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1.
BMC Infect Dis ; 20(1): 659, 2020 Sep 07.
Artigo em Inglês | MEDLINE | ID: mdl-32894092

RESUMO

BACKGROUND: Diarrheagenic Escherichia coli (DEC) are among the leading pathogens associated with endemic diarrhea in low income countries. Yet, few epidemiological studies have focused the contribution of enterohemorrhagic E. coli (EHEC), enteroinvasive E. coli (EIEC) and diffusely adherent E. coli (DAEC). METHODS: We assessed the contribution of EHEC, EIEC and DAEC isolated from stool samples from a case-control study conducted in children aged < 5 years in Southern Mozambique between December 2007 and November 2012. The isolates were screened by conventional PCR targeting stx1 and stx2 (EHEC), ial and ipaH (EIEC), and daaE (DAEC) genes. RESULTS: We analyzed 297 samples from cases with less-severe diarrhea (LSD) matched to 297 controls, and 89 samples from cases with moderate-to-severe diarrhea (MSD) matched to 222 controls, collected between November 3, 2011 and November 2, 2012. DEC were more common among LSD cases (2.7%, [8/297] of cases vs. 1.3% [4/297] of controls; p = 0.243]) than in MSD cases (0%, [0/89] of cases vs. 0.4%, [1/222] of controls; p = 1.000). Detailed analysis revealed low frequency of EHEC, DAEC or EIEC and no association with diarrhea in all age strata. Although the low frequency, EIEC was predominant in LSD cases aged 24-59 months (4.1% for cases vs. 0% for controls), followed by DAEC in similar frequency for cases and controls in infants (1.9%) and lastly EHEC from one control. Analysis of a subset of samples from previous period (December 10, 2007 and October 31, 2011) showed high frequency of DEC in controls compared to MSD cases (16.2%, [25/154] vs. 11.9%, [14/118], p = 0.383, respectively). Among these, DAEC predominated, being detected in 7.7% of cases vs. 17.6% of controls aged 24-59 months, followed by EIEC in 7.7% of cases vs. 5.9% of controls for the same age category, although no association was observed. EHEC was detected in one sample from cases and two from controls. CONCLUSIONS: Our data suggests that although EHEC, DAEC and EIEC are less frequent in endemic diarrhea in rural Mozambique, attention should be given to their transmission dynamics (e.g. the role on sporadic or epidemic diarrhea) considering that the role of asymptomatic individuals as source of dissemination remains unknown.


Assuntos
Diarreia/epidemiologia , Escherichia coli Êntero-Hemorrágica/genética , Infecções por Escherichia coli/epidemiologia , Saúde da População Rural , Estudos de Casos e Controles , Pré-Escolar , Diarreia/microbiologia , Doenças Endêmicas , Escherichia coli Êntero-Hemorrágica/isolamento & purificação , Infecções por Escherichia coli/microbiologia , Fezes/microbiologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Moçambique/epidemiologia , Reação em Cadeia da Polimerase , Prevalência , População Rural
2.
Vet Parasitol Reg Stud Reports ; 21: 100435, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32862896

RESUMO

Faecal specimens from 36 scouring neonatal calves from two dairy farms located in the Al Ain region of the UAE were screened with pathogen-specific antigen ELISA for Cryptosporidium parvum, Escherichia coli K99, rotavirus, and coronavirus. Additionally, faecal smears were stained with modified-acid-fast for Cryptosporidium oocysts, and the VITEK 2 system plus Gram's stain used to identify bacteria isolated from the faecal samples. Farm management practices were also evaluated during a farm visit. Of the 36 calves, 29, 13, 5, and 6 were positive for C. parvum, E. coli K99, bovine coronavirus, and rotavirus antigens respectively, while 27 were positive for Cryptosporidium oocysts. In various combinations, mixed infections were detected in 20/36 calves. This is the first report of C. parvum, E. coli K99, Salmonella spp., rotavirus, and coronavirus in ≤14-days-old scouring neonatal dairy calves from the UAE. Molecular characterization of these pathogens and nationwide epidemiological calf scour studies are recommended.


Assuntos
Doenças dos Bovinos/epidemiologia , Criptosporidiose/epidemiologia , Cryptosporidium parvum , Animais , Animais Recém-Nascidos/microbiologia , Animais Recém-Nascidos/parasitologia , Bovinos , Doenças dos Bovinos/microbiologia , Doenças dos Bovinos/parasitologia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/veterinária , Coronavirus Bovino , Indústria de Laticínios , Infecções por Escherichia coli/epidemiologia , Infecções por Escherichia coli/microbiologia , Infecções por Escherichia coli/veterinária , Feminino , Masculino , Infecções por Rotavirus/epidemiologia , Infecções por Rotavirus/veterinária , Salmonelose Animal/epidemiologia , Emirados Árabes Unidos/epidemiologia
3.
PLoS One ; 15(8): e0232305, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32785271

RESUMO

Shiga toxin-producing Escherichia coli (STEC) that cause severe disease predominantly carry the toxin gene variant stx2a. However, the role of Shiga toxin in the ruminant reservoirs of this zoonotic pathogen is poorly understood and strains that cause severe disease in humans (HUSEC) likely constitute a small and atypical subset of the overall STEC flora. The aim of this study was to investigate the presence of stx2a in samples from cattle and to isolate and characterize stx2a-positive E. coli. In nationwide surveys in Sweden and Norway samples were collected from individual cattle or from cattle herds, respectively. Samples were tested for Shiga toxin genes by real-time PCR and amplicon sequencing and stx2a-positive isolates were whole genome sequenced. Among faecal samples from Sweden, stx1 was detected in 37%, stx2 in 53% and stx2a in 5% and in skin (ear) samples in 64%, 79% and 2% respectively. In Norway, 79% of the herds were positive for stx1, 93% for stx2 and 17% for stx2a. Based on amplicon sequencing the most common stx2 types in samples from Swedish cattle were stx2a and stx2d. Multilocus sequence typing (MLST) of 39 stx2a-positive isolates collected from both countries revealed substantial diversity with 19 different sequence types. Only a few classical LEE-positive strains similar to HUSEC were found among the stx2a-positive isolates, notably a single O121:H19 and an O26:H11. Lineages known to include LEE-negative HUSEC were also recovered including, such as O113:H21 (sequence type ST-223), O130:H11 (ST-297), and O101:H33 (ST-330). We conclude that E. coli encoding stx2a in cattle are ranging from strains similar to HUSEC to unknown STEC variants. Comparison of isolates from human HUS cases to related STEC from the ruminant reservoirs can help identify combinations of virulence attributes necessary to cause HUS, as well as provide a better understanding of the routes of infection for rare and emerging pathogenic STEC.


