1887

Abstract

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.

Isolation of , , and was realized by culture. strains were screened by multiplex PCR, PFGE and O:H serotyping. Antimicrobial susceptibility testing was also performed.

Most of the 127 enteropathogens isolated were diarrheagenic (96.1 %), with predominance of several serotypes of enteropathogenic (EPEC) and enteroaggregative (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.

The occurrence of genetically similar diarrheagenic 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.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.001020
2019-07-01
2024-04-23
Loading full text...

Full text loading...

/deliver/fulltext/jmm/68/7/1033.html?itemId=/content/journal/jmm/10.1099/jmm.0.001020&mimeType=html&fmt=ahah

References

  1. Nataro JP, Kaper JB. Diarrheagenic Escherichia coli . Clin Microbiol Rev 1998; 11:142–201 [View Article]
    [Google Scholar]
  2. Denno DM, Shaikh N, Stapp JR, Qin X, Hutter CM et al. Diarrhea etiology in a pediatric emergency department: a case control study. Clin Infect Dis 2012; 55:897–904 [View Article]
    [Google Scholar]
  3. Gomes TA, Elias WP, Scaletsky IC, Guth BE, Rodrigues JF et al. Diarrheagenic Escherichia coli . Braz J Microbiol 2016; 47 Suppl 1:3–30 [View Article]
    [Google Scholar]
  4. WHO World Health Organization The Management and Prevention of Diarrhea: Practical Guidelines Geneva: World Health Organization; 1993
    [Google Scholar]
  5. Trabulsi LB, Alterthum F. Microbiologia, 4. ed. São Paulo: Atheneu; 2004
    [Google Scholar]
  6. Caldorin M, Almeida IAZC, Peres JTM, Alves EC. Ocorrência de Escherichia coli produtora de toxina Shiga (STEC) no Brasil e sua importância em saúde pública. Bol epidemiol paul 2013; 10:4–20
    [Google Scholar]
  7. Laxminarayan R, Bhutta ZA. Antimicrobial resistance-a threat to neonate survival. Lancet Glob Health 2016; 4:e676–e677 [View Article]
    [Google Scholar]
  8. Paton JC, Paton AW. Pathogenesis and diagnosis of shiga toxin-producing Escherichia coli infections. Clin Microbiol Rev 1998; 11:450–479 [View Article]
    [Google Scholar]
  9. Freitas Neto OCde, Penha Filho RAC, Barrow P, Berchieri A Jr. Sources of human non-typhoid S almonellosis: a review. Rev Bras Cienc Avic 2010; 12:01–11 [View Article]
    [Google Scholar]
  10. Marinou I, Bersimis S, Ioannidis A, Nicolaou C, Mitroussia-Ziouva A et al. Identification and antimicrobial resistance of Campylobacter species isolated from animal sources. Front Microbiol 2012; 3:1–6 [View Article]
    [Google Scholar]
  11. Nunes MR, Magalhães PP, Penna FJ, Nunes JM, Mendes EN. Diarrhea associated with Shigella in children and susceptibility to antimicrobials. J Pediatr 2012; 88:125–128 [View Article]
    [Google Scholar]
  12. Maranhão HS, Medeiros MC, Scaletsky IC, Fagundes-Neto U, Morais MB. The epidemiological and clinical characteristics and nutritional development of infants with acute diarrhoea, in north-eastern Brazil. Ann Trop Med Parasitol 2008; 102:357–365 [View Article]
    [Google Scholar]
  13. Ochoa TJ, Barletta F, Contreras C, Mercado E. New insights into the epidemiology of enteropathogenic Escherichia coli infection. Trans R Soc Trop Med Hyg 2008; 102:852–856 [View Article]
    [Google Scholar]
  14. Centro de Vigilância Epidemiológica "Prof. Alexandre Vranjac” (CVE) Informe técnico Vacina contra Rotavírus - normas e instruções São Paulo, Brazil: Ministérioda Saúde; 2006 pp 1–6
    [Google Scholar]
  15. Nóbrega DB, Brocchi M. An overview of extended-spectrum beta-lactamases in veterinary medicine and their public health consequences. J Infect Dev Ctries 2014; 8:954–960 [View Article]
    [Google Scholar]
  16. Omulo S, Thumbi SM, Njenga MK, Call DR. A review of 40 years of enteric antimicrobial resistance research in Eastern Africa: what can be done better?. Antimicrob Resist Infect Control 2015; 4:1–13 [View Article]
    [Google Scholar]
  17. ANVISA- Agência Nacional de Vigilância Sanitária Resolução RDC n°20, de 05 de maio de 2011 Brasil: Diário Oficial da União; 2011
    [Google Scholar]
  18. Mattioli MC, Boehm AB, Davis J, Harris AR, Mrisho M et al. Enteric pathogens in stored drinking water and on caregiver's hands in Tanzanian households with and without reported cases of child diarrhea. PLoS One 2014; 9:e84939 [View Article]
    [Google Scholar]
  19. Edwards PR, Ewing WH. Edwards and Ewing’s Identification of Enterobacteriaceae, 4th ed. Elsevier Science Publishers; 1986
    [Google Scholar]
  20. Church DL, Emshey D, Semeniuk H, Lloyd T, Pitout JD. Evaluation of BBL CHROMagar O157 versus sorbitol-MacConkey medium for routine detection of Escherichia coli O157 in a centralized regional clinical microbiology laboratory. J Clin Microbiol 2007; 45:3098–3100 [View Article]
    [Google Scholar]
