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1.
BMC Infect Dis ; 19(1): 620, 2019 Jul 12.
Artigo em Inglês | MEDLINE | ID: mdl-31299909

RESUMO

BACKGROUND: Escherichia coli lineage ST131 predominates across various spectra of extra-intestinal infections, including urinary tract infection (UTI). The distinctive resistance profile, diverse armamentarium of virulence factors and rapid global dissemination of ST131 E. coli makes it an intriguing pathogen. However, not much is known about the prevalence and genetic attributes of ST131 lineage in Pakistan. METHODS: We estimated prevalence and genetic attributes of E. coli ST131 isolates causing UTI among 155 randomly selected samples. Samples were analyzed for phylogenetic grouping, O-typing and fumC/fimH typing. Isolates were further tested for the ESBL and virulence factors using PCR. RESULTS: Overall, 59% of the UPEC isolates belonged to the phylogenetic group B2, followed by D = 28%, B1 = 8% and A = 5%. Among 18 different Sequence-types, ST131 was the dominant lineage (n = 71; 46%) out of which 72% of the isolates were assigned to the phylogenetic group B2, while 61% adhered to the serogroup O25b. FumC/fimH typing confirmed 49% of the ST131 as H30 sub-types. In this study, significant numbers of the identified ST131 isolates were MDR and 42% showed ESBL phenotypes, out of which 37% carried bla-CTX-M-15. Moreover, different virulence factors were detected in following percentages: fimH,155(100%), iutA 86 (55%), feoB 76 (49%), papC 75 (48%), papGII 70 (45%), kpsMTII 40 (26%), papEF 37 (24%), fyuA 37 (24%), usp 22 (14%), papA 20 (13%), sfa/foc20 (13%), hlyA 18 (12%), afa 15 (10%), cdtB 11 (7%), papGI 6 (4%), papGIII 6 (4%), kpsMTIII 4 (3%) and bmaE2 (1%). CONCLUSION: Conclusively, this study provides important insight into the genetic and virulence attributes of pandemic MDR ST131 strains involved in UTIs. It also highlights higher prevalence of ST131-O25b-H30 UPEC isolates in patients, which was previously unreported from this part of globe.


Assuntos
Infecções por Escherichia coli/microbiologia , Infecções Urinárias/diagnóstico , Escherichia coli Uropatogênica/classificação , Farmacorresistência Bacteriana Múltipla/genética , Infecções por Escherichia coli/diagnóstico , Infecções por Escherichia coli/epidemiologia , Feminino , Humanos , Masculino , Paquistão/epidemiologia , Filogenia , Prevalência , Infecções Urinárias/epidemiologia , Infecções Urinárias/microbiologia , Escherichia coli Uropatogênica/isolamento & purificação , Escherichia coli Uropatogênica/patogenicidade , Virulência , Fatores de Virulência/classificação , Fatores de Virulência/genética , beta-Lactamases/classificação , beta-Lactamases/genética
2.
J Med Microbiol ; 68(9): 1330-1340, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31347999

RESUMO

Purpose. This study aimed to characterize 27 Escherichia coli isolates obtained from peritoneal dialysis (PD)-related peritonitis that occurred at the University Hospital of Botucatu Medical School, Brazil, between 1997 and 2015.Methodology. These isolates were characterized regarding the occurrence of 22 virulence factor-encoding genes, antimicrobial resistance and biofilm production. We then evaluated whether these factors influenced the clinical outcome.Results. Over an 18-year period, 726 episodes of PD-related peritonitis were diagnosed, with 27 of them (3.7 %) being due to E. coli. The majority of the isolates were classified in phylogroups B1 (33.3 %), B2 (30.0 %) or F (18.0 %). fimH (100.0 %), ompT (66.7 %) and irp2 (51.9 %) were the most prevalent genes, while papA, papC, iha, sat, irp2, iucD, ireA, ibe10, ompT and kpsMTII were significantly more prevalent among isolates belonging to phylogroups B2 and F (P<0.05). Non-susceptibility to quinolones was detected in six isolates, which harboured chromosomal and/or plasmid-mediated quinolone resistance determinants, while two CTX-M extended-spectrum ß-lactamase-producing E. coli were identified. Virulence factor-encoding genes (alone or in combination) and antimicrobial resistance were not associated with non-resolution outcomes. However, there was a trend for the ability to produce biofilm to be associated with treatment failure, although this association was not statistically significant.Conclusion. The E. coli isolates were heterogeneous in terms of the features investigated, and were susceptible to most of the antimicrobial drugs tested, despite the unsuccessful treatment observed in more than 50.0 % of the patients. Studies including more cases could help to clarify if biofilm production can influence the outcome in patients with PD-related peritonitis.


Assuntos
Infecções por Escherichia coli/microbiologia , Escherichia coli/isolamento & purificação , Diálise Peritoneal/efeitos adversos , Peritonite/microbiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/farmacologia , Biofilmes/crescimento & desenvolvimento , Variação Biológica da População , Brasil/epidemiologia , Criança , Escherichia coli/efeitos dos fármacos , Escherichia coli/genética , Escherichia coli/patogenicidade , Infecções por Escherichia coli/epidemiologia , Variação Genética , Técnicas de Genotipagem , Hospitais Universitários , Humanos , Masculino , Testes de Sensibilidade Microbiana , Pessoa de Meia-Idade , Peritonite/epidemiologia , Filogenia , Plasmídeos/análise , Fatores de Virulência/genética , Adulto Jovem
3.
BMC Vet Res ; 15(1): 268, 2019 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-31357996

