Enterobacterial repetitive intergenic consensus (ERIC)-PCR analysis as a reliable evidence for suspected Shigella spp. outbreaks

Abstract Background Shigellosis remains a serious public health problem and an important cause of morbidity and mortality worldwide. The aim of this study was to characterize fliC and the genetic relatedness of Shigella spp. isolated during a one-year period from children in a suspected outbreak in Tehran, Iran. Methods and results Fifty Shigella spp. were isolated from 3779 stool samples of children with diarrhea (prevalence rate: 1.32%). Among the isolates, 92% were characterized as Shigella sonnei, while 6% and 2% were identified as S. flexneri and S. boydii, respectively. S. dysenteriae was not recovered from the patients. All isolates were negative for fliC except for Shigella standard strains. The enterobacterial repetitive intergenic consensus-polymerase chain reaction (ERIC-PCR) profiles allowed differentiating the 50 isolates into 5 ERIC types, which were grouped into five clusters (ET1-ET5). Computer-assisted clustering of the strains showed a high degree of similarity among the isolates. Conclusion In conclusion, given the clonal correlation of the Shigella strains isolated in this study and the lack of fliC among them, we propose that probably a single or limited fliC-defected Shigella clone spread and caused the outbreak.

Effects of ischemic preconditioning in a pig model of large-for-size liver transplantation

OBJECTIVE: In most cases of pediatric liver transplantation, the clinical scenario of large-for-size transplants can lead to hepatic dysfunction and a decreased blood supply to the liver graft. The objective of the present experimental investigation was to evaluate the effects of ischemic preconditioning on this clinical entity. METHODS: Eighteen pigs were divided into three groups and underwent liver transplantation: a control group, in which the weights of the donors were similar to those of the recipients, a large-for-size group, and a large-for-size + ischemic preconditioning group. Blood samples were collected from the recipients to evaluate the pH and the sodium, potassium, aspartate aminotransferase and alanine aminotransferase levels. In addition, hepatic tissue was sampled from the recipients for histological evaluation, immunohistochemical analyses to detect hepatocyte apoptosis and proliferation and molecular analyses to evaluate the gene expression of Bax (pro-apoptotic), Bcl-XL (anti-apoptotic), c-Fos and c-Jun (immediate-early genes), ischemia-reperfusion-related inflammatory cytokines (IL-1, TNF-alpha and IL-6, which is also a stimulator of hepatocyte regeneration), intracellular adhesion molecule, endothelial nitric oxide synthase (a mediator of the protective effect of ischemic preconditioning) and TGF-beta (a pro-fibrogenic cytokine). RESULTS: All animals developed acidosis. At 1 hour and 3 hours after reperfusion, the animals in the large-for-size and large-for-size + ischemic preconditioning groups had decreased serum levels of Na and increased serum levels of K and aspartate aminotransferase compared with the control group. The molecular analysis revealed higher expression of the Bax, TNF-alpha, I-CAM and TGF-beta genes in the large-for-size group compared with the control and large-for-size + ischemic preconditioning groups. Ischemic preconditioning was responsible for an increase in c-Fos, IL-1, IL-6 and e-NOS ...

Enhanced resistance to fluoroquinolones in laboratory-grown mutants & clinical isolates of Shigella due to synergism between efflux pump expression & mutations in quinolone resistance determining region.

