Epidemiological characteristics of Yersinia enterocolitica in patients with diarrhea from 2013 to 2019 in Pudong New Area, Shanghai / 中华预防医学杂志

Objective: To investigate the epidemiological characteristics of Yersinia enterocolitica in patients with diarrhea in Pudong New Area, Shanghai. Methods: Active surveillance of diarrhea was conducted in 14 sentinel hospitals (three tertiary-level hospitals, nine secondary-level hospitals, and two primary-level hospitals) from January 2013 to December 2019 in Pudong New Area of Shanghai, China base on their location, catchment area, and patient volume. Cold enrichment method was used to isolate Y. enterocolitica and further detection of bioserotype, virulence genes and antimicrobial susceptibility of the isolates were conducted. The difference of rates was determined using chi-square test or Fisher's exact test. Results: A total of 12 941 diarrhea cases were included, and 0.7% (88/12 941) cases were confirmed with Yersinia enterocolitica infection. 67.0% (59/88) cases were single infection, 33.0% (29/88) cases were mixed infections. Detection rates of Y. enterocolitica increased annually (0.3%-1.2%) and were highest in children<5 years of age (1.1%, 37/3 218) and in spring (1.1%, 32/2 998) (χ2 were 18.64 and 9.76, respectively, P<0.05). 58.0% (51/88) cases had watery diarrhea, 15.9% (14/88) had fever and 14.8% (13/88) had vomiting. The predominant bioserotypes were 3/O:3 (53.4%, 47/88), followed by 1A/O:8 (15.9%, 14/88) and 1A/O:5(6.8%, 6/88), respectively. Bioserotype 3/O:3 counted for the highest proportions (89.2%, 33/37) in children <5 years of age. All the strains of bioserotype 3/O:3 harbored ail, ystA, yadA and virF genes, which encoded pathogenic Y. enterocolitica. 11/14 strain of 1A/O:8 and 4/6 strains of 1A/O:5 harbored ystB gene. Most strains were resistant to ampicillin (80.7%,71/88) and amoxicillin/clavulanic acid (71.6%,63/88), and 63.8% (56/88) strains were multidrug resistance (MDR). The difference of antimicrobial resistance rates between 3/O:3 and non 3/O:3 was statistically significant in ampicillin, cefoxitin, nalidixic acid, tetracycline and ampicillin/sulbactam (χ2 was 14.68, 43.80, 41.86, 30.54 and 5.07, respectively, P<0.05). Conclusion: The detection rate of Yersinia enterocolitica was higher in children than in adults in Pudong New Area , Shanghai. The predominant bioserotype was pathogenic 3/O:3 with multidrug resistance.

Sepsis due to Yersinia enterocolitica in an aborted equine fetus: case report / Sepse por Yersinia enterocolitica em um feto equino abortado: relato de caso

Yersinia enterocolitica is a bacterium with zoonotic potential and there are no previous records of this bacteria being isolated from aborted foals. This report aims to describe a case of sepsis due to Y. enterocolitica in a seven month old aborted equine. The fequinoetus was submitted to necropsy and samples of all the organs were collected for the histological exam. Samples of liver, lung, placenta, and stomach contents were collected for bacterial culture. Macroscopically, the liver was enlarged with yellowish heterogeneous color, heart with pale myocardial areas; lungs not collapsed, heavy and shiny, thickened umbilical cord covered with fibrin and pus. Histopathologically, there was moderate multifocal necrosuppurative myocarditis and thrombosis, moderate diffuse suppurative bronchopneumonia, mild multifocal fibrinonecrotic hepatitis, and moderate diffuse necrosuppurative omphalitis with intralesional bacterial myriads and thrombosis. Mild multifocal suppurative placentitis, nephritis, myositis, cystitis, and dermatitis were also observed, in addition to mild diffuse lymphoid rarefaction. The microbiological evaluation identified Y. enterocolitica in the liver, lung, and stomach fluid. This is the first report of sepsis due to Y. enterocolitica causing an abortion in a horse. This bacterium has zoonotic importance; therefore, it should be investigated in abortion in this species, serving as a differential diagnosis in reproductive disorders.(AU)

Yersinia enterocolitica é uma bactéria com potencial zoonótico, e não há informações desse agente como causa de abortamento em equinos. O objetivo deste relato é descrever um caso de sepse por Y. enterocolitica em um feto equino abortado aos sete meses. O feto foi submetido à necropsia, e amostras de todos os órgãos foram processadas para histopatologia. Para microbiologia, foram coletadas amostras de fígado, pulmão, placenta e conteúdo estomacal. Macroscopicamente, observou-se fígado aumentado com coloração amarelada heterogênea; coração com áreas pálidas no miocárdio; pulmões não colabados, pesados e brilhantes; e cordão umbilical espessado e recoberto por fibrina e pus. Na análise histopatológica, havia miocardite necrossupurativa multifocal moderada e trombose, broncopneumonia supurativa difusa moderada, hepatite fibrinonecrótica multifocal discreta e onfalite necrossupurativa difusa moderada com miríades bacterianas intralesionais e trombose. Observou-se também placentite, nefrite, miosite, cistite e dermatite supurativa multifocal discreta, além de rarefação linfoide difusa discreta. A avaliação microbiológica identificou Y. enterocolitica no fígado, no pulmão e no líquido estomacal. Este é o primeiro relato de sepse por Y. enterocolitica causando abortamento na espécie equina. Essa bactéria tem importância zoonótica, portanto deve ser investigada em casos de abortamento nessa espécie, servindo como diagnóstico diferencial em tal distúrbio reprodutivo.(AU)

Virulence genotyping and antimicrobial resistance profiles of Yersinia enterocolitica isolated from meat and meat products in Egypt / Genotipagem de virulência e perfis de resistência antimicrobiana de Yersinia enterocolitica isolados de carne e derivados no Egito