RESUMO

BACKGROUND: This study investigated changes over time in the epidemiology of extended-spectrum ß-lactamase (ESBL) producing Escherichia coli within a single equine referral hospital in the UK. Faecal samples were collected from hospitalised horses in 2008 and 2017, processed using selective media and standard susceptibility laboratory methods. A novel real-time PCR with high resolution melt analysis was used to distinguish blaCTX-M-1 and blaCTX-M-15 within CTX-M-1 group. RESULTS: In 2008, 457 faecal samples from 103 horses were collected, with ESBL-producing E. coli identified in 131 samples (28.7, 95% CI 24.6-33.1). In 2017, 314 faecal samples were collected from 74 horses with ESBL-producing E. coli identified in 157 samples (50.0, 95% CI 44.5-55.5). There were 135 and 187 non-duplicate ESBL-producing isolates from 2008 and 2017, respectively. In 2008, 12.6% of isolates belonged to CTX-M-1 group, all carrying blaCTX-M-1, whilst in 2017, 94.1% of isolates were CTX-M-1 group positive and of these 39.2 and 60.8% of isolates carried blaCTX-M-1 and blaCTX-M-15, respectively. In addition, the prevalence of doxycycline, gentamicin and 3rd generation cephalosporin resistance increased significantly from 2008 to 2017 while a decreased prevalence of phenotypic resistance to potentiated sulphonamides was observed. CONCLUSIONS: The real-time PCR proved a reliable and high throughput method to distinguish between blaCTX-M-1 and blaCTX-M-15. Furthermore, its use in this study demonstrated the emergence of faecal carriage of CTX-M-15 in hospitalised horses, with an increase in prevalence of ESBL-producing E. coli as well as increased antimicrobial resistance to frequently used antimicrobials.


Assuntos
Infecções por Escherichia coli/veterinária , Fezes/microbiologia , Doenças dos Cavalos/epidemiologia , Doenças dos Cavalos/microbiologia , beta-Lactamases/metabolismo , Animais , Antibacterianos/farmacologia , Farmacorresistência Bacteriana , Escherichia coli/efeitos dos fármacos , Escherichia coli/enzimologia , Escherichia coli/genética , Infecções por Escherichia coli/epidemiologia , Infecções por Escherichia coli/microbiologia , Cavalos , Hospitais Veterinários/estatística & dados numéricos , Prevalência , Reino Unido/epidemiologia , beta-Lactamases/genética
4.
J Med Microbiol ; 68(7): 1033-1041, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31199225

RESUMO

PURPOSE: Enteropathogens are frequently associated with diarrheal disease. Knowledge of their etiology and epidemiology is essential for the prevention and control of the sickness. This study describes the microbiological and epidemiological features of diarrheal disease in 197 symptomatic and 223 asymptomatic under-five-year-old children from southeastern Brazil, between January 2015 and September 2016. METHODS: Isolation of Escherichia coli, Salmonella, Shigella and Campylobacter was realized by culture. E. coli strains were screened by multiplex PCR, PFGE and O:H serotyping. Antimicrobial susceptibility testing was also performed. RESULTS: Most of the 127 enteropathogens isolated were diarrheagenic E. coli (96.1 %), with predominance of several serotypes of enteropathogenic E. coli (EPEC) and enteroaggregative E. coli (EAEC). Age, sex, rotavirus vaccination, recent use of antibiotics and previous contact with pets, were factors that revealed no significant effects on the probability of infection by the predominant pathogens. Even so, higher incomes could be related to a lesser chance of testing positive for EPEC. Evidence of possible EAEC clonal spread was detected, as well as genetic similarity among strains from both symptomatic and asymptomatic children. Resistance to antimicrobial agents was more pronounced among EAEC than EPEC. CONCLUSION: The occurrence of genetically similar diarrheagenic E. coli in both groups of children, likewise resistant to these agents, underscores the importance of establishing strategies for the prevention of outbreaks, especially among low-income households.


Assuntos
Diarreia/epidemiologia , Diarreia/microbiologia , Infecções por Escherichia coli/epidemiologia , Infecções por Escherichia coli/microbiologia , Escherichia coli/genética , Brasil/epidemiologia , Pré-Escolar , Diarreia/economia , Escherichia coli/classificação , Infecções por Escherichia coli/economia , Fezes/microbiologia , Feminino , Humanos , Renda , Lactente , Masculino
5.
BMC Infect Dis ; 19(1): 488, 2019 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-31151426

RESUMO

BACKGROUND: There are limited studies focusing on liver abscess with negative microbiological cultures. This study evaluated the clinical and prognostic differences of patients with culture-negative liver abscess (CNLA) compared to those with a positive culture (CPLA) and compared these factors between K. pneumoniae liver abscess (KLA) and E. coli liver abscess (ELA). METHODS: A retrospective study of the patients who admitted with a liver abscess at two tertiary hospitals in Korea from 2012 to 2016 was performed. RESULTS: Among a total of 402 patients with liver abscess, 61.2% had positive cultures. K. pneumoniae (n = 133) was the most common cause, followed by E. coli (n = 74). Patients with CPLA were significantly older (p = 0.02) and more frequently had cholelithiasis or biliary tract disease (p = 0.001) compared to patients with CNLA. In-hospital mortality (p = 0.63) and recurrence (p = 0.77) were no different between the two groups. The length of hospital stay was significantly longer in patients with CPLA (p = 0.03) compared with those with CNLA. Subgroup analysis for patients who received 3rd generation cephalosporins empirically showed that in-hospital mortality (p = 0.18) and recurrence (p = 0.27) were not also significantly different. Cholelithiasis, or biliary tract disease (p = 0.001), liver disease (p = 0.001), malignancy (p = 0.0001), and ESBL production (p = 0.0001) were found more frequently in patients with ELA compared with those with KLA. CONCLUSIONS: The prognosis of the CNLA patients was similar to that of the CPLA patients, although the length of hospital stay was shorter in the CNLA patients. The epidemiologic and clinical characteristics of the ELA patients are somewhat different than those of the KLA patients.