Background & objectives: There is a worldwide emergence of fluoroquinolone resistance in Shigella species. To understand the molecular mechanisms associated with fluoroquinolone resistance, naturally occurring fluoroquinolone-resistant strains and laboratory-induced spontaneous mutants of Shigella spp. were used and the relative contributions of acrAB-tolC efflux pumps, gyrase and topoisomerase target gene mutations towards fluoroquinolone resistance were determined. Methods: Eight Shigella flexneri and six S. dysenteriae clinical isolates were studied. Three consecutive mutants resistant to ciprofloxacin for S. flexneri SFM1 (≥0.25 μg/ml), SFM2 (≥4 μg/ml) and SFM3 (≥32 μg/ml) were selected in 15 steps from susceptible isolates by serial exposure to increasing concentrations of nalidixic acid and ciprofloxacin. Similarly, two mutants for S. dysenteriae SDM1 (≥0.25 μg/ml) and SDM2 (≥4 μg/ml) were selected in eight steps. After PCR amplification sequence analyses of gyrase and topoisomerase target genes were performed. Expression of efflux genes acrA, acrB, acrR and tolC was measured using real-time PCR. Results: Mutations were observed in gyrA Ser83→Leu, Asp87→Asn/Gly, Val196→Ala and in parC Phe93→Val, Ser80→Ile, Asp101→Glu and Asp110→Glu. Overall, acrA and acrB overexpression was associated with fluoroquinolone resistance (p<0.05); while tolC and acrR expression levels did not. Interpretation & conclusions: Fluoroquinolone resistance in Shigella spp. is the end product of either a single or a combination of mutations in QRDRs and/ or efflux activity. Novel polymorphisms were observed at Val196→Ala in gyrA in clinical isolates and Phe93→Val, Asp101→Glu, Asp110→Glu and in parC in majority of laboratory-grown mutants.

Evaluation of the Impact of Automated Specimen Inoculation, Using Previ Isola, on the Quality of and Technical Time for Stool Cultures

BACKGROUND: This study was designed as a quasi-experiment to evaluate automatic inoculation of fecal specimens, using the automated specimen inoculator Previ Isola (bioMerieux, France). METHODS: We evaluated the quality of cultures, recovery rates of enteropathogenic bacteria (Salmonella, Shigella, Campylobacter, and Yersinia species), and cost-effectiveness in terms of technical time. The Previ Isola recovery rates for the two-year period from August 2009 to July 2011 were compared with historical manual inoculation data of the previous two years (August 2007 to July 2009). The regional (Baden-Wurttemberg) and nationwide (Germany) trends of recovery rates for this four-year period were referred. RESULTS: A total of 5,884 fecal specimens were collected over the study period. Most positive cultures were for Salmonella, followed by Campylobacter. Compared with the historical data, the numbers of Campylobacter-positive specimens for a year between August and July were increased significantly, from 19 in 2007-2008 and 10 in 2008-2009 to 32 in 2009-2010 (P=0.002) and 32 in 2010-2011 (P=0.003), respectively. During the study period, the official data for our region and nationwide did not show this increase in the recovery rate of Campylobacter. For Salmonella, Shigella, and Yersinia, no significant changes were observed. Compared with manual inoculation, the mean hands-on time with Previ Isola inoculation was significantly shortened, from 37:30 min to 8:42 min per 15 fecal specimens. CONCLUSIONS: Inoculation by Previ Isola improves the quality of routine culture of fecal specimens, with better sensitivity for Campylobacter and less hands-on time.

A novel multiplex PCR for the simultaneous detection of Salmonella enterica and Shigella species

Salmonella enterica and Shigella species are commonly associated with food and water borne infections leading to gastrointestinal diseases. The present work was undertaken to develop a sensitive and reliable PCR based detection system for simultaneous detection of Salmonella enterica and Shigella at species level. For this the conserved regions of specific genes namely ipaH1, ipaH, wbgZ, wzy and invA were targeted for detection of Shigella genus, S. flexneri, S. sonnei, S. boydii and Salmonella enterica respectively along with an internal amplification control (IAC). The results showed that twenty Salmonella and eleven Shigella spp., were accurately identified by the assay without showing non-specificity against closely related other Enterobacteriaceae organisms and also against other pathogens. Further evaluation of multiplex PCR was undertaken on 50 natural samples of chicken, eggs and poultry litter and results compared with conventional culture isolation and identification procedure. The multiplex PCR identified the presence of Salmonella and Shigella strains with a short pre-enrichment step of 5 h in peptone water and the same samples were processed by conventional procedures for comparison. Therefore, this reported multiplex PCR can serve as an alternative to the tedious time-consuming procedure of culture and identification in food safety laboratories.

Antimicrobial resistance in Shigella - rapid increase & widening of spectrum in Andaman Islands, India.