Pathogenic Yersinia enterocolitica (Y. enterocolitica) is one of the food-borne entero-pathogen responsible for yersiniosis in humans. The purpose of this research was to survey the prevalence, virulence-associated genes, and antimicrobial resistance of Y. enterocolitica isolated from meat and meat product samples in Egypt. Forty-one (5.9%) out of 700- samples of chicken meat, beef, ground beef, and sausage were positive Y. enterocolitica with a high prevalence in chicken meat (12%). Five virulence genes (ail, inv, ystA, ystB, and yadA) were characterized among 41 Y. enterocolitica isolates with variable frequencies. Among the strains tested, the ystB gene was detected with a high percentage (78.1%), followed by inv gene (70.7%), ail gene (14.6%), ystA gene (12.2%), and yadA gene (2.4%). A high resistance rate was estimated to amoxicillin-clavulanic acid (100%), followed by cefazolin (95%), ampicillin (65.9%), and doxycycline (51.2%), whilst a high sensitivity rate was observed to gentamicin and ciprofloxacin (97.6% each). Interestingly, the multidrug resistance was specified in the 70.7% of strains and showing 13 resistance patterns. Based on nucleotide sequence analysis of the 16s rRNA gene, the phylogenetic tree showed the genetic relatedness amongst Y. enterocolitica isolates. These findings highlighted the emergence of virulent and multidrug-resistant pathogenic Y. entrocolitica in retailed meat and meat products in Egypt.

A Yersinia enterocolitica patogênica (Y. enterocolitica) é um dos enteropatógenos de origem alimentar responsáveis pela yersiniose no ser humano. O objetivo desta pesquisa foi avaliar a prevalência, genes associados à virulência e resistência antimicrobiana de Y. enterocolitica isolada de amostras de carne e produtos à base de carne no Egito. Quarenta e um (5,9%) de 700 amostras de carne de frango, carne bovina, moída e linguiça foram Y. enterocolitica positivas, com alta prevalência em carne de frango (12%). Cinco genes de virulência (ail, inv, ystA, ystB e yadA) foram caracterizados entre 41 isolados de Y. enterocolitica com frequências variáveis. Entre as cepas testadas, o gene ystB foi detectado com uma alta porcentagem (78,1%), seguido pelo gene inv (70,7%), ail genes (14,6%), gene ystA (12,2%) e gene yadA (2,4%). Foi estimada uma alta taxa de resistência ao ácido amoxicilina-clavulânico (100%), seguida de cefazolina (95%), ampicilina (65,9%) e doxiciclina (51,2%), enquanto uma alta taxa de sensibilidade foi observada para gentamicina e ciprofloxacina (97,6% cada). Curiosamente, a resistência a múltiplas drogas foi especificada em 70,7% das cepas e mostrando 13 padrões de resistência. Com base na análise da sequência nucleotídica do gene rRNA 16s, a árvore filogenética mostrou a relação genética entre isolados de Y. enterocolitica. Esses achados destacaram o surgimento de Y. entrocolitica patogênica virulenta e multirresistente em carnes e produtos à base de carne no Egito.

Investigation of Listeria monocytogenes, Salmonella enterica and Yersinia enterocolitica in pig carcasses in Southern Brazil / Pesquisa de Listeria monocytogenes, Salmonella enterica and Yersinia enterocolitica em carcaças de suínos no sul do Brasil

The intensification of pig production and advances in the sanitary control of herds profoundly changed the profile of risk attributed to pork consumption. In the actual scenario, most microorganisms related to macroscopic lesions observed in the post mortem inspection are not transmitted by food, while foodborne bacteria of importance to consumer health do not cause macroscopic lesions. In Brazil, the "Ministério da Agricultura, Pecuária e Abastecimento" requested a scientific opinion on the prioritizing of pathogens potentially transmitted by unprocessed pork. After conducting a qualitative risk assessment, only Salmonella enterica was classified as of high risk to consumers. The present study was part of the validation step of the risk assessment and aimed to investigate the frequency of S. enterica, Yersinia enterocolitica and Listeria monocytogenes and hygienic-sanitary indicators in pig carcasses of pigs rose under intensive production and slaughtered under the Federal Inspection System in three slaughterhouses located in Southern Brazil. Additionally, the antimicrobial resistance profile of the isolated pathogens was also investigated. A total of 378 carcasses were sampled by superficial sponges before the chilling step in three slaughterhouses. Samples were investigated for the presence of the three aforementioned pathogens and subjected to enumeration of Colony Formation Units (log CFU.cm-1) of total aerobic mesophiles (TAM) and Enterobacteriaceae. Salmonella strains were tested by disc diffusion test for resistance to eleven antimicrobials. There were significantly statistical differences (p<0.0001) on the median counts of both indicators between the slaughterhouses. The median of TAM was very close for Slaughterhouses A and B: 1.573 log CFU.cm-1 and 1.6014 log CFU.cm-1, respectively. While in Slaughterhouse C, a higher TAM median was detected (2.216 log CFU.cm-1). A similar profile was observed regarding to Enterobacteriaceae, and medians were calculated as follow: -0.426 log CFU.cm-1 in Slaughterhouse A; 0.2163 log CFU.cm-1 in B; and 0.633 log CFU.cm-1 in C. Regarding the pathogens investigated, L. monocytogenes was not detected and only one carcass from Slaughterhouse C was positive for Y. enterocolitica. Thus, the results suggest a very low prevalence of L. monocytogenes and Y. enterocolitica in the sampled population. A total of 65 (17.2%) carcasses were positive for S. enterica, with a difference in frequencies between slaughterhouses and slaughter days. The prevalence of Salmonella positive carcasses was higher in the Slaughterhouse C (25.4%; CI 95% 19-32%) in comparison with A (9.5%; CI 95% 9-14%) and B (18.3%; CI 95% 12-24%). There was no significantly statistical association between Enterobacteriaceae counts and Salmonella isolation on carcass surface (p=0.69). The slaughtering day, nested within the slaughterhouse, explains 31.3% of Salmonella prevalence variability. S. Typhimurium (38.1%) was the most prevalent, followed by S. Infantis (30.1%). Among the 61 Salmonella strains tested for resistance to antimicrobials, 18 (31.6%) were full-susceptible. No strain displayed resistance to azithromycin, ceftazidime, cefotaxime and meropenem. The highest resistance frequency was displayed to tetracycline (54.1%), followed by ampicillin (50.82%), nalidixic acid (42.62%) and chloramphenicol (42.62). Multi-resistance was detected in 52.54% of the, strains. In conclusion, S. enterica is more prevalent in pre-chill pig carcasses than Y. enterocolitica and L. monocytogenes and thus should be prioritized in monitoring and control programs at slaughter. Salmonella serovars varied among slaughterhouses and present significant differences in their resistance to antimicrobials. Slaughterhouses that present higher medians of TAM or Enterobacteriaceae in a monitoring period may have higher S. enterica prevalences as well. However, there is a high variation of S. enterica prevalence among slaughter days, which cannot be always related to the hygienic indicators counts observed on a given day.(AU)