Assuntos
Abscesso Hepático Piogênico/diagnóstico , Abscesso Hepático Piogênico/microbiologia , Adulto , Idoso , Doenças Biliares/diagnóstico , Doenças Biliares/epidemiologia , Doenças Biliares/microbiologia , Escherichia coli/isolamento & purificação , Infecções por Escherichia coli/diagnóstico , Infecções por Escherichia coli/epidemiologia , Infecções por Escherichia coli/microbiologia , Feminino , Mortalidade Hospitalar , Hospitalização/estatística & dados numéricos , Humanos , Infecções por Klebsiella/diagnóstico , Infecções por Klebsiella/epidemiologia , Infecções por Klebsiella/microbiologia , Klebsiella pneumoniae/isolamento & purificação , Abscesso Hepático Piogênico/epidemiologia , Masculino , Pessoa de Meia-Idade , Prognóstico , Recidiva , República da Coreia/epidemiologia , Estudos Retrospectivos , Centros de Atenção Terciária/estatística & dados numéricos
6.
Vet Microbiol ; 233: 61-67, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31176414

RESUMO

The incidence of infections with extended spectrum ß-lactamase producing Escherichia coli (ESBL-E) is increasing both in humans and animals. There is a paucity of data about the rate of faecal carriage of ESBL-E in pets. In this study, faecal swabs collected from 586 pets (225 cats; 361 dogs) in Auckland, New Zealand, were analysed for the presence of ESBL-E by culture, and a questionnaire was delivered to the owners. The ESBL-E were characterised and data elicited by the questionnaires were used for a multivariable analysis, to investigate the factors associated with faecal ESBL-E carriage. The prevalence of ESBL-E in faecal swabs was 6.4%. The ß-lactamase genes detected in the ESBL-E were the blaCTX-M-14 (n = 2) and blaCMY-2 (n = 34). Several isolates displayed multilocus sequence types (ST) associated with human and animal infections. Multiple isolates sharing the same ST displayed different antibiograms and ß-lactamase genes, reflecting horizontal gene transfer between and within ST. Variables independently associated with increased odds of ESBL-E carriage were: animal received systemic antimicrobial treatment in the six months before the sampling; presence of household members working in veterinary clinics; presence of household members travelling overseas in the six months before the sampling. We conclude that pets are colonised by ESBL-E which are genotypically similar to the bacteria found to infect humans and animals. The statistical analysis suggested a number of eco-epidemiological factors associated with ESBL-E carriage. In particular, they suggest veterinary clinics may represent hot-spots of antimicrobial resistance.


Assuntos
Portador Sadio/veterinária , Farmacorresistência Bacteriana Múltipla/genética , Infecções por Escherichia coli/veterinária , Escherichia coli/genética , Animais de Estimação/microbiologia , beta-Lactamases/genética , Animais , Antibacterianos/farmacologia , Proteínas de Bactérias/genética , Portador Sadio/epidemiologia , Gatos/microbiologia , Cães/microbiologia , Escherichia coli/enzimologia , Infecções por Escherichia coli/epidemiologia , Fezes/microbiologia , Feminino , Transferência Genética Horizontal , Genética Populacional , Genótipo , Hospitais Veterinários , Humanos , Masculino , Tipagem de Sequências Multilocus , Nova Zelândia/epidemiologia , Prevalência , beta-Lactamases/biossíntese
7.
BMC Vet Res ; 15(1): 159, 2019 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-31118039

RESUMO

BACKGROUND: Avian pathogenic Escherichia coli (APEC) is the principle cause of colibacillosis affecting poultry. The main challenge to the poultry industry is antimicrobial resistance and the emergence of multidrug resistant bacteria that threaten the safety of the food chain. Risk factors associated with emergence of antimicrobial resistance among avian pathogenic E. coli were correlated with the inappropriate use of antimicrobials along with inadequate hygienic practices, which encourages the selection pressure of antimicrobial resistant APEC. The aim of this study was to isolate, identify, serogroup and genotype APEC from broilers, assess their antibiotic resistance profile, expressed genes and the associated risk factors. RESULTS: APEC was isolated from the visceral organs of sick chickens with a prevalence of 53.4%. The most prevalent serotypes were O1, O2, O25 and O78, in percentage of 14.8, 12.6, 4.4 and 23.7%, respectively. Virulence Associated Genes; SitA, iss, iucD, iucC, astA, tsh cvi and irp2 were detected in rate of 97.4, 93.3, 75, 74, 71, 46.5, 39 and 34%, respectively and 186 (69.2%) isolates possess > 5-10 genes. The highest resistance was found against sulphamethoxazole-trimethoprim, florfenicol, amoxicillin, doxycycline and spectinomycin in percentage; 95.5, 93.7, 93.3, 92.2 and 92.2%, respectively. Sixty-eight percent of APEC isolates were found to have at least 5 out of 8 antimicrobial resistant genes. The most predominant genes were Int1 97%, tetA 78.4%, bla TEM 72.9%, Sul1 72.4%, Sul2 70.2%. Two risk factors were found to be associated with the presence of multi-drug resistant APEC in broiler chickens, with a P value ≤0.05; the use of ground water as source of drinking water and farms located in proximity to other farms. CONCLUSIONS: This study characterized the VAGs of avian pathogenic E. coli and establish their antimicrobial resistance patterns. The widespread of antimicrobial resistance of APEC isolates and detection of ARGs highlighted the need to monitor the spread of ARGs in poultry farms and the environment in Jordan. Use of ground water and closely located farms were significant risk factors associated with the presence of MDR APEC in broiler chickens in Jordan.


