Genetic and Phenotypic Variation of Campylobacter jejuni NCTC11168 Caused by flhA Mutation during Laboratory Passage / 生物医学与环境科学（英文）

OBJECTIVE@#Campylobacter jejuni NCTC11168 is commonly used as a standard strain for flagellar biosynthesis research. In this report, two distinguished phenotypic isolates (CJ1Z, flhA mutant strain, lawn; CJ2S, flhA complemented strain, normal colony) appeared during laboratory passages for NCTC11168.@*METHODS@#Phenotypic assessments, including motility plates, transmission electron microscopy, biofilm formation assay, autoagglutination assay, and genome re-sequencing for these two isolates (CJ1Z, flhA mutant strain; CJ2S, flhA complemented strain) were carried out in this study.@*RESULTS@#Transmission electron microscopy revealed that the flagellum was lost in CJ1Z. Phenotypic assessments and genome sequencing of the two isolates were performed in this study. The capacity for biofilm formation, colony auto-agglutination, and isolate motility was reduced in the mutant CJ1Z. Comparative genomic analysis indicated a unique native nucleotide insertion in flhA (nt, 2154) that caused the I719Y and I720Y mutations and early truncation in flhA.@*CONCLUSION@#FlhA has been found to influence the expression of flagella in C. jejuni. To the best of our knowledge, this is the first study to describe the function of the C-terminal of this protein.

Efectividad de la educación sanitaria para la prevención de enfermedades diarreicas agudas / Effectiveness of health education for the prevention of acute diarrheal diseases

En investigaciones similares se ha reportado un grado de desconocimiento respecto a las enfermedades diarreicas agudas en los padres de grupos de riesgo. Varias investigaciones han abordado el tema de la educación sanitaria como factor determinante en la prevención de enfermedades. Las políticas de salud, están obligadas a mantener vigentes las estrategias de prevención efectivas y proponer una búsqueda continua y exhaustiva de nuevas políticas que ayuden a desterrar la EDA de las principales causas de morbilidad en grupos vulnerables. El desafío actual es atenuar los determinantes sociales y atender a la población con factores de riesgo. En esta revisión se evaluó y sistematizó publicaciones en busca de pruebas de la efectividad de la educación sanitaria en la prevención de la enfermedad diarreica aguda(AU)

Similar investigations have reported a degree of ignorance regarding acute diarrheal diseases in parents of risk groups. Several investigations have addressed the issue of health education as a determining factor in disease prevention. Health policies are obliged to keep effective prevention strategies in force and propose a continuous and exhaustive search for new policies that help banish ADD from the main causes of morbidity in vulnerable groups. The current challenge is to mitigate the social determinants and care for the population with risk factors. In this review, we evaluated and systematized publications looking for evidence of the effectiveness of health education in the prevention of acute diarrheal disease(AU)

Agentes infecciosos en muestras biológicas de pacientes con síndrome de Guillain-Barré en Perú, 2018-2019 / Infectious agents in biological samples from patients with Guillain-Barré syndrome in Peru, 2018-2019

RESUMEN Objetivo: Describir los resultados de los exámenes de laboratorio realizados en muestras biológicas de pacientes con síndrome de Guillain-Barré (SGB), recibidas en el Instituto Nacional de Salud (INS) entre los años 2018 y 2019. Materiales y métodos: Se realizó un estudio observacional en pacientes con SGB notificados en el sistema de vigilancia epidemiológica. Se obtuvieron muestras biológicas analizadas en el INS para investigar arbovirus, virus respiratorios, enterovirus y enterobacterias, entre otros. Resultados: Se recibió un total de 2051 especímenes clínicos de 906 pacientes con SGB. Tres pacientes dieron positivo al dengue y tres pacientes al Zika. En 19 pacientes, el cultivo en heces fue positivo para Campylobacter jejuni. El análisis filogenético de diez cepas de Campylobacter jejuni las clasificó como genotipo ST2993, reportado previamente en China y asociado a un brote de SGB. En 2018, hubo 12 muestras que habían dado positivo al PCR para enterovirus en el líquido cefalorraquídeo, pero ninguna pudo corroborarse con el cultivo respectivo ni con secuenciamiento de genoma completo. Un paciente dio positivo por virus de la influenza A, dos por virus de la influenza B, dos por adenovirus, cinco por virus respiratorio sincicial, y diez por rinovirus. Conclusión: Se han encontrado diversos agentes patógenos en especímenes de pacientes con SGB, sin embargo, la presencia de Campylobacter jejuni genotipo ST2993, un patógeno relacionado a brotes de SGB en varios continentes, sería el probable agente causal. Es necesario confirmar esta hipótesis con estudios analíticos y determinar la cadena de transmisión de este agente para implementar las medidas de prevención y control.

