Infecciones por helmintos intestinales en Chile: Análisis retrospectivo en Santiago, años 2015-2019 / Intestinal helminth infections in Chile: a retrospective analysis in Santiago, 2015-2019

INTRODUCCIÓN: Existe escasa evidencia epidemiológica actual sobre helmintos intestinales en Chile. OBJETIVO: Describir la prevalencia de infecciones por helmintos intestinales en un centro de salud en Santiago, Chile. MÉTODOS: Análisis retrospectivo de helmintos intestinales diagnosticados en muestras parasitológicas de rutina en el Laboratorio de Microbiología de Clínica Alemana de Santiago, entre los años 2015 y 2019. Las pruebas diagnósticas se seleccionaron según la solicitud médica. Los datos se obtuvieron de los sistemas informáticos del laboratorio y se analizaron de manera anonimizada. RESULTADOS: Se detectaron 127 infecciones por helmintos en 11.809 muestras estudiadas (1,1%). Estas infecciones fueron: 78 (61,4%) Enterobius vermicularis, 25 (19,6%) Dibothriocephalus/Adenocephalus spp., 9 (7,1%) Taenia spp., 6 (4,7%) Pseudoterranova spp., 5 (3,9%) Strongyloides stercoralis y 4 (3,1%) Ascaris lumbricoides. Enterobius vermicularis predominó en niños y adolescentes; Dibothriocephalus/ Adenocephalus spp. predominó en adultos. CONCLUSIÓN: El estudio proporciona información epidemiológica actual sobre la distribución de helmintos intestinales en muestras clínicas en Santiago, Chile. Enterobius vermicularis fue prevalente, seguido de helmintos transmitidos por alimentos mientras que los transmitidos por el suelo solo se detectaron ocasionalmente. El surgimiento de difilobotriasis y anisakidosis (pseudoterranoviasis), es relevante y posiblemente se relacione con cambios en las condiciones de vida y la cultura alimentaria en Chile.

BACKGROUND: Epidemiological information on the current prevalence of intestinal helminths in Chile is scarce. AIM: To describe the prevalence of different intestinal helminth infections in a healthcare center in Santiago, Chile. METHODS: We performed a retrospective analysis of intestinal helminths diagnosed in routine parasitological samples in the microbiological laboratory of Clínica Alemana Santiago, Chile, between 2015 and 2019. Diagnostic tests were applied according to the sender's request. Data were obtained from laboratory information systems and analyzed in an anonymized manner. RESULTS: Among 11,809 samples, 127 (1.1%) helminth infections were detected, of those, 78 (61.4%) were Enterobius vermicularis, 25 (19.6%) Dibothriocephalus/Adenocephalus spp., 9 (7.1%) Taenia spp., 6 (4.7%) Pseudoterranova spp., 5 (3.9%) Strongyloides stercoralis, and 4 (3.1%) Ascaris lumbricoides. Enterobius vermicularis was predominant among children and adolescents, while Dibothriocephalus/Adenocephalus spp. was the most frequent helminth in adults. CONCLUSION: The study provides updated epidemiological information on distribution of helminth infections in clinical samples in Santiago, Chile. After E. vermicularis, food-borne helminths were second most prevalent, while soiltransmitted helminths were very rarely detected. The emergence of diphyllobothriasis and anisakidosis (pseudoterranoviasis) is noteworthy and possibly related to changes in living conditions and food culture in Chile.

Genomic epidemiology of Vibrio parahaemolyticus from acute diarrheal patients in Shenzhen City from 2013 to 2021 / 中华预防医学杂志