Background & objectives: Shigellosis is known to be a major cause of acute childhood diarrhoea in Andaman & Nicobar Islands, India. Rapid emergence of antibiotic resistance warrants continuous monitoring of sensitivity pattern of bacterial isolates. We report here the salient findings of an ongoing study on shigellosis in Andaman Islands, India, with regards to change in drug resistance pattern during the past one decade. Method: During 2006-2009, stools samples from 412 paediatric diarrhoea patients were collected and processed for isolation and identification of Shigella spp. Susceptibility to 22 antimicrobial drugs was tested and MICs were determined for 3rd generation cephalosporins, quinolones, amoxicillin-clavulanic acid combination and gentamicin. Drug susceptibility pattern of these isolates were compared with that of 33 isolates obtained during 2000-2002. Results: Shigella isolates were recovered from 50 of 412 stool samples processed. Resistance to ampicillin, nalidixic acid, tetracycline and ciprofloxacin was observed in 100, 96, 94 and 82 per cent of the isolates, respectively. The frequency of resistance to these drugs was significantly (P<0.001) higher than that observed during 2000-2002. Resistance to seven drugs was observed in 2000-2002, whereas resistance to 21 drugs was seen during 2006-2009. The number of drug resistance pattern increased from 13 in 2000-2002 to 43 in 2006-2009. Resistance to newer generation fluoroquinolones, 3rd generation cephalosporins and augmentin, which was not observed during 2000-2002, appeared during 2006-2009. Interpretation & conclusions: The frequency of resistance among Shigella isolates has increased substantially between 2000-2002 and 2006-2009 and the spectrum of resistance has widened. At present, the option for antimicrobial therapy in shigellosis in Andaman is limited to a small number of drugs. Continuous local monitoring of resistance patterns is necessary for the appropriate selection of empirical antimicrobial therapy.

Incidence and Risk Factors of Irritable Bowel Syndrome in Community Subjects with Culture-proven Bacterial Gastroenteritis / 대한소화기학회지

BACKGROUND/AIMS: The aim of this study was to investigate the incidence and risk factors of irritable bowel syndrome (IBS) in community subjects with culture-proven bacterial gastroenteritis. METHODS: This was a prospective, community-based, cohort study, which followed patients with a recent history of culture-proven bacterial gastroenteritis. IBS was diagnosed with the use of the Rome II criteria at 3 and 6 months after bacterial dysentery. RESULTS: Sixty five cases were included and completed the 6 month follow-up. Thirty four cases (52.3%) were female. Salmonella was the pathogen most frequently identified and seen in 41 patients (63.1%). The cumulative incidence of IBS among patients with microbiologically proven bacterial gastroenteritis within a community was 9.2% and 12.3% at 3 and 6 months of follow-up, respectively. The duration of initial diarrhea (> or =7 days) was associated with an increased risk for the development of IBS (aOR, 14.50 [95% CI, 1.38-152.72]; p=0.022). CONCLUSIONS: Our study suggests that the incidence of IBS among patients with culture-proven bacterial gastroenteritis within a community is similar to that reported among Western populations. A large, prospective study is encouraged to confirm our results and to evaluate the influence of the microbial species on the epidemiology of IBS in Asian populations.

Antimicrobial Resistance of Shigella spp. isolated in the State of Pará, Brazil / Resistência Antimicrobiana de Shigella spp. isoladas no Estado do Pará

INTRODUCTION: Shigella spp. are Gram-negative, nonsporulating, rod-shaped bacteria that belong to the family Enterobacteriaceae and are responsible for shigellosis or bacillary dysentery, an important cause of worldwide morbidity and mortality. METHODS: We studied the antibiotic resistance profiles of 122 Shigella spp. strains (81 S. flexneri, 41 S. sonnei, 1 S. boydii) isolated from patients (female and male from 0 to 80 years of age) presenting diarrhea in different districts of the State of Pará, in the North of Brazil. The antibiotic resistance of the strains, isolated from human fecal samples, was determined by the diffusion disk method and by using the VITEK-2 system. RESULTS: The highest resistance rate found was the resistance rate to tetracycline (93.8 percent), followed by the resistance rate to chloramphenicol (63.9 percent) and to trimethoprim/sulfamethoxazole (63.1 percent). Resistance to at least three drugs was more common among S. flexneri than S. sonnei (39.5 percent vs. 10 percent). Six (4.9 percent) strains were susceptible to all the antibiotics tested. All strains were susceptible to cefotaxime, ceftazidime, ciprofloxacin, nalidixic acid and nitrofurantoin. CONCLUSIONS: High rates of multidrug resistance in Shigella spp. are a serious public health concern in Brazil. It is extremely important to continuously monitor the antimicrobial resistances of Shigella spp. for effective therapy and control measures against shigellosis.

