RESUMEN
Enteropathogenic Escherichia coli (EPEC) and Shigatoxigenic E. coli (STEC) strains are among the major pathotypes found in poultry and their products, which are capable of causing human enteric infections. Colistin has been claimed the drug of choice against diseases caused by multidrug-resistant Gram-negative bacteria (MDRGN) in humans. The mcr-1 gene was the first plasmidial gene that has been described to be responsible for colistin resistance and has also been detected in birds and poultry products. Our study aimed to detect the mcr-1 gene in enteropathogenic strains of E. coli in order to evaluate the resistance to colistin in broilers. The material was obtained from 240 cloacal samples and 60 broiler carcasses. The strains were isolated by the conventional bacteriological method and by the virulence genes, which characterize the enteropathogenic strains and resistance, and the samples were detected by polymerase chain reaction (PCR). Of the 213 isolated strains of E. coli, 57 (26.76%) were characterized as atypical EPEC and 35 (16.43%) as STEC. The mcr-1 gene was found in 3.5% (2/57) of the EPEC strains and 5.7% (2/35) of the STEC strains. In this study, it was possible to confirm that the mcr-1 resistance gene is already circulating in the broiler flocks studied and may be associated with the pathogenic strains.(AU)
Escherichia coli Enteropatogênica (EPEC) e Shigatoxigênica (STEC) estão entres os principais patotipos encontrados em aves e produtos avícolas que são capazes de causar doença entérica no homem. A colistina tem sido preconizada como droga de escolha para o tratamento de doenças causadas por bactérias Gram-negativas multirresistentes em humanos. O gene mcr-1 foi o primeiro gene plasmidial a ser descrito como responsável pela resistência a colistina e tem sido descrito em aves e produtos avícolas. Este estudo tem como objetivo a detecção do gene mcr-1 em estirpes de E. coli enteropatogênicas a fim de avaliar a resistência a colistina em frangos de corte. O material foi obtido a partir de 240 amostras cloacais e 60 carcaças de frango de corte. As estirpes foram isoladas pelo método bacteriológico convencional e os genes de virulência, que caracterizam as estirpes enteropatogênicas, e resistência foram detectados pela reação em cadeia pela polimerase (PCR). Das 213 estirpes de E. coli isoladas, 57 (26,76%) foram caracterizadas como EPEC atípica e 35 (16,43%) como STEC. O gene mcr-1 foi encontrado em 3,5% (2/57) das estirpes EPEC e 5,7% (2/35) das estirpes STEC. Neste estudo foi possível confirmar que o gene de resistência mcr-1 já está em circulação nos lotes de frango de corte estudados e pode estar associado às estirpes patogênicas.(AU)
Asunto(s)
Pollos/microbiología , Escherichia coli Enteropatógena/aislamiento & purificación , Escherichia coli Enteropatógena/genética , Escherichia coli Shiga-Toxigénica/aislamiento & purificación , Escherichia coli Shiga-Toxigénica/genética , Reacción en Cadena de la Polimerasa/veterinaria , Colistina , Genes MDR , Farmacorresistencia BacterianaRESUMEN
O objetivo do trabalho foi verificar a capacidade de adaptação cruzada de EPEC CDC O55 aos compostos majoritários citral e cinamaldeído. Para isso, foi determinada a Concentração Mínima Bactericida (CMB) do citral e em seguida,as células de EPEC foram expostas a concentração subletal de cinamaldeído (CMB/16). Posteriormente testadas frente a diferentes concentrações do composto citral (CMB/2; CMB; 1,2CMB; 1,4CMB; 1,6CMB; 1,8CMB e 2CMB), estas foram incubadas e plaqueadas em TSA (Ágar Triptona de Soja) empregando-se a técnica de microgotas. As células de EPEC foram classificadas como capazes de se adaptarem, quando cresceram em placas após cultivo em presença do composto em concentração igual ou maior que a CMB. A CMB do citral foi de 1,0% (v/v). As células de EPEC não apresentaram a capacidade de adaptação cruzada. Os resultados demonstram que os compostos majoritários são alternativas eficazes no controle de EPEC.