Assuntos
Antibacterianos/farmacologia , Farmacorresistência Bacteriana , Infecções por Escherichia coli/veterinária , Escherichia coli/efeitos dos fármacos , Escherichia coli/genética , Doenças das Aves Domésticas/microbiologia , Criação de Animais Domésticos , Animais , Galinhas , Infecções por Escherichia coli/epidemiologia , Infecções por Escherichia coli/microbiologia , Água Subterrânea/microbiologia , Jordânia/epidemiologia , Doenças das Aves Domésticas/epidemiologia , Fatores de Risco
8.
Vet Med Sci ; 5(3): 462-469, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31124305

RESUMO

Shiga toxin-producing Escherichia coli (STEC) strains are food-borne pathogens of public health concern. Despite ruminants are the most important reservoir, STEC human infections have also been attributed to pigs. We examined for the presence of STEC in 234 samples of swine caecal content collected during the year 2015 at Italian abattoirs in the framework of the harmonized monitoring of antimicrobial resistance (Decision 2013/652/EU). The presence of stx genes was detected in 122 (52.1%) samples, which were subsequently subjected to STEC isolation and characterization. The analysis of the 66 isolated STEC strains showed that the majority of the isolates (74.2%) possessed the stx2a gene subtype, in a few cases (16.7%) in combination with stx2b or stx2c. Only 25.8% of isolates possessed the stx2e subtype, typical of swine-adapted STEC. None of the isolates possessed the intimin-coding eae gene and the majority of them did not belong to serogroups commonly associated with human infections. The results of this study suggest that pigs can be considered as potential reservoir of certain STEC types.


Assuntos
Reservatórios de Doenças/microbiologia , Infecções por Escherichia coli/microbiologia , Toxina Shiga II/genética , Escherichia coli Shiga Toxigênica/isolamento & purificação , Doenças dos Suínos/microbiologia , Matadouros , Animais , Ceco/microbiologia , Infecções por Escherichia coli/epidemiologia , Humanos , Itália/epidemiologia , Prevalência , Sorogrupo , Escherichia coli Shiga Toxigênica/genética , Escherichia coli Shiga Toxigênica/imunologia , Suínos , Doenças dos Suínos/epidemiologia , Virulência/genética
9.
Environ Pollut ; 251: 619-627, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31108295

RESUMO

Antibiotic resistance among gram-negative bacteria is increasingly becoming a problem of global concern. Particularly problematic is the emergence of resistance to last-resort antibiotics such as carbapenems and colistin. The increasing number of reports on the plasmid-mediated colistin resistance gene mcr-1 in isolates worldwide is raising concerns for the future usefulness of this class of antibiotics. Dissemination of mcr-1 is believed to have originated mainly from animal breeding, however, the role of the environment as a transmission source is not yet fully understood. In the current study, 89 extended-spectrum ß-lactamase-producing Escherichia coli isolated from 231 samples from different environmental sources in 12 villages in a rural area of Shandong, China, were screened for mcr-1. 17 (19.1%) mcr-1-positive isolates were found from different environmental sources, aggregated in 6 villages. Plasmids of three different Inc-groups carrying mcr-1 were confirmed, indicating that the widespread geographical distribution of mcr-1 in the local area is due to a number of different plasmids. Additionally, almost a third (29.4%) of the isolates carried virulence factors associated to intestinal pathogenic E. coli. These results illustrate the high complexity of the transmission patterns of mcr-1 among different environmental matrices on a local scale and the potential for the environment to facilitate dissemination and emergence of antibiotic-resistant and virulent strains of bacteria.


Assuntos
Portador Sadio/microbiologia , Microbiologia Ambiental , Infecções por Escherichia coli/microbiologia , Proteínas de Escherichia coli/genética , Escherichia coli/isolamento & purificação , beta-Lactamases/biossíntese , Animais , Antibacterianos/farmacologia , Portador Sadio/epidemiologia , China , Conjugação Genética , Farmacorresistência Bacteriana/genética , Microbiologia Ambiental/normas , Escherichia coli/efeitos dos fármacos , Escherichia coli/genética , Infecções por Escherichia coli/epidemiologia , Genes Bacterianos , Humanos , Sequenciamento Completo do Genoma
10.
Int J Food Microbiol ; 304: 1-10, 2019 Sep 02.
Artigo em Inglês | MEDLINE | ID: mdl-31146052

RESUMO

Water contamination by pathogenic bacteria is a global public health problem. Contamination of surface water utilized to irrigate food products, or for human consumption, causes outbreaks of foodborne and waterborne disease. Of these, those caused by diarrheagenic Escherichia coli (DEC) strains present substantial morbidity and mortality. The aim of this study was, therefore, to investigate the microbiological quality of surface water and the presence of DEC strains in different water bodies. A total of 472 water samples were collected from irrigation canal, dam, river, and dike water bodies from January through December 2015 in Sinaloa, a State located in Northwestern Mexico. Our studies demonstrated that 47.0% (222/472) of samples contained thermotolerant coliforms above permissive levels whereas E. coli strains were isolated from 43.6% (206/472). Among these E. coli isolates, DEC strains were identified in 14% (29/206) of samples including in irrigation canal (26/29) and river water (3/29) collected from the northern (83%) and central area (17%). Isolated DEC strains were classified as enteroaggregative E. coli (EAEC) 34.4% (10/29), enteropathogenic E. coli (EPEC) 31.0% (9/29), diffuse adherent E. coli (DAEC) 27.5% (8/29), and enterotoxigenic E. coli (ETEC) 6.8% (2/29). Moreover, 90% of isolated DEC strains exhibited resistance to at least one commonly prescribed antibiotic in Mexico whereas 17% were multi-drug resistant. In conclusion, the presence of DEC strains in surface water represents a potential source for human infection, and thus routine monitoring of DEC in surface water and other indirect affected areas should be considered at northwestern Mexico.


