Fatal neutropenic enterocolitis due to Clostridium septicum / Enterocolitis neutropénica fatal a causa de Clostridium septicum

We describe a case of Clostridium septicum enterocolitis in a patient with pre-B acute lymphoblastic leukaemia undergoing autologous stem cell transplant. In the setting of neutropenia, Clostridium septicum should be suspected in patients who develop signs and symptoms of acute abdomen.

Se describe el caso de una enterocolitis por Clostridium septicum en un paciente con leucemia linfoblástica aguda (LLA) pre-B sometido a trasplante de células madre autológico. En el marco de una neutropenia, debe sospecharse la presencia de Clostridium septicum en pacientes que desarrollan signos y síntomas de abdomen agudo.

Viability of Campylobacter jejuni in commercial eggs / Viabilidade de Campylobacter jejuni em ovos comerciais

The aim of this study was to verify the penetration and permanence of C. jejuni inside commercial eggs. Thirty eggs were submerged in peptone water artificially contaminated with 10 5 UFC.mL-1 of C. jejuni. An equal number of eggs were submerged in an identical solution, however, without addition of the microorganism. Parallel to this, 60 eggs were inoculated by means of a small incision in the larger pole, without lesion to the internal membrane, inserted into the air chamber with a sterile insulin needle containing 10 5 CFU.mL-1 of C. jejuni. Thirty eggs were inoculated with a sterile solution of 0.85% sodium chloride and kept as negative control. After storage at 25ºC, and after 1, 6 and 24 hours, 10 eggs from each of the two treatments were separated into the albumen and yolk contents, and each portion was individually analyzed by the traditional culture method for the presence/absence of Campylobacter. In another nine eggs, obtained from the same lot of animals, the albumens were separated to verify their inhibitory activity against the microorganism. The albumen in different concentrations was incorporated into Bolton broth and inoculated with 10 6 CFU.mL-1 of C. jejuni, and after incubation at 37ºC for 24 hours, striated in selective agar. In none of the analyzed samples (treatments and controls) was the growth of Campylobacter observed. The results demonstrated that under the experimental conditions used, Campylobacter jejuni is incapable of surviving, colonizing and multiplying inside commercial eggs. The white of the eggs, as an isolated factor, even at the concentration of 84.9% was incapable of completely inhibiting the growth of the microorganism in Bolton broth at 37ºC, in a microaerophilic atmosphere. The consumption of commercial eggs is not a risk factor for the acquisition of Campylobacteriosis by humans.

O objetivo desse estudo foi verificar a passagem e a permanência de C. jejuni no interior de ovos comerciais. Trinta ovos foram submersos em água peptona artificialmente contaminada com 105 CFU.mL-1 de C. jejuni e igual número de ovos foi submerso em solução idêntica, porém, sem adição do microrganismo. Em paralelo, 60 ovos foram inoculados por meio de uma pequena incisão no pólo maior, sem lesionar a membrana interna, inseridos na câmara de ar com uma agulha de insulina estéril contendo 10 5 CFU.mL-1 de C. jejuni. Trinta ovos foram inoculados com solução estéril de cloreto de sódio 0,85% e mantidos como controle negativo. Após armazenamento a 25ºC, e após 1, 6 e 24 horas, 10 ovos de cada um dos dois tratamentos foram separados nos conteúdos de albume e gema, e cada porção individualmente analisada pelo método tradicional de cultivo para presença/ausência de Campylobacter. Em outros nove ovos, obtidos do mesmo lote de animais, foram separados albume, para verificar sua atividade inibitória frente ao microrganismo. O albume em diferentes concentrações foi incorporada em caldo Bolton e inoculada com 10 6 CFU.mL-1 de C. jejuni, e após incubação a 37ºC por 24 horas, estriadas em ágar seletivo. Em nenhuma das amostras analisadas (tratamentos e controle) foi observado o crescimento de Campylobacter. Os resultados demonstraram que nas condições experimentais utilizadas, Campylobacter jejuni não é capaz de sobreviver, colonizar e se multiplicar no interior de ovos comerciais. O albume, como fator isolado, mesmo na concentração de 84,9% não foi capaz de inibir completamente o crescimento do microrganismo em caldo Bolton a 37ºC em microaerofilia. O consumo de ovos não é um fator de risco para a aquisição de campilobacteriose por humanos.

Intestinal bleeding and occlusion associated with shiga toxin-producing Escherichia coli 0127: H21

We report a case of a nine-year old boy with vomiting, abdominal pain and fever, who underwent surgery with a diagnosis of appendicitis in Mendonza and from whom a Shiga toxin-producing Escherichia coli (STEC) 0127:H21 strain was recovered. Forty-eight hours after surgery he presented bilious vomiting and two episodes of intestinal bleeding. Loboratory findings included: hematocrit, 35 per cent; blood urea nitrogen, 0.22 g/L. The urinary output was normal. The following day physical examination showed an alert mildy hydrated child, without fever but with distended and painful abdomen. The patient was again submitted to surgery with a diagnosis of intestinal occlusion. Bleeding and multiple adhesions in jejunum and ileum were found. The patient still had tense and painful abdomen and presented two bowel movements with blood; hematocrit fell to 29 per cent and blood urea nitrogen rose to 0.32 g/L. STEC 0127:H21 eae(-)/Stx2/Stx2vh-b(+)/E-Hly(+) was isolated from a stool sample. He was discharged after 10 days of hospitalization and no long-term complications such as HUS or TTP were observed. This is the first report, to our knoweledge, on the isolation of E.coli 0127:H21, carrying the virulence factors that characterize STEC strains, associated to an enterohemorrhagic colitis case. This serotype was previously characterized as a non-classic enteropathogenic E. coli (EPEC). STEC infections can mimic infectious or noninfectious pathologies. Therefore an important aspect of clinical managements is making the diagnosis using different criteria thereby avoiding misdiagnoses which have occasionally led to invasive diagnostic and therapeutic procedures or the inappropriate use of antibiotics.

Aeromonas spp en niños con síndrome diarreico agudo / Aeromonas spp in children with acute diarrheal disease

El interés por el género Aeromonas es creciente, tanto como causante de enfermedades diarreicas como extraintestinales. Produce cuadros intestinales a través de acción citotóxica y enterotóxica. Empleando agar sangre con 30 mg/l de ampicilina (ASA) se aislaron Aeromonas spp en 8 de 400 niños diarreicos y en ninguno de 230 controles no diarreicos. El aislamiento fue muy inferior en los medios tradicionales del coprocultivo, agar lactosa y agar Shigella-Salmonella, así como agar sangre sin ampicilina, en el que hubo sobredesarrollo de flora entérica. Cinco cepas aisladas fueron A. hydrophila, 2 A. caviae y 1 A. veroni biotipo sobria. Cuatro de cinco cepas probadas resultaron enterotoxigénicas en asa de conejo. Todas las cepas fueron hemolíticas; 6 fueron Voges Proskauer (+), lisina decarboxilasa (+) y glucosa con gas (+), características que han sido relacionadas con la virulencia. Todos los aislados resultaron resistentes a las aminopenicilinas con o sin sulbactama y sensibles a cloranfenicol, colistin, gentamicina, neomicina y norfloxacina. Dos cepas resultaron resistentes a sulfametoxazol-trimetoprima