ABSTRACT Objective: To describe the results of laboratory tests performed on biological samples from patients with Guillain-Barré syndrome (GBS) submitted to the Instituto Nacional de Salud (INS) between 2018 and 2019. Materials and methods: We conducted an observational study on patients with GBS, by using data from the epidemiological surveillance system. Biological samples, previously analyzed at the INS, were obtained to study arboviruses, respiratory viruses, enteroviruses and enterobacteria, among others. Results: A total of 2,051 specimens were obtained from 906 patients with GBS. Three patients tested positive for dengue and three for Zika. In 19 patients, the stool culture was positive for Campylobacter jejuni. Phylogenetic analysis of 10 Campylobacter jejuni strains classified them as genotype ST2993, which was previously reported in China and associated to a GBS outbreak. Twelve cerebrospinal fluid samples tested positive for enterovirus by PCR in 2018, but none could be verified by culture or complete genome sequencing during the study. One patient was positive for influenza A, two for influenza B, two for adenovirus, five for respiratory syncytial virus, and ten for rinovirus. Conclusion: Several pathogens were found in samples from patients with GBS. However, we found that the genotype ST2993 of Campylobacter jejuni was the most likely causal agent, a pathogen that is related to GBS outbreaks in different continents. It is necessary to confirm this hypothesis with additional analytical studies and it is important to describe the transmission mechanism of C. jejuni genotype ST2993 in order to implement prevention and control measures.

Prevalence of Campylobacter jejuni and Campylobacter coli from broilers at conventional and kosher abattoirs and retail stores / Prevalencia de Campylobacter jejuni y Campylobacter coli en carcasas de pollo procedentes de frigoríficos, faena tradicional y kosher, y de locales de expendio

Abstract We studied and compared the prevalence of Campylobacter jejuni and Campylobacter coli in chicken carcasses from conventional and kosher broiler abattoirs and retail stores. The prevalence of thermotolerant Campylobacter-positive carcasses was 94.0 (kosher) and 32.0% (conventional) (p< 0.0001), while the prevalence of samples contaminated with C. jejuni, C. coli and simultaneously with both species was 36.0, 2.0 and 56.0% (kosher) and 26.0, 4.0 and 2.0% (conventional) (p< 0.0001), respectively. Samples of chicken carcasses (n = 25) and food contact surfaces (tables, n = 25; knives, n=25) from 25 retails were collected and risk quantification was performed. Retails were categorized as high-risk (n = 11), moderate-risk (n = 11) and low-risk (n = 3). Nineteen (76.0%) carcasses, 20 (80.0%) tables and 18 (72.0%) knives were Campylobacter-positive. Retails and abattoirs proved to be sources of carcass contaminaron with Campylobacter spp. Carcasses from kosher abattoirs were mostly contaminated with Campylobacter spp., whereas C. coli was the most prevalent species isolated from carcasses in retail stores.

Resumen El objetivo del estudio fue determinar y comparar la prevalencia de Campylobacter jejuni y Campylobacter coli en carcasas de pollo obtenidas en frigoríficos por faena convencional y kosher, y en locales de expendio. La prevalencia de Campylobacter spp. termotolerante fue del 94,0 (kosher) y del 32,0% (convencional) (p< 0,0001). La prevalencia de muestras contaminadas con C. jejuni, C. coli y con ambas especies fue del 36,0, del 2,0 y del 56,0% (Kosher) y del 26,0, del 4,0 y del 2,0% (convencional) (p< 0,0001), respectivamente. Se tomaron muestras de carcasas (n = 25) y superficies (tablas, n = 25; cuchilla, n = 25) en 25 locales. Los locales fueron categorizados como de riesgo alto (n = 11), moderado (n = 11) y bajo (n = 3). Diecinueve (76,0%) carcasas, 20 (80,0%) tablas y 18 (72,0%) cuchillas fueron positivas para Campylobacter spp. Frigoríficos y locales fueron fuente de contaminación de carcasas con Campylobacter spp. La prevalencia de Campylobacter spp. fue mayor en carcasas kosher. Campylobacter coli fue la especie más prevalente en carcasas de locales.

Phenotypic and molecular characterization of erythromycin resistance in Campylobacter jejuni and Campylobacter coli strains isolated from swine and broiler chickens / Caracterização fenotípica e molecular da resistência à eritromicina em cepas de Campylobacter jejuni e Campylobacter coli isoladas de suínos e frangos de corte

Campylobacter spp. is a bacterial agent that causes gastroenteritis in humans and may trigger Guillain-Barré Syndrome (GBS) and is also considered one of the main foodborne diseases in developed countries. Poultry and pigs are considered reservoirs of these microorganisms, as well as raw or undercooked by-products are often incriminated as a source of human infection. Treatment in human cases is with macrolide, such erythromycin, that inhibits the protein synthesis of the microorganism. This study aimed to isolate Campylobacter jejuni and Campylobacter coli from intestinal content samples of broiler chickens (n=20) and swine (n=30) to characterize the erythromycin resistance profile of the strains and to detect molecular mechanisms involved in this resistance. The minimum inhibitory concentration was determined by agar dilution. The Mismatch Amplification Mutation Assay-Polymerase Chain Reaction (MAMA-PCR) was performed to detect mutations at positions 2074 and 2075 of 23S rRNA region, in addition to PCR test to detect the erm(B) gene. From the intestinal content of broiler chickens, 18 strains of C. jejuni and two strains of C. coli were isolated, whereas, from swine samples, no C. jejuni strain and 14 strains of C. coli were isolated. All C. coli strains were resistant, and three C. jejuni strains from broilers chickens were characterized with intermediate resistance to erythromycin. The MIC of the strains ranged from ≤0.5mg/μL to ≥128mg/μL. All resistant strains had the A2075G mutation, and one strain with intermediate resistance had the A2075G mutation. However, the A2074C mutation and the erm(B) gene were not detected. High resistance levels were detected in C. coli strains isolated from swine. The MAMA-PCR is a practical tool for detecting the erythromycin resistance in Campylobacter strains.(AU)