Assuntos
Bovinos/microbiologia , Toxina Shiga II/genética , Escherichia coli Shiga Toxigênica/genética , Animais , Reservatórios de Doenças/microbiologia , Infecções por Escherichia coli/epidemiologia , Infecções por Escherichia coli/microbiologia , Variação Genética , Genoma Bacteriano , Síndrome Hemolítico-Urêmica/epidemiologia , Síndrome Hemolítico-Urêmica/microbiologia , Humanos , Tipagem de Sequências Multilocus , Noruega/epidemiologia , Prevalência , Reação em Cadeia da Polimerase em Tempo Real , Escherichia coli Shiga Toxigênica/citologia , Escherichia coli Shiga Toxigênica/isolamento & purificação , Suécia/epidemiologia , Virulência/genética , Zoonoses/epidemiologia , Zoonoses/microbiologia
4.
PLoS Negl Trop Dis ; 14(8): e0008520, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32776938

RESUMO

Diarrhea is a leading cause of antibiotic consumption among children in low- and middle-income countries. While vaccines may prevent diarrhea infections for which children often receive antibiotics, the contribution of individual enteropathogens to antibiotic use is minimally understood. We used data from the Global Enteric Multicenter Study (GEMS) to estimate pathogen-specific incidence of antibiotic-treated diarrhea among children under five years old residing in six countries of sub-Saharan Africa and South Asia before rotavirus vaccine implementation. GEMS was an age-stratified, individually-matched case-control study. Stool specimens were obtained from children presenting to sentinel health clinics with newly-onset, acute diarrhea (including moderate-to-severe and less-severe diarrhea) as well as matched community controls without diarrhea. We used data from conventional and quantitative molecular diagnostic assays applied to stool specimens to estimate the proportion of antibiotic-treated diarrhea cases attributable to each pathogen. Antibiotics were administered or prescribed to 9,606 of 12,109 moderate-to-severe cases and 1,844 of 3,174 less-severe cases. Across all sites, incidence rates of clinically-attended, antibiotic-treated diarrhea were 12.2 (95% confidence interval: 9.0-17.8), 10.2 (7.4-13.9) and 1.9 (1.3-3.0) episodes per 100 child-years at risk at ages 6 weeks to 11 months, 12-23 months, and 24-59 months, respectively. Based on the recommendation for antibiotic treatment to be reserved for cases with dysentery, we estimated a ratio of 12.6 (8.6-20.8) inappropriately-treated diarrhea cases for each appropriately-treated case. Rotavirus, adenovirus serotypes 40/41, Shigella, sapovirus, Shiga toxin-producing Escherichia coli, and Cryptosporidium were the leading antibiotic-treated diarrhea etiologies. Rotavirus caused 29.2% (24.5-35.2%) of antibiotic-treated cases, including the largest share in both the first and second years of life. Shigella caused 14.9% (11.4-18.9%) of antibiotic-treated cases, and was the leading etiology at ages 24-59 months. Our findings should inform the prioritization of vaccines with the greatest potential to reduce antibiotic exposure among children.


Assuntos
Antibacterianos/uso terapêutico , Países em Desenvolvimento , Diarreia/tratamento farmacológico , Diarreia/epidemiologia , Diarreia/etiologia , Adenoviridae , África ao Sul do Saara/epidemiologia , Antibacterianos/administração & dosagem , Ásia/epidemiologia , Estudos de Casos e Controles , Pré-Escolar , Criptosporidiose/tratamento farmacológico , Criptosporidiose/epidemiologia , Criptosporidiose/etiologia , Cryptosporidium , Disenteria/tratamento farmacológico , Disenteria/epidemiologia , Disenteria/etiologia , Infecções por Escherichia coli/tratamento farmacológico , Infecções por Escherichia coli/epidemiologia , Infecções por Escherichia coli/etiologia , Fezes/virologia , Feminino , Inquéritos Epidemiológicos , Hospitalização , Humanos , Incidência , Renda , Lactente , Masculino , Vacinas contra Rotavirus , Escherichia coli Shiga Toxigênica , Shigella
5.
PLoS One ; 15(8): e0236703, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32785284

RESUMO

Travelers' diarrhea (TD) is the most prevalent illness encountered by deployed military personnel and has a major impact on military operations, from reduced job performance to lost duty days. Frequently, the etiology of TD is unknown and, with underreporting of cases, it is difficult to accurately assess its impact. An increasing number of ailments include an altered or aberrant gut microbiome. To better understand the relationships between long-term deployments and TD, we studied military personnel during two nine-month deployment cycles in 2015-2016 to Honduras. To collect data on the prevalence of diarrhea and impact on duty, a total of 1173 personnel completed questionnaires at the end of their deployment. 56.7% reported reduced performance and 21.1% reported lost duty days. We conducted a passive surveillance study of all cases of diarrhea reporting to the medical unit with 152 total cases and a similar pattern of etiology. Enteroaggregative E. coli (EAEC, 52/152), enterotoxigenic E. coli (ETEC, 50/152), and enteropathogenic E. coli (EPEC, 35/152) were the most prevalent pathogens detected. An active longitudinal surveillance of 67 subjects also identified diarrheagenic E. coli as the primary etiology (7/16 EPEC, 7/16 EAEC, and 6/16 ETEC). Eleven subjects were recruited into a nested longitudinal substudy to examine gut microbiome changes associated with deployment. A 16S rRNA amplicon survey of fecal samples showed differentially abundant baseline taxa for subjects who contracted TD versus those who did not, as well as detection of taxa positively associated with self-reported gastrointestinal distress. Disrupted microbiota was also qualitatively observable for weeks preceding and following the incidents of TD. These findings illustrate the complex etiology of diarrhea amongst military personnel in deployed settings and its impacts on job performance. Potential factors of resistance or susceptibility can provide a foundation for future clinical trials to evaluate prevention and treatment strategies.


Assuntos
Diarreia/epidemiologia , Disenteria/epidemiologia , Escherichia coli Enteropatogênica/isolamento & purificação , Infecções por Escherichia coli/epidemiologia , Adulto , Diarreia/genética , Diarreia/microbiologia , Disenteria/genética , Disenteria/microbiologia , Disenteria/patologia , Escherichia coli Enteropatogênica/genética , Escherichia coli Enteropatogênica/patogenicidade , Infecções por Escherichia coli/genética , Infecções por Escherichia coli/microbiologia , Infecções por Escherichia coli/patologia , Fezes/microbiologia , Feminino , Microbioma Gastrointestinal/genética , Honduras/epidemiologia , Humanos , Masculino , Militares , RNA Ribossômico 16S/genética , Fatores de Risco , Viagem , Doença Relacionada a Viagens
6.
BMC Infect Dis ; 20(1): 453, 2020 Jun 29.
Artigo em Inglês | MEDLINE | ID: mdl-32600258

