Performance of fecal S100A12 as a novel non-invasive diagnostic biomarker for pediatric inflammatory bowel disease: a systematic review and meta-analysis

Abstract Objective: The incidence and prevalence of inflammatory bowel disease (IBD) in pediatric patients are increasing. Currently, the diagnostic method for IBD is inconvenient, expensive, and difficult. S100A12, a type of calcium-binding protein, detected in the feces of patients with IBD has recently been suggested as a promising diagnostic tool. Hence, the authors aimed to evaluate the accuracy of fecal S100A12 in diagnosing IBD in pediatric patients by performing a meta-analysis. Methods: The authors performed a systematic literature search in five electronic databases for eligible studies up to July 15, 2021. Pooled diagnostic accuracies of fecal S100A12 were analyzed as the primary outcomes. Secondary outcomes were standardized mean difference (SMD) of fecal S100A12 levels between IBD and non-IBD groups and a comparison of diagnostic accuracies between fecal S100A12 and fecal calprotectin. Results: Seven studies comprising 712 children and adolescents (474 non-IBD controls and 238 IBD cases) were included. Fecal S100A12 levels were higher in the IBD group than in the non-IBD group (SMD = 1.88; 95% confidence interval [CI] = 1.19-2.58; p < 0.0001). Fecal S100A12 could diagnose IBD in pediatric patients with a pooled sensitivity of 95% (95% CI = 88%-98%), specificity of 97% (95% CI = 95%-98%), and area under the receiver operating summary characteristics (AUSROC) curve of 0.99 (95% CI = 0.97-0.99). Fecal S100A12 specificity and AUSROC curve values were higher than those of fecal calprotectin (p < 0.05). Conclusion: Fecal S100A12 may serve as an accurate and non-invasive tool for diagnosing pediatric IBD. © 2023 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. This is an open access article under the CC BY-NC-ND license (https://creativecommons.org/licenses/by-nc-nd/4.0/).

The Role of Non-Contrast CT in the Diagnosis of a Rare Cause of Small Bowel Obstruction Due to Bezoar

@#Contrast Enhanced CT Abdomen is usually used to investigate the source of the small bowel obstruction. A 13-year old girl presented with signs of small bowel obstruction and was complicated with acute renal injury. Non-contrast CT Abdomen showed findings consistent with bezoar, and the findings are similar to the features seen in a contrast study. This case shows that both the plain and the contrast CT abdomen give similar findings of bezoar, one not inferior to the other.

The effect of feeding methods on fecal metabolites of infants delivered by cesarean section based on non-targeted metabolomics / 中华实用儿科临床杂志

Objective:To explore the effect of breast feeding versus mixed feeding on fecal metabolites of infants delivered by cesarean section.Methods:This was a cross-sectional study.Fecal samples were collected from 23 healthy 1-month-old infants delivered by cesarean section from autumn 2021 and winter 2022 in two maternal and infant care facilities in the North and South of Xi′an city.The samples were divided into the breast feeding group (11 cases) and mixed feeding group (12 cases). Fecal metabolites were analyzed by the non-targeted metabolomic approach and gas chromatography-mass spectrometry coupling, and differentially expressed fecal metabolites between groups were screened using the non-parametric Mann- Whitney U test.Metabolic pathways enriched in them were further analyzed. Results:A total of 155 metabolites were characterized, including 57 sugars and sugar derivatives, 34 fatty acids, 25 organic acids, 22 amino acids, 8 esters, 4 nucleosides, 3 vitamins and 2 other substances.The relative contents of the differentially expressed fecal metabolites were measured, and it was found that some types of sugars and sugar derivatives were highly expressed in the fecal samples of breast feeding group, while amino acids, organic acids and fatty acids were highly expressed in those of the mixed feeding group.A total of 28 metabolic pathways enriched in differentially expressed fecal metabolites were obtained.Among them, alanine, aspartic acid and glutamic acid metabolism, valine, leucine and isoleucine metabolism, arginine metabolism and the tricarboxylic acid (TCA) cycle influenced infant health.Conclusions:Feeding methods have an effect on the fecal metabolites in infants delivered by cesarean section born infants, and mixed feeding may speed up the process of TCA cycle and amino acid metabolism in the intestine of infants delivered by cesarean section to a certain extent.

Analysis on Metabolites and Metabolic Pathways of Limonin in Rats by UHPLC-Q-Orbitrap HRMS / 中国实验方剂学杂志

ObjectiveUltra-high performance liquid chromatography-quadrupole-electrostatic field orbitrap high resolution mass spectrometry（UHPLC-Q-Orbitrap HRMS） was used to identify the metabolites of limonin in rats， and to explore the gender differences in the distribution of prototype components and metabolites in rats after single dose intragastric administration of limonin， as well as to speculate the metabolic pathways. MethodThe separation was performed on a Thermo Scientific Accucore™ C18 column（3 mm×100 mm， 2.6 μm） with 0.1% formic acid aqueous solution（A）-0.1% formic acid acetonitrile solution（B） as mobile phase in a gradient elution mode（0-1 min， 5%B； 1-6 min， 5%-20%B； 6-18 min， 20%-50%B； 18-23 min， 50%-80%B； 23-25 min， 80%-95%B； 25-30 min， 95%B） at a flow rate of 0.3 mL·min-1 and a column temperature of 30 ℃. MS data of biological samples were collected under the positive ion mode of electrospray ionization（ESI） and in the scanning range of m/z 100-1 500. Plasma， tissues（heart， liver， spleen， lung， kidney， stomach and small intestine）， urine and fecal samples were collected and prepared after intragastric administration， and the prototype component and metabolites of limonin were identified. ResultThe prototype component of limonin were detected in the feces， stomach， small intestine of female and male rats， and in the heart， liver， spleen， lung and kidney tissues of female rats. A total of 23 metabolites related to limonin were detected in rats， of which 2， 1， 5， 4， 23 metabolites were detected in liver， stomach， small intestine， urine and feces， respectively， and the main metabolic pathways were hydrolysis， reduction， hydroxylation and methylation， etc. The distribution of some metabolites differed between male and female rats. ConclusionThe prototype component of limonin are mainly distributed in the stomach and small intestine in rats， and the distribution of prototype component and some metabolites are different by gender. Limonin is mainly excreted through feces with phase Ⅰ metabolites as the main ones. The results of this study can provide a reference for further elucidation of the effect of gender differences on the metabolism of limonin in vivo and its mechanism of action.