A intensificação da produção de suínos e os avanços no controle sanitário dos rebanhos alterou de forma importante o perfil de risco do consumo de carne suína. No cenário atual, a maioria dos microrganismos causadores de lesões macroscópicas detectáveis na inspeção post mortem não são transmissíveis por alimentos, enquanto bactérias de importância como causadoras de doenças transmitidas por alimentos não causam lesões macroscópicas. No Brasil, o Ministério da Agricultura, Pecuária e Abastecimento solicitou uma opinião científica sobre a priorização de patógenos potencialmente transmitidos pela carne suína in natura. Após conduzir uma avaliação de risco qualitativa, apenas Salmonella enterica foi classificada como de alto risco para o consumidor. O presente estudo foi parte da etapa de validação da avaliação de risco e objetivou: investigar a frequência de S. enterica, Yersinia enterocolitica e Listeria. monocytogenes; e enumerar indicadores higiênico-sanitários em carcaças de suínos abatidos sob inspeção federal em frigoríficos dedicados ao abate de suínos sob sistema intensivo de criação no sul do Brasil. Além disso, o perfil de resistência a antimicrobianos dos patógenos isolados foi investigado. A superfície de um total de 378 carcaças foi amostrada por esponjas, na etapa de pré-resfriamento em três matadouros frigoríficos (A, B, C). As amostras foram investigadas quanto à presença dos três patógenos acima mencionados e quanto à enumeração de Unidades Formadoras de Colônia (log UFC.cm-1) de mesófilos aeróbios totais (MAT) e Enterobacteriaceae. As cepas isoladas de Salmonella foram testadas quanto à resistência a onze antimicrobianos pela técnica de disco difusão. As medianas de contagem de ambos os indicadores apresentaram diferença significativa (p<0,0001) entre matadouros-frigoríficos. A mediana de MAT foi bastante próxima para A e B (1,573 log UFC.cm-1 e 1,6014 log UFC.cm-1, respectivamente), enquanto em C uma mediana de MAT mais elevada foi determinada (2,216 log CFU.cm-1). Um perfil semelhante foi observado em relação a Enterobacteriaceae, sendo as medianas calculadas para A, B e C, respectivamente: -0,426 log CFU.cm-1; 0,2163 log UFC.cm-1; e 0,633 log UFC.cm-1. Em relação aos patógenos investigados, L. monocytogenes não foi detectada e apenas uma carcaça, do Matadouro C, foi positiva para Y. enterocolitica. Portanto, os resultados sugerem uma prevalência muito baixa desses patógenos na população amostrada. Em um total de 65 (17,2%) carcaças houve isolamento de S. enterica, com diferença nas frequências observadas entre matadouros e dias de abate. A prevalência de carcaças positivas para S. enterica foi maior no Matadouro C (25,4%; IC95% 19-32%) em comparação com A (9,5%; IC95% 9-14%) e B (18,3%; IC95% 12-24%). Não houve associação estatística entre o número de Enterobacteriaceae e o isolamento de S. enterica na superfície das carcaças (p=0,69). O dia de abate agrupado por frigorífico explica 31,3% da variação na prevalência de Salmonella. O sorovar mais frequente de S. enterica foi Typhimurium (38,1%) seguido de S. Infantis (30,1%). Entre as 61 cepas de S. enterica testadas quanto à resistência a antimicrobianos, 18 (31,6%) foram totalmente suscetíveis aos antimicrobianos testados. Nenhuma cepa apresentou resistência a azitromicina, ceftazidima, cefotaxima e meropenem. As maiores frequências de resistência foram demonstradas contra tetraciclina (54,1%), ampicilina (50,8%), ácido nalidíxico (42,62%) e cloranfenicol (42,62%). Em 52,54% das cepas foi detectada multi-resistência. Em conclusão, S. enterica é mais prevalente em carcaças suínas no pré-resfriamento do que Y. enterocolitica e L. monocytogenes. Portanto, S. enterica deve ser priorizada em programas de monitoramento e controle ao abate. Os sorovares de Salmonella variam entre matadouros e apresentam diferenças significativas na resistência a antimicrobianos. Matadouros de suínos que apresentam medianas de MAT e Enterobacteriaceae num período de monitoramento podem apresentar também prevalências mais de altas de presença de S. enterica. Entretanto, há uma alta variabilidade na frequência de S. enterica entre dias de abate, e nem sempre há relação entre essa frequência e a contagem de indicadores higiênico-sanitários determinados num determinado dia.(AU)

Ileítis terminal por Yersinia enterocolitica: diagnóstico diferencial con la enfermedad de Crohn en un varón de 12 años / Terminal ileitis due to Yersinia enterocolitica: differential diagnosis with Crohn ́s disease in a 12-year-old male

Yersinia enterocolitica es un bacilo Gram-negativo causante de infección intestinal en los humanos. Se presenta con diferentes cuadros clínicos que obligan a descartar una variedad de etiologías, lo cual, a veces, hace difícil alcanzar un diagnóstico correcto en forma oportuna.Se expone el caso de un varón adolescente con dolor en la fosa ilíaca derecha a partir de una ileítis terminal con hallazgos similares a la enfermedad de Crohn, que se diagnosticó, finalmente, como infección por Yersinia enterocolitica. Se destaca la utilidad de los diferentes métodos auxiliares empleados.