Assuntos
Irrigação Agrícola/métodos , Escherichia coli Enteropatogênica/isolamento & purificação , Escherichia coli Enterotoxigênica/isolamento & purificação , Rios/microbiologia , Qualidade da Água , Antibacterianos/farmacologia , Diarreia/microbiologia , Farmacorresistência Bacteriana Múltipla , Escherichia coli Enteropatogênica/efeitos dos fármacos , Escherichia coli Enterotoxigênica/efeitos dos fármacos , Infecções por Escherichia coli/epidemiologia , Infecções por Escherichia coli/microbiologia , Doenças Transmitidas por Alimentos/microbiologia , Humanos , México/epidemiologia , Água , Microbiologia da Água , Doenças Transmitidas pela Água/microbiologia
11.
Adv Clin Exp Med ; 28(7): 899-905, 2019 07.
Artigo em Inglês | MEDLINE | ID: mdl-31066244

RESUMO

BACKGROUND: The relationship of diffusely adherent Escherichia coli (DAEC) with pediatric inflammatory bowel disease (IBD) has not been previously studied. Diffusely adherent E. coli are a common cause of long-lasting childhood diarrhea and we postulated that they may induce inflammation of the intestinal mucosa, contributing to the development of IBD in susceptible children. OBJECTIVES: The aim of the study was to investigate the relationship between DAEC and pediatric IBD, including Crohn's disease (CD) and ulcerative colitis (UC). Diffusely adherent E. coli isolates were also assessed regarding their pathogenicity. MATERIAL AND METHODS: Diffusely adherent E. coli were screened among 130 E. coli strains isolated from intestinal biopsy specimens from 26 children with IBD using polymerase chain reaction (PCR) with primers specific to the pathotype and adherence assays to HEp-2 cells. Diffusely adherent E. coli were further analyzed for their ability to adhere to and invade polarized Caco-2 cells. The immunomodulatory effect of DAEC on the secretion of tumor necrosis factor α (TNF-α) by human monocyte-derived macrophages (MDM) was assessed using an immunoenzymatic assay. RESULTS: Diffusely adherent E. coli were recovered from 18 (69.2%) of the 26 intestinal biopsy specimens from both CD and UC patients. Most DAEC isolates carried AfaE3 adhesin, adhered to and were internalized by Caco-2 cells, and induced secretion of elevated levels of TNF-α. CONCLUSIONS: The study demonstrated the internalization of DAEC by intestinal epithelial cells and their ability to induce secretion of increased level of TNF-α in a Caco-2/macrophage compartmentalized culture. This indicated that the pathovar should be considered a pathobiont inducing inflammation of the intestinal mucosa in pediatric patients with IBD.


Assuntos
Aderência Bacteriana , Moléculas de Adesão Celular/metabolismo , Colite Ulcerativa/microbiologia , Doença de Crohn/microbiologia , Infecções por Escherichia coli/epidemiologia , Escherichia coli/isolamento & purificação , Doenças Inflamatórias Intestinais/microbiologia , Mucosa Intestinal/microbiologia , Adesinas de Escherichia coli , Células CACO-2 , Moléculas de Adesão Celular/genética , Criança , Colite Ulcerativa/epidemiologia , Colite Ulcerativa/imunologia , Doença de Crohn/epidemiologia , Doença de Crohn/imunologia , Escherichia coli/genética , Infecções por Escherichia coli/imunologia , Infecções por Escherichia coli/microbiologia , Humanos , Doenças Inflamatórias Intestinais/epidemiologia , Doenças Inflamatórias Intestinais/imunologia , Mucosa Intestinal/imunologia , Polônia/epidemiologia , Prevalência
12.
J Med Microbiol ; 68(6): 837-847, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31084700

RESUMO

INTRODUCTION: The last few years have seen the emergence of multi-drug resistant (MDR) Gram-negative infections, which are associated with high morbidity and mortality. The indiscriminate use of colistin has led to the development of resistance, which can be diagnosed effectively by broth microdilution. Studies from India are limited, and this study was conducted in order to determine the prevalence and risk factors associated with colistin resistance. METHODS: Urine samples from patients admitted with urinary tract infection (UTI), growing MDR Escherichia coli and Klebsiella pneumoniae, were tested for the minimum inhibitory concentration (MIC) of colistin by broth microdilution. Isolates with an MIC >2 µg ml-1 (resistant) were subjected to polymerase chain reaction (PCR) for the mcr1, mcr2 and mgrB genes. A case-control study with 21 cases (resistant) and 42 matched controls (sensitive) was designed to evaluate risk factors and outcomes (recurrent UTI, readmission and hospital stay >2 weeks). RESULTS: Two hundred and fifty MDR isolates (E. coli=142/2319 and K.pneumoniae=108/775) from 216 patients were selected from the 25 046 isolates screened. Twenty-five isolates (20 K.pneumoniae and 5 E. coli) were resistant to colistin, with a prevalence of 3.52  % in E. coli and 18.5  % in K. pneumoniae among the MDR isolates. PCR for the mcr1 and mcr2 genes was negative. Multivariate regression showed that multiple episodes of hospitalization, hospital stay >2 weeks, exposure to >three antibiotic classes and abnormality/surgery of the lower urinary tract were the significant risk factors for colistin resistance. Previous use of colistin and colistin resistance had a significant effect on all outcomes. CONCLUSIONS: K. pneumoniae show six times higher prevalence of colistin resistance than E. coli, and the emergence of resistant organisms has led to an increase in morbidity in infected patients.