Effect of Porcine Large Intestine-processed Dahuang （Radix et Rhizoma Rhei） on Defecation and Colon Pathological Changes in Constipation Model Mice / 中医杂志

ObjectiveTo investigate the effect of porcine large intestine-processed Dahuang （Radix et Rhizoma Rhei） on defecation in constipation model mice and the possible mechanism. MethodsFifty Kunming mice were randomized to blank group （n=10） and model group （n=40）. Loperamide suspension at the dose of 8 mg/（kg·d） was given by gavage for four consecutive days to establish a model of constipation. The 24 successfully modeled mice were randomly divided into model group， processed Dahuang group， lactulose group， raw Dahuang group， with six mice in each group. Moreover， six randomly selected mice were chosen as control group. Since the fifth day， 8 mg/（kg·d） of loperamide suspension by gavage was given to the model group， processed Dahuang group， raw Dahuang group， and lactulose group； two hours later， the processed and raw Dahuang groups were administered with 0.6 g/（kg·d） of processed and raw Dahuang suspension， respectively， while the lactulose group was given 0.6 g/（kg·d） of latulose suspension， and the blank group and the model group were given 0.2 ml/10 g of distilled water by gavage， all for four days. The general condition， body weight after the last gavage， number of fecal particles within six hours， fecal wet weight， fecal water content ratio， intestinal propulsion rate and colonic histology changes by HE staining of each group were detected. ResultsThe body weight of the mice in the raw Dahuang group was significantly lighter than that in the other groups （P＜0.05 or P＜0.01）. The number of fecal particles， fecal wet weight and intestinal propulsion rate of mice significantly decreased in the model group than in the blank group （P＜0.05 or P＜0.01）. Compared to those in the model group， the number of fecal particles and fecal wet weight in the processed Dahuang group， lactulose group and raw Dahuang group significantly increased， and the fecal water content ratio in the raw Dahuang group increased as well （P＜0.05 or P＜0.01）. Compared to those in the processed Dahuang group， the number of fecal particles and fecal wet weight in the raw Dahuang group decreased， while the fecal water content ratio increased （P＜0.05 or P＜0.01）， and the fecal water content ratio in the lactulose group increased significantly （P＜0.05）. The intestinal propulsion rate in the processed Dahuang group was higher than that in the model group， lactulose group and raw Dahuang group （P＜0.05 or P＜0.01）. Histopathological analysis showed that the colonic crypts and goblet cells in the blank group were normal and clear， and the colonic muscular layer was thicker. The colonic crypts of the mice in the model group were damaged， with reduced goblet cells to varying degrees and changed colonic muscularis. In the lactulose group and raw Dahuang group， part of the crypts were broken， and the goblet cells were damaged to varying degrees， while in the processed Dahuang group， still the colonic tissue structure of the mice was relatively clear， and the colonic crypts and goblet cells were relatively normal， with thickened muscular layer of the colon. ConclusionPorcine large intestine-processed Dahuang could improve defecation in constipation model mice， and reduce the drastic purgation function of raw Dahuang， for which the mechanism may be related to the protection of colon histopathological damage.

Incidence of intestinal constipation during the COVID-19 pandemic period in medical students from a private institution in São Paulo, SP

Introduction: Chronic intestinal constipation (CIC) presents an incidence of 2.6 to 30.7% in the overall population and due to the social reality imposed by the coronavirus pandemic, some behavior changes in the Brazilian population occurred that might or not be associated with alterations of CIC prevalence. Objective: To assess CIC incidence in medical students before and during the COVID-19 pandemic in Brazil in a private higher educational institution in the city of São Paulo, state of São Paulo. Methods: Clinic data were collected through Google Forms software from the same students seeking to analyze the variables before (year of 2019) and during the coronavirus pandemic. The data were: age, sex, body mass index, constipation referred in a subjective way and confirmed through the ROME III criteria, feces consistency and anxiety and/or depression during the pandemic. Results: A total of 126 medical students from a private higher education institution from São Paulo, SP were included. The average age was 22.9 years old, 70.6% were female and the average BMI was 23.3 kg/m2. Regarding the ROME III criteria, 32.5% presented >2 in 2019 and 42.1% during the pandemic. Concerning the feces consistency, 31.75 and 35.71% presented dry Bristol 1 feces or in both periods, respectively. Conclusion: It was observed an increase in the prevalence of chronic intestinal constipation in medical students from a private higher education institution from São Paulo, state of São Paulo, during the COVID-19 pandemic, as well as dryness in the feces. (AU)

Avaliação molecular de populações fecais de lactobacilos em crianças com prisão de ventre funcional / Molecular assessment of fecal lactobacilli populations in children with functional constipation

ABSTRACT Background: Investigation of the gut-specific bacterial strains including lactobacilli is essential for understanding the bacterial etiology of constipation. Objective: This study aimed to compare the prevalence and quantity of intestinal lactobacilli in constipated children and healthy controls. Methods: Forty children fulfilling Rome IV criteria for functional constipation and 40 healthy controls were recruited. Fecal samples were analyzed using species-specific polymerase chain reaction followed by random amplified polymorphic DNA-PCR and quantitative real-time PCR. Results: Totally, seven different species of lactobacilli were detected. Out of 80 volunteers, 65 (81.3%) were culture and species-specific PCR positive from which 25 (38.46%) constipated children and 40 (61.54%) healthy subjects. The most prevalent species were L. paracasei 21 (32.3%) followed by L. plantarum 18 (27.7%) among both healthy and patient groups. Analysis of the RAPD dendrograms displayed that strains isolated from constipated and non-constipated children have similarity coefficients of more than 90%. The qPCR assays demonstrated constipated children had a lower amount of total lactobacilli population (per gram of feces) than healthy controls. Conclusion: Our findings showed that the mere existence of various species of Lactobacillus in the gut does not enough to prevent some gastrointestinal disorders such as functional constipation, and their quantity plays a more important role.

RESUMO Contexto: A investigação das cepas bacterianas específicas do intestino, incluindo lactobacilos, é essencial para a compreensão da etiologia bacteriana da prisão de ventre. Objetivo: Este estudo teve como objetivo comparar a prevalência e a quantidade de lactobacilos intestinais em crianças constipadas e controles saudáveis. Métodos: Foram recrutadas quarenta crianças que preenchem os critérios de Roma IV para prisão de ventre funcional e 40 controles saudáveis. As amostras fecais foram analisadas utilizando-se uma reação da cadeia de polimerase específica da espécie, seguida por DNA polimórfico amplificado aleatório e PCR quantitativo em tempo real. Resultados: Foram detectadas sete espécies diferentes de lactobacilos. Dos 80 voluntários, 65 (81,3%) eram cultura em PCR específico de espécies, dos quais 25 (38,46%) crianças constipadas e 40 (61,54%) indivíduos saudáveis. As espécies mais prevalentes foram L. paracasei 21 (32,3%) seguidas por L. plantarum 18 (27,7%) entre grupos saudáveis e de pacientes. A análise dos dendrogramas do RAPD mostrou que cepas isoladas de crianças constipadas e não constipadas têm coeficientes de similaridade superiores a 90%. Os ensaios qPCR demonstraram que as crianças constipadas apresentavam uma quantidade menor de população total de lactobacilos (por grama de fezes) do que os controles saudáveis. Conclusão: Nossos achados mostraram que a mera existência de várias espécies de Lactobacillus no intestino não é suficiente para prevenir alguns distúrbios gastrointestinais, como a prisão de ventre funcional, e sua quantidade desempenha um papel mais importante.

