitis surveillance.


Assuntos
Infecções por Escherichia coli/epidemiologia , Malária Cerebral/epidemiologia , Meningite Pneumocócica/epidemiologia , Meningite/epidemiologia , Meningite/microbiologia , África Ocidental/epidemiologia , Pré-Escolar , Técnicas de Cultura , Infecções por Citomegalovirus/líquido cefalorraquidiano , Infecções por Citomegalovirus/diagnóstico , Infecções por Citomegalovirus/epidemiologia , Infecções por Escherichia coli/líquido cefalorraquidiano , Infecções por Escherichia coli/diagnóstico , Feminino , Gana/epidemiologia , Infecções por HIV/líquido cefalorraquidiano , Infecções por HIV/diagnóstico , Infecções por HIV/epidemiologia , Vacinas Anti-Haemophilus/uso terapêutico , Humanos , Lactente , Recém-Nascido , Infecções por Klebsiella/líquido cefalorraquidiano , Infecções por Klebsiella/diagnóstico , Infecções por Klebsiella/epidemiologia , Malária Cerebral/líquido cefalorraquidiano , Malária Cerebral/diagnóstico , Masculino , Meningite/líquido cefalorraquidiano , Meningite/diagnóstico , Meningite por Haemophilus/líquido cefalorraquidiano , Meningite por Haemophilus/epidemiologia , Meningite por Haemophilus/prevenção & controle , Meningite Meningocócica/líquido cefalorraquidiano , Meningite Meningocócica/epidemiologia , Meningite Meningocócica/prevenção & controle , Meningite Pneumocócica/líquido cefalorraquidiano , Meningite Pneumocócica/prevenção & controle , Vacinas Meningocócicas/uso terapêutico , Técnicas de Diagnóstico Molecular , Mortalidade , Reação em Cadeia da Polimerase Multiplex , Níger/epidemiologia , Nigéria/epidemiologia , Vacinas Pneumocócicas/uso terapêutico , Reação em Cadeia da Polimerase em Tempo Real , Infecções por Roseolovirus/líquido cefalorraquidiano , Infecções por Roseolovirus/diagnóstico , Infecções por Roseolovirus/epidemiologia , Senegal/epidemiologia , Infecções Estafilocócicas/líquido cefalorraquidiano , Infecções Estafilocócicas/diagnóstico , Infecções Estafilocócicas/epidemiologia , Togo/epidemiologia
10.
Klin Lab Diagn ; 65(6): 368-374, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32459896

RESUMO

Were studied the genes encoding the virulence factors of 221 strains: E. coli O6:H1 (194) and E. coli O25:H4 (27), isolated in 2014-2018 from stool samples of children and adults examined according to epidemic indications. Molecular methods included PCR with hybridization-fluorescence and electrophoresis detection of amplified products. The strains did not have virulence genes for diarrheagenic E. coli (DEC) pathogroups EPEC, ETEC, EIEC, EHEC, EAggEC, and belonged to the phylogenetic group B2. They contained from four to eight genes encoding virulence factors of ExPEC: E. coli O6:H1 - pap (68,6%), sfa (87,6%), fimH (96,4%), hly (62,4%), cnf (74,7%), iutA (97,9%), fyuA (95,9%), chu (100%); E. coli O25:H4 - pap (66,7%), afa (22,2%), fimH (100%), hly (44,4%), cnf (44,4%), iutA (100%) , fyuA (100%), chu (100%). The antimicrobial susceptibility testing to 6 classes of antimicrobials (beta-lactams, fluoroquinolones, aminoglycosides, nitrofurantoin, sulfanilamide, trimethoprim / sulfamethoxazole) according the EUCAST. 60,3% of E. coli O6:H1 were sensitive to antibiotics, E. coli O25:H4 remained sensitive to carbapenems and nitrofurans. Extended-spectrum cephalosporins resistance was due to the production ESBL (CTX-M). The 57,1% resistant strains of E. coli O6:H1 and 100% of E. coli O25:H4 strains belonged to the MDR phenotype. The XDR phenotype had one in five MDR strains of E. coli O6:H1 and E. coli O25:H4. All strains of E. coli O25:H4 belonged to ST131. Given the important role of E. coli in human pathology, detection of virulence genes should be performed to confirm the etiological significance of the isolated strain.