RESUMO

INTRODUCTION: Uropathogenic E. coli is the leading cause of Urinary tract infections (UTIs), contributing to 80-90% of all community-acquired and 30-50% of all hospital-acquired UTIs. Biofilm forming Uropathogenic E. coli are associated with persistent and chronic inflammation leading to complicated and or recurrent UTIs. Biofilms provide an environment for poor antibiotic penetration and horizontal transfer of virulence genes which favors the development of Multidrug-resistant organisms (MDRO). Understanding biofilm formation and antimicrobial resistance determinants of Uropathogenic E. coli strains will provide insight into the development of treatment options for biofilm-associated UTIs. The aim of this study was to determine the biofilm forming capability, presence of virulence genes and antimicrobial susceptibility pattern of Uropathogenic E. coli isolates in Uganda. METHODS: This was a cross-sectional study carried in the Clinical Microbiology and Molecular biology laboratories at the Department of Medical Microbiology, Makerere University College of Health Sciences. We randomly selected 200 Uropathogenic E. coli clinical isolates among the stored isolates collected between January 2018 and December 2018 that had significant bacteriuria (> 105 CFU). All isolates were subjected to biofilm detection using the Congo Red Agar method and Antimicrobial susceptibility testing was performed using the Kirby disk diffusion method. The isolates were later subjected PCR for the detection of Urovirulence genes namely; Pap, Fim, Sfa, Afa, Hly and Cnf, using commercially designed primers. RESULTS: In this study, 62.5% (125/200) were positive biofilm formers and 78% (156/200) of these were multi-drug resistant (MDR). The isolates were most resistant to Trimethoprim sulphamethoxazole and Amoxicillin (93%) followed by gentamycin (87%) and the least was imipenem (0.5%). Fim was the most prevalent Urovirulence gene (53.5%) followed by Pap (21%), Sfa (13%), Afa (8%), Cnf (5.5%) and Hyl (0%). CONCLUSIONS: We demonstrate a high prevalence of biofilm-forming Uropathogenic E. coli strains that are highly associated with the MDR phenotype. We recommend routine surveillance of antimicrobial resistance and biofilm formation to understand the antibiotics suitable in the management of biofilm-associated UTIs.


Assuntos
Antibacterianos/uso terapêutico , Biofilmes/crescimento & desenvolvimento , Infecções por Escherichia coli/epidemiologia , Infecções Urinárias/epidemiologia , Escherichia coli Uropatogênica/genética , Escherichia coli Uropatogênica/patogenicidade , Estudos Transversais , Farmacorresistência Bacteriana Múltipla/genética , Infecções por Escherichia coli/tratamento farmacológico , Infecções por Escherichia coli/microbiologia , Humanos , Testes de Sensibilidade Microbiana , Fenótipo , Reação em Cadeia da Polimerase , Prevalência , Uganda/epidemiologia , Infecções Urinárias/tratamento farmacológico , Infecções Urinárias/microbiologia , Escherichia coli Uropatogênica/efeitos dos fármacos , Escherichia coli Uropatogênica/isolamento & purificação , Virulência/genética , Fatores de Virulência/genética
7.
PLoS Negl Trop Dis ; 14(6): e0008375, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32603324

RESUMO

BACKGROUND: Acute gastroenteritis (AGE) is a major cause of morbidity and mortality in children aged less than 5 years in low- and middle-income countries where limited access to potable water, poor sanitation, deficient hygiene, and food product contamination are prevalent. Research on the changing etiology of AGE and associated risk factors in Latin America, including Colombia, is essential to understand the epidemiology of these infections. The primary objectives of this study were to describe etiology of moderate to severe AGE in children less than 5 years of age from Bucaramanga, Colombia, a middle-income country in Latin American, and to identify the presence of emerging E. coli pathotypes. METHODOLOGY/PRINCIPAL FINDINGS: This was a prospective, matched for age, case-control study to assess the etiology of moderate to severe AGE in children less than 5 years of age in Bucaramanga, Colombia, South America. We tested for 24 pathogens using locally available diagnostic testing, including stool culture, polymerase chain reaction, microscopy and enzyme-linked immunoassay. Adjusted attributable fractions were calculated to assess the association between AGE and each pathogen in this study population. The study included 861 participants, 431 cases and 430 controls. Enteric pathogens were detected in 71% of cases and in 54% of controls (p = <0.001). Co-infection was identified in 28% of cases and in 14% of controls (p = <0.001). The adjusted attributable fraction showed that Norovirus GII explained 14% (95% CI: 10-18%) of AGE, followed by rotavirus 9.3% (6.4-12%), adenovirus 3% (1-4%), astrovirus 2.9% (0.6-5%), enterotoxigenic Escherichia coli (ETEC) 2.4% (0.4-4%), Cryptosporidium sp. 2% (0.5-4%), Campylobacter sp. 2% (0.2-4%), and Salmonella sp.1.9% (0.3 to 3.5%). Except for Cryptosporidium, all parasite infections were not associated with AGE. Three emergent diarrheagenic E. coli pathotypes were identified in cases (0.7%), including an enteroaggregative/enterotoxigenic E.coli (EAEC/ETEC), an enteroaggregative/enteropathogenic E.coli (EAEC/EPEC), and an emergent enteroinvasive E. coli with a rare O96:H19. No deaths were reported among cases or controls. CONCLUSIONS/SIGNIFICANCE: Norovirus and rotavirus explained the major proportion of moderate to severe AGE in this study. Higher proportion of infection in cases, in the form of single infections or co-infections, showed association with AGE. Three novel E. coli pathotypes were identified among cases in this geographic region.


Assuntos
Gastroenterite/epidemiologia , Gastroenterite/etiologia , Gastroenterite/microbiologia , Gastroenterite/virologia , Adenoviridae , Infecções por Adenoviridae/complicações , Infecções por Adenoviridae/epidemiologia , Infecções por Astroviridae/complicações , Infecções por Astroviridae/epidemiologia , Infecções por Caliciviridae/complicações , Infecções por Caliciviridae/epidemiologia , Campylobacter , Infecções por Campylobacter/complicações , Infecções por Campylobacter/epidemiologia , Estudos de Casos e Controles , Pré-Escolar , Coinfecção/microbiologia , Coinfecção/virologia , Colômbia/epidemiologia , Criptosporidiose/complicações , Criptosporidiose/epidemiologia , Cryptosporidium , Diarreia/epidemiologia , Diarreia/etiologia , Diarreia/microbiologia , Diarreia/virologia , Escherichia coli Enterotoxigênica , Infecções por Escherichia coli/complicações , Infecções por Escherichia coli/epidemiologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Norovirus , Reação em Cadeia da Polimerase , Rotavirus , Infecções por Rotavirus/complicações , Infecções por Rotavirus/epidemiologia , Salmonella , Infecções por Salmonella/complicações , Infecções por Salmonella/epidemiologia
8.
PLoS One ; 15(6): e0233704, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32516308