Campylobacter spp. é um agente bacteriano causador de gastroenterite em humanos e associado à síndrome de Guillain-Barré, sendo a campilobacteriose considerada uma das principais enfermidades de origem alimentar. Aves e suínos são importantes reservatórios desses microrganismos e seus produtos derivados crus ou mal cozidos são muitas vezes incriminados como fonte de infecção humana. A primeira escolha para o tratamento em casos humanos são os antimicrobianos da classe dos macrolídeos como à eritromicina. Dentro desse contexto, o objetivo deste estudo foi isolar Campylobacter jejuni e C. coli a partir de 20 amostras de conteúdo intestinal de frangos de corte e de 30 de suínos ao abate e investigar a resistência à eritromicina das estirpes obtidas e os possíveis mecanismos moleculares envolvidos nesta resistência. A concentração inibitória mínima foi determinada pela diluição em ágar e a técnica MAMA-PCR foi utilizada para detecção de mutações nas posições 2074 e 2075 da região 23s rRNA, foi pesquisado também a presença do gene erm(B) pela PCR. A partir do conteúdo intestinal de frangos de corte foram isoladas 18 estirpes de C. jejuni e duas de C. coli, enquanto de suínos foram obtidas 14 estirpes de C. coli e nenhuma estirpe de C. jejuni. Todas as estirpes de C. coli de suínos foram identificadas como resistentes e três estirpes de C. jejuni de frangos foram caracterizadas com resistência intermediária. A CIM das estirpes variou de ≤0,5mg/μL a ≥128mg/μL. Todas as estirpes resistentes tinham a mutação A2075G e uma cepa com resistência intermediária também apresentou a mutação A2075G. Não foi detectada a mutação A2074C ou a presença do gene erm(B) em nenhuma das estirpes obtidas. Os resultados revelam um alto nível de resistência em estirpes de C. coli isoladas de suínos frente a eritromicina. A técnica MAMA PCR utilizada se constitui em uma ferramenta prática para detecção da resistência à eritromicina em estirpes de C. jejuni e C. coli.(AU)

Consumption of minas frescal cheese may be a source of human infection by Campylobacter jejuni / Consumo de queijo minas frescal pode ser fonte de infecção humana por Campylobacter jejuni

Campylobacter spp. is an emerging pathogen that causes gastroenteritis in humans and the consumption of dairy food can characterize sources of infection. We aimed to verify the viability and a presence of transcripts associated with characteristics of virulence and adaptation of C. jejuni isolated from Minas Frescal cheeses, produced with contaminated milk and stored under refrigeration for up to ten days. The samples were analyzed for bioindicators, Campylobacter spp., pH, acidity, moisture and sodium chloride. Campylobacter spp. recovered were evaluated for the production of transcripts of: ciaB, dnaJ, p19 and sodB. The results were correlated with the viability of C. jejuni and changes in their transcriptome. Storage at lowtemperatures reduced C. jejuni from the first to the fourth day. The variations in humidity, pH and acidity influenced the decreasing of C. jejuni. There was a reduction in transcripts' production of the four genes, more pronounced on the fourth day, indicating the inability of the microorganism to perform its metabolic activities, due to the conditions of injury. Despite the presence of mechanisms of virulence and adaptation, C. jejuni could not remain viable four days after production. However, consumption of fresh cheese contaminated with Campylobacter jejuni can be a source of infection when consumed up to four days after production.

Campylobacter spp. é um patógeno emergente que causa gastroenterite em seres humanos e o consumo de produtos lácteos pode caracterizar fontes de infecção. O objetivo deste estudo foi verificar a viabilidade e a presença de transcritos associadas a características de virulência e adaptação de C. jejuniisoladas de queijos frescos, produzidos com leite contaminado e mantidos refrigeradas por dez dias. Foram analisados bioindicadores, Campylobacter spp., pH, acidez, umidade e cloreto de sódio. Campylobacter spp. recuperados foram avaliados quanto à produção dos transcritos: ciaB, dnaJ, p19 e sodB. Os resultados foram correlacionados com a viabilidade de C. jejuni e alterações no transcriptoma. O armazenamento em baixas temperaturas reduziu C. jejuni do primeiro ao quarto dia. As variações na umidade, pH e acidez influenciaram a queda de C. jejuni. Houve uma redução na produção de transcritos dos quatro genes, mais pronunciada no quarto dia, indicando a incapacidade do micro-organismo em realizar suas atividades metabólicas, devido às condições de injúria. Apesar da presença de mecanismos de virulência e adaptação, C. jejuni não permaneceu viável quatro dias após a produção. Porém, o consumo de queijo fresco contaminado com Campylobacter jejunipode ser uma fonte de infecção quando consumido até quatro dias após a produção.