Assuntos
Infecções por Escherichia coli/diagnóstico , Escherichia coli/classificação , Sorotipagem , Adulto , Criança , Escherichia coli/efeitos dos fármacos , Genes Bacterianos , Humanos , Testes de Sensibilidade Microbiana , Filogenia , Fatores de Virulência/genética , beta-Lactamases
11.
Lett Appl Microbiol ; 70(6): 440-446, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32270510

RESUMO

Typical haemolytic uraemic syndrome (STEC-HUS), caused by Shiga toxin (Stx)-producing Escherichia coli (STEC), is a serious, life-threating disease that mainly affects children. Bacteriological and genetic tests are commonly used in the routine laboratory diagnosis of STEC-HUS; however, serological methods have emerged as useful and reliable diagnostic tools, especially when bacterial isolation fails. In this study, we present the results of the serological investigation of 72 paediatric patients suspected for HUS, hospitalized during 2011-2019 at the Department of Pediatrics and Nephrology of Children's Hospitals in Poland. During the routine laboratory investigation STEC strains were isolated only from nine stool samples. However, serological investigations confirmed 45 cases of STEC infections in children with HUS. In this study, 22 (48·9%) paediatric patients were infected by E. coli serotype O26, 11 (24·4%) by serotype O145, 9 (20·0%) by serotype O157, and 3 (6·7%) by E. coli serotype O111. In the majority of these patients, in addition to a high level of IgA, IgG and IgM antibodies to lipopolysaccharide of particular E. coli serotypes, antibodies to recombinant proteins Tir, Stx2b and intimin were detected. Our results confirm that serological tests are useful in the diagnosis of STEC-HUS. SIGNIFICANCE AND IMPACT OF THE STUDY: This study showed that serological analysis greatly complements bacterial isolation and helps in the diagnosis and confirmation of Shiga toxin (verotoxin)-producing Escherichia coli (STEC) infections. Serological tests can be performed to qualify the patient for the typical haemolytic uraemic syndrome (STEC-HUS). In Poland, STEC-HUS in children is mostly caused by the E. coli serotype O26, which indicates that there is an increasing number of non-O157 STEC infections associated with human diseases in Europe.


Assuntos
Anticorpos Antibacterianos/sangue , Infecções por Escherichia coli/diagnóstico , Síndrome Hemolítico-Urêmica/microbiologia , Lipopolissacarídeos/imunologia , Toxina Shiga/imunologia , Escherichia coli Shiga Toxigênica/imunologia , Adesinas Bacterianas/genética , Formação de Anticorpos , Criança , Pré-Escolar , Infecções por Escherichia coli/microbiologia , Proteínas de Escherichia coli/genética , Proteínas de Escherichia coli/imunologia , Europa (Continente) , Feminino , Síndrome Hemolítico-Urêmica/diagnóstico , Humanos , Imunoglobulina A/sangue , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Lactente , Masculino , Polônia , Proteínas Recombinantes/genética , Sorogrupo , Toxina Shiga/genética , Escherichia coli Shiga Toxigênica/genética
13.
Ann Rheum Dis ; 79(5): 605-611, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32179576