Yersinia enterocolitica is a gram-negative rod causing intestinal infection in humans. It shows different clinical pictures with many different etiologies to be ruled-out, which sometimes makes it difficult to reach a timely and correct diagnosis. We report the case of an adolescent boy presenting with right lower quadrant pain from terminal ileitis with endoscopic findings akin to Crohn ́s disease finally diagnosed as Yersinia enterocolitica, highlighting the usefulness of the different ancillary methods employed.

Effectiveness of aqueous and hydroalcoholic extracts of Acanthospermum australe (Loefl) Kuntze against diarrhea-inducing bacteria / Eficácia de extratos aquosos e hidroalcoólicos de Acanthospermum australe (Loefl) Kuntze contra bactérias indutoras de diarreia

Abstract Leaves and roots of Acanthospermum australe (Asteraceae) have been used in Brazilian folk medicine for the treatment of various ailments including diarrhea, skin diseases, blennorrhagia, dyspepsia, parasitic worms and malaria. The aim of study was to characterize the chemical profiles of the aqueous and hydroalcoholic extracts of leaves and roots of A. australe, and to evaluate their antimicrobial activities against diarrhea-inducing bacteria (Enterococcus faecalis, Shigella dysenteriae and Yersinia enterocolitica), as well as their cytotoxic properties. Aqueous leaf extracts were obtained by infusion, while aqueous root extracts were obtained by decoction. The hydroalcoholic leaf and root extracts were prepared by maceration in 90% ethanol for 3 days. Antimicrobial activity was assessed using standard techniques and cytotoxicity was evaluated using Chinese hamster ovary cells CHO-K1. Chemical analysis revealed the presence of tannins, flavonoids, saponins and phenolic compounds in the extracts. Although root extracts were not effective against E. faecalis, leaf extracts at concentrations of 20 mg/mL exhibited bactericidal activities against this microorganism. The hydroalcoholic root extract was unique in presenting a bactericidal effect against S. dysenteriae. None of the extracts showed bacteriostatic or bactericidal activities against Y. enterocolitica. The results presented herein demonstrate that the Gram-positive E. faecalis and the Gram-negative S. dysenteriae were susceptible to A. australe extracts, although bacteriostatic/bactericidal activities were only observed at concentrations considered too high for clinical application. Our results support the ethnopharmacological use of A. australe in the treatment of gastrointestinal disorders, particularly diarrhea caused by infectious bacteria, although further studies are required to determine the anti-diarrhea effects and the toxicities of the extracts in vivo.

Resumo Folhas e raízes de Acanthospermum australe (Asteraceae) têm sido usadas na medicina popular brasileira para o tratamento de várias doenças, incluindo diarreia, doenças de pele, blenorragia, dispepsia, vermes parasitas e malária. O objetivo deste estudo foi caracterizar os perfis químicos dos extratos aquosos e hidroalcoólicos das raízes e folhas de A. australe, e avaliar as suas atividades antimicrobianas contra as bactérias indutoras de diarreia (Enterococcus faecalis, Shigella dysenteriae e Yersinia enterocolitica), bem como sua citotoxicidade. Os extratos aquosos de folhas foram obtidos por infusão, enquanto que os extratos aquosos de raízes foram obtidos por decocção. Os extratos hidroalcoólicos de folhas e raízes foram preparados por maceração em etanol a 90% durante 3 dias. A atividade antimicrobiana foi avaliada utilizando técnicas padrão e a citotoxicidade foi avaliada utilizando células de ovário de hamster chinês CHO-K1. A análise química revelou a presença de taninos, flavonóides, saponinas e compostos fenólicos nos extratos. Apesar de extratos de raiz não foram eficazes contra E. faecalis, extratos de folhas em concentrações de 20 mg/mL apresentaram atividades bactericidas contra este microrganismo. O extrato hidroalcoólico de raiz foi o único a apresentar um efeito bactericida contra S. dysenteriae. Nenhum dos extratos apresentaram atividades bacteriostáticas ou bactericidas contra Y. enterocolitica. Os resultados apresentados demonstram que a bactéria Gram-positiva E. faecalis e a Gram-negativa S. dysenteriae foram suscetíveis aos extratos de A. australe, embora as atividades bacteriostáticos/bactericidas tenham sido apenas observados em concentrações consideradas elevadas para aplicação clínica. Os nossos resultados apoiam a utilização de etnofarmacológica de A. australe no tratamento de perturbações gastrointestinais, especialmente diarreia causadas por bactérias infecciosas, embora sejam necessários mais estudos para determinar os efeitos anti-diarreia e as toxicidades dos extratos in vivo.