Objective: To characterize the prevalence and genomic epidemiology of Vibrio parahaemolyticus from acute diarrheal patients in Shenzhen City from 2013 to 2021. Methods: Based on the Shenzhen Infectious Diarrhea Surveillance System, acute diarrheal patients were actively monitored in sentinel hospitals from 2013 to 2021. Whole-genome sequencing (WGS) of Vibrio parahaemolyticus isolates was performed, and the genomic population structure, serotypes, virulence genes and multilocus sequence typing were analyzed. Outbreak clusters from 2019 to 2021 were explored based on single-nucleotide polymorphism analysis. Results: A total of 48 623 acute diarrhea cases were monitored in 15 sentinel hospitals from 2013 to 2021, and 1 135 Vibrio parahaemolyticus strains were isolated, with a positive isolation rate of 2.3%. Qualified whole-genome sequencing data of 852 isolates were obtained. Eighty-nine serotypes, 21 known ST types and 5 new ST types were identified by sequence analysis, and 93.2% of strains were detected with toxin profile of tdh+trh-. 8 clonal groups (CGs) were captured, with CG3 as the absolute predominance, followed by CG189. The CG3 group was dominated by O3:K6 serotype and ST3 sequence type, while CG189 group was mainly O4:KUT, O4:K8 serotypes and ST189a and ST189 type. A total of 13 clusters were identified, containing 154 cases. About 30 outbreak clusters with 29 outbreak clusters caused by CG3 strains from 2019 to 2021. Conclusion: Vibrio parahaemolyticus is a major pathogen of acute infectious diarrhea in Shenzhen City, with diverse population structures. CG3 and CG189 have been prevalent and predominant in Shenzhen City for a long time. Scattered outbreaks and persistent sources of contamination ignored by traditional methods could be captured by WGS analysis. Tracing the source of epidemic clone groups and taking precise prevention and control measures are expected to significantly reduce the burden of diarrhea diseases caused by Vibrio parahaemolyticus infection in Shenzhen City.

Tracing investigation and analysis of a Clostridium botulinum food poisoning incident in Bayingolin Mongolian Autonomous Prefecture, Xinjiang / 中华预防医学杂志

To analyze a suspected case of Clostridium botulinum food poisoning in Bayingolin Mongolian Autonomous Prefecture, Xinjiang and to help validating the diagnosis and providing technical support for clinical treatment. The basic information and clinical manifestations of food poisoning cases were investigated by using the epidemiological method of food safety accidents. The botulinum toxin genes in the samples were detected by real-time PCR and inoculation of KM mouse. The enriched bacteria were further purified and validated. PFGE and cluster analysis were performed on five isolates. Clostridium botulinum type A was detected in two homemade fermented bean samples and stool lavage fluid samples of three patients from enriched samples by toxin test and real-time PCR, and were further validated after isolation of Clostridium botulinum. PFGE showed 100% homology among five isolates. Five isolates of bacteria isolated from the stool lavage fluid of three patients and two homemade fermented bean curd were identified as the same source through PFGE. The cause of this food poisoning cases is food pollution of Clostridium botulinum type A.

Combined application of field epidemiology and laboratory etiology analysis in the investigation of a foodborne disease outbreak in Xinjiang uygur Autonomous Region, 2016 / 中华预防医学杂志

Objectives: To analyze the causes of a foodborne outbreak in rural areas of Xinjiang between April 2 and April 5 in 2016. Methods: Cases and the relevant background information were obtained by consulting outpatient records of local health centers and regional people's hospitals and interviewing doctors and residents. All samples were collected by the laboratory test through epidemiological and food hygiene investigations. The χ2 test (Fisher's exact probability method) was used to compare differences in incidence rates. Molecular typing, virulence genes and single nucleotide polymorphisms (SNPS) were analyzed by using Pulsed Field Gel Electrophoresis (PFGE) and Whole Genome Sequencing (WGS). Results: A total of 142 cases were found in this study, with incidence rate at 5.7‰ (142/24 979). Among all cases, the main symptoms were nausea (94%), vomiting (92%) and abdominal pain (67%), and the incubation period was about 2 h (1-7.5 h). There were 16 Staphylococcus aureus isolates identified and all of them could produce A+C+E mixed enterotoxin. PFGE showed 100% homology. WGS further revealed that there were 9 and 1 strains contained by Sequence Type 1 (ST1) and ST5405, respectively. All ST1 strains were in the same clade on the genome tree. Among these, 7 strains shared close proximity (74 SNPs) and 2 strains shared close relationships as well (127 SNPs). The S. aureus isolates that caused the outbreak were introduced by a mutant isolate from the milk supply station. Conclusions: This foodborne outbreak was mainly caused by Staphylococcus aureus contamination.