RESUMO

OBJECTIVES: Using a prospective research design, we evaluated the association between acquisition of diarrhoeagenic Escherichia coli (DEC) and development of reactive arthritis (ReA) and other reactive musculoskeletal (MSK) symptoms among international travellers. METHODS: A total of 526 study participants were asked to provide pretravel and post-travel stool samples and fill in questionnaires (pretravel, post-travel and 3-week follow-up). A multiplex quantitative PCR assay was deployed to detect five DEC comprising enteroaggregative E. coli, enteropathogenic E. coli, enterotoxigenic E. coli, enterohaemorrhagic E. coli and enteroinvasive E. coli and Salmonella, Shigella, Campylobacter, Yersinia, and Vibrio cholerae. Multivariate analysis was employed to identify factors predisposing to MSK symptoms. New post-travel MSK symptoms reported by participants with DEC were assessed by phone interviews and, if needed, clinically confirmed. RESULTS: From among the total of 224 volunteers who returned all questionnaires and stool specimens, 38 (17.0%) reported MSK symptoms. Multivariate analysis revealed that acquisition of DEC was associated with MSK symptoms (OR 3.9; 95% CI 1.2 to 13.3). Of the 151 with only-DEC, four (2.6%) had ReA, two (1.3%) reactive tendinitis and three (2.0%) reactive arthralgia. ReA was mostly mild, and all patients with ReA were negative for human leucocyte antigen B27. Antibiotic treatment of travellers' diarrhoea did not prevent development of MSK symptoms. CONCLUSION: A total of 17% of volunteers reported post-travel MSK symptoms. DEC acquisition was associated with an increased risk of developing them, yet the ReA incidence remained low and the clinical picture mild. Antibiotic treatment did not protect against development of MSK symptoms.


Assuntos
Antibacterianos/uso terapêutico , Artrite Reativa/epidemiologia , Diarreia/complicações , Infecções por Escherichia coli/complicações , Doenças Musculoesqueléticas/epidemiologia , Doença Relacionada a Viagens , Centros Médicos Acadêmicos , Artrite Reativa/etiologia , Artrite Reativa/fisiopatologia , Estudos de Coortes , Diarreia/diagnóstico , Diarreia/microbiologia , Escherichia coli/patogenicidade , Infecções por Escherichia coli/diagnóstico , Feminino , Finlândia , Humanos , Incidência , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase Multiplex/métodos , Análise Multivariada , Doenças Musculoesqueléticas/etiologia , Doenças Musculoesqueléticas/fisiopatologia , Prognóstico , Estudos Prospectivos , Medição de Risco , Índice de Gravidade de Doença
14.
Clin Chem ; 66(2): 302-315, 2020 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-32040589

RESUMO

BACKGROUND: Rapid detection of Shiga toxin-producing Escherichia coli (STEC) enables appropriate monitoring and treatment. We synthesized available evidence to compare the performance of enzyme immunoassay (EIA) and PCR tests for the detection of STEC. METHODS: We searched published and gray literature for studies of STEC EIA and/or PCR diagnostic test accuracy relative to reference standards including at least one nucleic acid amplification test. Two reviewers independently screened studies, extracted data, and assessed quality with the second version of the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. Bivariate random effects models were used to meta-analyze the clinical sensitivity and specificity of commercial EIA and PCR STEC diagnostic tests, and summary receiver operator characteristic curves were constructed. We evaluated the certainty of evidence with the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. RESULTS: We identified 43 articles reflecting 25 260 specimens. Meta-analysis of EIA and PCR accuracy included 25 and 22 articles, respectively. STEC EIA pooled sensitivity and specificity were 0.681 (95% CI, 0.571-0.773; very low certainty of evidence) and 1.00 (95% CI, 0.998-1.00; moderate certainty of evidence), respectively. STEC PCR pooled sensitivity and specificity were 1.00 (95% CI, 0.904-1.00; low certainty of evidence) and 0.999 (95% CI, 0.997-0.999; low certainty of evidence), respectively. Certainty of evidence was downgraded because of high risk of bias. CONCLUSIONS: PCR tests to identify the presence of STEC are more sensitive than EIA tests, with no meaningful loss of specificity. However, given the low certainty of evidence, our results may overestimate the difference in performance.