Asunto(s)
Adaptación a Desastres , Antibacterianos/administración & dosificación , Escherichia coli Enteropatógena/efectos de los fármacos , Escherichia coli Enteropatógena/aislamiento & purificación , Fenómenos Microbiológicos , Aceites VolátilesRESUMEN
ABSTRACT Shigatoxigenic and enteropathogenic Escherichia coli with virulence and multidrug resistance profile were isolated from Nile tilapia. This study finding is of great importance to public health because they help understand this pathogen epidemiology in fish and demonstrate how these animals can transmit E. coli related diseases to humans.
Asunto(s)
Humanos , Animales , Escherichia coli Enteropatógena/aislamiento & purificación , Escherichia coli Shiga-Toxigénica/aislamiento & purificación , Peces/microbiología , Filogenia , Contaminación de Alimentos/análisis , Seguridad de Productos para el Consumidor , Proteínas de Escherichia coli/genética , Escherichia coli Enteropatógena/clasificación , Escherichia coli Enteropatógena/genética , Escherichia coli Shiga-Toxigénica/clasificación , Escherichia coli Shiga-Toxigénica/genética , Carne/microbiologíaRESUMEN
ABSTRACT Psittacine birds have been identified as reservoirs of diarrheagenic Escherichia coli, a subset of pathogens associated with mortality of children in tropical countries. The role of other orders of birds as source of infection is unclear. The aim of this study was to perform the molecular diagnosis of infection with diarrheagenic E. coli in 10 different orders of captive wild birds in the state of São Paulo, Brazil. Fecal samples were analyzed from 516 birds belonging to 10 orders: Accipitriformes, Anseriformes, Columbiformes, Falconiformes, Galliformes, Passeriformes, Pelecaniformes, Piciformes, Psittaciformes and Strigiformes. After isolation, 401 E. coli strains were subjected to multiplex PCR system with amplification of genes eae and bfp (EPEC), stx1 and stx2 for STEC. The results of these tests revealed 23/401 (5.74%) positive strains for eae gene, 16/401 positive strains for the bfp gene (3.99%) and 3/401 positive for stx2 gene (0.75%) distributed among the orders of Psittaciformes, Strigiformes and Columbiformes. None of strains were positive for stx1 gene. These data reveal the infection by STEC, typical and atypical EPEC in captive birds. The frequency of these pathotypes is low and restricted to few orders, but the data suggest the potential public health risk that these birds represent as reservoirs of diarrheagenic E. coli.
Asunto(s)
Animales , Aves/microbiología , Reservorios de Enfermedades/microbiología , Escherichia coli Enteropatógena/aislamiento & purificación , Escherichia coli Shiga-Toxigénica/aislamiento & purificación , Animales Salvajes/microbiología , Aves/clasificación , Brasil , Proteínas de Escherichia coli/genética , Proteínas de Escherichia coli/metabolismo , Escherichia coli Enteropatógena/clasificación , Escherichia coli Enteropatógena/genética , Escherichia coli Enteropatógena/metabolismo , Escherichia coli Shiga-Toxigénica/clasificación , Escherichia coli Shiga-Toxigénica/genética , Escherichia coli Shiga-Toxigénica/metabolismo , Animales Salvajes/clasificaciónRESUMEN
The bacterial pathogen most commonly associated with endemic forms of childhood diarrhoea is Escherichia coli. Studies of epidemiological characteristics of HEp-2 cell-adherent E. coli in diarrhoeal disease are required, particularly in developing countries. The aim of this study was evaluate the presence and significance of adherent Escherichia coli from diarrhoeal disease in children. The prevalence of LA, AA, and DA adherence patterns were determined in HEp-2 cells, the presence of virulence genes and the presence of the O serogroups in samples obtained from 470 children with acute diarrhoea and 407 controls in Porto Velho, Rondônia, Brazil. E. coli isolates were identified by PCR specific for groups of adherent E. coli. Out of 1,156 isolates obtained, 128 (11.0%) were positive for eae genes corresponding to EPEC, however only 38 (29.6%) of these amplified bfpA gene. EAEC were isolated from 164 (14.1%) samples; of those 41(25%), 32 (19%) and 16 (9.7%) amplified eagg, aggA or aafA genes, respectively and aggA was significantly associated with diarrhoea (P = 0.00006). DAEC identified by their adhesion pattern and there were few isolates. In conclusion, EAEC was the main cause of diarrhoea in children, especially when the aggA gene was present, followed by EPEC and with a negligible presence of DAEC.