Epidemiological and etiological characteristics of Vibrio parahaemolyticus strains causing foodborne disease outbreaks in Guangdong Province from 2017 to 2020 / 中华预防医学杂志

Objective: To study the epidemiological and pathogenic characteristics of Vibrio parahaemolyticus isolated from outbreaks cases in Guangdong Province, 2017-2020. Methods: Epidemiological characteristics of 87 outbreak events caused by Vibrio parahaemolyticus were analyzed. Strains were serotyped, and then analyzed by pulsed-field gel electrophoresis (PFGE). Results: The food-borne disease outbreak caused by Vibrio parahaemolyticus was found in 16 cities. 44.8% (39/87) and 37.9% (33/87) of the outbreaks occurred in hotels, restaurants and school canteens, respectively. Improper food processing and storage (40.2%, 35/87) and cross contamination caused by indiscriminate raw and cooked food (25.3%, 22/87) were the main causes of food-borne disease outbreaks of Vibrio parahaemolyticus. The main serotypes of patient derived strains were O3:K6 (87.5%) and O4:KUT (22.5%). The similarity value between O3:K6 type isolates was 65.5%-100.0%, and the PFGE pattern similarity value of O4:KUT type isolates was 66.5%-100.0%. Conclusion: Outbreaks caused by Vibrio parahaemolyticus are widely distributed in Guangdong province. It is necessary to strengthen the publicity and education on the correct handling of food in hotels, restaurants, schools, and unit canteens. O3:K6 and O4:KUT serotypes are the main serotypes of the outbreak. There is genetic diversity among the epidemic strains.

Molecular characterization of Staphylococcus aureus ST6 and ST7 isolates from food-borne illness outbreaks / 中华预防医学杂志

Objective: To analyze the Staphylococcal enterotoxins, Staphylococcal enterotoxin genes, drug resistance and molecular typing of 41 Staphylococcus aureus isolates from 2 food-borne illness outbreaks on 21 August and 27 September 2020 in Guangzhou. Methods: A total of 41 Staphylococcus aureus isolates from 2 outbreaks were analyzed by multilocus sequence typing (MLST) and spa typing. The Staphylococcal enterotoxins typing and the Staphylococcal enterotoxin genes of the isolates were analyzed by ELISA and PCR, respectively. The antimicrobial susceptibility of the isolates was performed by disc diffusion. 21 Staphylococcus aureus isolates were characterized using whole genome sequencing (WGS). Based on the whole genome single nucleotide polymorphism (SNP), the phylogenetic tree was constructed by Snippy. Results: 41 Staphylococcus aureus isolates were divided into 2 types by MLST and spa typing: ST6-t701 and ST7-t091. 2 ST7-t091 isolates were identified as methicillin-resistant Staphylococcus aureus (MRSA). 25 ST7-t091 isolates and 14 ST6-t701 isolates were methicillin-sensitive Staphylococcus aureus (MSSA), and were resistant to 7 and 6 antibiotics, respectively. All isolates were positive for sea by PCR. WGS revealed all 21 isolates carried scn, sak, sea, hla, hld, hlgA, hlgB, hlgC, lukD virulence genes. The results showed the isolates contained an immune evasion cluster type D which located in bacteriophage ϕSa3. The SNP phylogenetic tree showed 2 MRSA ST7-t091 were constituted a separate clade from the 12 MSSA ST7-t091 isolates and 7 ST6-t701 isolates showed high similarity to each other. Conclusion: Base on the results of phylogenetic analysis, the 2 food-borne illness outbreaks occurred on 21 August and 27 September 2020 are caused by the combination of the MRSA ST7-t091 strain and the MSSA ST7-t091 strain, and the MSSA ST6-t701 strain, respectively. All isolates have high level of antibiotic resistance and carry high virulent genes.

Prospect of microbial food borne diseases in Pakistan: a review / Perspectiva de doenças microbianas transmitidas por alimentos no Paquistão: uma revisão

Abstract Nowadays food borne illness is most common in people due to their epidemic nature. These diseases affect the human digestive system through bacteria, viruses and parasites. The agents of illness are transmitted in our body through various types of food items, water and uncooked. Pathogens show drastic changes in immunosuppressant people. This review gives general insights to harmful microbial life. Pakistan is a developed country and because of its improper food management, a lot of gastrointestinal problems are noted in many patients. Bacteria are most common agents to spread diarrhoea, villi infection, constipation and dysenteric disease in human and induce the rejection of organ transplant. Enhancement of their lifestyle, properly cooked food should be used and to overcome the outbreak of the diseases.