Assuntos
Infecções por Escherichia coli/diagnóstico , Toxina Shiga/análise , Escherichia coli Shiga Toxigênica/patogenicidade , Testes Diagnósticos de Rotina/métodos , Escherichia coli/enzimologia , Escherichia coli/metabolismo , Proteínas de Escherichia coli/metabolismo , Técnicas Imunoenzimáticas/métodos , Técnicas de Amplificação de Ácido Nucleico/métodos , Reação em Cadeia da Polimerase/métodos , Sensibilidade e Especificidade , Toxina Shiga/metabolismo , Escherichia coli Shiga Toxigênica/genética , Escherichia coli Shiga Toxigênica/metabolismo
15.
BMC Genomics ; 21(1): 138, 2020 Feb 10.
Artigo em Inglês | MEDLINE | ID: mdl-32041522

RESUMO

BACKGROUND: We investigated the association of symptoms and disease severity of shigellosis patients with genetic determinants of infecting Shigella and entero-invasive Escherichia coli (EIEC), because determinants that predict disease outcome per individual patient could be used to prioritize control measures. For this purpose, genome wide association studies (GWAS) were performed using presence or absence of single genes, combinations of genes, and k-mers. All genetic variants were derived from draft genome sequences of isolates from a multicenter cross-sectional study conducted in the Netherlands during 2016 and 2017. Clinical data of patients consisting of binary/dichotomous representation of symptoms and their calculated severity scores were also available from this study. To verify the suitability of the methods used, the genetic differences between the genera Shigella and Escherichia were used as control. RESULTS: The isolates obtained were representative of the population structure encountered in other Western European countries. No association was found between single genes or combinations of genes and separate symptoms or disease severity scores. Our benchmark characteristic, genus, resulted in eight associated genes and > 3,000,000 k-mers, indicating adequate performance of the algorithms used. CONCLUSIONS: To conclude, using several microbial GWAS methods, genetic variants in Shigella spp. and EIEC that can predict specific symptoms or a more severe course of disease were not identified, suggesting that disease severity of shigellosis is dependent on other factors than the genetic variation of the infecting bacteria. Specific genes or gene fragments of isolates from patients are unsuitable to predict outcomes and cannot be used for development, prioritization and optimization of guidelines for control measures of shigellosis or infections with EIEC.


Assuntos
Disenteria Bacilar/diagnóstico , Disenteria Bacilar/microbiologia , Infecções por Escherichia coli/diagnóstico , Infecções por Escherichia coli/microbiologia , Escherichia coli/genética , Shigella/genética , Estudos Transversais , Escherichia coli/classificação , Escherichia coli/isolamento & purificação , Marcadores Genéticos , Estudo de Associação Genômica Ampla , Humanos , Filogenia , Shigella/classificação , Shigella/isolamento & purificação
16.
J Immunol Res ; 2020: 5948256, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32104715

RESUMO

Obese mice exhibited more lymphocytes in the bronchoalveolar lavage fluid and milder lung injury after Escherichia coli (E. coli) infection. However, it remained unclear whether the spleen contributed to the effect of obese mice with infection. The study was purposed to reveal the histopathological changes of the spleen caused by oxidative stress and inflammation in diet-induced obesity (DIO) mice challenged by Escherichia coli. After infection, the spleen tissues were obtained in normal and DIO mice at 0 h (uninfected), 12 h, 24 h, and 72 h postinfection. Results revealed that DIO mice have higher contents of resistin, TNF-α, IL-6, and IL-1ß in the spleen than normal mice and lower concentrations of GSH-Px, SOD, and CAT and higher MDA than normal mice. After an intranasal drip of E. coli, the activities of GSH-Px, SOD, and CAT in the DIO mice were elevated and the content of MDA declined. The activities of SOD and CAT in the normal mice declined, and the content of MDA was elevated. Moreover, the contents of TNF-α, IL-6, and IL-1ß in the spleen declined in DIO mice at 24 and 72 h, although the contents of leptin, resistin, TNF-α, IL-6, and IL-1ß were elevated at 12 h. The contents of resistin, TNF-α, IL-6, and IL-1ß were elevated in normal mice at 12 and 24 h. Those results indicated that obesity elevated splenic oxidation and inflammatory levels, but it enhanced antioxidant capacity and reduced cytokine levels of the spleen in mice to resist splenic injury after an intranasal drip of E. coli.