Detecção de Campylobacter jejuni em produtos de frango utilizando separação imunomagnética / Detection of Campylobacter jejuni in chicken products using immunomagnetic separation

Campylobacter jejuni é o principal causador de gastroenterite bacteriana aguda, e a carne de frango tem se mostrado uma importante fonte de transmissão. Este microrganismo é de difícil isolamento e os métodos convencionais muitas vezes não são eficientes, podendo levar a resultados errôneos. O objetivo deste trabalho foi desenvolver e testar a técnica de separação imunomagnética (IMS) na detecção de C. jejuni em produtos de frango. Micropartículas magnéticas ligadas a anticorpos policlonais anti-C. jejuni foram utilizadas para concentrar C. jejuni antes da semeadura em ágar. O protocolo foi comparado com o método convencional. C. jejuni foi recuperado do alimento experimentalmente contaminado por ambos os métodos, entretanto, quando foi usada a IMS, a presença de microrganismos contaminantes nos meios de cultura foi menor. C. jejuni foi isolado de 7% das amostras de alimento naturalmente contaminadas, usando IMS, e de 3% pelo método convencional. C. coli foi isolado de uma amostra pelo método convencional, mas não foi detectado pelo protocolo com IMS. A técnica de IMS pode ser usada para isolamento de C. jejuni de alimentos, oferecendo a vantagem de detectar em amostras o microrganismo cujo isolamento não é obtido por meio do método convencional.(AU)

Campylobacter jejuni is the main cause of acute bacterial gastroenteritis and chicken meat has shown to be an important source of infection. This microorganism is difficult to isolate and the conventional methods are often inefficient and may lead to erroneous results. This study aimed at developing and testing the technique of immunomagnetic separation (IMS) in the detection of C. jejuni in chicken products. Microparticles magnetically connected anti-C. jejuni polyclonal antibodies were used to concentrate C. jejuni before agar seeding. The protocol was compared with the conventional method. C. jejuni was recovered from experimentally contaminated food for both methods, however, when the IMS was used, the presence of contaminating microorganisms in the means of culture was smaller. C. jejuni was isolated from 7% of samples of food naturally contaminated, using IMS, and 3% by conventional method. C. coli was isolated from a sample by conventional method, but it was not detected by protocol with IMS. The IMS technique can be used for isolation of C. jejuni in food, offering the advantage of detecting the microorganism in samples from which the isolation is not obtained with the use of the conventional method.(AU)

Bacteriemia por Campylobacter jejuni en un paciente con infección por VIH en etapa SIDA / Campylobacter jejuni bacteremia in a patient with HIV infection in AIDS stage

Resumen La bacteriemia es una presentación atípica de la infección por Campylobacter jejuni, y es más frecuente en pacientes con inmunodepresión avanzada debido al VIH u otras enfermedades sistémicas. Debido a la terapia anti-retroviral, en las últimas décadas el número de casos ha disminuido. Presentamos el caso de una mujer en situación de calle, con VIH en etapa C3, que cursó con una bacteriemia por C. jejuni durante su hospitalización por una tuberculosis pulmonar. Realizamos una breve revisión de bacteriemia por C. jejuni en pacientes con VIH.

Bacteremia is an atypical presentation of Campylobacter jejuni infection and it is more frequent in patients with advanced inmunodepression due to HIV or other sistemic diseases. Because of the highly active antiretroviral therapy, in the last decades the number of cases had declined. We report a case of a homeless woman with HIV in C3 stage who was diagnosed with the bacteremia during her hospitalization for pulmonary tuberculosis, and a brief review of C. jejuni bacteremia in HIV patients.

Viability and gene transcription of Campylobacter jejuni in infant milk formulas / Viabilidade e transcrição genética de Campylobacter jejuni em fórmulas lácteas infantis

This study simulated the contamination of two varieties of infant milk formulas (homemade and commercial) with 103 and 104 CFU/mLof Campylobacter jejuni, that were kept under refrigeration (4-7ºC) for up to 48 hours. The aim of this study was to verify the maintenance of the viability and ability of Campylobacter jejuni to produce transcripts of virulence and resistance to stress conditions during periods of 0 (after preparation), 24 and 48 hours. C. jejuni remained viable during all analyzed stages and thepresence of coliforms was not detected. In general, the counts reduced 1 log cycle after 48 hours for all samples, except the 104 CFU/mL inoculum of commercial formula, which reduced 2 log cycles, indicating greater injury of C. jejuni in this food matrix. C. jejuni showed to be more adapted to homemade matrix, due to high transcription of the gene related to cell invasion, ciaB, and more susceptible in the commercial matrix, due to the high transcription of genes related to conditions of stress tolerance (dnaJ, p19, sodB). The low infective dose of C. jejuni coupled with greater vulnerability of children less than five years indicate the need for care in the preparation and maintenance of infant formulas, to prevent the use of contaminated raw material and cross-contamination, especially in homemade formulations