Assuntos
Antibacterianos/farmacologia , Colistina/farmacologia , Infecções por Escherichia coli/epidemiologia , Escherichia coli/genética , Infecções por Klebsiella/epidemiologia , Klebsiella pneumoniae/genética , Infecções Urinárias/epidemiologia , Adulto , Proteínas de Bactérias/genética , Estudos de Casos e Controles , Farmacorresistência Bacteriana Múltipla/genética , Escherichia coli/efeitos dos fármacos , Escherichia coli/isolamento & purificação , Infecções por Escherichia coli/tratamento farmacológico , Infecções por Escherichia coli/microbiologia , Feminino , Humanos , Índia/epidemiologia , Infecções por Klebsiella/tratamento farmacológico , Infecções por Klebsiella/microbiologia , Klebsiella pneumoniae/efeitos dos fármacos , Klebsiella pneumoniae/isolamento & purificação , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de Risco , Infecções Urinárias/tratamento farmacológico , Infecções Urinárias/microbiologia , Adulto Jovem
13.
Malawi Med J ; 31(1): 12-18, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-31143391

RESUMO

Introduction: In Malawi, EcoSan sludge from ecological sanitation (EcoSan) latrines has been found to contain helminths, Salmonella and E. coli above WHO recommended levels making sludge unsuitable for direct handling and use on food crops. This research investigated survival of pathogens in EcoSan sludge with time after sealing the pit. Method: An observational longitudinal follow-up study was conducted where EcoSan latrines were followed from August 2015 to July 2016 in Blantyre and Chikwawa in Southern Malawi. The study enrolled 51 latrines in total with 35 latrines [13 fossa alterna (FAs) and 22 urine diverting dry latrines (UDDLs)] remaining at the end of study. Samples were collected five times from each latrine and examined for helminths, Salmonella and E. coli in the laboratory. Poisson regression was employed to assess factors that significantly contribute to pathogen die off at p<0.05. Results: Average concentrations of all pathogens investigated reduced over 12-month follow-up period except for Salmonella which increased. A. lumbricoides, increased to 2.3 viable eggs during the second sampling and decreased to 0.4 viable eggs per gram after 12 months of follow-up. Time was the only consistent predictor for concentration of helminths. Type of latrine and location were not significant predictors of helminths concentration (p>0.05). However, Salmonella and E. coli colonies were significantly higher in UDDLs (Blantyre) than FAs (Chikwawa) (p<0.05). Conclusion: Pathogen concentration was highest after recommended six months of storage posing a public health risk to those handling and using it for agriculture purposes. It is therefore recommended that the current guidelines be reviewed to suit Malawi context. A storage period of one year or more is recommended.


Assuntos
Infecções por Escherichia coli/epidemiologia , Helmintíase/epidemiologia , Saúde Pública , Saneamento/métodos , Esgotos/análise , Toaletes/estatística & dados numéricos , Animais , Escherichia coli/fisiologia , Infecções por Escherichia coli/microbiologia , Seguimentos , Helmintíase/parasitologia , Helmintos/fisiologia , Humanos , Estudos Longitudinais , Malaui/epidemiologia
14.
J Med Microbiol ; 68(6): 930-939, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30994441

RESUMO

PURPOSE: This study describes the epidemiology of Shiga toxin-producing Escherichia coli (STEC) infections in a population in the South East of England. METHODS: From 1 November 2013 to 31 March 2017 participating diagnostic laboratories reported Shiga toxin gene (stx) positive real-time PCR results to local public health teams. Stx positive faecal samples/isolates were referred to the Gastrointestinal Bacteria Reference Unit (GBRU) for confirmation by culture and typing by whole genome sequencing (WGS). Key clinical information was collected by public health teams.Results/Key findings. Altogether, 548 faecal specimens (420 were non-travel associated) were stx positive locally, 535 were submitted to the GBRU. STEC were isolated from 42 %, confirmed by stx PCR in 21 % and 37 % were PCR negative. The most common non-travel associated STEC serogroups were O157, O26, O146 and O91. The annualized incidence of confirmed STEC infections (PCR or culture) was 5.8 per 100 000. The ratio of O157 to non-O157 STEC serogroups was 1:7. The annualized incidence of non-O157 haemolytic uraemic syndrome-associated Escherichia coli (HUSEC) strains was 0.4 per 100 000. Bloody diarrhoea was reported by 58 % of cases infected with E. coli O157, 33 % of cases infected with non-O157 HUSEC strains and 12 % of other lower risk non-O157 strains. Overall, 76 % of non-O157 HUSEC isolates possessed the eae virulence gene. CONCLUSIONS: HUSEC including serogroup O157 were uncommon and more likely to cause bloody diarrhoea than other STEC. The routine use of stx PCR testing can influence clinical management. Understanding the local epidemiology facilitates a proportionate public health response to STEC, based on clinical and microbiological characteristics including stx subtype(s).


Assuntos
Infecções por Escherichia coli/epidemiologia , Síndrome Hemolítico-Urêmica/epidemiologia , Toxina Shiga/metabolismo , Escherichia coli Shiga Toxigênica/imunologia , Diarreia/epidemiologia , Diarreia/microbiologia , Inglaterra/epidemiologia , Infecções por Escherichia coli/microbiologia , Fezes/microbiologia , Síndrome Hemolítico-Urêmica/microbiologia , Humanos , Incidência , Saúde Pública , Sorogrupo , Escherichia coli Shiga Toxigênica/isolamento & purificação , Escherichia coli Shiga Toxigênica/patogenicidade , Virulência
15.
BMC Infect Dis ; 19(1): 322, 2019 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-30987589