Assuntos
Antioxidantes/metabolismo , Citocinas/metabolismo , Infecções por Escherichia coli/metabolismo , Infecções por Escherichia coli/microbiologia , Escherichia coli , Obesidade/metabolismo , Baço/metabolismo , Baço/microbiologia , Animais , Biomarcadores , Biópsia , Modelos Animais de Doenças , Infecções por Escherichia coli/diagnóstico , Fibrose , Camundongos , Obesidade/etiologia , Estresse Oxidativo , Baço/patologia , Avaliação de Sintomas
17.
Rev. esp. anestesiol. reanim ; 67(2): 103-107, feb. 2020. ilus
Artigo em Espanhol | IBECS | ID: ibc-197460

RESUMO

La endocarditis infecciosa (EI) debida a Escherichia coli es una enfermedad rara, aunque cada vez más frecuente. La fiebre persistente en pacientes sépticos a pesar de un tratamiento adecuado plantea la necesidad de considerar la EI como diagnóstico diferencial. Presentamos el caso de un paciente varón de 36 años al que se le practica una nefrectomía radical derecha por diagnóstico de pielonefritis xantogranulomatosa, presentando en el postoperatorio un estado de shock séptico con fiebre persistente de hasta 41°C. Ante el hallazgo de un soplo de nueva aparición se le diagnostica EI mitroaórtica mediante ecocardiograma transesofágico (ETE) teniendo que someterse a cirugía cardiaca para sustitución valvular. Tras múltiples complicaciones postoperatorias es dado de alta exitosamente


Infective endocarditis (IE) due to Escherichia coli is a rare disease, although increasingly frequent. Persistent fever in septic patients despite adequate treatment raises the need to consider IE as a differential diagnosis. We present the case of a 36-year-old male patient who underwent a radical right nephrectomy as a result of diagnosis of xanthogranulomatous pyelonephritis, presenting in the postoperative period a state of septic shock with persistent fever of 41°C. Given the finding of a new-onset murmur, he was diagnosed with a mitroaortic IE by means of a transesophageal echocardiogram (TEE), having to undergo cardiac surgery for valve replacement. After multiple postoperative complications, he is successfully discharged


Assuntos
Humanos , Masculino , Adulto , Endocardite Bacteriana/diagnóstico , Endocardite Bacteriana/microbiologia , Escherichia coli , Infecções por Escherichia coli/diagnóstico , Nefrectomia , Pielonefrite Xantogranulomatosa/cirurgia , Ecocardiografia Transesofagiana , Complicações Pós-Operatórias
18.
J Med Microbiol ; 69(3): 487-491, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31935188

RESUMO

Shiga toxin-producing Escherichia coli (STEC) are zoonotic pathogens that cause symptoms of severe gastrointestinal disease, including haemolytic uraemic syndrome (HUS), in humans. Currently in England, STEC serotypes other than O157:H7 are not cultured at the local hospital laboratories. The aim of this study was to evaluate the utility of CHROMagar STEC for the direct detection of STEC from faecal specimens in a diagnostic setting, compared to the current reference laboratory method using PCR targeting the Shiga-toxin gene (stx) to test multiple colonies cultured on MacConkey agar. Of the 292 consecutive faecal specimens submitted to the Gastrointestinal Bacterial Reference Unit that tested positive for stx by PCR, STEC could not be cultured on MacConkey agar or CHROMagar STEC from 87/292 (29.8 %). Of the 205 that were cultured, 106 (51.7 %) were detected on both MacConkey agar and CHROMagar STEC and 99 (48.3 %) were detected on MacConkey agar only. All 106 (100 %) isolates that grew on CHROMagar STEC had the ter gene cassette, known to be associated with resistance to tellurite, compared to 13/99 (13.1 %) that were not detected on CHROMagar STEC. CHROMagar STEC supported the growth of 36/40 (90 %) isolates harbouring stx2a or stx2d, the subtypes most frequently associated with progression to HUS. Of the 92 isolates harbouring eae, an important STEC virulence marker, 77 (83.7 %) grew on CHROMagar STEC. CHROMagar STEC is a useful selective media for the rapid, near-patient detection of STEC that have the potential to cause HUS.