Asunto(s)
Niño , Preescolar , Humanos , Lactante , Recién Nacido , Diarrea/microbiología , Escherichia coli Enteropatógena/genética , Infecciones por Escherichia coli/microbiología , Escherichia coli/genética , Factores de Virulencia/genética , Adhesión Bacteriana , Brasil , Escherichia coli Enteropatógena/clasificación , Escherichia coli Enteropatógena/aislamiento & purificación , Escherichia coli Enteropatógena/fisiología , Células Epiteliales/microbiología , Escherichia coli/clasificación , Escherichia coli/aislamiento & purificación , Escherichia coli/fisiología , Antígenos O/análisis , SerogrupoRESUMEN
Enteropathogenic Escherichia coli (EPEC) are important human gastroenteritis agents. The prevalence of six non-LEE genes encoding type 3 translocated effectors was investigated. The nleC, cif and nleB genes were more prevalent in typical than in atypical EPEC, although a higher diversity of genes combinations was observed in atypical EPEC.
Asunto(s)
Humanos , Sistemas de Secreción Bacterianos/genética , Escherichia coli Enteropatógena/genética , Proteínas de Escherichia coli/genética , Variación Genética , Fosfoproteínas/genética , Factores de Virulencia/genética , Escherichia coli Enteropatógena/clasificación , Escherichia coli Enteropatógena/aislamiento & purificación , Infecciones por Escherichia coli/microbiología , Gastroenteritis/microbiologíaRESUMEN
En Argentina, Escherichia coli enteropatogénico (EPEC) es uno de los agentes más prevalentes aislados de niños con diarrea. Debido a que la contaminación con este patotipo en productos de pollo podría ocurrir durante el proceso de faena, nos planteamos como objetivo aislar y caracterizar EPEC de muestras de animales vivos (cloacas), carcasas evisceradas sin lavar, carcasas lavadas y agua del tanque de enfriamiento. Se caracterizaron 29 aislamientos de EPEC que presentaron una amplia variedad de serotipos, algunos de los cuales (O2:H40, O8:H19 y O108:H9) han sido informados en otras especies animales. También se encontró el serotipo O45:H8, aislado con anterioridad de niños con diarrea. Se detectaron aislamientos de los serotipos O2:H40, O108:H9 y O123:H32 en distintas etapas del proceso de faena, lo que sugiere que el procesamiento no se realiza en forma adecuada. Se torna necesario reforzar las medidas de control e higiene en las distintas etapas del proceso para disminuir la contaminación microbiana
In Argentina, EPEC is one of the most prevalent agents isolated from children with diarrhea. Because contamination with this pathotype could occur during slaughter, the aim of this study was to isolate and characterize EPEC strains obtained from live animals (cloacae), eviscerated carcasses, washed carcasses and water from chillers. Twenty nine isolates of atypical EPEC were characterized. These isolates presented a wide variety of serotypes, some of which (O2:H40, O8:H19 and O108:H9) had been reported in other animal species. Serotype O45:H8, previously isolated from children with diarrhea was also found. Isolates of serotypes O2:H40, O108:H9 and O123:H32 were detected at different stages of the slaughtering process, suggesting that the process is not adequately performed. This latter fact highlights the importance of reinforcing control and hygienic measures at different stages of the chicken slaughtering process in order to reduce microbial contamination
Asunto(s)
Animales , Pollos/microbiología , Escherichia coli Enteropatógena/aislamiento & purificación , Colimetría/análisis , Cloaca/microbiología , Cáscara de Huevo/microbiología , Infecciones por Escherichia coli/prevención & control , Escherichia coli Enteropatógena/clasificaciónRESUMEN
Psittaciformes are one of the most endangered groups of birds, and several Brazilian species are classified between vulnerable and critically endangered. It is thus necessary to identify agents that cause infections in captive wild animals and to assess the risks posed thereof and to design interventions to minimize the possibility of disease outbreaks, leading to the conservation of endangered species. The purpose of this study was to identify enteropathogenic Escherichia coli (EPEC) cloacal isolates from asymptomatic psittacines in captivity and evaluate the distribution of the EPEC pathotype. Cloacal swabs were obtained from 46 asymptomatic birds, and resulting isolates were tested by polymerase chain reaction (PCR) for the presence of the attaching and effacing gene (eae) and bundle-forming pilus structural gene (bfpA) of EPEC. Samples from several species were tested, and three samples were found to be positive for the eae and bfpA genes and characterized as typical EPEC. This is the first report of this pathotype in asymptomatic psittacines. Although certain E. coli strains are more pathogenic than others, various factors should be considered when determining the potential of E. coli isolates to cause disease in captive psittacines. Birds that are positive for the EPEC (typical) strain could be zoonotic sources of infection, and may have acquired these strains through contact with humans or domestic animals. These findings may also be valuable for the long-term management of endangered species ex situ as one EPEC sample was isolated from a Red-tailed Amazon (Amazona brasiliensis).
Os psitacídeos são um dos grupos de aves mais ameaçadas no mundo e diversas espécies brasileiras são classificadas desde vulneráveis à criticamente ameaçadas de extinção. Torna-se, portanto, necessário identificar os agentes que causam infecções em animais selvagens em cativeiro e determinar os riscos relacionados de modo a intervir sobre os fatores envolvidos para diminuir a possibilidade de surtos de doenças e promover a conservação de espécies ameaçadas. O objetivo deste estudo foi identificar Escherichia coli Enteropatogência (EPEC) de isolados cloacais de psitacídeos assintomáticos em cativeiro e avaliar a distribuição do patotipo EPEC. Suabes cloacais foram coletados de 46 psitacídeos assintomáticos e os isolados foram testados pela reação em cadeia pela polimerase (PCR) para a presença do gene attaching and effacing (eae) e bundle forming pilus (bfpA) de EPEC. Amostras oriundas de diversas espécies foram testadas e três amostras resultaram positivas para os genes eae e bfp e caracterizadas como EPEC típicas. Esse é o primeiro relato em psitacídeos assintomáticos para esse patotipo. Apesar de que algumas cepas de E.coli serem mais patogênicas do que outras, diversos fatores devem ser considerados para determinar o potencial de isolados de E.coli de causar doença em psitacídeos em cativeiro. Aves positivas para cepas de EPEC (típicas) poderiam ser fontes de infecção zoonóticas e adquirir essas cepas através do contato com humanos e animais domésticos. Esses achados também podem ser valiosos para o manejo a longo prazo de espécies ameaçadas ex situ já que uma amostra de EPEC foi isolada de um Papagaio-de-cara-roxa (Amazona brasiliensis).
Asunto(s)
Animales , Aves de Corral/prevención & control , Escherichia coli Enteropatógena/aislamiento & purificación , Terapia de Inmunosupresión/veterinaria , Loros/microbiología , Reacción en Cadena de la Polimerasa/veterinaria , Apareamiento , Cloaca/microbiología , Infecciones Bacterianas/transmisiónRESUMEN
Purpose: Enteropathogenic Escherichia coli (EPEC) are among the most important pathogens infecting children worldwide and are one of the main causes of diarrhoea. The study was carried out to investigate the occurrence of EPEC as a cause of infectious diarrhoea in children younger than 2 years of age and characterize their virulence genes. Materials and Methods: During the study period, a total of 656 faecal specimens from children with diarrhoea and 54 from healthy children were analyzed. E. coli isolates were serotypically identified with EPEC polyvalent and monovalent antisera. The isolated EPEC were examined for the presence of the attaching and effacing (eaeA), bundle-forming pilus (bfpA), Shiga like toxins (stx1 and stx2 ), enterohaemorrhagic E. coli enterohaemolysin (EHEC hlyA) and EPEC adherence factor (EAF) genes by the PCR assay. Results: The study has shown that 22 (3.4%) had diarrhoea due to EPEC, while no EPEC isolates were detected in asymptomatic children. The highest number of the EPEC isolated belonging to polyvalent 2. The primers encoding virulence genes were subjected to all the EPEC isolates. Only 9.1%, 27.3%, and 9.1% isolates gave positive re sults with intimin (eaeA), bfbA and (EAF) genes, respectively. None of the isolates were positive for stx 1, stx 2, and hlyA genes. Typical EPEC (eaeA +, bfpA +) was diagnosed in two isolates, while, atypical EPEC was manifested in four isolates. Conclusions: According to the results, the frequency of EPEC isolates in Najaf was lower than what has been suspected and the investigation including the use of molecular technique and serotyping, are necessary to allow precise identification and epidemiological study of these pathogens.