RESUMO

BACKGROUND: Despite major improvements in child survival rates, the number of deaths due to diarrhea remains unacceptably high. We aimed to describe diarrhea-associated mortality and evaluate risk factors for death among Mozambican children with moderate-to-severe diarrhea (MSD). METHODS: Between December 2007 and November 2012, children under-five with MSD were enrolled in Manhiça district, as part of the Global Enteric Multicenter study (GEMS). Clinical, epidemiological, and socio-demographic characteristics were collected. Anthropometric measurements were performed and stool samples collected upon recruitment. A follow-up visit ~ 60 days post-enrolment was conducted and verbal autopsies performed in all death cases. RESULTS: Of the 916 MSD-cases analyzed; 90% (821/916) completed 60 days follow-up and 69 patients died. The case fatality rate at follow-up was 8% (69/821), and the mortality rate 10.2 (95%CI: 7.75-13.59) deaths per 1000 persons-week at risk. Nearly half of the deaths 48% (33/69) among study participants clustered within 2 weeks of the onset of diarrhea. Typical enteropathogenic Escherichia coli (typical EPEC) and Cryptosporidium were the two pathogens associated to an increased risk of death in the univariate analysis with (HR = 4.16, p = 0.0461) and (H = 2.84, p = 0.0001) respectively. Conversely, Rotavirus infection was associated to a decreased risk of death (HR = 0.52, p = 0.0198). According to the multivariate analysis, risk factors for death included co-morbidities such as malnutrition (HR = 4.13, p <  0.0001), pneumonia/lower respiratory infection (HR = 3.51, p <  0.0001) or invasive bacterial disease (IBD) (HR = 6.80, p = 0.0009), presenting on arrival with lethargy or overt unconsciousness (HR = 1.73, p = 0.0302) or wrinkled skin (HR = 1.71, p = 0.0393), and cryptosporidium infection (HR = 2.14, p = 0.0038). When restricting the analysis to those with available HIV results (n = 191, 22% of the total study sample), HIV was shown to be a significant risk factor for death (HR = 5.05, p = 0.0009). Verbal autopsies were conducted in 100% of study deaths, and highlighted diarrhea as the main underlying cause of death 39%, (27/69); followed by HIV/AIDS related deaths 29.0% (20/69) and sepsis 11.6% (8/69). CONCLUSION: Preventive strategies targeting Cryptosporidium, malnutrition and early identification and treatment of associated co-morbidities could contribute to the prevention of the majority of diarrhea associated deaths in Mozambican children.


Assuntos
Diarreia/mortalidade , Estudos de Casos e Controles , Pré-Escolar , Comorbidade , Criptosporidiose/epidemiologia , Criptosporidiose/mortalidade , Diarreia/epidemiologia , Diarreia/microbiologia , Diarreia/virologia , Infecções por Escherichia coli/epidemiologia , Infecções por Escherichia coli/mortalidade , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Moçambique/epidemiologia , Fatores de Risco , Infecções por Rotavirus/epidemiologia , Infecções por Rotavirus/mortalidade , Taxa de Sobrevida
17.
Vet Ital ; 55(1): 26-33, 2019 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-30951179

RESUMO

Colibacillosis is the most frequent bacterial disease in avian species and antimicrobials are the main weapon to reduce incidence and mortality associated to it. However, indiscriminate use of antibiotics may lead to therapy failure and economic losses for the breeder. The aims of this study were to, determine the antibiotic resistance of Escherichia coli isolates, evaluate the correlation between E. coli isolation and systems of breeding included in this study, and identify the avian pathogenic E.coli (APEC) amongst the E. coli strains isolated. A total of 51 E. coli strains were subjected to antimicrobial susceptibility test and they were screened for the presence of virulence genes through PCR. Resistance was most frequently detected against ampicillin and nalidixic acid meanwhile E. coli isolates showed less resistance to the cephalosporins. Overall, 40% of the isolates showed resistance to at least three or more antimicrobials and 16/51 isolates were defined APEC strains. The virulence genes iucD, cvi/cva, irp2 and iss were detected from all 16 APEC strains. The virulence genes tsh, vat, papC, and astA were detected from 11, 7, 5 and 3 APEC strains, respectively. Results demonstrated the importance of studies on APEC and antibiotic resistance genes in Italy, and it was shown that the systems of breeding might influence the antibiotic resistanc.


Assuntos
Resistência Microbiana a Medicamentos/genética , Infecções por Escherichia coli/veterinária , Escherichia coli/genética , Escherichia coli/patogenicidade , Genes Bacterianos/genética , Doenças das Aves Domésticas/epidemiologia , Animais , Antibacterianos/farmacologia , Cruzamento , Columbidae , Patos , Infecções por Escherichia coli/epidemiologia , Infecções por Escherichia coli/microbiologia , Galliformes , Gansos , Itália/epidemiologia , Testes de Sensibilidade Microbiana/veterinária , Doenças das Aves Domésticas/microbiologia , Virulência
18.
Vet Ital ; 55(1): 35-46, 2019 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-30951180

RESUMO

The objective of the study was to determine the virulence and antimicrobial resistance traits of 100 fecal E. coli strains isolated from clinically healthy chickens in Algeria. Most of isolates belonged to phylogroups A (45%) and B1 (37%) and showed a great diversity in DNA profiles. The genes fimH, tsh, entB, iutA, irp2, fyuA, iroN, sitA, etsA, etsB, eitA, iss, traT, ompT, hlyF, vat, ibeA, cvaA, cvaB5', cvaB3', cvaC, cma and cbi were detected. Combinations of virulence genes defined 67 virulence profiles. High resistance rates (62­97%) were noted for amoxicillin, amoxicillin­clavulanic acid, cefazolin, fluoroquinolones, tetracycline, trimethoprim, sulfonamides and sulfamethoxazole/ trimethoprim, and 93% of strains were multidrug­resistant. Combinations of resistance phenotypes defined 59 resistance patterns. The genes blaTEM, blaSHV, blaCTX­M­1, tetA, tetB, qnrB, qnrS1, sul1, sul2, sul3, dfrA1, dfrA7, dfrA12 and dfrA14 were identified and class 1 integrons were detected in 49% of isolates. A rate of 37% of strains was resistant to mercury, with the presence of merA gene. The study reports the presence in the avian strains isolated from fecal swabs of virulence genes of plasmid origin characteristic of ExPEC strains associated with high resistance to first­line antibiotics and class 1 integrons, this augurs a risk for human and animal health.