Este estudo simulou a contaminação de duas variedades de fórmulas de leite infantil com Campylobacter jejuni (caseiras e comerciais), que foram mantidas sob refrigeração (4-7ºC) por até 48 horas. O objetivo do estudo foi verificar a manutenção da viabilidade e capacidade de produzir transcritos de virulência e resistência a condições de estresse durante os períodos de 0 (após preparação), 24 e 48 horas. C. jejunipermaneceu viável durante todas as etapas analisadas e a presença de coliformes não foi detectada. Em geral, as contagens reduziram 1 ciclo log após 48 horas para todas as amostras, exceto o inóculo de 104 CFU/mL na fórmula comercial, que reduziu 2 ciclos logarítmicos, indicando maior lesão de C. jejuni nesta matriz alimentar. C. jejuni mostrou-se mais adaptado à matriz popular, devido à alta transcrição do gene relacionado à invasão celular, ciaB, e mais suscetível na matriz comercial, devido à alta transcrição de genes relacionados a tolerância a condições de estresse (dnaJ, p19, sodB). A baixa dose infectante de C. jejuni, juntamente com maior vulnerabilidade de crianças menores de cinco anos, indicam a necessidade de cuidados na preparação e manutenção de fórmulas infantis, para prevenir o uso de matéria-prima contaminada e contaminação cruzada, especialmente em formulações caseiras.

Campylobacter jejuni and Campylobacter coli originated from chicken carcasses modulate their transcriptome to translate virulence genes in human cells / Campylobacter jejuni e Campylobacter coli originadas de carcaças de frango modulam seu transcriptoma para traduzir genes de virulência em células humanas

The aim was to determine the spread of genetically similar profiles of Campylobacter in chicken carcasses and evaluate their ability to produce transcripts for ciaB, dnaJ, p19 and sodB genes, before and after cultivation in Caco-2 cells. The strains used were isolated from 420 samples of chicken carcasses chilled and frozen ready for marketing. The species were identified by PCR-multiplex, the phylogeny was determined by RAPD-PCR and the presence of transcripts was performed by RT-PCR. We identified 74 (17.6%) of Campylobacter strains, being 55 (74.3%) C. jejuni and 19 (25.7%) C. coli. The phylogenetic relationship demonstrated heterogeneity between isolates of the same species, with absence of clones, indicating the high level of diversity of circulating genotypes. The gene transcription showed conflicting results before and after the culture in Caco-2 cell, so that before cultivation isolates showed greater capacity to transcribe genes related to survival and after the interaction with human cells, the strains showed higher potential to transcribe genes associated with virulence. The result of this study contributes to the understanding of how these seemingly fragile microorganisms are the most prevalent bacterial agents in human gastroenteritis.(AU)

O objetivo foi determinar a disseminação de perfis geneticamente semelhantes de Campylobacter em carcaças de frango e avaliar sua capacidade de produzir transcritos para os genes ciaB, dnaJ, p19 e sodB, antes e após o cultivo em células Caco-2. As cepas utilizadas foram isoladas de 420 amostras de carcaças de frango resfriadas e congeladas prontas para comercialização. As espécies foram identificadas por PCR-multiplex, a filogenia foi determinada por RAPD-PCR e a presença de transcritos foi realizada por RT-PCR. Identificamos 74 (17,6%) das cepas de Campylobacter, sendo 55 (74,3%) C. jejuni e 19 (25,7%) C. coli. A relação filogenética demonstrou heterogeneidade entre isolados da mesma espécie, com ausência de clones, indicando o alto nível de diversidade dos genótipos circulantes. A transcrição gênica mostrou resultados conflitantes antes e após a cultura em células Caco-2, de modo que, antes do cultivo, os isolados apresentaram maior capacidade de transcrever genes relacionados à sobrevivência e após a interação com células humanas, as linhagens apresentaram maior potencial para transcrever genes associados à virulência. O resultado deste estudo contribui para a compreensão de como esses microrganismos aparentemente frágeis são os agentes bacterianos mais prevalentes na gastroenterite humana.(AU)

Antimicrobial Susceptibility and Genetic Analysis of Campylobacter jejuni Isolated from Diarrhea Patients in Busan / 대한임상미생물학회지