  21. OIE. World Organization for Animal Health Campylobacter jejuni and Campylobacter coli International des Epizooties; 2008 pp 1185–1191
    [Google Scholar]
  22. Peresi JTM, Almeida IAZC, Vaz TMI, Hernandes RT, Teixeira ISC et al. Search for diarrheagenic Escherichia coli in raw kibbe samples reveals the presence of Shiga toxin-producing strains. Food Control 2016; 63:165–170 [View Article]
    [Google Scholar]
  23. Ori EL, Takagi EH, Andrade TS, Miguel BT, Cergole-Novella MC et al. Diarrhoeagenic Escherichia coli and Escherichia albertii in Brazil: pathotypes and serotypes over a 6-year period of surveillance. Epidemiol Infect 2018; 19:1–9
    [Google Scholar]
  24. Hunter SB, Vauterin P, Lambert-Fair MA, Van Duyne MS, Kubota K et al. Establishment of a universal size standard strain for use with the PulseNet standardized pulsed-field gel electrophoresis protocols: converting the national databases to the new size standard. J Clin Microbiol 2005; 43:1045–1050 [View Article]
    [Google Scholar]
  25. Bauer AW, Kirby WM, Sherris JC, Turck M. Antibiotic susceptibility testing by a standardized single disk method. Am J Clin Pathol 1966; 45:493–496 [View Article]
    [Google Scholar]
  26. CLSI - Clinical and Laboratory Standards Institute Performance Standards for Antimicrobial Susceptibility Testing, Sixteenth informational supplement. CLSI document M100-S16. Wayne, PA: CLSI; 2013
    [Google Scholar]
  27. Cabin R, Mitchell R. To Bonferroni or not to Bonferroni: when and how are the questions. Bull Ecol Soc Am 2000; 81:246–248
    [Google Scholar]
  28. Pezzullo J. Logistic regression; 2012 http://statpages.org/logistic.html
  29. Gardener M. Statistics for ecologists using R and Excel: data collection, exploration, analysis and presentation. Pelagic Publishing Ltd 2017
    [Google Scholar]
  30. Fernandes MC, Takai S, Leite DS, Pinto JP, Brandão PE et al. Identification of pathogens and virulence profile of Rhodococcus equi and Escherichia coli strains obtained from sand of parks. Braz J Microbiol 2013; 44:485–492 [View Article]
    [Google Scholar]
  31. Bonkoungou IJ, Haukka K, Österblad M, Hakanen AJ, Traoré AS et al. Bacterial and viral etiology of childhood diarrhea in Ouagadougou, Burkina Faso. BMC Pediatr 2013; 13:1–6 [View Article]
    [Google Scholar]
  32. Humphrey JM, Ranbhise S, Ibrahim E, Al-Romaihi HE, Farag E et al. Multiplex polymerase chain reaction for detection of gastrointestinal pathogens in migrant workers in Qatar. Am J Trop Med Hyg 2016; 95:1330–1337 [View Article]
    [Google Scholar]
  33. Piralla A, Lunghi G, Ardissino G, Girello A, Premoli M et al. FilmArray™ GI panel performance for the diagnosis of acute gastroenteritis or hemorragic diarrhea. BMC Microbiol 2017; 17:1–10 [View Article]
    [Google Scholar]
  34. Shrivastava AK, Kumar S, Mohakud NK, Suar M, Sahu PS. Multiple etiologies of infectious diarrhea and concurrent infections in a pediatric outpatient-based screening study in Odisha, India. Gut Pathog 2017; 9:1–12 [View Article]
    [Google Scholar]
  35. Lozer DM, Souza TB, Monfardini MV, Vicentini F, Kitagawa SS et al. Genotypic and phenotypic analysis of diarrheagenic Escherichia coli strains isolated from Brazilian children living in low socioeconomic level communities. BMC Infect Dis 2013; 13:418 [View Article]
    [Google Scholar]
  36. Lima AAM, Oliveira DB, Quetz JS, Havt A, Prata MMG et al. Etiology and severity of diarrheal diseases in infants at the semiarid region of Brazil: a case-control study. PLoS Negl Trop Dis 2019; 13:e0007154–14 [View Article]
    [Google Scholar]
  37. Barletta F, Ochoa TJ, Mercado E, Ruiz J, Ecker L et al. Quantitative real-time polymerase chain reaction for enteropathogenic Escherichia coli: a tool for investigation of asymptomatic versus symptomatic infections. Clin Infect Dis 2011; 53:1223–1229 [View Article]
    [Google Scholar]
  38. Corbishley A, Ahmad NI, Hughes K, Hutchings MR, McAteer SP et al. Strain-dependent cellular immune responses in cattle following Escherichia coli O157:H7 colonization. Infect Immun 2014; 82:5117–5131 [View Article]
    [Google Scholar]
  39. Wöchtl B, Gunzer F, Gerner W, Gasse H, Koch M et al. Comparison of clinical and immunological findings in gnotobiotic piglets infected with Escherichia coli O104:H4 outbreak strain and EHEC O157:H7. Gut Pathog 2017; 9:30 [View Article]
    [Google Scholar]
  40. Centro de Vigilância Epidemiológica “Prof.Alexandre Vranjac” (CVE) Vigilância epidemiológica das doençastransmitidas por água e alimentos: Investigação de surtos - normase instruções São Paulo, Brazil: Ministérioda Saúde; 2008 pp 7–13
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.001020
Loading
/content/journal/jmm/10.1099/jmm.0.001020
Loading

Data & Media loading...

Supplements

Supplementary material 1

PDF
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error