RESUMO

BACKGROUND: The pathogenic spectrum of bloodstream infections (BSIs) varies across regions. Monitoring the pathogenic profile and antimicrobial resistance is a prerequisite for effective therapy, infection control and for strategies aimed to counter antimicrobial resistance. The pathogenic spectrum of BSIs in blood cultures was analysed, focusing on the resistance patterns of Acinetobacter baumannii, Escherichia coli, and Klebsiella pneumoniae, in Aljouf region. METHODS: This descriptive cross-sectional study analysed the culture reports of all non-duplicate blood samples collected from January 1 to December 31, 2019. Antibiograms of A. baumannii, E. coli, and K. pneumoniae were analysed for antibiotic resistance. The frequency and percentages of multi-drug, extensively-drug, pan-drug and carbapenem resistance were calculated. RESULTS: Of the 222 bloodstream infections, 62.2% and 36.4% were caused by gram-negative and gram-positive bacteria, respectively. Most BSIs occurred in patients aged ≥60 years (59.5%). Among the 103 isolates of the studied Gram-negative bacteria (GNB), 47.6%, 38.8%, and 2.9% were multi-drug, extensively drug and pan-drug resistant respectively. 46% of K. pneumoniae isolates were carbapenemase producers. Resistance to gentamycin, 1st-4th generation cephalosporins, and carbapenems was observed for A. baumannii. More than 70% of E. coli isolates were resistant to 3rd- and 4th-generation cephalosporins. Klebsiella pneumoniae presented a resistance rate of >60% to imipenems. CONCLUSIONS: Gram-negative bacteria dominate BSIs, with carbapenem-resistant K. pneumoniae most frequently detected in this region. Resistant GNB infections make it challenging to treat geriatric patients. Regional variations in antimicrobial resistance should be continually monitored.


Assuntos
Antibacterianos/farmacologia , Bacteriemia/microbiologia , Carbapenêmicos/farmacologia , Infecções por Klebsiella/epidemiologia , Klebsiella pneumoniae/isolamento & purificação , Infecções por Acinetobacter/sangue , Infecções por Acinetobacter/tratamento farmacológico , Infecções por Acinetobacter/epidemiologia , Infecções por Acinetobacter/microbiologia , Acinetobacter baumannii/efeitos dos fármacos , Acinetobacter baumannii/isolamento & purificação , Adulto , Antibacterianos/uso terapêutico , Bacteriemia/sangue , Bacteriemia/tratamento farmacológico , Bacteriemia/epidemiologia , Carbapenêmicos/uso terapêutico , Estudos Transversais , Farmacorresistência Bacteriana , Escherichia coli/efeitos dos fármacos , Escherichia coli/isolamento & purificação , Infecções por Escherichia coli/sangue , Infecções por Escherichia coli/tratamento farmacológico , Infecções por Escherichia coli/epidemiologia , Infecções por Escherichia coli/microbiologia , Feminino , Humanos , Infecções por Klebsiella/sangue , Infecções por Klebsiella/tratamento farmacológico , Infecções por Klebsiella/microbiologia , Klebsiella pneumoniae/efeitos dos fármacos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Arábia Saudita , Adulto Jovem
9.
Epidemiol Health ; 42: e2020034, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32512665

RESUMO

OBJECTIVES: Regions with limited sanitation facilities have higher rates of infections with various enteric pathogens. It is therefore important to identify different hosts and their relative contribution to pathogen shedding into the environment, and to assess the subsequent health risks to humans. METHODS: In this study, human faecal (n=310), animal faecal (n=150), and environmental (soil) samples (n=40) were collected from the same locality and screened for selected enteric pathogens by immunochromatography and/or polymerase chain reaction. RESULTS: At least 1 microbial agent was detected in 49.0%, 44.7%, and 40.0% of the samples from human, animals, and soil, respectively. Among humans, rotavirus was predominantly detected (17.4%) followed by enteropathogenic Escherichia coli (EPEC) (15.4%), Shigella (13.8), and Shiga toxin-producing E. coli (STEC) (9.7%). Among animals, STEC was detected most frequently (28.0%), and EPEC was the major enteric pathogen detected in soil (30.0%). The detection rate of rotavirus was higher among younger children (≤2 years) than among older children. Single infections were more commonly detected than multiple infections in humans (p<0.01), unlike the observations in animal and soil samples. For diarrhoeagenic E. coli and Shigella, most of the human and animal isolates showed close relatedness, suggesting possible cross-infection between humans and domesticated animals in the area studied. CONCLUSIONS: The present study provides an improved understanding of the distribution of major enteric pathogens coexisting in humans and animals in the region, thereby suggesting a high potential for possible transmission among livestock and communities residing in the studied locality.


Assuntos
Escherichia coli Enteropatogênica/isolamento & purificação , Fezes/microbiologia , Rotavirus/isolamento & purificação , Escherichia coli Shiga Toxigênica/isolamento & purificação , Shigella/isolamento & purificação , Microbiologia do Solo , Animais , Animais Domésticos , Pré-Escolar , Estudos Transversais , Disenteria Bacilar/epidemiologia , Disenteria Bacilar/transmissão , Infecções por Escherichia coli/epidemiologia , Infecções por Escherichia coli/transmissão , Humanos , Índia/epidemiologia , Lactente , Prevalência , Infecções por Rotavirus/epidemiologia , Infecções por Rotavirus/transmissão , Zoonoses
10.
PLoS One ; 15(6): e0235066, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32584859

RESUMO

Shiga toxin-producing Escherichia coli (STEC) are a leading cause of foodborne outbreaks of human disease, but they reside harmlessly as an asymptomatic commensal in the ruminant gut. STEC serogroup O145 are difficult to isolate as routine diagnostic methods are unable to distinguish non-O157 serogroups due to their heterogeneous metabolic characteristics, resulting in under-reporting which is likely to conceal their true prevalence. In light of these deficiencies, the purpose of this study was a twofold approach to investigate enhanced STEC O145 diagnostic culture-based methods: firstly, to use a genomic epidemiology approach to understand the genetic diversity and population structure of serogroup O145 at both a local (New Zealand) (n = 47) and global scale (n = 75) and, secondly, to identify metabolic characteristics that will help the development of a differential media for this serogroup. Analysis of a subset of E. coli serogroup O145 strains demonstrated considerable diversity in carbon utilisation, which varied in association with eae subtype and sequence type. Several carbon substrates, such as D-serine and D-malic acid, were utilised by the majority of serogroup O145 strains, which, when coupled with current molecular and culture-based methods, could aid in the identification of presumptive E. coli serogroup O145 isolates. These carbon substrates warrant subsequent testing with additional serogroup O145 strains and non-O145 strains. Serogroup O145 strains displayed extensive genetic heterogeneity that was correlated with sequence type and eae subtype, suggesting these genetic markers are good indicators for distinct E. coli phylogenetic lineages. Pangenome analysis identified a core of 3,036 genes and an open pangenome of >14,000 genes, which is consistent with the identification of distinct phylogenetic lineages. Overall, this study highlighted the phenotypic and genotypic heterogeneity within E. coli serogroup O145, suggesting that the development of a differential media targeting this serogroup will be challenging.