Asunto(s)
Escherichia coli Enteropatógena/clasificación , Escherichia coli Enteropatógena/inmunología , Escherichia coli Enteropatógena/aislamiento & purificación , Escherichia coli Enteropatógena/patogenicidad , Infecciones por Escherichia coli/microbiología , Proteínas de Escherichia coli/genética , Heces/microbiología , Genotipo , Humanos , Lactante , Irak , Reacción en Cadena de la Polimerasa , Serotipificación , Factores de Virulencia/genéticaRESUMEN
Enteropathogenic Escherichia coli (EPEC) comprise one of the six categories of diarrhoeagenic E. coli (DEC). EPEC is subgrouped into typical (tEPEC) and atypical (aEPEC). The identification of DEC cannot be based only on cultural and biochemical criteria, since they are indistinguishable from the non-pathogenic E. coli commonly found in human feces. Several PCR methods, with both single and multiple target genes, have been reported for detecting the different DEC pathotypes. In the present study five hundred E. coli isolates from children with diarrhea were subjected into multiplex PCR. Furthermore the strains were typed serologically with O antisera and their fliC gene was characterized by PCR-RFLP. The results obtained revealed that overall 41 (8.2 percent) isolates could be detected as EPEC by this multiplex PCR assay. Of these isolates; 27 (66 percent) were typical (escv+, bfp+) and 14 (34 percent) atypical EPEC (escv+, bfp-). None of these 41 isolates contained the Stx1 and Stx2 genes. Among 37 (90 percent) typeable strains, nine different serogroups were present. The most common serogroups were O111, followed by O86, O55 and O119 and 10 different H types were found among these isolates. The multiplex PCR assay was found to be rapid and reliable in comparison to serological test; especially when screening the large number of isolates.
Asunto(s)
Niño , Humanos , ADN Bacteriano/análisis , Escherichia coli Enteropatógena/clasificación , Proteínas de Escherichia coli/genética , Reacción en Cadena de la Polimerasa Multiplex , Antígenos O/análisis , Polimorfismo de Longitud del Fragmento de Restricción , Diarrea/microbiología , Escherichia coli Enteropatógena/genética , Escherichia coli Enteropatógena/aislamiento & purificación , Heces/microbiología , Serotipificación/métodos , Toxina Shiga I/genética , /genéticaRESUMEN
Background & objectives Limited information is available on shiga toxin producing Escherichia coli (STEC) in animals and birds from India. An outbreak of acute diarrhoea in poultry birds at Aizawl, Mizoram was investigated for detection and characterization of STEC and enteropathogenic E. coli (EPEC). Methods E. coli was isolated and identified from rectal swabs, intestinal contents, heart blood and spleen of 19 poultry birds that died due to acute diarrhoea during the outbreak. Phenotypic characterization was done by standard bacteriological and biochemical techniques. All the isolates were serotyped based on their somatic antigens. Virulence genes (stx1, stx2, eaeA and hlyA) were detected by multiplex PCR assay. Results A total of 42 E. coli isolates were obtained, of which 24 belonged to 3 serogroups (O64, O89 and O91) and the remaining 18 were untypable (UT). Altogether, 14 (33.33%) isolates carried at least 1 virulence gene, of which 10 (23.81%) and 4 (9.52%) were recorded as STEC and EPEC, respectively. Of the 10 STEC isolates, one carried only stx2, one carried stx2 and hlyA, four carried stx1, stx2 and hlyA, two carried stx1, eaeA and hlyA genes and two carried stx1 and eaeA. Of the four EPEC isolates, two carried eaeA and hlyA, one carried only eaeA gene and 1 carried only hlyA gene. Interpretation & conclusions This is the first report on the involvement of STEC in poultry in India.