INTRODUÇÃO: Shigella spp. são bactérias Gram-negativas, não esporuladas, em forma de bastonete, pertencentes a família Enterobacteriaceae responsáveis pela shigelose ou disenteria bacilar, uma importante causa de mortalidade e morbidade mundial. MÉTODOS: Foi estudado o perfil de resistência a antimicrobianos de 122 amostras de Shigella spp. (81 S. flexneri, 41 sonnei, 1 S. boydii) isoladas de pacientes (sexo feminino e masculino com faixa etária de 0 a 80 anos) com distúrbios gastrointestinais em diferentes municípios no Estado do Pará, Brasil. A resistência antimicrobiana das amostras isoladas de coprocultura, foi determinada pelo método de difusão em disco e pelo sistema Vitek II. RESULTADOS: A maior resistência foi observada em relação à tetraciclina (93,8 por cento), seguida de cloranfenicol (63,9 por cento), e trimetoprimsulfametoxazol (63,1 por cento). Multirresistência a pelo menos três antimicrobianos foi mais comum em S. flexneri comparada a S. sonnei (39,5 por cento vs. 10 por cento). Seis (4,9 por cento) amostras foram sensíveis a todos antimicrobianos testados. Todas as amostras apresentaram sensibilidade a cefotaxima, ceftazidima, ciprofloxacina, ácido nalidixico e nitrofurantoína. CONCLUSÕES: As altas taxas de multirresistência de Shigella spp. são um sério problema de saúde pública no Brasil. Sendo assim, torna-se extremamente importante um monitoramento contínuo da resistência antimicrobiana de Shigella spp. para uma terapia efetiva e medidas de controle contra shigelose.

Avaliação do sistema de cultivo integrado, a partir da reciclagem de águas residuais submetidas a tratamento primário: pesquisa de espécies dos gêneros Salmonella, Shigella, Vibrio e Aeromonas / Assessment of integrated aquaculture system from the recycling of wastewater undergoing primary treatment: search of species of Salmonella, Schigella, Vibrio and Aeromonas

Para avaliar um sistema integrado de agrucultura foram realizadas análises microbiológicas da água utilizada neste sistema e determinada a incidência e resistência antimicrobiana dos enteropatógenos no ecossistema relacionado. As amostras de água testadas apresentaram 32,9% de taxas de coliformes fecais (<- 1.600/100mL), de acordo com a OMS para piscicultura em águas residuais. Salmonella spp. foram detectadas em 14,5% das amostras. De um total de 33 cepas, 15,1% eram resistentes a um ou dois antimicrobianos testados e resistência a múltiplas drogas não foi observada. Aeromonas spp. foram identificadas em 91,6% das amostras. De um total de 416 cepas, resistência a uma classe de antimicrobianos foi observada em 66,3% e a multirresistência às drogas em 37,7%. Na avaliação da virulência dos isolados de Aeromonas hydrophila, 85,3% das cepas apresentaram Beta-hemólise nos três diferentes tipos de eritrócitos empregados e 99,1% nos eritrócitos de coelho e cavalo, sendo possível a caracterização através da PCR do gene aerA e lip, em 100% das amostras. Os resultados obtidos apontam para a relevância quanto às vantagens da implementação de um sistema integrado, disponibilizando alimentos com custo reduzido, porém este sistema necessita de um controle rígido e efetivo para que estes produtos não constituam veículos para a disseminação de doenças.