Assuntos
Carbono/metabolismo , Infecções por Escherichia coli , Genótipo , Filogenia , Sorogrupo , Escherichia coli Shiga Toxigênica , Animais , Infecções por Escherichia coli/epidemiologia , Infecções por Escherichia coli/genética , Infecções por Escherichia coli/metabolismo , Humanos , Malatos/metabolismo , Nova Zelândia/epidemiologia , Serina/genética , Serina/metabolismo , Escherichia coli Shiga Toxigênica/genética , Escherichia coli Shiga Toxigênica/isolamento & purificação , Escherichia coli Shiga Toxigênica/metabolismo
11.
PLoS Negl Trop Dis ; 14(5): e0008274, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32357189

RESUMO

Multidrug-resistant Escherichia coli ST131 fimH30 responsible for extra-intestinal pathogenic (ExPEC) infections is globally distributed. However, the occurrence of a subclone fimH27 of ST131 harboring both ExPEC and enteroaggregative E. coli (EAEC) related genes and belonging to commonly reported O25:H4 and other serotypes causing bacteremia in African children remain unknown. We characterized 325 E. coli isolates causing bacteremia in Mozambican children between 2001 and 2014 by conventional multiplex polymerase chain reaction and whole genome sequencing. Incidence rate of EAEC bacteremia was calculated among cases from the demographic surveillance study area. Approximately 17.5% (57/325) of isolates were EAEC, yielding an incidence rate of 45.3 episodes/105 children-years-at-risk among infants; and 44 of isolates were sequenced. 72.7% (32/44) of sequenced strains contained simultaneously genes associated with ExPEC (iutA, fyuA and traT); 88.6% (39/44) harbored the aggregative adherence fimbriae type V variant (AAF/V). Sequence type ST-131 accounted for 84.1% (37/44), predominantly belonging to serotype O25:H4 (59% of the 37); 95.6% (35/44) harbored fimH27. Approximately 15% (6/41) of the children died, and five of the six yielded ST131 strains (83.3%) mostly (60%; 3/5) due to serotypes other than O25:H4. We report the emergence of a new subclone of ST-131 E. coli strains belonging to O25:H4 and other serotypes harboring both ExPEC and EAEC virulence genes, including agg5A, associated with poor outcome in bacteremic Mozambican children, suggesting the need for prompt recognition for appropriate management.


Assuntos
Adesinas de Escherichia coli/genética , Bacteriemia/microbiologia , Infecções por Escherichia coli/microbiologia , Proteínas de Escherichia coli/genética , Escherichia coli/classificação , Fímbrias Bacterianas/genética , Genótipo , Transativadores/genética , Adolescente , Bacteriemia/epidemiologia , Criança , Pré-Escolar , Escherichia coli/isolamento & purificação , Infecções por Escherichia coli/epidemiologia , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Moçambique/epidemiologia , Reação em Cadeia da Polimerase , Sorogrupo , Sequenciamento Completo do Genoma
12.
Int J Food Microbiol ; 324: 108589, 2020 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-32442794

RESUMO

Shiga-toxigenic Escherichia coli (STEC) are important human pathogens associated with diarrhea and in some cases haemorrhagic colitis. Contaminated food derived from cattle and wildlife species are often associated with disease outbreaks. In this study, we report the prevalence, serogroup diversity and virulence profiles of STEC strains derived from cattle, rusa deer and pig. Of the 422 samples analyzed, STEC were detected in 40% (80/200) of cattle, 27.0% (33/122) of deer and 13.0% (13/100) of pigs. STEC isolates belonged to 38 O-serogroups whereby 5.2% (24/462) of the isolates belonged to clinically important EHEC-7 serogroups: O26 (n = 2), O103 (n = 1), O145 (n = 3) and O157 (n = 18). Fourteen serogroups (O26, O51, O84, O91, O100, O104, O110, O117, O145, O146, O156, O157, O177 and ONT) displayed multiple virulence profiles. We also identified two serovars (O117 and O119) in deer which are not well-documented in epidemiological surveys. 73.7% (28/38) of recovered O-serogroups are known to be associated with serious human illnesses including haemolytic uremic syndrome (HUS) and bloody diarrhea. STEC isolates harboring single genotypes stx1, stx2, eae and hlyA accounted for 3.0% (14/462), 9.1% (42/462), 47.6% (220/462) and 1.7% (8/462) of all STEC isolates screened, respectively. Virulence combinations stx1 and stx2 were harboured by 1.3% of isolates while strains with genetic profiles eae/hlyA were the second most prevalent amongst STEC isolates. The full known virulent genotypes (stx2/eae, stx1/stx2/eae, stx1/stx2/hlyA and stx2/eae/hlyA) were present in 22 of the 462 STEC strains. A total of 10 different virulence patterns were recovered amongst animal species. Phylogeny of the gnd gene showed that amongst STEC strains, serovar O100 outlined the main cluster. Fourteen (n = 14) different sequence types (STs) were identified from a panel of twenty (n = 20) STEC isolates. One of the isolate (PG007B) possessed a unique ST (adk 10, fumC 693, gyrB 4, icd 1, mdh 8, purA 8, recA 2) that could not be assigned using MLST databases. None of the ST's recovered in deer were observed in domestic species. Our findings shows that food associated animals found on the tropical island of Mauritius carry a diversity of STEC strains with many serovars known to be associated with human disease. This report indicates that increased awareness, surveillance and hygienic attention at critical stages of the human food chain are warranted.