Perfil epidemiológico das enteroparasitoses em pré-escolares e escolares da rede municipal de ensino de Sinop - MT / Epidemiological profile of endoparasitoses in preschoolers and school children of the school district of Sinop - state of Mato Grosso

ntrodução: As enteroparasitoses são causadas por protozoários e helmintos e representam um importante proble-ma de saúde pública. As crianças em idade pré-escolar e escolar apresentam maior vulnerabilidade à contaminação por enteroparasitas pelo fato de estarem mais expostas a fatores de risco, tais como hábitos precários de higiene e aglomeração em locais fechados, e por não apresentarem o sistema imunológico totalmente desenvolvido. Os para-sitas mais comumente encontrados nessa faixa etária compreendem Giardia lamblia, Ascaris lumbricoides, Trichuris trichiura e ancilostomídeos. Objetivos: Avaliar a prevalência de enteroparasitos em crianças pré-escolares e escola-res e em caixas de areia de instituições públicas de ensino no município de Sinop-MT. Métodos: O estudo realizado foi transversal, quantitativo com delineamento experimental. Foi realizado no período de julho de 2015 a setembro de 2016. Foram avaliadas crianças pré-escolares e escolares de 3 a 12 anos escolhidas por amostragem de conveniência de quatro instituições da rede municipal de ensino localizadas na região central de Sinop ­ MT e sete afastadas do centro da cidade e que atendem novos bairros e a zona rural. As amostras de fezes foram coletadas pelos responsá-veis das crianças que encaminharam para as instituições de ensino e, posteriormente, foram transportadas ao labo-ratório para realização do exame parasitológico. As amostras de areia foram coletadas a partir de caixas das áreas de recreações de todas as instituições de ensino, sendo coletada 100 gramas de areia da raspagem superficial e pro-funda dos quatro quadrantes e do centro, totalizando 10 amostras/caixa. Os métodos parasitológicos utilizados para análises das amostras de fezes e areia foram Hoffmann, migração ativa, centrífugo-flutuação espontânea por Faust e flutuação espontânea por Willis. Resultados: Foram avaliadas 646 amostras de fezes de crianças pré-escolares e escolares de 3 a 12 anos, apresentando 21,05% de positividade para parasitos intestinais. Giardia lamblia apresentou maior prevalência, seguida de Entamoeba coli, Endolimax nana,Ascaris lumbricoides, Enterobius vermicularis, Hy-menolepis nana, ancilostomídeo e Entamoeba hartmanni. As 80 amostras de areia das caixas das áreas de recreação infantil avaliadas, apresentaram 100% de positividade para G. lamblia, seguida de 66,66% para Toxocara sp. nas areias das áreas centrais e 100% nas periféricas, 66,66% para Toxoplasma gondii nas centrais e 80% nas periféricas, 33,33% para A. lumbricoides nas centrais e 60% nas periféricas e 33,33% de Strongyloides stercoralis somente nas areias das áreas centrais. Conclusão: A faixa etária mais acometida foi verificada entre as crianças de 6 a 12 anos e pode estar relacionada aos precários hábitos de higiene e assim, maior risco de contaminação. Pode-se concluir que os resultados estão de acordo com a maioria dos estudos epidemiológicos realizados no Brasil, demonstrando elevada prevalência de enteroparasitoses em crianças em idade escolar (AU)

Introduction: Protozoa and helminths cause enteroparasitoses, which constitute an important public health issue. Preschoolers and school children, who do not have a fully developed immune system, are more vulnerable to con-tamination by intestinal parasites because they are more exposed to risk factors, such as poor hygiene habits and crowding in closed places. The most common parasites affecting this age group include Giardia lamblia, Ascaris lumbricoides, Trichuris trichiura, and hookworms. Objectives: To evaluate the prevalence of intestinal parasites in preschoolers, school children, and sandboxes of government schools in the city of Sinop ­ state of Mato Gros-so (MT). Methods: This cross-sectional, quantitative study with an experimental design was carried out from July 2015 to September 2016 and included preschoolers and school children aged 3 to 12 years, chosen by convenience sampling from government schools in the school district of the city of Sinop ­ MT; four schools were in the central region of Sinop, whereas seven schools, attended by children living in the suburban and rural areas, were far from the city center. Fecal samples were collected by the children's family and sent to the schools, from where they were transported to the laboratory for parasitological examination. Sand samples were collected from sandboxes in the play areas of the schools. More specifically,100 g of sand was collected by scraping one of the four quadrants or the center of the sandbox surface or deeper into the sandbox, totaling 10 samples/box. The parasitological methods spontaneous sedimentation described by Hoffmann, active migration described by Rugai, centrifugal-spontaneous flotation described by Faust, and spontaneous flotation described by Willis were used to analyze the fecal and sand samples. Results: A total of 646 fecal samples obtained from preschoolers and school children aged 3 to 12 years were evaluated; 21.05% of the samples tested positive for intestinal parasites. As for the sand samples, 100% tested positive for intestinal parasites. In all the fecal and sand samples that tested positive for intestinal parasites, G. lamblia predominated, followed by Toxacara sp, Toxoplasma gondii, A. lumbricoides, Enterobius vermicularis, Hymenolepis nana, Strongyloides stercoralis, hookworm, Entamoeba coli, Endolimax nana, and Entamoeba hart-manni, commensal amoebae of the large intestine, were also identified. Conclusion: Children aged 6 to 12 years were the most affected by enteroparasitoses. This may be related to poor hygiene habits, which puts these children at greater risk of contamination. The results agree with most epidemiological studies conducted in Brazil and show a high prevalence of enteroparasitoses in children (AU)

Escalas validadas para avaliação das fezes: revisão integrativa / Validated scales for stool assessment: integrative review