To evaluate an integrated aquaculture system, microbiological analyses of water used in this system were carried out and the incidence and antimicrobial resistance of enteropathogens were determined in the related ecosystem. Water samples tested had 32.9% of fecal coliforms rates (<-1600/100mL) in accordance with WHO for psiculture in wastewater. Salmonella spp. were detected in 14.5% of the samples. From a total of 33 strains, 15.1% were resistant to one or two antimicrobial drugs tested and multidrug-resistance was not observed. Aeromonas spp. were identified in 91.6% of the samples. From a total of 416 strains, resistance to one antimicrobial class was observed in 66.3% and multidrug-resistance in 37.7%. In relation to virulence factors of Aeromonas hydrophila, 85.3% of the strains showed beta-hemolysis in three different types of erythrocytes and 99.1% in horse and rabbit erythrocytes. It was possible to characterize by PCR assay, the genes aerA and lip in 100% of the strains. The results indicate the relevance of the benefits of implementing an integrated system, providing food with reduced cost, but this system requires a strict and effective control so that these products do not constitute a vehicle for the spread of disease.

Frequency and antimicrobial susceptibility of Shigella species isolated in Children Medical Center Hospital, Tehran, Iran, 2001-2006

Appropriate antimicrobial treatment of shigellosis depends on identifying its changing resistance pattern over time. We evaluated 15,255 stool culture submitted from July 2001 to June 2006 to the Laboratory of Children Medical Center Hospital. Specimen culture, bacterial identification, and disk diffusion susceptibility testing were performed according to National Committee for Clinical Laboratory Standards guidelines. From 15,255 stool samples, 682 (4.5 percent) were positive for Shigella species. The most common species of Shigella were S. flexneri (48 percent) and S. sonnei (45 percent); other results were S. dysenteriae (5 percent) and S. boydii (2 percent). The rate of Sensitivity to ceftriaxone (95 percent), ceftizoxime (94 percent), and nalidixic acid (84 percent) were among our isolates. Resistance to co-trimoxazole and ampicillin was 87 percent and 86 percent, respectively. S. flexneri was more multiresistant than other species (47.9 percent). Our isolates are overall most sensitive to ceftriaxone, ceftazidime, and nalidixic acid (> 84 percent). They were most resistant to co-trimoxazole and ampicillin (> 86 percent). Because resistance varies according to specific location, continuous local monitoring of resistance patterns is necessary for the appropriate selection of empirical antimicrobial therapy.

Standardization of a quantification method for Salmonella spp. and Shigella spp. in specific liquid media / Estandarización de un método de recuento para Salmonella spp. y Shigella spp. en medios de cultivo líquidos especializados

Introduction: Chlorination is the most widely used disinfection process for drinking water production. The formation of chlorination carcinogenic by-products and chlorine intoxication by direct manipulation in small communities has motivated the study of alternative disinfection processes. In this sense, processes of advanced oxidation (PAOs) have yielded promising results. Escherichia coli (E. coli) is customarily used as faecal bacterial indicator to determine the efficiency of disinfection processes. However, it has been shown that E. coli is less resistant to disinfection than other enteric bacteria such as Shigella  spp. and Salmonella  spp. Additionally, the viable non-culturable (VNC) state yields bacteria which are not detectable on many culture media. Objective: The main objective is to standardize a method for counting Salmonella  spp. and Shigella  spp. in specific liquid media to reliably quantify the bacteriological potential risk related to disinfection processes based on PAO. Methods: The study followed a randomized bi-factorial experimental design and the Duncan multiple comparison test. This design allowed the selection of specific liquid media to fittingly standardize the counting of Salmonella  spp. and Shigella  spp. Results: We found that the best broth for counting Salmonella typhimurium strain at different concentrations in pure and mixed cultures was the Rappaport broth RP, the EE broth also allowed growing the two bacterial species tested in this research. Nonetheless, the latter results suggest the use of additional tests for this particular broth. Discussion: There was a variation in the counting results when pure cultures were used compared to those obtained from mixtures of microorganisms. It was also noted that Salmonella typhimurium and Shigella sonnei, were recovered from minimal concentrations in both RP and EE broths, respectively. To some extent, this suggests an additional confirmative method when using the EE® broth...