BACKGROUND: Campylobacter jejuni is an important food-borne pathogen that causes human gastroenteritis. This study was conducted to investigate the incidence of isolation, antimicrobial susceptibility pattern, and C. jejuni genotype from diarrhea patients in Busan, Korea. METHODS: A total of 97 C. jejuni were isolated from diarrhea patients during five food-borne outbreaks from 2014 to September 2017. Antimicrobial susceptibility tests were carried out by the broth microdilution method for ciprofloxacin (CIP), nalidixic acid (NAL), tetracycline (TET), chloramphenicol, azithromycin (AZI), erythromycin (ERY), streptomycin (STR), gentamicin, and telithromycin. To investigate C. jejuni genotypes, pulsed-field gel electrophoresis (PFGE) profile analysis was performed. RESULTS: The isolation rate of C. jejuni was 2.0% for the last 4 years and increased annually. Antimicrobial resistance rates of C. jejuni were shown to be in the order of NAL (90.9%), CIP (89.4%), TET (13.6%), AZI (3.0%), ERY (3.0%), and STR (1.5%). The proportion of multidrug-resistance was 18.2%, and they commonly contained quinolones (CIP-NAL). Analysis of PFGE patterns of SmaI-restricted DNA of C. jejuni isolates showed 17 clusters; cluster 11 was the major genotype pattern. CONCLUSION: This study will provide useful data for the proper use of antimicrobials and the management of resistant C. jejuni. Also it will help to provide data for the epidemiological investigation of foodborne diseases caused by C. jejuni, which is expected to increase in the future.

Campylobacter jejuni, Campylobacter coli, Salmonella spp. e Yersinia enterocolitica isoladas de animais silvestres em um centro de reabilitação / Campylobacter jejuni, Campylobacter coli, Salmonella spp. and Yersinia enterocolitica isolated from wildlife animals of a reabilitation center

Muitas espécies de animais silvestres de vida livre servem como reservatório de bactérias patogênicas que ameaçam a saúde humana e dos animais domésticos. Algumas bactérias, como Campylobacter jejuni, Campylobacter coli, Yersinia enterocolitica e Salmonella enterica, causam enfermidades em humanos e podem contaminar os animais domésticos e silvestres. O Núcleo de Reabilitação da Fauna Silvestre da Universidade Federal de Pelotas (NURFS-UFPel) soluciona uma demanda regional específica de atenção à fauna silvestre brasileira. O objetivo desse trabalho foi identificar a presença de Campylobacter jejuni, Campylobacter coli, Salmonella spp. e Yersinia enterocolitica em animais silvestres que se encontravam em processo de reabilitação. Foram coletadas amostras de fezes, com uso de zaragatoas estéreis, de 34 aves, 16 mamíferos e 23 répteis. Dos 73 animais amostrados, quatro (5,48%) albergavam Y. enterocolitica, sendo duas aves, um mamífero e um réptil. Salmonella e Campylobacter não foram isolados. Os perfis de bandas dos isolados de Y. enterocolitica analisados pela rep-PCR foram diferentes entre si. Esses resultados indicam que as cepas isoladas não estão relacionadas entre si, não possuindo uma origem comum recente. Vanellus chilensis, Turdus rufiventris, Didelphis albiventris e Pantherophis guttatus podem albergar Y. enterocolitica e eliminá-la nas fezes, oferecendo risco de disseminação desse micro-organismo no ambiente, além de constituírem possíveis fontes de contaminação para humanos e outros animais.(AU)

Wild animals can transmit pathogenic bacteria to human and domestic animal's health. Some bacteria, such as Campylobacter jejuni, Campylobacter coli, Yersinia enterocolitica and Salmonella enterica, cause diseases in humans and can contaminate domestic and wild animais. The Núcleo de Reabilitação da Fauna Silvestre of Universidade Federal de Pelotas (Nurfs-UFPel) attend a specific regional demand of wildlife in Brazil. The aim of this paper was to identify the presence of these pathogenic bacteria in wild animals in rehabilitation. Stool samples were collected using sterile swabs from 34 birds, 16 mammals and 23 reptilian that were housed at Nurfs. Of the 73 collections, Y. enterocolitica was isolated from four (5.48%) of two birds, one mammal and one reptile. Salmonella and Campylobacter were not isolated. The molecular profile of bands of Y. enterocolitica identified in rep-PCR had differences. These results indicated that the isolates did not have a recent common origin. Pantherophis guttatus, Didelphis albiventris, Turdus rufiventris and Vanellus chilensis could shelt Y. enterocolitica and eliminate the bacteria in stool, offering risk of dissemination of these microorganisms in the environment with possible contamination of humans and other animals.(AU)

Prevalencia y caracterización del perfil de susceptibilidad antimicrobiana de Campylobacter jejuni y Campylobacter coli en niños con diarrea de la ciudad de Loja, Ecuador / Prevalence and antimicrobial behavior of Campylobacter jejuni and Campylobacter coli in children with diarrhea in Loja city, Ecuador

Resumen Introducción: Campylobacter es un importante agente de diarrea en el ser humano. En Ecuador, la información sobre Campylobacter es escasa y no existen antecedentes de susceptibilidad antimicrobiana. Objetivo: Describir la prevalencia de Campylobacter en niños con diarrea y su comportamiento in vitro frente a cinco antimicrobianos. Método: Se estudiaron 253 niños entre siete meses y 9 años de edad, que consultaron por diarrea en dos hospitales de la ciudad de Loja. Se realizó cultivo de muestras fecales e identificación por pruebas fenotípicas y por RPC múltiple. La susceptibilidad antimicrobiana fue determinada por el método de difusión en disco. Resultados: Campylobacter fue diagnosticado en 16 (6,3%) de las muestras, aislándose C. jejuni en 13 (5,1%) y C. coli en 3 (1,2%). Todas las cepas fueron susceptibles a gentamicina y ampicilina/ ácido clavulánico, con baja resistencia a ampicilina y eritromicina y alta resistencia a ciprofloxacina.