Assuntos
Infecções por Escherichia coli/microbiologia , Infecções por Escherichia coli/veterinária , Microbiologia de Alimentos , Escherichia coli Shiga Toxigênica/isolamento & purificação , Animais , Animais Domésticos , Animais Selvagens , Bovinos , Cervos , Infecções por Escherichia coli/epidemiologia , Proteínas de Escherichia coli/genética , Genótipo , Maurício/epidemiologia , Filogenia , Prevalência , Sorogrupo , Escherichia coli Shiga Toxigênica/classificação , Escherichia coli Shiga Toxigênica/genética , Suínos , Fatores de Virulência/genética
13.
PLoS One ; 15(5): e0232903, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32407346

RESUMO

BACKGROUND: Recent UK antibiotic stewardship policies have resulted in significant changes in primary care dispensing, but whether this has impacted antimicrobial resistance is unknown. AIM: To evaluate associations between changes in primary care dispensing and antimicrobial resistance in community-acquired urinary Escherichia coli infections. METHODS: Multilevel logistic regression modelling investigating relationships between primary care practice level antibiotic dispensing for approximately 1.5 million patients in South West England and resistance in 152,704 community-acquired urinary E. coli between 2013 and 2016. Relationships presented for within and subsequent quarter drug-bug pairs, adjusted for patient age, deprivation, and rurality. RESULTS: In line with national trends, overall antibiotic dispensing per 1000 registered patients fell 11%. Amoxicillin fell 14%, cefalexin 20%, ciprofloxacin 24%, co-amoxiclav 49% and trimethoprim 8%. Nitrofurantoin increased 7%. Antibiotic reductions were associated with reduced within quarter same-antibiotic resistance to: amoxicillin, ciprofloxacin and trimethoprim. Subsequent quarter reduced resistance was observed for trimethoprim and amoxicillin. Antibiotic dispensing reductions were associated with increased within and subsequent quarter resistance to cefalexin and co-amoxiclav. Increased nitrofurantoin dispensing was associated with reduced within and subsequent quarter trimethoprim resistance without affecting nitrofurantoin resistance. CONCLUSIONS: This evaluation of a national primary care stewardship policy on antimicrobial resistance in the community suggests both hoped-for benefits and unexpected harms. Some increase in resistance to cefalexin and co-amoxiclav could result from residual confounding. Randomised controlled trials are urgently required to investigate causality.


Assuntos
Antibacterianos/administração & dosagem , Gestão de Antimicrobianos/legislação & jurisprudência , Prescrições de Medicamentos/normas , Farmacorresistência Bacteriana/efeitos dos fármacos , Infecções por Escherichia coli/tratamento farmacológico , Escherichia coli/efeitos dos fármacos , Infecções Urinárias/tratamento farmacológico , Adolescente , Adulto , Criança , Pré-Escolar , Uso de Medicamentos , Inglaterra/epidemiologia , Infecções por Escherichia coli/epidemiologia , Infecções por Escherichia coli/microbiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Padrões de Prática Médica/normas , Atenção Primária à Saúde/métodos , Atenção Primária à Saúde/normas , Infecções Urinárias/epidemiologia , Infecções Urinárias/microbiologia , Adulto Jovem
14.
PLoS One ; 15(5): e0232890, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32392237

RESUMO

Diarrhea caused by Escherichia coli in calves is an important problem in terms of survivability, productivity and treatment costs. In this study, 88 of 150 diarrheic animals tested positive for E. coli. Of these, 54 samples had mixed infection with other bacterial and/or parasitic agents. There are several diarrheagenic E. coli pathotypes including enteropathogenic E. coli (EPEC), Shiga-toxin producing E. coli (STEC), enterotoxigenic E. coli (ETEC) and necrotoxigenic E. coli (NTEC). Molecular detection of virulence factors Stx2, Cdt3, Eae, CNF2, F5, Hly, Stx1, and ST revealed their presence at 39.7, 27.2, 19.3, 15.9, 13.6, 9.0, 3.4, and 3.4 percent, respectively. As many as 13.6% of the isolates lacked virulence genes and none of the isolate had LT or CNF1 toxin gene. The odds of isolating ETEC from male calves was 3.6 times (95% CI: 1.1, 12.4; P value = 0.042) that of female calves, whereas the odds of isolating NTEC from male calves was 72.9% lower (95% CI: 91.3% lower, 15.7% lower; P value = 0.024) than that in females. The odds of isolating STEC in winter was 3.3 times (95% CI: 1.1, 10.3; P value = 0.037) that of spring. Antibiograms showed 48 (54.5%) of the isolates to be multi-drug resistant. The percent resistance to tetracycline, streptomycin, ampicillin, and trimethoprim-sulfamethoxazole was 79.5, 67.0, 54.5, and 43.0, respectively. Ceftazidime (14.8%), amoxicillin-clavulanic acid (13.6%) and aztreonam (11.3%) showed the lowest resistance, and none of the isolates was resistant to imipenem. The results of this study can help improve our understanding of the epidemiological aspects of E. coli infection and to devise strategies for protection against it. The prevalence of E. coli pathotypes can help potential buyers of calves to avoid infected premises. The antibiograms in this study emphasizes the risks associated with the random use of antibiotics.


Assuntos
Doenças dos Bovinos/epidemiologia , Doenças dos Bovinos/microbiologia , Diarreia/veterinária , Infecções por Escherichia coli/veterinária , Criação de Animais Domésticos , Animais , Búfalos , Bovinos , Diarreia/epidemiologia , Diarreia/microbiologia , Farmacorresistência Bacteriana Múltipla/genética , Escherichia coli/efeitos dos fármacos , Escherichia coli/genética , Escherichia coli/isolamento & purificação , Infecções por Escherichia coli/epidemiologia , Proteínas de Escherichia coli/genética , Feminino , Masculino , Testes de Sensibilidade Microbiana , Fatores de Risco , Estações do Ano , Fatores de Virulência/genética
15.
Artigo em Inglês | MEDLINE | ID: mdl-32366011

RESUMO

(1) Background: In response to the notification made by an elementary school authority that reported a number of elementary school children being absent in three schools as a result of gastroenteritis symptoms on 4 July 2018, in Gyeongsangbuk-Do Province, South Korea, an epidemic investigation was carried out to determine the extent, cause, and source of the outbreak in order to prevent secondary cases and make recommendations to prevent future recurrences. (2) Methods: In this epidemiologic study, a total of 106 human subjects (school children, staff members, and cooks) who had consumed the possibly contaminated foodstuffs were enrolled retrospectively. Human specimens from clinically defined cases, food and drinks, supply and storage of them, and environmental and sanitary conditions were also assessed by observation, laboratory tests, and survey questionnaires-where and whatever applicable. The attack rate and positive rate for human specimens were first presented followed by the calculation of the relative risk ratio (RR) with 95% CI (confidence intervals) in order to identify the exposure and outcome relationships. (3) Results: The attack rate was 12.26% (13/106) for those who had ingested the food items at the three schools and the positive rate of enteropathogenic Escherichia coli (EPEC) was 15.38% (2/13). The relative risk (RR) of developing food poisoning of those who consumed the cucumber chili with ssamjang and seasoned cucumber and chives were 4.55 (95% CI 1.05-19.54) and 9.20 (95% CI 1.24-68.22), respectively. In addition, within the human specimens as well as the water and environmental samples different strains of diarrhoeagenic enteropathogenic Escherichia coli (EPEC) were detected. (4) Conclusions: Provision of safe and wholesome water access to all elementary schools by concerned authorities, especially during the likely seasons of water source contamination, as well as health education promotion about foodborne outbreaks to all school stakeholders is therefore recommended.