Introdução: A eliminação intestinal é uma necessidade fisiológica humana básica, que deve ser considerada e avaliada em toda a assistência prestada pelos profissionais de saúde. Objetivo: identificar as escalas validadas utilizadas na atualidade para avaliação das fezes em adultos e idosos. Método: revisão integrativa, protocolada na plataforma Open Science Framework, cujo registro está disponível sob o DOI https://doi.org/10.17605/OSF.IO/9CTMB, que incluiu estudos primários publicados na íntegra, que utilizaram escalas para avaliação de fezes, publicados nos idiomas inglês, português ou espanhol, no período de janeiro de 2001 a julho de 2021. As buscas foram realizadas nas bases de dados eletrônicas PubMed, LILACS, CINAHL e EMBASE em 16 de julho de 2021. Em seguida, as referências identificadas foram exportadas para o aplicativo Rayyan para remoção das duplicatas, seleção e avaliação dos estudos por dois revisores de forma independente e mascarada; os casos de divergência foram avaliados por um terceiro revisor. As evidências foram sintetizadas de forma descritiva. Resultados: a busca nas bases de dados resultou em 1.567 estudos. Após o processo de seleção e leitura na íntegra, 353 estudos foram considerados nesta revisão, dos quais 339 utilizaram escalas validadas (333 estudos utilizaram a Escala de Bristol e seis outras escalas) e 14 escalas não validadas. Também se verificou aumento na quantidade de publicações que avaliaram a consistência das fezes a partir do ano de 2015. Após a leitura dos 353 estudos, foram identificadas cinco escalas validadas: Escala de Forma das Fezes de Bristol, King's Stool Chart, Escala de consistência das fezes segundo Anastasi e Capili (2001) e Hansen (1981), Escala pictórica validada do Diarrhea Questionnaire e a ferramenta de avaliação fecal de Ohno. Conclusão: foram identificadas cinco escalas validadas e utilizadas nos últimos 20 anos para avaliação das fezes. Adicionalmente, os dados mostraram aumento mundial do uso das escalas e a necessidade de desenvolvimento de uma escala para avaliação das fezes com estudos de validação mais robustos

Introduction: Bowel elimination is a basic human physiological need, which must be considered and evaluated in all care provided by health professionals. Aim: to identify the validated scales used to assess stool in adults and the elderly. Method: an integrative review, registered on the Open Science Framework platform and available under DOI 10.17605/OSF.IO/9CTMB, which included primary studies published in full that used scales for stool assessment, published in English, Portuguese or Spanish, between January 2001 and July 2021. Searches of the PubMed, LILACS, CINAHL, and EMBASE electronic databases were performed on July 16, 2021. Afterward, the identified references were exported to the Rayyan application for removal of duplicates, selection, and independent and masked evaluation of studies by two reviewers; cases of divergence were evaluated by a third reviewer. The evidence was synthesized descriptively. Results: the database search resulted in 1,567 studies. After the selection process and reading in full, 353 studies were considered in this review. Of these 353, 339 used validated scales (333 studies used the Bristol Scale and six studies used other scales) and 14 studies used non-validated scales. There was also an increase in the number of publications that evaluated stool consistency from the year 2015. After reading the 353 studies, five validated scales were identified: Bristol Stool Form Scale, King's Stool Chart, Stool Consistency Scale according to Anastasi and Capili (2001) and Hansen (1981), the Diarrhea Questionnaire's validated pictorial scale, and Ohno's fecal assessment tool. Conclusion: Five validated scales were identified and used in the last 20 years for stool assessment. Additionally, the data showed a worldwide increase in the use of scales and the need to develop a scale to assess stool with more robust validation studies

Clinical significance of the determination of fecal short-chain fatty acids in patients with nonalcoholic fatty liver disease / 临床肝胆病杂志

Objective To investigate the association of the metabolism of intestinal short-chain fatty acids (SCFAs) with the development and progression of the disease spectrum of nonalcoholic fatty liver disease (NAFLD) by determining the content of fecal SCFAs in patients with different NAFLD diseases and the change in the content of fecal SCFAs after treatment in patients at a high risk of nonalcoholic steatohepatitis (NASH). Methods A total of 90 patients who were diagnosed with NAFLD in The Affiliated Hospital of Qinghai University from July 2020 to July 2021 were enrolled and divided into simple nonalcoholic fatty liver (NAFL) group with 30 patients, NASH group with 30 patients, and nonalcoholic fatty liver fibrosis group with 30 patients, and 40 individuals who underwent physical examination during the same period of time were enrolled as control group. Related case data and fecal SCFAs content were collected for the four groups, and related clinical indices and fecal SCFAs content were collected for 10 patients at a high risk of NASH after 3 months of intervention. The analysis of variance was used for comparison of normally distributed continuous data between multiple groups, and the paired samples t -test was used for comparison within each group; the Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups, and the paired samples Wilcoxon signed rank sum test was used for comparison within each group; a Spearman correlation analysis was used to investigate the correlation between variables; the receiver operating characteristic (ROC) curve analysis was used for diagnostic evaluation. Results Compared with the control group, the nonalcoholic fatty liver fibrosis group had significantly higher contents of valeric acid and caproic acid, and the NAFL group had significantly lower contents of valeric acid and caproic acid (all P < 0.05); the nonalcoholic fatty liver fibrosis group had significantly higher contents of valeric acid and caproic acid than the NAFL group ( P < 0.05); the nonalcoholic fatty liver fibrosis group had a significantly higher content of valeric acid than the NASH group ( P < 0.05); the NASH group had a significantly higher content of caproic acid than the NAFL group ( P < 0.05). After treatment, the high-risk patients in the NASH group had significant reductions in HbA1c, fasting plasma glucose (FPG), triglyceride (TG), total cholesterol (TC), alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transpeptidase (GGT), total bile acid (TBA), prothrombin time (PT), uric acid (UA), controlled attenuation parameter (CAP), and liver stiffness measurement (LSM) ( Z =-2.805, -2.703, -2.193, -2.599, -2.805, -2.701, -2.803, -1.988, -2.807, -2.803, -2.803, and -2.668, all P < 0.05); for these patients, the contents of acetic acid and propionic acid after treatment were significantly higher than those before treatment ( Z =-2.803 and -2.803, both P < 0.05), and the content of isobutyric acid after treatment was significantly lower than that before treatment ( Z =-2.803, P < 0.05). In the diagnosis of nonalcoholic fatty liver fibrosis, valeric acid had an area under the ROC curve (AUC) of 0.842, with a sensitivity of 86.7% and a specificity of 70% at the optimal cut-off value of 141.42 μg/g; caproic acid had an AUC of 0.819, with a sensitivity of 70% and a specificity of 85% at the optimal cut-off value of 6.93 μg/g. Conclusion Valeric acid and caproic acid may promote the development of NAFLD disease spectrum. Acetic acid and propionic acid may have a certain protective effect on the liver of NAFLD patients, and isobutyric acid may promote the development and progression of NASH. The protective effect of acetic acid and propionic acid on the liver may further lead to the reductions in HbA1c, FPG, TG, TC, ALT, AST, GGT, TBA, PT, UA, CAP, and LSM. Valeric acid and caproic acid have an inferior diagnostic value to PIIIP N-P and a superior diagnostic value to type IV collagen and hyaluronic acid. Valeric acid with the optimal cut-off value of 141.42 μg/g and caproic acid with the optimal cut-off value of 6.93 μg/g can be used as the auxiliary diagnostic indicators for the early diagnosis of nonalcoholic fatty liver fibrosis.