Asunto(s)
Animales , Pollos , Cartilla de ADN/genética , Diarrea/epidemiología , Diarrea/etiología , Diarrea/microbiología , Diarrea/veterinaria , Brotes de Enfermedades/veterinaria , Escherichia coli Enteropatógena/aislamiento & purificación , Escherichia coli Enteropatógena/patogenicidad , Escherichia coli , Infecciones por Escherichia coli/complicaciones , Infecciones por Escherichia coli/epidemiología , Infecciones por Escherichia coli/microbiología , Infecciones por Escherichia coli/veterinaria , India/epidemiología , Fenotipo , Enfermedades de las Aves de Corral/epidemiología , Enfermedades de las Aves de Corral/microbiología , Prevalencia , Escherichia coli Shiga-Toxigénica/aislamiento & purificación , Escherichia coli Shiga-Toxigénica/patogenicidad , Factores de Virulencia/genéticaRESUMEN
Introducción. Las E. coli diarrogénicas (DEC) son una de las principales causas de diarrea en niños en países en vías de desarrollo. Sin embargo, no son rutinariamente diagnosticadas en los laboratorios clínicos. Objetivos. Determinar la prevalencia de las DEC en niños peruanos y describir la variabilidad genética de estas cepas. Materiales y métodos. Se utilizaron 8 003 cepas de E. coli previamente aisladas de ocho estudios previos de diarrea en niños, mayormente en zonas periurbanas de Lima. El diagnóstico de las DEC fue a través de un PCR múltiple a tiempo real para los seis grupos de DEC. Se empleó PCR para la determinación de genes adicionales de virulencia. Resultados. La prevalencia promedio global en muestras de diarrea (n=4 243) fue: E. coli enteroagregativa (EAEC) 9,9 por ciento, enteropatogénica (EPEC) 8,5 por ciento, enterotoxigénica (ETEC) 6,9 por ciento, difusamente adherente (DAEC) 4,8 por ciento, productora de toxina shiga (STEC) 0,8 por ciento y enteroinvasiva (EIEC) 0,6 por ciento. La frecuencia relativa de cada patógeno varía según la edad y tipo de estudio. Los principales patotipos en muestras control (n=3 760) fueron EPEC (10,9 por ciento) y EAEC (10,4 por ciento). Se encontró una gran variabilidad en la frecuencia de genes de virulencia para cada patotipo, así como en los mecanismos moleculares de resistencia, sin diferencias significativas entre muestras de diarrea y control. Conclusiones. Las DEC son causa importante de diarrea en niños peruanos. Estos patógenos son altamente heterogéneos. Se requieren estudios adicionales para determinar la prevalencia en zonas rurales del Perú, así como en casos graves de diarrea.
Introduction. Diarrheagenic E. coli (DEC) are a major cause of diarrhea in children in developing countries. However, they are not part of routine diagnosis in clinical laboratories. Objectives. To determine the DEC prevalence in Peruvian children and to describe the genetic variability of these strains. Materials and methods. A total of 8 003 E. coli strains previously isolated from eight different studies of diarrhea in children, mainly from peri-urban areas of Lima, were analyzed. Diagnosis of DEC was done with Multiplex real-time PCR using genes for each of the 6 DEC groups. Conventional PCR was performed for the detection of additional virulence genes. Results. Globally, the mean prevalence in diarrhea samples (n=4,243) was: enteroaggregative E. coli (EAEC) 9.9 percent, enteropathogenic E. coli (EPEC) 8.5 percent, enterotoxigenic E. coli (ETEC) 6.9 percent, diffusely adherent E. coli (DAEC) 4.8 percent, Shiga toxin-producing E. coli (STEC) 0.8 percent and enteroinvasive E. coli (EIEC) 0.6 percent. The relative frequency of each pathogen varies according to the age and the type of study. The main pathotypes in control samples (n=3,760) were EPEC (10.9 percent) and EAEC (10.4 percent). An important variability in the virulence genes frequency and molecular resistance mechanisms for each pathotype was found, without differences between diarrhea and control groups. Conclusions. DEC are a major cause of diarrhea in Peruvian children. These pathogens are highly heterogeneous. Additional studies are required to determine the prevalence in rural areas of Peru and in severe diarrhea cases.