Introduction: Campylobacter is an important agent of diarrhea in humans. In Ecuador, the information on Campylobacter is scarce and there are not antecedents about antimicrobial susceptibility. Objective: To describe Campylobacter prevalence in children with diarrhea and their behavior against five antimicrobials in vitro. Method: We studied 253 children with diarrhea aging 7 months to 9 years who consulted for diarrhea in two hospitals in the city of Loja. Fecal samples were cultured and identification by tests by phenotypic tests and multiplex PCR. Susceptibility to 5 antibiotics was determined by the disc-diffusion method. Results: Campylobacter was found in 16 (6.3%) children, being C. jejuni the most frequent one (5.1%), followed by C. coli (1.2%). All strains were susceptible to gentamicin and ampicillin/clavulanic acid, being found low resistance to ampicillin and erythromycin and high resistance to ciprofloxacin.

Recurrent Guillain-Barré Syndrome Following Urinary Tract Infection by Escherichia coli

Recurrent Guillain-Barré syndrome (GBS) is a rare, immune-mediated disease of the peripheral nervous system. It has been reported to occur at intervals ranging from four months to 10 years; published case studies suggest that 1%–6% of patients who have had GBS will experience recurrent attacks. The most commonly identified infections coinciding with GBS are Campylobacter jejuni, Haemophilus influenzae, Mycoplasma pneumonia, and cytomegalovirus, while an antecedent infection with Escherichia coli is very uncommon. In this case report, we present a rare episode of recurrent GBS, which followed a urinary tract infection (UTI) by E. coli, and an accompanying literature review. A 75-year-old woman with a prior history of acute motor axonal neuropathy (AMAN), a subtype of GBS, presented with subsequent weakness of limbs and areflexia following 10 days of fever, frequency, and dysuria. Base on nerve conduction studies, cerebrospinal fluid analysis and other clinical investigation, we diagnosed the patient with recurrent GBS caused by E. coli. The patient recovered with mild subjective weakness following treatment of intravenous immunoglobulin with ceftriaxone. We suggest that E. coli causes UTI could be one of the diverse trigger factors involved in recurrent GBS.

Caracterización de cepas de Campylobacter jejuni obtenidas desde carne de pollo y heces de aves de corral de la zona central de Chile / Characterization of Campylobacter jejuni samples coming form poultry meat and feces

Background Campylobacter jejuni is one of the main causal agents of food borne diseases. Infections with this pathogen are mainly caused by chicken meat consumption. Aim To characterize antibiotic resistance and virulence factors in C. jejuni strains obtained from chicken meat and poultry feces in Central Chile. Material and Methods The presence of C. jejuni in 30 meat and 40 feces samples from poultry was studied. From these samples, we obtained 40 strains which were characterized at the molecular level for the presence of 16 genes involved in virulence using PCR. In parallel, antibiotic resistance for ciprofloxacin, nalidixic acid, tetracycline, erythromycin, azithromycin, chloramphenicol y ampicillin was analyzed. Results Twenty and 63% of feces and chicken meat samples were positive for C. jejuni, respectively. Moreover, a high percentage of strains showed antibiotic resistance, where 27% of strains were resistant to all tested antibiotics, except for azithromycin. Finally, 10% of the strains coming from feces contained 14 out of 16 virulence genes evaluated. Only 23% of the strains did not contain any of these genes. Conclusions A high percentage of feces and chicken meat samples are contaminated with C. jejuni. Moreover, these strains show a high genetic and phenotypic diversity represented by their antibiotic resistance profiles and the presence of virulence factors.

Síndrome de Guillain Barré recurrente: reporte de caso / Guillain Barré Syndrome Recurrent: Case report

El síndrome de Guillain-Barré (SGB) o poli-rradiculoneuritis aguda es una enfermedad autoinmune, desencadenada por una infec-ción viral o bacteriana, su incidencia es de 1.7/100000, únicamente el 3% puede recaer en los años subsiguientes. Es una patología poco frecuente y menos frecuente aún son los casos recurrentes, por lo que realizamos una revisión de su epidemiología, cuadro clínico, criterios diagnósticos y su manejo. Se trata de un paciente masculino de 9 años de edad, que el 13 de octubre de 2008 al primer año de edad fue ingresado durante 1 mes al Instituto Hondureño de Seguridad Social (IHSS) con cuadro de parálisis flácida ascendente progresiva (Síndrome de Guillain Barré), recibió manejo con inmunoglobulina cuya dosis y otros datos sobre su tratamiento, exámenes o estudios realizados se descono-cen. La recuperación completa se dio aproxi-madamente a los 6 meses posteriores al inicio de los síntomas. Sin embargo reingresa el 12 de noviembre de 2014 en IHSS con diagnóstico de Parálisis Flácida ascendente recurrente (segundo episodio), sin recupera-ción completa ya que presentó secuelas en miembros inferiores. Se le realizó Electromio-grafía con datos compatibles con polirradicu-lopatía motora desmielinizante simétrica. En marzo de este año (2017) se presenta con igual sintomatología por lo que se ingresa como síndrome de Guillain barré recurrente (tercer episodio)...(AU)