Assuntos
Diarreia , Surtos de Doenças , Escherichia coli Enteropatogênica , Infecções por Escherichia coli , Infecções , Criança , Diarreia/epidemiologia , Diarreia/microbiologia , Infecções por Escherichia coli/complicações , Infecções por Escherichia coli/epidemiologia , Humanos , República da Coreia/epidemiologia , Estudos Retrospectivos , Água
16.
PLoS One ; 15(3): e0230489, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32226038

RESUMO

Surveillance of antimicrobial resistance (AMR) enables monitoring of trends in AMR prevalence. WHO recommends laboratory-based surveillance to obtain actionable AMR data at local or national level. However, laboratory-based surveillance may lead to overestimation of the prevalence of AMR due to bias. The objective of this study is to assess the difference in resistance prevalence between laboratory-based and population-based surveillance (PBS) among uropathogens in Indonesia. We included all urine samples submitted to the laboratory growing Escherichia coli and Klebsiella pneumoniae in the laboratory-based surveillance. Population-based surveillance data were collected in a cross-sectional survey of AMR in E. coli and K. pneumoniae isolated from urine samples among consecutive patients with symptoms of UTI, attending outpatient clinics and hospital wards. Data were collected between 1 April 2014 until 31 May 2015. The difference in percentage resistance (95% confidence intervals) between laboratory- and population-based surveillance was calculated for relevant antibiotics. A difference larger than +/- 5 percent points was defined as a biased result, precluding laboratory-based surveillance for guiding empirical treatment. We observed high prevalence of AMR ranging between 63.1% (piperacillin-tazobactam) and 85% (ceftriaxone) in laboratory-based surveillance and 41.3% (piperacillin-tazobactam) and 74.2% (ceftriaxone) in population-based surveillance, except for amikacin and meropenem (5.7%/9.8%; 10.8%/5.9%; [laboratory-/population-based surveillance], respectively). Laboratory-based surveillance yielded significantly higher AMR prevalence estimates than population-based surveillance. This difference was much larger when comparing surveillance data from outpatients than from inpatients. All point estimates of the difference between the two surveillance systems were larger than 5 percent points, except for amikacin and meropenem. Laboratory-based AMR surveillance of uropathogens, is not adequate to guide empirical treatment for community-based settings in Indonesia.


Assuntos
Antibacterianos/farmacologia , Farmacorresistência Bacteriana , Infecções por Escherichia coli , Escherichia coli , Infecções por Klebsiella , Klebsiella pneumoniae , Infecções Urinárias , Estudos Transversais , Escherichia coli/crescimento & desenvolvimento , Escherichia coli/isolamento & purificação , Infecções por Escherichia coli/tratamento farmacológico , Infecções por Escherichia coli/epidemiologia , Infecções por Escherichia coli/microbiologia , Feminino , Humanos , Indonésia , Infecções por Klebsiella/tratamento farmacológico , Infecções por Klebsiella/epidemiologia , Infecções por Klebsiella/microbiologia , Klebsiella pneumoniae/crescimento & desenvolvimento , Klebsiella pneumoniae/isolamento & purificação , Masculino , Testes de Sensibilidade Microbiana , Infecções Urinárias/tratamento farmacológico , Infecções Urinárias/epidemiologia , Infecções Urinárias/microbiologia
17.
Am J Trop Med Hyg ; 103(1): 472-479, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32342843

RESUMO

There are scarce data describing the etiology and clinical sequelae of sepsis in low- and middle-income countries (LMICs). This study describes the prevalence and etiology of sepsis among critically ill patients at a referral hospital in Malawi. We conducted an observational prospective cohort study of adults admitted to the intensive care unit or high-dependency unit (HDU) from January 29, 2018 to March 15, 2018. We stratified the cohort based on the prevalence of sepsis as defined in the following three ways: quick sequential organ failure assessment (qSOFA) score ≥ 2, clinical suspicion of systemic infection, and qSOFA score ≥ 2 plus suspected systemic infection. We measured clinical characteristics and blood and urine cultures for all patients; antimicrobial sensitivities were assessed for positive cultures. During the study period, 103 patients were admitted and 76 patients were analyzed. The cohort comprised 39% male, and the median age was 30 (interquartile range: 23-40) years. Eighteen (24%), 50 (66%), and 12 patients (16%) had sepsis based on the three definitions, respectively. Four blood cultures (5%) were positive, two from patients with sepsis by all three definitions and two from patients with clinically suspected infection only. All blood bacterial isolates were multidrug resistant. Of five patients with urinary tract infection, three had sepsis secondary to multidrug-resistant bacteria. Hospital mortality for patients with sepsis based on the three definitions ranged from 42% to 75% versus 12% to 26% for non-septic patients. In summary, mortality associated with sepsis at this Malawi hospital is high. Bacteremia was infrequently detected, but isolated pathogens were multidrug resistant.


Assuntos
Bacteriemia/epidemiologia , Farmacorresistência Bacteriana Múltipla , Sepse/epidemiologia , Infecções Urinárias/epidemiologia , Adulto , Antibacterianos/uso terapêutico , Antifúngicos/uso terapêutico , Bacteriemia/tratamento farmacológico , Bacteriemia/microbiologia , Bacteriemia/mortalidade , Infecções por Burkholderia/tratamento farmacológico , Infecções por Burkholderia/epidemiologia , Infecções por Burkholderia/microbiologia , Infecções por Burkholderia/mortalidade , Candida glabrata , Candidíase Invasiva/tratamento farmacológico , Candidíase Invasiva/epidemiologia , Candidíase Invasiva/microbiologia , Candidíase Invasiva/mortalidade , Ceftriaxona/uso terapêutico , Estudos de Coortes , Estado Terminal , Infecções por Escherichia coli/tratamento farmacológico , Infecções por Escherichia coli/epidemiologia , Infecções por Escherichia coli/microbiologia , Infecções por Escherichia coli/mortalidade , Feminino , Infecções por Bactérias Gram-Positivas/tratamento farmacológico , Infecções por Bactérias Gram-Positivas/epidemiologia , Infecções por Bactérias Gram-Positivas/microbiologia , Infecções por Bactérias Gram-Positivas/mortalidade , Mortalidade Hospitalar , Humanos , Unidades de Terapia Intensiva , Infecções por Klebsiella/tratamento farmacológico , Infecções por Klebsiella/epidemiologia , Infecções por Klebsiella/microbiologia , Infecções por Klebsiella/mortalidade , Malaui/epidemiologia , Masculino , Metronidazol/uso terapêutico , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Prevalência , Estudos Prospectivos , Infecções por Proteus/tratamento farmacológico , Infecções por Proteus/epidemiologia , Infecções por Proteus/microbiologia , Infecções por Proteus/mortalidade , Sepse/tratamento farmacológico , Sepse/microbiologia , Sepse/mortalidade , Infecções Estafilocócicas/tratamento farmacológico , Infecções Estafilocócicas/epidemiologia
18.
Am J Trop Med Hyg ; 102(5): 1137-1143, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32157990