Asunto(s)
Humanos , Lactante , Diarrea/microbiología , Escherichia coli Enteropatógena/clasificación , Escherichia coli Enteropatógena/aislamiento & purificación , Infecciones por Escherichia coli/complicaciones , Escherichia coli Enteropatógena/genética , PerúRESUMEN
Escherichia coli enteropatógena (EPEC) es una de las principales causas de diarrea en niños menores de dos años en países en vías de desarrollo. La principal característica histopatológica de la infección es una lesión que induce la EPEC en el intestino conocida como la lesión A/E (adherencia y eliminación). Las bacterias se adhieren a los enterocitos y permiten la acumulación de la actina del citoesqueleto en la región apical de la célula, hasta formar una estructura de tipo "pedestal" y causar la eliminación de las microvellosidades intestinales. A pesar de que se conoce de modo detallado el proceso de formación de los pedestales de actina, aún no se ha esclarecido el mecanismo global de la diarrea que induce EPEC. La diarrea se ha vinculado con: a) la destrucción de las microvellosidades del enterocito, b) la salida masiva de iones hacia la luz intestinal y c) la secreción de alguna enterotoxina. En estudios realizados en países en vías de desarrollo se ha demostrado que EPEC es uno de los principales agentes participantes en la diarrea infantil, con elevadas tasas de morbilidad y mortalidad. El diagnóstico microbiológico de la infección se realiza con metodologías adicionales a las utilizadas con regularidad en el laboratorio de microbiología clínica, entre ellas las siguientes: a) serotipificación, b) ensayo de adherencia, c) prueba de FAS (tinción fluorescente para actina) y d) detección específica de genes que codifican a proteínas incluidas en la patogénesis, como el bfpA y eae. Un objetivo de esta revisión es actualizar los avances observados en la patogénesis molecular de la infección por EPEC, las metodologías para el diagnóstico microbiológico y la epidemiología en México y otros países en vías de desarrollo.
Enteropathogenic Escherichia coli (EPEC) is a leading cause of diarrhea in infants less than two years of age in developing countries. To induce diarrhea EPEC uses several virulence factors acting on a still unknown and mysterious mechanism. The hallmark of EPEC infection is a histological intestinal alteration known as the attaching and effacing (A/E) lesion. The bacterium attaches intimately to the enterocyte and induces assembly of cytoskeleton intracellular actin on the cellular surface. Rearrangements of the actin cytoskeleton form a pedestal-like structure where bacterium tightly cups the cells, leading to degeneration of brush border microvilli. Although the mechanism of EPEC-induced pedestal formation has been dissected in detail, the overall mechanism of diarrhea is still obscure. It is believed that EPEC-mediated secretory diarrhea is related to a) intestinal microvilli effacement, b) massive loss of intracellular ions into the intestinal milieu and c) secretion of an EPEC enterotoxin. Epidemiological studies conducted in developing countries have shown that EPEC is one of the main bacteria frequently isolated from children with diarrhea, causing high morbidity and mortality rates. The microbiological diagnosis of EPEC-induced disease is performed with analytic methodologies different from those used by the standard microbiology laboratory, the most relevant being: a) serotypification, b) the adherence assay, c) FAS test, and d) the specific detection of virulence-involved genes (bfpA and eae genes) using molecular biology techniques. The purpose of this review is to update the most recent findings regarding the molecular pathogenesis of EPEC, its epidemiology in Mexico as well as other developing countries, and also the developed methodology for the diagnosis of EPEC infection.