Presencia de serotipos de Campylobacter jejuni O:19 en la cadena avícola Argentina / Campylobacter jejuni O:19 serotype in Argentine poultry meat supply chain

Las especies termotolerantes de Campylobacter han tomado gran relevancia en los últimos años debido a que son los principales agentes zoonóticos causantes de enfermedades transmitidas por alimentos. Adicionalmente, Campylobacter jejuni serotipo O:19 ha sido relacionado con el desarrollo del síndrome posdiarreico de Guillain-Barré. El objetivo de este trabajo fue determinar la proporción de cepas de C. jejuni que se corresponden con el serotipo O:19 dentro de las aisladas en diferentes etapas de 3 cadenas de producción de carne aviar en la provincia de Santa Fe. Se observó que el 18% del total de cepas de C. jejuni recuperadas (10/55) pertenecían al serotipo O:19; estas se aislaron en 4 de las 5 etapas de producción de carne aviar elegidas a los fines de este estudio. Este hallazgo da cuenta de un riesgo importante para la salud pública de los consumidores y debería ser considerado en los estudios epidemiológicos de Campylobacter, para implementar en forma urgente medidas de control sobre este microorganismo.

Thermotolerant species of Campylobacter have been focus of attention in the last years because they are the major agent causing zoonotic foodborne diseases. In addition, Campylobacter jejuni O:19 serotype was associated with Guillain Barré syndrome. The aim of this study was to determine the proportion of C. jejuni O:19 serotype isolated at different stages of three poultry meat supply chain in Santa Fe, Argentina. The analysis showed that 18% of isolated C. jejuni belong to serotype O:19. It was also determined that the presence of these strains is given in almost all production stages. These results reflect a significant risk to public health of consumers. Epidemiological studies of Campylobacter should be considered to establish a risk manager policy.

Campylobacter jejuni Bacteremia in a Liver Cirrhosis Patient and Review of Literature: A Case Study

Campylobacter infection causes gastrointestinal symptoms such as abdominal pain or diarrhea. Occasionally, Campylobacter bacteremia affects immunocompromised patients; however, serious outcomes are known to be rare. Here, we present a case of a patient with Campylobacter bacteremia who had underlying liver cirrhosis. The patient had fever and diarrhea. These symptoms subsided after treatment with cefotaxime. Campylobacter jejuni was isolated in the blood culture after 10 days. In addition, previously reported cases of Campylobacter bacteremia in Asian countries were reviewed with respect to antimicrobial sensitivities.

Campylobacter jejuni: un agente infrecuente de peritonitis en un niño con diálisis peritoneal / Campylobacter jejuni: A rare agent in a child with peritoneal dialysis-related peritonitis

La peritonitis es un problema grave en los niños que reciben diálisis peritoneal. La bacteria Campylobacter jejuni es una causa infrecuente de peritonitis. Un niño de 10 años de edad con insuficiencia renal terminal causada por síndrome urémico hemolítico atípico ingresó a nuestro hospital con dolor abdominal y fiebre. El líquido de la diálisis peritoneal era turbio; en el examen microscópico se observaron leucocitos abundantes. Se inició tratamiento con cefepime intraperitoneal. En el cultivo del líquido peritoneal se aisló Campylobacter jejuni, por lo que se agregó claritromicina oral al tratamiento. Al finalizar el tratamiento, el resultado del cultivo del líquido peritoneal era negativo. Hasta donde sabemos, no se había informado previamente peritonitis por C. jejuni en niños. Conclusión. Si bien la peritonitis por C. jejuni es rara en los niños, debe considerarse como factor etiológico de la peritonitis.

Peritonitis is a serious problem in children receiving peritoneal dialysis. Campylobacter jejuni is an unusual cause of peritonitis. A 10-year-old boy who had end stage renal failure due to atypical hemolytic uremic syndrome was admitted to our hospital with abdominal pain and fever. Peritoneal dialysis fluid was cloudy and microscopic examination showed abundant leukocytes. Intraperitoneal cefepime treatment was started. Campylobacter jejuni was isolated from peritoneal dialysis fluid culture and oral clarithromycin was added to the treatment. At the end of therapy, peritoneal fluid culture was negative. To our knowledge, C. jejuni peritonitis was not reported in children previously. Conclusion : Although C. jejuni peritonitis is rarely encountered in children, it should be considered as an etiologic factor for peritonitis.