Introducción: La cloración es el método más usado para desinfectar aguas de consumo. La formación de subproductos cancerígenos y las intoxicaciones por manipulación directa en pequeñas comunidades, han motivado el estudio de procesos alternativos. Los procesos de oxidación avanzada (PAOS), han arrojado resultados prometedores, utilizando el indicador bacteriano Escherichia coli (E. coli), con el método recuento en placa. Sin embargo, también se ha demostrado que E. coli es menos resistente a la desinfección que otras bacterias entéricas como Shigella y Salmonella y que estos procesos generan bacterias viables que no se cultivan durante el proceso, y no se descubren en medios sólidos. Objetivo: Estandarizar un método de recuento de Salmonella sp. y Shigella sp., en medios de cultivo líquidos especializados, que permita valorar de forma confiable el riesgo bacteriológico en procesos de desinfección PAOS. Métodos: En el presente trabajo se ensayaron y seleccionaron medios líquidos especializados, con los que se estandarizó el recuento de Salmonella sp. y Shigella sp., mediante un diseño experimental aleatorizado bifactorial y la prueba de comparaciones múltiples de Duncan. Resultados: Se encontró que el mejor caldo para recuperar a S. typhimurium a diferentes concentraciones, en cultivos puros y mezclas, fue el caldo Rappaport de Merck (RP). El caldo de enriquecimiento para entero bacterias de Oxoid (EE), permitió un buen crecimiento de las dos especies objeto de esta investigación. Lo cual sugiere el empleo de pruebas adicionales cuando se use caldo EE para NMP. Discusión: Se observó una variación en el recuento cuando se usaron cultivos puros, comparado con la obtenida a partir de mezclas de microorganismos. Sin embargo, S. typhimurium. y Shigella sonnei logran ser recuperadas de concentraciones mínimas en los caldos RP, respectivamente...

Bacterial and parasitic profile of acute infectious pediatric diarrhoea and the role of faecal screening tests in prediction of the invasive type of diarrhoea

Diarrhoea is one of the leading causes of morbidity and mortality in children worldwide. Faecal screening methods as detection of faecal leucocytes, faecal lactoferrin and faecal occult blood, have diagnostic and therapeutic implications in the provisional diagnosis of invasive diarrhea before culture results made available. Aim of the work was to outline the bacterial and parasitic profile of acute pediatric diarrhoea and to evaluate faecal screening test in preliminary diagnosis of invasive diarrhoea. Three hundred children under five years of age, suffering from acute diarrhoea [<4 days] and attending the out-patient clinic of El Shatby Children's University Hospital in Alexandria over a period of 1 year, were recruited in the study. Stool samples were collected from the children and were subjected to bacteriological examination, parasitological examination and 3 faecal screening tests to distinguish invasive [inflammatory] from non invasive [non inflammatory] diarrhoea. Forty eight percent of samples were positive for enteric pathogens. Enteric bacterial pathogens were isolated from 25% of samples. Parasites 29% and mixed bacterial and parasitic infections were detected in 6% of samples. Enterotoxigenic E.coli [ETEC] was the most common bacterial isolate detected in 10% of samples, followed by Salmonella [8%], Shigella [6.67%] Campylobacter [5%] and Vibrio parahaemolyticus [1.33%]. Cryptosporidium was the most commonly identified parasite [13%] followed by Giardi lamblia [11%], Entamoeba histolytica [8%] and Cyclospora cayetanensis [3%]. Ascaris lumbricoides and Haeminolipus nana were only identified in 1% of samples, each. The gold standard for evaluation of faecal screening tests was positive culture for invasive bacterial pathogens and/or positive E. histolytica on microscopic examination of stool samples. Leuko test had the highest sensitivity [85.54%], specificity [73.73%], positive predictive value [55.47%], negative predictive value [93.02%] and accuracy [77%]. False positive results of the Leuko-test were significantly higher in the breast-fed children than non breast-fed ones [26.7%, 11.7% respectively, p<0.01]. Better sensitivity, specificity, positive and negative predictive values of the Leuko-test was recorded in the non breast-fed children than in the breast-fed ones. The recorded values in the first group were: 91.11%. 83.64%, 69.5% and 95.83%, respectively compared to 78.95%, 63.55%, 43.48% and 89.47% respectively in the second group. The study concluded that, Leuko test is the best applicable faecal screening test in differentiation of invasive and non invasive diarrhoea but is better avoided in breast-fed infants as many false positive results might be interpreted