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)

Multiplex PCR Based Epidemiological Study for the Causes of Acute Diarrheal Disease in Adults Living in Jeju Island / 대한임상미생물학회지

BACKGROUND: We attempted to determine the characteristics of diarrheal pathogens according to species, seasonal variations, and patient age using multiplex PCR for the epidemiologic study of diarrheal disease in Jeju Island. METHODS: From March 2015 to Feb 2017, stool specimens were collected from 537 diarrheal patients older than 16 years. Multiplex PCR was used to identify pathogens and found Group A Rotavirus, enteric Adenovirus, Norovirus GI/GII, Astrovirus, Salmonella spp., Shigella spp., Vibrio spp., Campylobacter spp., Clostridium difficile toxin B (CDB), Clostridium perfringens, Yersinia enterocolitica, Aeromonas spp., Escherichia coli O157:H7, and verocytotoxin-producing E. coli (VTEC). RESULTS: Pathogens were isolated from 221 of 537 samples (41.2%); 9.3% were positive only for viral pathogens; 30.2%, only for bacterial pathogens; and 1.7%, for both viral and bacterial pathogens. Bacteria were more prevalent in spring, summer, and autumn, but viral pathogens were more prevalent in winter. Overall prevalence were Campylobacter spp. (26.7%), Clostridium perfringens (23.9%); Norovirus GII (11.4%), CDB (8.2%), Aeromonas spp. (6.3%), Group A Rotavirus (5.1%), Salmonella spp. (3.9%), Astrovirus (3.9%), Norovirus GI (3.1%), Vibrio spp (2.7%), enteric Adenovirus (1.6%), Shigella spp. (1.2%), VTEC (1.2%), and Yersinia enterocolitica (0.4%). Group A Rotavirus and Norovirus GII were more prevalent in winter and early spring. Campylobacter spp., CDB, and C. perfringens were detected frequently, without seasonal variation. CONCLUSION: Bacterial pathogens are more prevalent than viruses in acute diarrhea in adults living in Jeju Island, especially in spring, summer, and autumn. Viral pathogens are prevalent in winter. Campylobacter spp., CDB, and Clostridium perfringens are the major pathogens occurring without seasonal variations. These data will be helpful in identifying diarrheal pathogens and for treatments and prevention strategies.

The influence of glycerol upon L. reuteri activity against enteropathogens / A influência do glicerol sobre a atividade de L. Reuteri contra enteropatógenos

BACKGROUND: Probiotics containing L. reuteri are popular for treating and preventing bacterial gastrointestinal infections. L. reuteri, produces reuterin, an antibiotic that inhibits gram-negative bacteria. Reuterin production is the result of glycerol fermentation by L reuteri. Although L. reuteri is normally present in the gastrointestinal system, only small amounts of glycerol are usually available; therefore, the production of reuterin may not occur and this could reduce the effectiveness of the probiotic supplement. Our objective is to identify the minimum concentrations of glycerol required for L. reuteri to exert an inhibitory effect on enteropathogenic enterobacteriaceae. METHOD: Samples containing 10(8) colony forming units (CFU) of L. reuteri DSM17938 (Colikids®, Ache, Brazil/BioGaia, Sweden) were grown with varying concentrations of glycerol (0.05-5%). 10(6) CFU of E.coli (CDC0126/INCQS/FIOCRUZ), Shigella flexneri (ATCC/120022), S. enterica (ATCC6539) and Y. enterocolitica (ATCC9610) were inoculated with L. reuteri in the different glycerol concentrations. Each enterobacteria and glycerol 5% without L. reuteri cultures were used as positive control groups. RESULTS: All bacteria were completely inhibited at higher ranges of glycerol concentrations (0.2-5%) and grew at lower concentrations (0.05-0.1%). CONCLUSION: L. reuteri requires at least 0.2% of glycerol to completely inhibit enterobacterial growth. These preliminary findings may influence the current method of use of probiotic supplements. The antibiotic activity of L. reuteri may have potential clinical use against important enteropathogens.

CONTEXTO: Os probióticos que contêm L. reuteri são populares para tratar e prevenir infecções bacterianas do trato gastrointestinal. L. reuteri produz reuterina, um antibiótico que inibe bactérias gram-negativas. A produção de reuterina depende da presença de quantidades adequadas de glicerol, cuja fermentação resulta na produção do antibiótico. Embora L. reuteri esteja normalmente presente no sistema GI, apenas pequenas quantidades de glicerol estão geralmente disponíveis; portanto, a produção de reuterina pode não ocorrer o que poderia reduzir a eficácia do suplemento probiótico. Nosso objetivo é identificar as concentrações mínimas de glicerol necessárias para que L. reuteri exerça um efeito inibitório nas enterobacteriaceas enteropatogênicas. MÉTODO: 108 CFU de L. reuteri DSM17938 (Colikids®, Ache, Brasil / BioGaia, Suécia) cresceu com concentrações variáveis de glicerol (0,05-5%). Foram inoculadas 106 UFC de E. coli (CDC0126 / INCQS / FIOCRUZ), Shigella flexneri (ATCC / 120022), S. enterica (ATCC6539) e Y. enterocolitica (ATCC9610) com L. reuteri nas diferentes concentrações de glicerol. Cada enterobacteria e glicerol 5% sem culturas de L. reuteri foram utilizadas como grupos de controle positivo. RESULTADOS: Todas as bactérias foram completamente inibidas em maiores concentrações de glicerol (0.2-5%) e cresceram em concentrações mais baixas (0.05-0.1%). CONCLUSÃO: L. reuteri requer pelo menos 0,2% de glicerol para inibir completamente o crescimento de enterobacteria. Essas descobertas preliminares podem influenciar o método atual de uso de suplementos de probióticos. A atividade antibiótica de L. reuteri pode ter potencial uso clínico contra importantes enteropatógenos.

Next-generation sequencing virulome analysis of a Yersinia enterocolitica subsp. palearctica bioserotype 4/O: 3 ST18 isolated from human blood in Brazil

Abstract Yersinia enterocolitica is a widespread Gram-negative bacterium that causes gastrointestinal disease and other clinical manifestations in humans. Potentially pathogenic Y. enterocolitica has been isolated in Brazil, from human, environmental, food, and animal sources. Herein we report a genome sequence of Y. enterocolitica subsp. palearctica strain YE 19, serotype O:3, biotype 4, sequence type 18, with virulence determinants isolated from human blood in Rio de Janeiro in 2005. The results corroborate other findings that this strain harbors a set of virulence determinants that could play a role in host pathoadaptation and may also justify the successful dissemination of bioserotype 4/O:3 in Brazil. The presence of strains harboring all of these virulence genes in Brazil is a potential threat to young children and immunocompromised individuals, for whom yersiniosis are a significant source of morbidity and mortality. The results of a genomic data analysis will help understand the virulence of Brazilian strains and provide data for Y. enterocolitica studies worldwide.