Values of combined detection of polygene methylation in stool for the diagnosis of colorectal cancer and precancerous lesions / 肿瘤研究与临床

Objective:To investigate the methylation status of SDC2, PPP2R5C and ADHFE1 genes in stool and their values in the screening of colorectal cancer and precancerous lesions.Methods:From August 2020 to March 2021, 64 patients with colorectal cancer, 72 patients with adenoma, 33 patients with hyperplastic polyps and 59 healthy people were recruited from Qingdao Central Hospital Affiliated to Qingdao University, and the morning stool samples were collected from the research subjects. The genomic DNA was extracted and modified with sulfite. The methylation status of SDC2, PPP2R5C and ADHFE1 genes were detected by methylation specific polymerase chain reaction (MSP), and the fecal occult blood test (FOBT) was performed. Taking the pathological results as the gold standard, receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to compare the effect of combined detection of methylation of three genes and FOBT in predicting colorectal cancer and precancerous lesions. R-Studio software was used to construct a nomogram for the prediction of colorectal cancer with combined detection of gene methylation in stool and other clinical features, and the calibration and validation were performed.Results:The positive rates of combined detection of methylation of SDC2, PPP2R5C and ADHFE1 genes in stool were higher than those of FOBT in colorectal cancer+adenoma [74.3% (101/136) vs. 47.1% (64/136), χ2 = 23.20, P = 0.001], colorectal cancer [90.6% (58/64) vs. 70.3% (45/64), χ2 = 8.91, P = 0.003] and adenoma [59.7% (43/72) vs. 26.4% (19/72), χ2 = 14.43, P = 0.002]. There was no significant difference in the positive rates in hyperplastic polyps [21.2% (7/33) vs. 6.1% (2/33), χ2 = 0.12, P = 0.125] and healthy controls [10.2% (6/59) vs. 8.5% (5/59), χ2 = 4.01, P = 1.000]. The combined detection of gene methylation was better than FOBT in the prediction of colorectal cancer + adenoma [AUC: 0.85 (95% CI 0.80-0.91) vs. 0.71 (95% CI 0.64-0.78), P < 0.05], especially in the prediction of adenoma [AUC: 0.82 (95% CI 0.74-0.89) vs 0.64 (95% CI 0.57-0.69), P < 0.001]. The sensitivity and specificity of ADHFE1 gene methylation status in predicting colorectal cancer were high (90.6% and 96.6%). In colorectal cancer patients over 50 years old, the positive rate of combined detection of gene methylation was higher than that of FOBT [90.2% (55/61) vs. 68.9% (42/61), P < 0.05]. The nomogram calibration curve for predicting colorectal cancer constructed based on the combined detection of gene methylation and each clinical feature showed a high degree of concordance between the predicted and observed diagnostic performance of colorectal cancer. Conclusions:The methylation levels of SDC2, PPP2R5C AND ADHFE1 genes in stool are increased in patients with colorectal cancer or adenoma. The combined detection of gene methylation is expected to be a non-invasive method for the screening of colorectal cancer and precancerous lesions.

Preliminary study on the biological characteristics of intestinal flora in IgA nephropathy based on high-throughput sequencing / 中华肾脏病杂志

Objective:To study the structure and diversity of intestinal flora in IgA nephropathy (IgAN) patients, and to explore the correlation of intestinal microorganisms with clinical indicators and renal pathology.Methods:Fifteen IgAN patients in the First Affiliated Hospital of Baotou Medical College from May 2020 to September 2020 were retrospectively enrolled as IgAN group, and 8 healthy families and 7 health checkups were enrolled as healthy control group. Illumina high-throughput sequencing technology was performed for DNA sequencing in the 16S rDNA-V4 region of all bacteria in the feces sample. QIIME 2 was used to process and analyze original sequence, compared with Greengenes (V138) database. The DADA2 software was called to denoise the data, which was equivalent to a 100% similarity cluster (OTU was a 97% similarity cluster). PCoA was used to analyze the structure and diversity of intestinal flora. Spearman correlation or Pearson correlation analysis was used to analyze the correlation of differential flora with renal pathology and clinical indicators.Results:(1) The intestinal microbial β diversity in IgAN patients was significantly different from that in healthy controls ( P=0.010). (2) Compared with the healthy control group, the numbers of intestinal flora species in IgAN group were significantly increased in 1 phylum, 3 families and 22 genus. At the levels from phylum to family, the species numbers of Firmicutes and Ruminococcaceae in IgAN patients reduced than those in healthy controls and the species numbers of Chloroflexi, Gaiellaceae, Staphylococcaceae and Family-XⅢ in IgAN patients increased than those in healthy controls (all P<0.05). At the genus level, compared with the healthy controls, the species number of Subdoligranulum in IgAN patients was significantly reduced ( P=0.020), and the species number of Ruminococcus- gnavus- group was significantly increased ( P=0.004). (3) At the phylum level of the species number, Firmicutes in IgAN patients was positively correlated to albumin (ALB) ( r=0.637, P=0.037) and IgG ( r=0.452, P=0.046), Gemmatimonadetes was negatively correlated to serum creatinine ( r=-0.453, P=0.045), Verrucomicrobia was negatively correlated to IgM ( r=-0.450, P=0.046), and Patescibacteria was positively correlated to IgA ( r=0.469, P=0.037). At the genus level of the species number, Ruminococcus- gnavus- group ( r=-0.614, P=0.004) and Megamonas ( r=-0.451, P=0.042) were negatively correlated to ALB; Subdoligranulum was positively correlated to ALB ( r=0.563, P=0.009); Dialister was negatively correlated to C3 ( r=-0.427, P=0.041) and was positively correlated to IgA ( r=0.434, P=0.035); Veillonella was positively correlated to estimated glomerular filtration rate ( r=0.452, P=0.043). The species numbers of Eisenbergiella ( r=-0.850, P=0.007), Holdemania ( r=-0.845, P=0.008), Flavonifractor ( r=-0.845, P=0.008), and Ruminiclostridium- 9 ( r=-0.845, P=0.008) were negatively correlated to glomerulosclerosis or adhesion (S) of Oxford classification; the species number of Fusicatenibacter was negatively correlated to mesangial hypercellularity ( r=-0.845, P=0.008); the number of Coprococcus- 2 was positively correlated to S ( r=0.738, P=0.037) and tubular atrophy or interstitial fibrosis ( r=0.756, P=0.030). (4) Random forest model was built with Ruminococcus- gnavus- group and Subdoligranulum, after fitting the area under the receiver operating characteristic curve was 0.927. Conclusions:The intestinal flora of IgAN patients is different from that in healthy subjects. Changes of intestinal flora in IgAN patients are related to clinical indicators and renal pathology. In particular, Ruminococcus- gnavus- group and Subdoligranulum may play an important role in IgAN.