Faecal contamination of feeding bottles contents, among artificially fed children

This study was carried out to investigate the bacterial contamination of feeding bottles contents in artificially fed children presenting with diarrhoea at the Paediatric outpatient clinic in Khartoum Hospital. Hundred bottle fed infants presenting with diarrhoea were included in the study. Specimens were collected from the contents of the feeding bottles and the faeces of children. Hundred and ten bacterial species were isolated from the contents. E. coli was the commonest isolate [33 [30%]]. Different other bacterial species were also isolated with very high count [1X10[6] - > 15X10[5]/ml]. Twenty one enteric pathogens were isolated from the stool specimens [Enteropathogenic E. coli [7] and Shigella species [14]]. The antibiotic sensitivity of the E. coli and Shigella species showed high resistance to co-trimoxazole [57.5%, 53.3% respectively] and to co-amoxiclav [85% - 53.3% respectively]. Awareness to the hazards of the feeding bottles among the community should be raised and breast feeding should be encouraged

Epidemiological studies on the role of fish in transmitting some zoonotic diseases to man

This study was performed for determination of the role played by fish in transmitting some bacterial and parasitic zoonoses to man. A total of 300 fish of Tilapia spp. were collected [50 from a farm in El-Fayoum Governorate, 100 from a farm in Beni-Suef Governorate and 150 from Beni-Suef markets]. In addition, 73 humans [60 fish sellers and 13 farm workers] were examined. Staph. aureus, Aeromonas hydrophila, Proteus spp., Shigella spp. Pseudomonas aeruginosa and Pseudomonas fluorescence were isolated from the examined fish at percentages of 4.3, 9.7, 3.0, 1.7, 2.0 and 2.0, respectively. Among the isolated bacteria, Staph. aureus, Proteus spp. and Shigella spp. were found restricted to fish skin and gills, while Aeromonas hydrophila and Pseudomonas spp. were isolated from all the examined fish bodyparts [skin, gills, muscles and internal organs] with varying percentages. Out of the examined fish, 26.7% were harboring parasitic cysts including metacercariae of CHnostomum complanatum, Heterophyes heterophyes, Centrocestus armatus and Haplorchis pumilio. Examination of hand swabs obtained from humans demonstrated that 12.3% revealed a positive result for Staph. aureus. Among farm worker stool samples examined, 7.7% tested positively for Staph. aureus and 15.4% were Aeromonas hydrophila-positivQ. None of the parasites recovered from fish was detectable in humans. It was concluded that fish sold in the examined localities may occasionally represent a serious threat to public health as a result of its content of zoonotic fish pathogens

Prevalence of Shigella serogroups and their antimicrobial resistance patterns in southern Trinidad.

The serogroup distribution and antimicrobial susceptibility patterns of Shigella isolates obtained from stool specimens of persons with acute diarrhoea in community-based studies from southern Trinidad during 1997-2006 were reviewed. Of the 5,187 stool specimens, 392 (8%) were positive for Shigella organisms. From these 392 isolates, 88.8% were recovered from children aged >0-10 year(s). Shigella sonnei was the most frequently-isolated serogroup (75%), followed by S. flexneri (19%), S. boydii (4.1%), and S. dysenteriae (1.8%). S. flexneri was the major isolate among the >20-30 years age-group. The most common drug resistance among all age-groups was to ampicillin. All strains of S. flexneri, S. boydii, and S. dysenteriae were fully susceptible to aztreonam, gentamicin, and ciprofloxacin. S. sonnei, the most common species isolated, showed resistance to all antibiotics tested. The data showed that, throughout the study period, the resistance to commonly-used drugs was relatively low. Since resistance to several drugs seems to be emerging, continuous monitoring of resistance patterns is mandatory for the appropriate selection of empiric antimicrobial drugs in the therapy of suspected cases of shigellosis.