Brotes de enfermedades transmitidas por los alimentos estudiados mediante técnicas moleculares / Foodborne disease outbreaks studied by molecular techniques

RESUMEN Objetivo Aplicar una técnica de reacción en cadena de la polimerasa (PCR) múltiple en tiempo real para la detección de Salmonella spp., Listeria monocytogenes y Yersinia enterocolitica, como herramienta de apoyo diagnóstico en la vigilancia de brotes de enfermedad transmitida por alimentos. Materiales y Métodos Se aplicó la metodología molecular en muestras clínicas provenientes de individuos que estaban asociados a brotes de enfermedad transmitida por alimentos de dos departamentos de Colombia. Los resultados se compararon con los datos arrojados por la metodología convencional de cultivo. Adicionalmente a los aislamientos obtenidos se les evaluó relación clonal mediante la técnica de electroforesis de campo pulsado (PFGE). Resultados Se determinó un total de 123 casos de enfermedad transmitida por alimentos de los cuales 45 muestras biológicas fueron confirmadas por laboratorio y 88 mediante nexo epidemiológico. La metodología molecular detectó 35/45 muestras positivas frente a 17/45 muestras positivas detectadas mediante la metodología convencional. La PFGE demostró relación clonal en cada brote. Conclusión Los resultados del estudio demuestran la aplicabilidad de la técnica molecular como herramienta útil de apoyo diagnóstico en la caracterización de brotes de enfermedad transmitida por alimentos, permitiendo una respuesta oportuna y confiable.(AU)

ABSTRACT Objective To apply a multiplex real-time polymerase chain reaction (PCR) technique to detect Salmonella spp., Listeria monocytogenes, and Yersinia enterocolitica as a diagnostic support tool for the surveillance of foodborne disease outbreaks. Materials and Methods Molecular methodology was applied on clinical samples taken from individuals who were associated with foodborne disease outbreaks in two departments of Colombia. The results were compared with the data obtained by conventional culture methodology. In addition, the clonal relation of the isolations was evaluated using the Pulsed Field Gel Electrophoresis (PFGE) technique. Results 123 cases of foodborne disease were determined, of which 45 biological samples were confirmed by laboratory and 88 by epidemiological link. The molecular methodology detected 35/45 positive samples versus 17/45 positive samples detected by conventional methodology. PFGE demonstrated a clonal relation during each outbreak. Conclusion The results of the study demonstrate the applicability of the molecular technique as a useful diagnostic support tool to characterize foodborne disease outbreaks, allowing a timely and reliable response.(AU)

Antimicrobial resistance and plasmid replicons in Yersinia enterocolitica strains isolated in Brazil in 30 years

Abstract Some studies evaluated the resistance profile of the Y. enterocolitica strains isolated in diverse countries. However, in Brazil the isolation and the study of Y. enterocolitica are not common and therefore information about the antimicrobial resistance profile of this species in this country is scarce. Therefore, the aim of this study was to evaluate the antimicrobial resistance of Y. enterocolitica of biotypes 1A, 2 and 4 isolated from clinical and non-clinical sources between 1979 and 2012, in Brazil. This study showed that some Yersinia enterocolitica of different biotypes remain susceptible to antimicrobials used for gastroenteritis treatment. Moreover, neither acquired resistance genes nor diversity of plasmids replicons were found; however, variation in the in vitro intrinsic resistant pattern was detected, except the non-resistance to cefoxitin in all strains. Notwithstanding, due to epidemiological link between Y. enterocolitica and the pork production chain, monitoring plasmid acquired resistance in Y. enterocolitica could also be considered for antimicrobial resistance control purposes and food safety measures.

Fontes de contaminação de Yersinia enterocolitica durante a produção de leite / Contamination sources of Yersinia enterocolitica during milk production

Objetivou-se determinar as possíveis fontes de contaminação de Yersinia enterocolitica em diferentes pontos do processo de ordenha de vacas leiteiras em oito propriedades da região de Pelotas, RS, ao longo de um ano. Foram analisadas amostras de leite cru de conjunto logo após a ordenha, água de estábulo leiteiro, mão de ordenhador, balde de recolhimento do leite e insuflador de teteiras. As amostras de leite cru e água foram coletadas em frascos estéreis, e as amostras de mão, balde e teteiras com zaragatoas estéreis. As amostras de leite cru foram submetidas a um pré-enriquecimento em água peptonada, sendo posteriormente incubadas em caldo PSTA, adicionado de ampicilina. As amostras de água foram filtradas em membrana de éster de celulose e incubadas em caldo TSB. As amostras de leite após incubação em PSTA, as membranas utilizadas na filtragem da água incubadas em TSB, bem como o material de mãos, balde e teteiras coletadas nas zaragatoas, foram semeados em ágar MacConkey e incubados para a obtenção de colônias. Colônias características foram analisadas por meio de duplex PCR para confirmação da espécie. Os perfis moleculares dos isolados de Y. enterocolitica foram comparados utilizando-se a técnica de rep-PCR. Y. enterocolitica foi isolada de 9,37% das amostras de leite, 6,25% das amostras de água e 12,5% das amostras de mão. Não houve similaridade no perfil de bandas dos isolados encontrados, entretanto foi identificada a presença de cepas diferentes na mesma amostra, demonstrando uma variedade grande de cepas distribuídas no ambiente. A presença de Y. enterocolitica em leite cru no Brasil é preocupante, já que uma quantidade considerável do produto ainda é comercializada de forma clandestina, expondo o consumidor ao risco de infecção pela bactéria, ao consumi-lo sem tratamento térmico adequado.(AU)