Resumo Hoje em dia, as doenças transmitidas por alimentos são mais comuns em pessoas devido à sua natureza epidêmica. Essas doenças afetam o sistema digestivo humano por meio de bactérias, vírus e parasitas. Os agentes das doenças são transmitidos em nosso corpo por meio de diversos tipos de alimentos, água e crus. Os patógenos mostram mudanças drásticas em pessoas imunossupressoras. Esta revisão fornece uma visão geral da vida microbiana prejudicial. O Paquistão é um país desenvolvido e, devido ao seu manejo alimentar inadequado, muitos problemas gastrointestinais são observados em muitos pacientes. As bactérias são os agentes mais comuns para espalhar diarreia, infecção de vilosidades, obstipação e doença disentérica em humanos e induzem a rejeição de transplantes de órgãos. Melhoria de seu estilo de vida, alimentos devidamente cozidos devem ser utilizados e para superar o aparecimento de doenças.

Vigilância epidemiológica das doenças de transmissão hídrica e alimentar: manual de treinamento / Epidemiological surveillance of water and foodborne diseases: training manual

Este Manual é um instrumento que subsidia o treinamento em vigilância epidemiológica das doenças de transmissão hídrica e alimentar (VE-DTHA), direcionado para profissionais de saúde que atuam na investigação de surtos ou de casos de doenças de notificação compulsória relacionadas à transmissão hídrica e alimentar.

Caracterización de agentes bacterianos aislados en brotes de enfermedades transmitidas por alimentos / Characterization of bacterial agents isolated in diseases outbreaks transmitted by foods

Introducción: Las enfermedades transmitidas por alimentos se producen por ingestión de un alimento, incluido el agua, que puede estar contaminado por diversos agentes. Objetivo: Caracterizar los agentes bacterianos aislados en brotes de enfermedades transmitidas por alimentos. Métodos: Se realizó un estudio observacional, descriptivo y transversal de 100,0 % de los brotes de enfermedades transmitidas por alimentos en la provincia de Santiago de Cuba, desde enero de 2018 hasta diciembre de 2019, para lo cual se seleccionaron muestras de alimentos y heces fecales. La caracterización de las bacterias aisladas se basó en los resultados del crecimiento y otras pruebas bioquímicas-metabólicas. Se utilizaron resultados del aislamiento y confirmación de los agentes identificados en cada uno de los brotes a partir de las muestras antes citadas. Entre las variables analizadas figuraron: número de brotes, muestras de alimentos, de heces fecales y resultados de pruebas bioquímicas y metabólicas. Resultados: Se obtuvo un aislamiento de agentes bacterianos en 100,0 % de las muestras de alimentos. Hubo una mayor frecuencia de bacterias Gram negativas (82,0 %) y la menor correspondió a microorganismos Gram positivos (18,0 %). La Salmonella D fue el microorganismo más frecuente. Conclusiones: Este resultado representa un instrumento para el diagnóstico etiológico de los brotes de enfermedades transmitidas por alimentos en Santiago de Cuba.

Introduction: Diseases transmitted by foods are produced due to ingestion of a food, including water that can be contaminated by diverse agents. Objective: To characterize the bacterial agents isolated in diseases outbreaks transmitted by foods. Methods: An observational, descriptive and cross-sectional study of 100.0 % of the diseases outbreaks transmitted by foods in Santiago de Cuba, from January, 2018 to December, 2019 was carried out, for which samples of foods and stools were selected. The characterization of the isolated bacterias was based on the results of growth and other biochemical-metabolic tests. Results of the isolation and confirmation of agents identified in each one of the outbreaks from the samples mentioned above were used. Among the analyzed variables we can mention: number of outbreaks, samples of foods, samples of stools and results of biochemical and metabolic tests. Results: An isolation of bacterial agents was obtained in 100.0 % of foods samples. There was a higher frequency of Gram negative bacterias (82.0 %) and the lower corresponded to Gram positive microorganisms (18.0 %). Salmonella D was the most frequent microorganism. Conclusions: This result represents an instrument for the etiological diagnosis of diseases outbreaks transmitted by foods in Santiago de Cuba.