Isolation and identification of a severe acute respiratory syndrome coronavirus 2 strain in feces from COVID-19 patients in Shanghai / 上海预防医学

ObjectiveTo isolate and study the biological characteristics of severe acute respiratory syndrome coronavirus 2 （SARS-CoV-2） from feces of coronavirus disease 2019 （COVID-19） patients. MethodsVero E6 cells were used for virus isolation and the isolated strains were tested by nucleic acid test， immunofluorescence test， virulence test and whole genome sequencing. 50% tissue culture infective dose （TCID50） was calculated after the cell cultures of each generation were collected ResultsEight fecal specimens were inoculated with Vero E6 cells after treatment and cultured for 48 h. One specimen showed obvious cytopathic effect on Vero E6 cells. One SARS-CoV-2 out of 8 fecal samples from COVID-19 patients were isolated， and separation rate was 12.5%. The TCID50 of P1， P2 and P3 were 104.0/0.2 mL， 104.5/0.2 mL and 104.75/0.2 mL， respectively. Only one of the 8 stool samples had SARS-CoV-2 virus replication and amplification， and the Ct value of the nucleic acid detection was about 10. The sequence of the isolation was more than 99.99% homologous with that of Wuhan-Hu-1（GenBank MN908947）. ConclusionThe SARS-CoV-2 strain is isolated from the fecal samples of COVID-19 cases and is confirmed by genomic sequencing and immunofluorescence test， which indicates the presence of live virus in feces of COVID-19 cases.

Staphylococcus aureus and Enterococcus faecium isolated from pigeon droppings (Columba livia) in the external environment close to hospitals

ABSTRACT Background: Domestic pigeons carry pathogens in their droppings, posing a potential public health problem. Methods: The phenotypic and genotypic antimicrobial resistances of Staphylococcus aureus and Enterococcus faecium in the feces of urban pigeons near hospitals with intensive care units were measured. Results: Twenty-nine samples showed Enterococcus growth, whereas one was positive for S. aureus. The S. aureus isolate was sensitive to the antibiotics tested via antibiogram, however resistance genes were identified. E. faecium isolates showed phenotypic resistance to gentamicin, erythromycin, and ciprofloxacin. Conclusions: Antimicrobial profiles harmful to health were demonstrated in bacterial pathogens isolated from the external environment of hospitals.

Anisakidosis diagnosticada tras la expulsión de vermes en deposiciones: forma poco frecuente de diagnóstico en humanos / Anisakidosis diagnosed after expulsion of worms in stools: a rare form of diagnosis in humans

Resumen La anisakidosis es una zoonosis parasitaria accidental y cosmopolita de los seres humanos, siendo su hospedero definitivo los mamíferos marinos como lobos de mar, focas y delfines, entre otros. El ser humano se infecta por el consumo en estado larvario del nemátodo de la familia Anisakidae presentes en pescados y mariscos crudos como la merluza o el congrio. Los helmintos se ubican preferentemente en el tubo digestivo alto, observándose la regurgitación del parásito a la boca o evidenciándose durante la realización de una endoscopía digestiva alta. En forma infrecuente las larvas pueden migrar al peritoneo o seguir su paso por el intestino delgado y colon, siendo inhabitual la expulsión por las deposiciones. Presentamos el caso de una expulsión dos larvas L3 de la familia Anisakidae en deposiciones.

Abstract Anisakidosis is an accidental and cosmopolitan parasitic zoonosis of human beings, its definitive host being marine mammals such as sea lions, seals and dolphins, among others. Humans are infested by consumption in the larval stage of the nematode of Anisakis present in raw fish and shellfish such as hake or conger eel. The infestation is preferably located in the upper digestive tract, observing the regurgitation of the parasite to the mouth or becoming evident during an upper gastrointestinal endoscopy. In rare cases, the larvae can migrate to the peritoneum or continue their passage through the small intestine and colon, with expulsion in stools being unusual. We present a case of expulsion of two larvae of the Anisakidae family in feces.

Dolor abdominal crónico en un niño con Blastocystis hominis: a propósito de un caso / Chronic abdominal pain in a child with Blastocystis hominis: case report

RESUMEN El Blastocystis sp. es un parásito frecuente en el humano, identificado por el laboratorio en muestras de heces fecales. Se presentó el caso de un paciente de 5 años atendido en consulta de Gastroenterología en el Hospital Pediátrico Docente Provincial Eliseo Noel Caamaño, de Matanzas, por presentar dolor abdominal, heces pastosas, náuseas y vómitos desde hacía un año. Llevó tratamiento con ranitidina, omeprazol y domperidona, sin mejoría clínica. Se realizó estudio coproparasitológico en muestras de heces fecales seriadas, con la presencia del Blastocystis hominis. Se indicó tratamiento con metronidazol, sin mejoría clínica, y posteriormente se indicó como alternativa la nitazoxanida. Se evaluó a los 15 días, sin sintomatología y con negativización de las heces fecales seriadas. Resulta frecuente el desconocimiento y la poca importancia que los profesionales sanitarios muestran ante esta infestación, aunque cada vez más se confirma la participación del parásito en manifestaciones clínicas (AU).