Assuntos
Infecções por Escherichia coli/diagnóstico , Escherichia coli Shiga Toxigênica/isolamento & purificação , Ágar , Compostos Cromogênicos , Infecções por Escherichia coli/microbiologia , Fezes/microbiologia , Humanos , Toxina Shiga/genética , Escherichia coli Shiga Toxigênica/genética
19.
Microb Drug Resist ; 26(1): 38-45, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31386590

RESUMO

In July 2018, a Klebsiella pneumoniae carbapenemase (KPC)-producing Escherichia coli ST131 was isolated from a patient admitted to the Vascular Surgery Unit of the main hospital of Molise region, Central Italy. Sequencing and alignment with the available sequences revealed that the isolate harbored the KPC-2 variant and TEM-1 beta-lactamase. This observation raises great concerns about the spread of carbapenem resistance in national and local settings with high endemicity level of KPC in K. pneumoniae, and underlines the importance of strengthening a proactive surveillance.


Assuntos
Antibacterianos/farmacologia , Infecções por Escherichia coli/diagnóstico , Escherichia coli/isolamento & purificação , Infecções Urinárias/diagnóstico , Idoso de 80 Anos ou mais , Escherichia coli/efeitos dos fármacos , Infecções por Escherichia coli/tratamento farmacológico , Infecções por Escherichia coli/microbiologia , Humanos , Itália , Masculino , Infecções Urinárias/tratamento farmacológico , Infecções Urinárias/microbiologia , beta-Lactamases/metabolismo
20.
Eur J Clin Microbiol Infect Dis ; 39(1): 151-158, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31529306

RESUMO

Shiga toxin-producing Escherichia coli (STEC) and Shigella spp./enteroinvasive E. coli (EIEC) are common diarrheagenic bacteria that cause sporadic diseases and outbreaks. Clinical manifestations vary from mild symptoms to severe complications. For microbiological diagnosis, culture confirmation of a positive stool screening PCR test is challenging because of time-consuming methods for isolation of strains, wide variety of STEC pathotypes, and increased emergence of non-classical strains with unusual serotypes. Therefore, molecular assays for the rapid identification of suspect colonies growing on selective media are very useful. In this study, the performance of the newly introduced eazyplex® EHEC assay based on loop-mediated isothermal amplification (LAMP) was evaluated using 18 representative STEC and Shigella strains and 31 isolates or positive-enrichment broths that were collected from clinical stool samples following screening by BD MAX™ EBP PCR. Results were compared to real-time PCR as a reference standard. Overall, sensitivities and specificities of the eazyplex® EHEC were as follows: 94.7% and 100% for Shiga toxin 1 (stx1), 100% and 100% for stx2, 93.3% and 97.1% for intimin (eae), 100% and 100% for enterohemolysin A (ehlyA), and 100% and 100% for invasion-associated plasmid antigen H (ipaH) as Shigella spp./EIEC target, respectively. Sample preparation for LAMP took only some minutes, and the time to result of the assay ranged from 8.5 to 13 min. This study shows that eazyplex® EHEC is a very fast and easy to perform molecular assay that provides reliable results as a culture confirmation assay for the diagnosis of STEC and Shigella spp./EIEC infections.


Assuntos
Escherichia coli Êntero-Hemorrágica/isolamento & purificação , Microbiologia de Alimentos/métodos , Escherichia coli Shiga Toxigênica/isolamento & purificação , Shigella/isolamento & purificação , Adulto , Pré-Escolar , Contagem de Colônia Microbiana/métodos , Meios de Cultura/química , DNA Bacteriano/isolamento & purificação , Disenteria Bacilar/diagnóstico , Disenteria Bacilar/microbiologia , Escherichia coli Êntero-Hemorrágica/genética , Infecções por Escherichia coli/diagnóstico , Infecções por Escherichia coli/microbiologia , Fezes/microbiologia , Feminino , Humanos , Técnicas de Amplificação de Ácido Nucleico/métodos , Estudos Prospectivos , Sensibilidade e Especificidade , Escherichia coli Shiga Toxigênica/genética , Shigella/genética
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