This work was performed in order to determine the possible Yersinia enterocolitica contamination sources at different points of the dairy cows milking process in eight properties of Pelotas, RS, in a year. Raw milk samples were analyzed immediately after milking, as well as water from milking parlor, milkers' hands, milk collection bucket, and inflator liners. The samples of raw milk and water were collected in sterile bottles and hand samples, and sterile swabs were used for the buckets and liners. The raw milk samples were subjected to a pre-enrichment peptone water buffered and subsequently incubated in PSTA broth with added ampicillin. Water samples were filtered through cellulose ester membrane and incubated in TSB medium. The milk samples after incubation in PSTA, the membranes used in water filtration were incubated in TSB and the material of the hands material, bucket and liners collected in the swabs were plated on MacConkey agar to obtain colonies. Characteristics of colonies were analyzed by duplex PCR to confirm the species. The molecular profiles of Y. enterocolitica isolates were compared using rep-PCR. Y. enterocolitica was isolated from 9,37% of milk samples, 6,25% of water samples and 12,5% of hand samples. There weren't similarities in the band profile of the isolates found; however, the presence of different strains was found in the same sample, demonstrating a variety of strains distributed in the environment. The presence of Y. enterocolitica in raw milk in Brazil is dangerous, considering that the product is sold clandestinely, exposing consumers to the risk of infection by the bacterium, when consuming it without proper heat treatment.(AU)

High Frequency of Enteric Protozoan, Viral, and Bacterial Potential Pathogens in Community-Acquired Acute Diarrheal Episodes: Evidence Based on Results of Luminex Gastrointestinal Pathogen Panel Assay

Infectious diarrhea is endemic in most developing countries. We aimed to investigate the protozoan, viral, and bacterial causes of acute diarrhea in Taif, Saudi Arabia. A cross-sectional prospective 1-year study was conducted on 163 diarrheal patients of various ages. Stool samples were collected, 1 per patient, and tested for 3 protozoa, 3 viruses, and 9 bacteria with the Luminex Gastrointestinal Pathogen Panel. Overall, 53.4% (87/163) of samples were positives (20.8% protozoa, 19.6% viruses, 2.8% bacteria, and 9.8% mixed). Rotavirus (19.6%), Giardia duodenalis (16.5%), and Cryptosporidium spp. (8.5%) were the mostly detected pathogens. Adenovirus 40/41 (4.2%), Salmonella (3%), Shiga toxin-producing Escherichia coli (3%), and Entamoeba histolytica (2.4%) were also detected. Norovirus GI/II, Vibrio cholerae, Yersinia enterocolitica, and Clostridium difficile toxin A/B were not detected in any patients. All pathogens were involved in coinfections except E. histolytica. Giardia (5.5%) and rotavirus (3%) were the most commonly detected in co-infections. Enterotoxigenic E. coli (2.4%), Campylobacter spp. (2.4%), E. coli 0157 (1.8%), and Shigella spp. (1.2%) were detected in patients only as co-infections. Infections were more in children 0–4 years, less in adults 40 years, with statistically significant differences in risk across age groups observed with rotavirus (P < 0.001), Giardia (P=0.006), and Cryptosporidium (P=0.036) infections. Lastly, infections were not significantly more in the spring. This report demonstrates the high burden of various enteropathogens in the setting. Further studies are needed to define the impact of these findings on the clinical course of the disease.

Yersinia enterocolitica Exploits Signal Crosstalk between Complement 5a Receptor and Toll-like Receptor 1/2 and 4 to Avoid the Bacterial Clearance in M cells

In the intestinal mucosal surface, microfold cells (M cells) are the representative gateway for the uptake of luminal antigens. At the same time, M cells are the primary infection site for pathogens invading mucosal surface for their infection. Although it is well recognized that many mucosal pathogens exploit the M cells for their infection, the mechanism to infect M cells utilized by pathogens is not clearly understood yet. In this study, we found that M cells expressing complement 5a (C5a) receptor (C5aR) also express Toll-like receptor (TLR) 1/2 and TLR4. Infection of Yersinia enterocolitica, an M cell-invading pathogen, synergistically regulated cyclic adenosine monophosphate-dependent protein kinase A (cAMP-PKA) signaling which are involved in signal crosstalk between C5aR and TLRs. In addition, Y. enterocolitica infection into M cells was enhanced by C5a treatment and this enhancement was abrogated by C5a antagonist treatment. Finally, Y. enterocolitica infection into M cells was unsuccessful in C5aR knock-out mice. Collectively, we suggest that exploit the crosstalk between C5aR and TLR signaling is one of infection mechanisms utilized by mucosal pathogens to infect M cells.

Enzyme activity and thermostability of a non-specific nuclease from Yersinia enterocolitica subsp. palearctica by site-directed mutagenesis

Background: To identify the critical amino acid residues that contribute to the high enzyme activity and good thermostability of Yersinia enterocolitica subsp. palearctica (Y. NSN), 15 mutants of Y. NSN were obtained by site-directed mutagenesis in this study. And their enzyme activity and thermostability were assayed. Effect of several factors on the enzyme activity and thermostability of Y. NSN, was also investigated. Results: The results showed that the I203F and D264E mutants retained approximately 75% and 70% enzyme activity, respectively, compared to the wild-type enzyme. In addition to the I203F and D264E mutants, the mutant E202A had an obvious influence on the thermostability of Y. NSN. According to the analysis of enzyme activity and thermostability of Y. NSN, we found that Glu202, Ile203 and Asp264 might be the key residues for its high enzyme activity and good thermostability. Conclusions: Among all factors affecting enzyme activity and thermostability of Y. NSN, they failed to explain the experimental results well. One reason might be that the enzyme activity and thermostability of Y. NSN were affected not only by a single factor but also by the entire environment.