ABSTRACT Blastocystis sp. is a frequent parasite in humans, identified in the laboratory in samples of fecal feces. The case of a 5-year-old patient is presented; he assisted the consultation of Gastroenterology in the Provincial Teaching Pediatric Hospital Eliseo Noel Caamaño in Matanzas, suffering abdominal pain, mash feces, nauseas and vomits for one year, and was treated with ranitidine, omeprazole and domperidone without clinical improvement. A coproparasitological study was carried out in serial fecal feces samples with the presence of Blastocystis hominis. Treatment with metronidazole was indicated without clinical improvement and them, as an alternative, nitazoxanide was indicated. He was evaluated at 15 days without symptoms and with negative serial fecal feces. The ignorance and the little importance that health professionals show towards this infestation are frequent, although more and more frequently it is confirmed the participation of the parasite in clinical manifestations (AU).

Stx1 and Stx2 subtyping and antimicrobial resistance in Shiga toxin-producing Escherichia coli (STEC) isolates from cattle and sheep feces in the Southeastern region of the State of Goiás, Brazil / Subtipagem de Stx1 e Stx2 e resistência antimicrobiana em isolados de Escherichia coli produtoras de toxina Shiga (STEC) de fezes de bovinos e ovinos na região sudeste de Goiás, Brasil

The present study was aimed at subtyping of Stx1 and Stx2 genes and characterization of antimicrobial resistance in 106 Shiga toxin-producing Escherichia coli (STEC) strains isolated from cattle and sheep feces. PCR was used to determine the subtypes, and the disk-diffusion method was used to evaluate the antimicrobial resistance. Ten antibiotics from five different classes were tested. Among the isolates of bovine origin, two subtypes of Stx1 (Stx1a and Stx1c), and four subtypes of Stx2 (Stx2a, Stx2b, Stx2c, and Stx2d) were identified. In isolates of sheep origin, two subtypes of Stx1 (Stx1a and Stx1c), and four subtypes of Stx2 (Stx2a, Stx2b, Stx2c, and Stx2 g) were identified. The results obtained suggest the presence of high diversity in Stx1 and Stx2 genes. Further, 96.6% (57/59) of bovine fecal strains and 89.4% (42/47) of sheep fecal strains showed resistance to at least one tested antibiotic. In both animal species, most strains were multidrug-resistant (MDR) (67.8% in cattle and 59.6% in sheep), with no significant difference between host animals. Adult animals were eight times more likely to have STEC with greater pathogenic potential. STEC with the highest pathogenic potential were three times more likely to be multidrug-resistant than STEC with the lowest pathogenic potential. The data reported in this study suggests the occurrence of strains with high potential pathogenicity in the region studied. Therefore, the ruminants of this region are carriers of strains that can cause infections in humans.(AU)

O presente estudo teve como objetivo subtipar os genes Stx1 e Stx2 e caracterizar a resistência antimicrobiana em 106 isolados de Escherichia coli produtoras de toxinas Shiga (STEC) isoladas de fezes de bovinos e ovinos. A PCR foi utilizada para determinar os subtipos e o método de difusão em disco foi utilizado para avaliar a resistência antimicrobiana. Dez antibióticos de cinco classes diferentes foram testados. Entre os isolados de origem bovina, foram identificados dois subtipos de Stx1 (Stx1a e Stx1c) e quatro subtipos de Stx2 (Stx2a, Stx2b, Stx2c e Stx2d). Nos isolados de origem ovina, foram identificados dois subtipos de Stx1 (Stx1a e Stx1c) e quatro subtipos de Stx2 (Stx2a, Stx2b, Stx2c e Stx2g). Os resultados obtidos sugerem a presença de alta variabilidade nos genes Stx1 e Stx2. Além disso, 96,6% (57/59) dos isolados fecais de bovinos e 89,4% (42/47) dos isolados de ovinos mostraram resistência a pelo menos um antibiótico testado. Em ambas as espécies animais, a maioria das cepas foi multirresistente (MDR) (67,8% em bovinos e 59,6% em ovinos), sem diferença significativa entre as espécies animais do reservatório. Os animais adultos tiveram oito vezes mais chances de apresentar STEC com maior potencial patogênico. STEC com o maior potencial patogênico teve três vezes mais chances de ser multirresistente do que o STEC com o menor potencial patogênico. Os dados relatados neste estudo sugerem a ocorrência de cepas com alto potencial de patogenicidade na região estudada. Portanto, os ruminantes dessa região são hospedeiros de isolados que podem causar infecções em humanos.(AU)

Research status of fecal detection for colorectal cancer markers / 国际肿瘤学杂志

There are four methods for fecal detection of colorectal cancer (CRC) markers: fecal occult blood test, fecal DNA test, fecal microRNA test, and fecal fusobacterium nucleatum (Fn) test. Fecal immunochemical test has been recommended by experts at home and abroad as the first choice for CRC screening. Fecal DNA test, due to its high price, has not yet been screened for large samples of people in China, so it is recommended as the second level of CRC screening. Fecal microRNA detection has been paid more and more attention by researchers. In recent years, the detection of fecal microbial markers has become more and more popular, especially fecal Fn detection, which is expected to become a microbial indicator for CRC screening.

Effect of Geniposide on Liver Injury and Bile Acid Profile in Serum, Liver and Excrement of Rats / 中国实验方剂学杂志