Nota sobre infecção por Salmonella sp. e Shigella sp. em bugios-ruivos, Alouatta clamitans Cabrera, 1940 (Primates: atelidae) mantidos em cativeiro / Note about Salmonella sp. and Shigella sp. infections in southern brown howler monkeys, Alouatta clamitans Cabrera, 1940 (Primates: atelidae) on captivity

Amostras de fezes de bugios-ruivos cativos foram investigadas quanto a presença de Salmonella sp. e Shigella sp. O padrão de sensibilidade a antibióticos foi testado. Este é o primeiro relato de infecção assintomática por Salmonella sp. nesta espécie. Não foi detectada infecção por Shigella sp. Destaca-se a importância de investigação em animais submetidos a translocação ou a reintrodução e a necessidade de inquéritos periódicos em populações cativas a fim de se evitar agravos ocupacionais.

Fecal samples of captive souther brown howler monkeys were screened for the presence of Salmonella sp. and Shigella sp. The sensibility for antibiotics was also measured. This is the first report of asymptomatic infection by Salmonella sp. in this specie. Shigella sp. infection was not detected. Screening for this bacteria should be performed during translocation and reintroduction programs. We recommend periodic investigations to prevent occupational hazard on captivity.

Occurrence of Campylobacter jejuni in Shiraz, Southwest Iran

To investigate the occurrence of Campylobacter jejuni among other bacterial agents of acute diarrhea. Over a period of 3 months, 114 specimens of acute diarrhea were collected from patients aged 2-58 years referred to Nemazi Hospital, Shiraz, Iran. The samples were tested for bacterial pathogens causing acute diarrhea. Of the 114 samples, 40 proved to be positive for bacterial enteric pathogens: C. jejuni 11 [9.6%], Salmonella spp.18 [15.8%] and Shigella spp. 11 [9.6%]. Maximum prevalence of C. jejuni was observed in patients aged 11-15 years. Significantly more females than males were infected with all diarrheal agents [p <0.05]. This study confirmed the presence of C. jejuni as a significant cause of gastroenteritis in Shiraz, Southwest Iran

Biodiagnóstico de las diarreas agudas bacterianas y virales / Biodiagnóstico of acute bacterial and viral diarrhea

El diagnóstico de las diarreas agudas bacterianas se realiza mediante la prescripción de coprocultivos típicos u orientados, realizados después del interrogatorio. Después del examen macroscópico y microscópico de las heces (diagnóstico de orientación), el cultivo puede poner en evidencia Salmonella, Shigella, Campylobacter o Yersinia, que serán siempre considerados como patógenos, mientras que, salvo excepción notable, la presencia de E. coli forma parte de la flora cólica comensal. En el niño, los agentes responsables de las gastroenteritis virales son, por orden devreciente de frecuencia, los rotavirus (sobre todo los del grupo A), calicivirus, astrovirus y adenovirus. En el diagnóstico virológico de rutina sólo se detectan rotavirus y adenovirus 40-41. Algunos coprocultivos se realizan en el curso de un cotexto epdemiológico-clínico particular en búsqueda de bacterias enteropatógenas como Vibrio cholerae, Clostridium difficile o E. Coli enterohemorrágico. Este patotipo de E. Coli puede ser responsable del síndrome hemolítico y urémico ligado a la producción de toxinas. Su responsabilidad a menudo se establece por cultivo después de serotipado, por detección de las toxinas producidas o más raramente por métodos serológicos. La diarrea aguda es un fenómeno patológico definido según la OMS por la emisión de al menos tres heces líquidas o blandas al fía con menos de 14 días de antelación. Puede tener diferentes orígene, infecciosos o no. Cuando el origen de la diarrea aguda es infeccioso puede ser bacteriana, viral o parasitaria. Es frecuente en el niño,en el que representa una causa mayor de morbilidad y mortalidad en el mundo. En Frencia, cerca de tres millones de pacientes consultan por una diarrea aguda y sólo del 3 al 4% de estas consultas originan la prescripción de un coprocultivo (1). Es importante para el microbiólogo conseguir informació de los signos clínicos (dolores abdominales, fiebre, aspecto de las heces) y del contexto epidemiológico...