Detection of Yersinia Enterocolitica Bacteriophage PhiYe-F10 Lysis Spectrum and Analysis of the Relationship between Lysis Ability and Virulence Gene of Yersinia Enterocolitica / 病毒学报

To determine the lysis spectrum of Yersinia enterocolitica bacteriophage phiYe-F10 and to analyze the relationship between the lysis ability of phiYe-F10 and the virulence gene of Yersinia enterocolitica. To observe the lysis ability of the phage phiYe-F10 to the different Yersinia strains with the double-layer technique. The strains used in this study including 213 of Yersinia enterocolitica and 36 of Yersinia pseudotuberculosis and 1 of Yersinia pestis. The virulence genes of these Yersinia enterocolitica (attachment invasion locus (ail) and enterotoxin (ystA, ystB) and yersinia adhesin A (yadA), virulence factor (virF), specific gene for lipopolysaccharide O-side chain of serotype O : 3 (rfbc) were all detected. Among the 213 Yersinia enterocolitica, 84 strains were O : 3 serotype (78 strains with rfbc gene), 10 were serotype O : 5, 13 were serotype O : 8, 34 were serotype O : 9 and 72 were other serotypes. Of these, 77 were typical pathogenic Yersinia enterocolitica harboring with virulence plasmid (ail+, ystA+, ystB-, yadA+, virF+), and 15 were pathogenic bacterial strains deficiency virulence plasmid (ail+, ystA+, ystB-, yadA-, virF-) and the rest 121 were non pathogenic genotype strains. PhiYe-F10 lysed the 71 serotype O : 3 Yersinia enterocolitica strains which were all carried with rfbc+, including 52 pathogenic Yersinia enterocolitica, 19 nonpathogenic Y. enterocolitica. The phiYe-F10 can not lysed serotype O : 5, O : 9 and other serotype Y. enterocolitica, the lysis rate of serotype O : 3 was as high as 84.5%. The phiYe-F10 can not lysed Yersinia pseudotuberculosis and Yersinia pestis. Yersinia phage phiYe-F10 is highly specific for serotype O : 3 Yersinia enterocolitic at 25 degrees C, which showed a typical narrow lysis spectrum. Phage phiYe-F10 can lysed much more pathogenic Y. enterocolitica than nonpathogenic Y. enterocolitica.

Microbiological criteria of some meat products

A total of two hundred of meat product samples [Beef burger, Luncheon, Pasterma and Sausage] were collected randomly from different retail shops at Alexandria province and examined for their microbiological criteria. All the examined samples found to be contaminated with different types of microorganisms with the mean values of 8.20×10[2], 6.29×10[2], 5.40×10[2] and 8.28×10[2], respectively for total aerobic bacterial counts; total 5.57×10[2], 4.96×10[2], 5.83×10[2] and 7.64×10[2], respectively for Psychotrophic bacterial count; 5.27×10[2],4.65×10[2], 3.74×10[2] and 7.47×10[2], respectively for total Enterobactericeae count; 2.92×10[2], 3.50×10[2], 4.19×10[2] and 7.64×10[2], respectively for total Coliforms count and at last 4.7×10[2], 1.21×10[2], 1.22×10[2] and 1.00×10[2], respectively for total Yeast and Mold count. The incidence of identified Staphylococcus aureus was 68, 80, 60 and 88%, respectively and the incidence of identified Salmonella spp was 20, 26, 6 and 40%, respectively, while the incidence of identified Yersinia enterocolitica was 46, 40, 54 and 34, respectively

Investigation on distribution of Yersinia enterocolitica in Henan province between 2005 and 2011 / 中华预防医学杂志

<p><b>OBJECTIVE</b>To investigate the distribution of Yersinia enterocolitica in Henan province from 2005 to 2011.</p><p><b>METHODS</b>A total of 6700 samples of stool specimen were collected from diarrhea patients and different domestic animals between 2005 and 2011 from Zhengzhou, Suixian and Dengfeng, as well as flies and the daub specimens of raw and cooked meat products. The bacteria were isolated by cold enrichment method, analyzed by the systematic biochemistry to determine the serotypes and bio-types, and tested the virulence genes by PCR method.</p><p><b>RESULTS</b>A total of 216 strains of Yersinia enterocolitica were isolated from 11 kinds of animal hosts and foods, while 29.63% (64/216) of them were from swine. The dominant epidemic serotypes of the Yersinia enterocolitica were O: 5 and O: 8, accounted for 23.2% (50/216) and 20.4% (44/216), respectively; type 1A was the dominant bio-type, accounted for 84.7% (183/216). The dominant serotype and bio-type differed a lot among various hosts.16 pathogenic strains were isolated from swine, followed by diarrhea patients (6 strains) and dogs (6 strains).</p><p><b>CONCLUSION</b>The distribution of the host of Yersinia enterocolitica was widespread, while swine was the dominant animal host.</p>

Bacterial contamination of Iranian paper currency

Transmission of human pathogens can be occurred via inert objects. Paper currency is a further common contact surface whereby pathogens can be transferred within a population although the significance remains unknown. Hence, the aim of the present study was to investigate microbial populations associated with Iranian paper currency. This study was carried out by getting 108 samples of the Iranian currency notes [1000, 2000, 5000, 10000, 20000 and 50000 RIALS] from food-related shops that included food service outlets, greengrocery, supermarket, bakery, confectionary and poultry meat retail outlets. All currency notes were examined for total bacterial count and identification of pathogenic bacteria. The average total bacterial count that was recovered from currency notes was found to be 3.27 +/- 0.31 colony forming unites. 2000R had the highest total bacterial count, followed by 5000R, 10000R and the lowest in 50000R. In this study, the isolated bacteria recovered were Bacillus cereus [8.33%], E.coli [48.14%], Staphylococcus aureus [28.7%], Salmonella [0.92%], Listeria moncytogenes [0.92%], Yersinia entrocolitica [6.48%]. It was revealed that all the pathogens screened for where encountered on currency notes were recovered from one sample. There were no significant [P>0.05] correlations between the carriage of pathogens/ fecal indicator bacteria and currency note condition. Our findings demonstrate that Iranian currency notes represent a significant vehicle for human pathogens