Characteristics related to fish consumption and the risk of ichthyozoonosis in a Colombian population / Características relacionas al con el consumo de pescado y el riesgo de ictiozoonosis en una población de Colombia

ABSTRACT Objective This study aimed to determine the dietary habits related to fish consumption and the risk factors associated with acquiring an ichthyo-zoonotic disease. Materials and Methods A descriptive, cross-sectional study was carried out by means of a structured survey administered to 150 individuals in the city of Cali, Colombia. Results Epidemiological variables regarding fish consumption and preparation were contrasted with the medical records of the respondents. The median fish consumption in the surveyed population was three times a month, with raw or salted/marinated fish once a month. A positive correlation between fish consumption and allergic conditions was confirmed. There was no infectious or parasitic history associated with the data on fish consumption. Conclusions A relationship between fish consumption and allergies was confirmed. Further research is necessary to establish the possible pathogens associated with hypersensitivity, such as parasites of the Anisakidae family.(AU)

RESUMEN Objetivo Este estudio tuvo como fin determinar los hábitos alimenticios relacionados con el consumo de pescado y los factores de riesgo asociados con la adquisición de una enfermedad ictio-zoonótica. Materiales y Métodos Se realizó un estudio descriptivo de corte transversal mediante una encuesta estructurada a 150 individuos de la ciudad de Cali, Colombia. Resultados Las variables epidemiológicas del consumo y preparación de pescado se relacionaron con la historia clínica de los encuestados. El consumo medio de pescado en los encuestados fue de tres veces al mes, con pescado crudo o salado/marinado una vez al mes. Se confirmó una correlación positiva entre el consumo de pescado y las condiciones alérgicas. No se asociaron antecedentes infecciosos o parasitarios con los datos sobre el consumo de pescado. Conclusión Fue posible confirmar una relación entre el consumo de pescado y las condiciones alérgicas. Se necesita investigación para establecer los posibles patógenos asociados con la hipersensibilidad, como los parásitos de la familia Anisakidae.(AU)

Levantamento de dados epidemiológicos de surtos de doenças transmitidas por alimentos na cidade de Juiz de Fora, MG, no período de 2007 a 2017 / Data research of foodborne diseases outbreaks from the city of Juiz de Fora, MG, in the period from 2007 to 2017

O perfil epidemiológico das doenças transmitidas por alimentos (DTAs) no Brasil ainda é pouco conhecido, nem todos os estados e/ou municípios dispõem de estatísticas e levantamentos reais sobre as variáveis associadas a essas enfermidades. O objetivo do trabalho foi realizar um levantamento dos dados sobre surtos de origem alimentar ocorridos em Juiz de Fora, MG, no período de 2007 a 2017. Houve 21 notificações de surtos, e em 71,42% desses não se identificou o agente etiológico envolvido. Dos alimentos incriminados, em 66,66% dos casos, estes eram ou continham em sua composição produtos de origem animal. A residência foi o local mais identificado como de início da ocorrência de surtos, representando 28,57% dos casos. Faz-se necessário o desenvolvimento de políticas públicas para a correta notificação das DTAs e, ainda, a conscientização de manipuladores de alimentos quanto aos cuidados na conservação e manipulação dos mesmos, com o objetivo reduzir a ocorrência dessas enfermidades.

Análise dos surtos de origem alimentar notificados no Brasil no período de 2015 a 2017

Perigos químicos, físicos ou microbiológicos podem contaminar os alimentos e causar doenças de origem alimentar. Neste estudo foram analisados os surtos de doenças transmitidas por alimentos notificados no Brasil entre 2015 e 2017. Os resultados indicam que neste período foram notificados 1.758 surtos. O maior número de surtos ocorreu na região sudeste 37,1 %. Os locais de ocorrência dos surtos aconteceram em maior número nas residências (34,3%), restaurantes, padarias e similares (17,1 %) e 16,7% dos locais de ocorrência não foram identificados. Os alimentos mistos foram os mais envolvidos (13,6%), seguidos pela água (8,4%), carnes vermelhas (3,3%), leites e derivados (3,1%) e frutas (1,2%), sendo que em 66% dos surtos, os alimentos responsáveis não foram identificados. Os surtos foram principalmente de origem bacteriana, seguido por vírus e protozoários. No presente estudo, o micro-organismo causador do maior número de surtos foi a Escherichia coli (8%), seguido da Salmonella sp. (4%) e Staphylococcus sp. (3,9%), vale salientar que o agente etiológico não identificado, obteve o maior percentual com 74%, porém tal fato se deve ao atraso ou à inexistência das coletas, tanto clínicas como bromatológicas. Diante da análise dos dados, conclui-se que a maioria dos surtos de origem alimentar notificados no período apresentou resultados inconclusivos em relação aos micro-organismos e alimentos causadores destes, salientando, portanto que os órgãos fiscalizadores devem se preocupar em criar estratégias que possibilitem diminuir essas incidências inconclusas que interferem negativamente na possibilidade da criação de intervenções para minimizar a ocorrências destes tipos de surtos.