RESUMO

Although there has been an increasing incidence of bacteremia caused by extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae (ESBL-E) across South East Asia, there are sparse data from the Lao PDR, where laboratory capacity for antimicrobial resistance surveillance is limited. We, therefore, retrospectively reviewed bacteremia caused by ESBL-producing Escherichia coli and Klebsiella pneumoniae between 2010 and 2014 at Mahosot Hospital, Vientiane, Lao PDR. Clinical and laboratory data relating to all episodes of ESBL-E bacteremia were reviewed over the 5-year period and compared with non-ESBL-E bacteremia. Blood cultures positive for E. coli or K. pneumoniae were identified retrospectively from laboratory records. Clinical and laboratory data were extracted from research databases and case notes and analyzed using STATA. Between 2010 and 2014, we identified 360 patients with E. coli (n = 249) or K. pneumoniae (n = 111) bacteremia, representing 34.8% of all patients with clinically significant bacteremia. Seventy-two (20%) isolates produced ESBL; E. coli accounted for 15.3% (55/360) and K. pneumoniae for 4.7% (17/360), respectively. The incidence of ESBL-producing E. coli bacteremia rose during the study period. By multiple logistic analysis, reported antibiotic use in the previous week was significantly associated with ESBL positivity (P < 0.001, odds ratio 3.89). Although multiresistant, most ESBL-producing E. coli and K. pneumoniae remained susceptible to meropenem (65/65; 100%) and amikacin (64/65; 98.5%). We demonstrated an alarming increase in the incidence of ESBL-E as a cause of bacteremia in Vientiane during the study period. This has implications for empiric therapy of sepsis in Laos, and ongoing surveillance is essential.


Assuntos
Bacteriemia/microbiologia , Infecções por Escherichia coli/tratamento farmacológico , Escherichia coli/efeitos dos fármacos , Infecções por Klebsiella/tratamento farmacológico , beta-Lactamases/metabolismo , Adolescente , Adulto , Idoso , Antibacterianos/uso terapêutico , Bacteriemia/tratamento farmacológico , Bacteriemia/epidemiologia , Escherichia coli/enzimologia , Infecções por Escherichia coli/epidemiologia , Feminino , Humanos , Infecções por Klebsiella/epidemiologia , Klebsiella pneumoniae/efeitos dos fármacos , Klebsiella pneumoniae/enzimologia , Laos/epidemiologia , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem , Resistência beta-Lactâmica
19.
Epidemiol Infect ; 148: e64, 2020 03 02.
Artigo em Inglês | MEDLINE | ID: mdl-32115003

RESUMO

Gastroenteritis remains a serious health condition among children under 5 years especially in Africa. We conducted a systematic review and meta-analysis to investigate the aetiologic pathogens of gastroenteritis in the region. We did a systematic search for articles with original data on the aetiology of gastroenteritis and acute diarrhoea among children younger than 5 years. Pooled results were extracted and analysed in STATA version 12.0 using random-effects for statistical test for homogeneity following the guidelines provided in the Cochrane Collaboration and Preferred reporting items for systematic reviews and meta-analyses. Overall, viruses accounted for 50.2% of the cases followed by bacteria with 31.6% of the cases. Parasites accounted for 12.1% of the case. Rotavirus was the most common cause of acute diarrhoea in all regions resulting in 29.2% of the cases followed by E. coli (15.6%) of diarrhoeal cases and Adenovirus (10.8%). The most prevalent parasite detected was Giardia lamblia (7.3%). Acute diarrhoea remains rampant with Rotavirus still being the major pathogen responsible for the disease in children less than 5 years old despite the introduction of vaccine. It is recommended that the vaccine should be promoted much more widely in the region.


Assuntos
Diarreia , Gastroenterite , Adenoviridae , Infecções por Adenovirus Humanos/epidemiologia , Infecções por Adenovirus Humanos/virologia , África ao Sul do Saara/epidemiologia , Pré-Escolar , Diarreia/epidemiologia , Diarreia/microbiologia , Diarreia/parasitologia , Escherichia coli , Infecções por Escherichia coli/epidemiologia , Infecções por Escherichia coli/microbiologia , Gastroenterite/epidemiologia , Gastroenterite/microbiologia , Gastroenterite/parasitologia , Giardia lamblia , Giardíase/epidemiologia , Giardíase/parasitologia , Humanos , Lactente , Recém-Nascido , Rotavirus , Infecções por Rotavirus/epidemiologia , Infecções por Rotavirus/virologia
20.
Trop Anim Health Prod ; 52(5): 2721-2724, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32125596

RESUMO

Nomadic populations do not have permanent settlements as they move their livestock between grazing areas in different seasons; such movements may have great impact on dissemination of food-borne pathogens in various regions. The aim of this study was to characterize Shiga toxin-producing Escherichia coli (STEC) strains as a food-borne pathogen in sheep and goats of Bakhtiari pastoral tribe in Iran. In the present study, 72 fecal samples were obtained from 26 sheep and 46 goats. First, all recovered E. coli isolates were screened for stx gene. After detection of stx-positive isolates, the virulence genes including stx1, stx2, eae, ehly, saa, astA, subAB, terD, and the genetic markers of O Island 57 (Z2098 and Z2099) were investigated. Also fifteen important STEC O-serogroups were determined using PCR assays. Results showed that 27 animals (27/72; 37.5%) carried STEC strains including 16/26 (61.6%) sheep and 11/46 (23.9%) goats. All STECs were eae-negative but 81.4% (22/27) were positive for saa. The most prevalent virulence profile was stx1/stx2/ehly/saa/subAB (37%; 10/27). Most STECs (24/27) were positive for at least one of the selected OI-57 markers. The O91 (n = 6), O5 (n = 3), O113 (n = 1), O128 (n = 1), and O104 (n = 1) were the detected O-serogroups in this study. It is concluded that such moving animal populations could have public health concerns which have to be addressed in the future.


Assuntos
Infecções por Escherichia coli/veterinária , Cabras/microbiologia , Ovinos/microbiologia , Escherichia coli Shiga Toxigênica/genética , Fatores de Virulência/genética , Animais , Infecções por Escherichia coli/epidemiologia , Infecções por Escherichia coli/microbiologia , Proteínas de Escherichia coli/genética , Fezes/microbiologia , Feminino , Irã (Geográfico)/epidemiologia , Masculino , Reação em Cadeia da Polimerase/veterinária , Saúde Pública , Sorogrupo , Sorotipagem/veterinária , Doenças dos Ovinos/epidemiologia , Doenças dos Ovinos/microbiologia , Toxina Shiga/genética , Escherichia coli Shiga Toxigênica/isolamento & purificação , Migrantes , Virulência/genética
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