Objective:To investigate the hepatotoxicity of different doses of geniposide on the liver of rats and the effects on bile acid profile in serum， liver tissue and feces. Method:The 60 Sprague Dawley rats， half male and half female， were randomly divided into 5 groups according to body weight： blank group and four different doses （50， 100， 200， 400 mg·kg^-1） geniposide groups， 12 rats in each group. The rats were treated by gavage once a day for 7 consecutive days， and the serum， liver and cecal contents were collected on the 8^th day of treatment. The activities of alanine aminotransferase （ALT）， aspartate aminotransferase （AST） and alkaline phosphatase （ALP）， the contents of albumin （ALB）， total bilirubin （TBIL）， total bile acid （TBA）， creatinine （Crea） and carbamide （Urea） were detected in each group. The sections of liver tissue were stained with hematoxylin-eosin（HE）， and the protein expressions of cytokeratin 7（CK7） and cytokeratin 19（CK19） were detected by immunohistochemistry. The protein expressions of CK7 and CK19 in the liver tissue were detected by Western blot. And the mRNA expressions of cholesterol 7<italic>α</italic>-hydroxylase （CYP7A1）， cholesterol 27<italic>α</italic>-hydroxylase （ CYP27A1） and cholesterol 12<italic>α</italic>-hydroxylase （CYP8B1） were detected by real-time PCR. The contents of 18 kinds of bile acids in serum， liver and cecal contents were determined by ultra-performance liquid chromatography-mass spectrometry（UPLC-MS）. Result:Compared with the control group， TBIL level in each dose of geniposide group was increasesd significantly （<italic>P</italic><0.01）. ALT， AST activity and TBA content in 400 mg·kg^-1 geniposide group were increased significantly （<italic>P</italic><0.05， <italic>P</italic><0.01）. HE staining showed that， compared with control group， there was bile duct reaction in the portal area and inflammatory cells infiltrate around bile duct in 200 mg·kg^-1 and 400 mg·kg^-1 geniposide groups， especially 400 mg·kg^-1. The expressions of CK7 and CK19 in liver tissue of 400 mg·kg^-1 geniposide group were significantly higher than those in the control group （<italic>P</italic><0.05， <italic>P</italic><0.01）. Compared with the control group， the contents of glycoursodeoxycholic acid （GUDCA） and glycohyodeoxycholic acid （GHDCA） in liver tissue of 400 mg·kg^-1 geniposide group decreased significantly （<italic>P</italic><0.05， <italic>P</italic><0.01）， the contents of sodium taurochenodeoxycholate （TCDCA）， hyodeoxycholic acid （HDCA）， cholic acid （CA） and chenodeoxycholic acid （CDCA） in liver tissue increased significantly （<italic>P</italic><0.01）， the contents of glycocholic acid hydrate （GCA）， glycochenodeoxycholic acid （GCDCA）， glycodeoxycholic acid hydrate （GDCA）， glycocholic acid （GLCA）， tauroursodeoxycholic acid （TUDCA）， GUDCA， GHDCA， ursodeoxycholic （UDCA） and taurolithocholic acid （TLCA） decreased， the proportions of TCDCA， HDCA， CA， CDCA and deoxycholic acid （DCA） in liver tissue increased， the contents of GHDCA and lithocholic acid （LCA） in serum decreased significantly （<italic>P</italic><0.01）， while sodium taurohyodeoxycholate hydrate （THDCA）， taurocholic acid （TCA）， GCA， TCDCA， UDCA， CA， CDCA， DCA in serum decreased significantly （<italic>P</italic><0.05， <italic>P</italic><0.01）. The contents of CA， UDCA， CA， CDCA and DCA increased significantly （<italic>P</italic><0.05）， the ratio of CA/DCA increased significantly （<italic>P</italic><0.05）， and the ratio of CA and CDCA increased by 19.60% and 4.63%， respectively； Compared with the control group， the contents of all bile acids in cecal contents of 400 mg·kg^-1 were decreased， and the contents of GCA， UDCA， HDCA， GCDCA， GDCA， TLCA， GLCA， CDCA， DCA and LCA were decreased significantly （<italic>P</italic><0.05， <italic>P</italic><0.01）. In addition， real-time PCR results showed that the mRNA expressions of CYP7A1， CYP27A1 in the 400 mg·kg^-1 geniposide group were significantly higher than those in the control group （<italic>P</italic><0.05， <italic>P</italic><0.01）. Conclusion:The 400 mg·kg^-1geniposide can cause obvious hepatotoxicity in rats， and the bile acid profile in liver， serum and excrement changes significantly， and the changes of the each bile acid in liver， serum and feces are different. However， the causal relationship between the gardenoside-induced liver injury and the changes in bile acid profile are<italic> </italic>not clear. It needs to be further studied.

Stx1 and Stx2 subtyping and antimicrobial resistance in Shiga toxin-producing Escherichia coli (STEC) isolates from cattle and sheep feces in the Southeastern region of the State of Goiás, Brazil

ABSTRACT: The present study was aimed at subtyping of Stx1 and Stx2 genes and characterization of antimicrobial resistance in 106 Shiga toxin-producing Escherichia coli (STEC) strains isolated from cattle and sheep feces. PCR was used to determine the subtypes, and the disk-diffusion method was used to evaluate the antimicrobial resistance. Ten antibiotics from five different classes were tested. Among the isolates of bovine origin, two subtypes of Stx1 (Stx1a and Stx1c), and four subtypes of Stx2 (Stx2a, Stx2b, Stx2c, and Stx2d) were identified. In isolates of sheep origin, two subtypes of Stx1 (Stx1a and Stx1c), and four subtypes of Stx2 (Stx2a, Stx2b, Stx2c, and Stx2 g) were identified. The results obtained suggest the presence of high diversity in Stx1 and Stx2 genes. Further, 96.6% (57/59) of bovine fecal strains and 89.4% (42/47) of sheep fecal strains showed resistance to at least one tested antibiotic. In both animal species, most strains were multidrug-resistant (MDR) (67.8% in cattle and 59.6% in sheep), with no significant difference between host animals. Adult animals were eight times more likely to have STEC with greater pathogenic potential. STEC with the highest pathogenic potential were three times more likely to be multidrug-resistant than STEC with the lowest pathogenic potential. The data reported in this study suggests the occurrence of strains with high potential pathogenicity in the region studied. Therefore, the ruminants of this region are carriers of strains that can cause infections in humans.

RESUMO: O presente estudo teve como objetivo subtipar os genes Stx1 e Stx2 e caracterizar a resistência antimicrobiana em 106 isolados de Escherichia coli produtoras de toxinas Shiga (STEC) isoladas de fezes de bovinos e ovinos. A PCR foi utilizada para determinar os subtipos e o método de difusão em disco foi utilizado para avaliar a resistência antimicrobiana. Dez antibióticos de cinco classes diferentes foram testados. Entre os isolados de origem bovina, foram identificados dois subtipos de Stx1 (Stx1a e Stx1c) e quatro subtipos de Stx2 (Stx2a, Stx2b, Stx2c e Stx2d). Nos isolados de origem ovina, foram identificados dois subtipos de Stx1 (Stx1a e Stx1c) e quatro subtipos de Stx2 (Stx2a, Stx2b, Stx2c e Stx2g). Os resultados obtidos sugerem a presença de alta variabilidade nos genes Stx1 e Stx2. Além disso, 96,6% (57/59) dos isolados fecais de bovinos e 89,4% (42/47) dos isolados de ovinos mostraram resistência a pelo menos um antibiótico testado. Em ambas as espécies animais, a maioria das cepas foi multirresistente (MDR) (67,8% em bovinos e 59,6% em ovinos), sem diferença significativa entre as espécies animais do reservatório. Os animais adultos tiveram oito vezes mais chances de apresentar STEC com maior potencial patogênico. STEC com o maior potencial patogênico teve três vezes mais chances de ser multirresistente do que o STEC com o menor potencial patogênico. Os dados relatados neste estudo sugerem a ocorrência de cepas com alto potencial de patogenicidade na região estudada. Portanto, os ruminantes dessa região são hospedeiros de isolados que podem causar infecções em humanos.