Assuntos
Galinhas , Farmacorresistência Bacteriana/genética , Infecções por Escherichia coli/veterinária , Escherichia coli/isolamento & purificação , Perfil Genético , Doenças das Aves Domésticas/epidemiologia , Argélia/epidemiologia , Animais , Anti-Infecciosos/farmacologia , Escherichia coli/classificação , Escherichia coli/genética , Infecções por Escherichia coli/epidemiologia , Infecções por Escherichia coli/microbiologia , Fezes/microbiologia , Filogenia , Doenças das Aves Domésticas/microbiologia , Virulência/genética
19.
BMC Genomics ; 20(1): 271, 2019 Apr 05.
Artigo em Inglês | MEDLINE | ID: mdl-30953471

RESUMO

BACKGROUND: Wild birds, in particular pigeons are considered a natural reservoir for stx2f-carrying E. coli. An extensive comparison of isolates from pigeons and humans from the same region is lacking, which hampers justifiable conclusions on the epidemiology of these pathogens. Over two hundred human and pigeon stx2f-carrying E. coli isolates predominantly from the Netherlands were analysed by whole genome sequencing and comparative genomic analysis including in silico MLST, serotyping, virulence genes typing and whole genome MLST (wgMLST). RESULTS: Serotypes and sequence types of stx2f-carrying E. coli showed a strong non-random distribution among the human and pigeon isolates with O63:H6/ST583, O113:H6/ST121 and O125:H6/ST583 overrepresented among the human isolates and not found among pigeons. Pigeon isolates were characterized by an overrepresentation of O4:H2/ST20 and O45:H2/ST20. Nearly all isolates harboured the locus of enterocyte effacement (LEE) but different eae and tir subtypes were non-randomly distributed among human and pigeon isolates. Phylogenetic core genome comparison demonstrated that the pigeon isolates and clinical isolates largely occurred in separated clusters. In addition, serotypes/STs exclusively found among humans generally were characterized by high level of clonality, smaller genome sizes and lack of several non-LEE-encoded virulence genes. A bundle-forming pilus operon, including bfpA, indicative for typical enteropathogenic E. coli (tEPEC) was demonstrated in 72.0% of the stx2f-carrying serotypes but with distinct operon types between the main pigeon and human isolate clusters. CONCLUSIONS: Comparative genomics revealed that isolates from mild human disease are dominated by serotypes not encountered in the pigeon reservoir. It is therefore unlikely that zoonotic transmission from this reservoir plays an important role in the contribution to the majority of human disease associated with stx2f-producing E. coli in the Netherlands. Unexpectedly, this study identified the common occurrence of STEC2f/tEPEC hybrid pathotype in various serotypes and STs. Further research should focus on the possible role of human-to-human transmission of Stx2f-producing E. coli.


Assuntos
Doenças das Aves/epidemiologia , Escherichia coli Enteropatogênica/patogenicidade , Infecções por Escherichia coli/epidemiologia , Proteínas de Escherichia coli/metabolismo , Genômica/métodos , Toxina Shiga/metabolismo , Fatores de Virulência/metabolismo , Animais , Columbidae , Escherichia coli Enteropatogênica/classificação , Infecções por Escherichia coli/metabolismo , Infecções por Escherichia coli/microbiologia , Proteínas de Escherichia coli/genética , Genoma Bacteriano , Humanos , Filogenia , Toxina Shiga/genética , Fatores de Virulência/genética
20.
Food Microbiol ; 82: 474-481, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31027808

RESUMO

A 2016/2017 outbreak of Shiga toxin-producing Escherichia coli (STEC) O121 in Canada, was linked to wheat flour, milled at a single facility on three consecutive days in October 2016. Most Probable Number (MPN) estimates of the concentration of STEC O121 in the recalled flour were made using the results of qualitative testing conducted during the outbreak investigation and from analysis of 5 × 2.5 g, 5 × 25 g and 5 × 100 g analytical units of the recalled flour. The STEC O121 levels were estimated at 0.15 to 0.43 MPN/100 g, with no significant difference between production days and the two MPN estimates. The microbiota of the recalled flour, and eight retail flour samples, was enumerated by aerobic colony count, MacConkey agar and E. coli/Coliform petrifilm. The composition of the microbiota to a genus level was determined by identifying individual colonies with a Bruker Biotyper. All retail flour samples were negative for STEC in 5 × 100 g analytical units. There was no evidence of higher levels of organisms associated with fecal contamination in the recalled flour. The low levels of STEC O121 in the recalled flour indicate that a robust sampling plan, with multiple analytical units for a total of several hundred grams, may be required to reliably detect STEC in flour at levels observed in this outbreak.


Assuntos
Surtos de Doenças , Infecções por Escherichia coli/epidemiologia , Farinha/microbiologia , Microbiologia de Alimentos/métodos , Doenças Transmitidas por Alimentos/epidemiologia , Escherichia coli Shiga Toxigênica/isolamento & purificação , Triticum , Técnicas Bacteriológicas , Canadá/epidemiologia , Infecções por Escherichia coli/microbiologia , Farinha/análise , Doenças Transmitidas por Alimentos/microbiologia , Microbiota , Toxina Shiga/genética , Toxina Shiga/metabolismo , Escherichia coli Shiga Toxigênica/classificação , Escherichia coli Shiga Toxigênica/metabolismo
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