Chemical, physical or microbiological hazards can contaminate food and cause food-borne diseases. In this study we analyzed the foodborne disease outbreaks reported in Brazil between 2015 and 2017. The results indicate that in this period 1,758 were reported outbreaks. The largest number of outbreaks occurred in the southeastern region 37.1%. The locations of occurrence of outbreaks occurred in greater numbers in the residences (34.3%), restaurants, bakeries and similar (17.1 %) and 16. 7% of occurrence sites have not been identified. The mixed foods were the most involved (13.6%), followed by water (8.4%), red meat (3.3%), milk and dairy products (3.1%) and fruits (1.2%), and in 66% of the outbreaks, the food responsible have not been identified. The outbreaks were primarily of bacterial origin, followed by viruses and protozoa. In the present study, the microorganism which caused the largest number of outbreaks was Escherichia coli (8%), followed by Salmonella sp. (4%) and Staphylococcus sp. (3.9%), it's worth pointing out that the Etiologic Agent not identified, obtained the highest percentage with 74%, however such fact is due to the delay or the absence of the collections, both clinics as qualitative characteristics. On the analysis of the data, it is concluded that the majority of food-borne outbreaks reported inconclusive results regarding the microorganisms and foods that cause these, stressing, so that regulatory agencies should be bothering to create strategies to decrease these incidents that interfere negatively inconclusive negotiations on the possibility of creating interventions to minimize the occurrences of these types of outbreaks.

Aislamiento de Bacillus cereus en restaurantes escolares de Colombia / Isolation of Bacillus cereus in school restaurants in Colombia

Resumen Introducción. Bacillus cereus es reconocido como un agente patógeno causante de intoxicaciones alimentarias. Se trata de una bacteria de metabolismo aerobio facultativo capaz de formar esporas, lo que le permite sobrevivir a la pasteurización y el calentamiento e, incluso, a la irradiación con los rayos gamma usados para reducir los agentes patógenos de los alimentos. Objetivo. Estudiar la presencia de B. cereus y su toxina diarreica en el arroz y en alimentos a base de cereales, harinas o féculas listos para el consumo en restaurantes escolares de algunos departamentos de Colombia. Materiales y métodos. Se hizo un estudio descriptivo y transversal con alimentos listos para el consumo distribuidos en restaurantes escolares de los departamentos que más notifican enfermedades transmitidas por alimentos al sistema de vigilancia, así como en los de menor notificación. Resultados. Se recolectaron 479 muestras en ocho departamentos, 74 municipios y 363 restaurantes escolares; el 63 % correspondió a muestras de arroz y el 37 % a alimentos como coladas. El 9 % de las muestras analizadas fueron positivas para B. cereus y, en el 91 % de estas, se detectó la toxina diarreica. Conclusiones. En todos los departamentos estudiados se encontró B. cereus. El manejo de materias primas y el inadecuado tratamiento térmico de los alimentos fueron los factores directamente relacionados con las enfermedades transmitidas por alimentos. Es importante reforzar la vigilancia e incentivar la investigación y la notificación de los brotes de enfermedades transmitidas por alimentos para mejorar la calidad de la información, llevar a cabo acciones de comunicación, prevención y coordinación intersectorial, y con los manipuladores, con el fin de adoptar las medidas necesarias que garanticen la inocuidad de los alimentos, así como la eliminación de los factores de riesgo de estas enfermedades.

Abstract Introduction: Bacillus cereus is recognized as a pathogen that causes food poisoning. It is a facultative aerobic metabolism bacterium capable of forming spores, which allows it to survive pasteurization and heating even by the gamma irradiation used to reduce pathogens in food. Objective: To study the presence of Bacillus cereus and its diarrheal toxin in rice and ready-to-eat cereals, flours, and starches in school restaurants in Colombia. Materials and methods: We conducted a descriptive cross-sectional study of ready-to-eat foods distributed in school restaurants in the departments with the most and the least notification of foodborne diseases to the surveillance system. Results: A total of 479 samples were collected from eight departments, 74 municipalities, and 363 school restaurants, 63% of which were rice samples and 37%, starchy food samples; 9% of them tested positive for Bacillus cereus. In 91% of the samples that tested positive, the bacterium was isolated with the presence of the diarrheal toxin. Conclusions: In all the departments with B. cereus in the samples, the factors directly related to food-borne diseases were the handling of raw materials and the poor thermal treatment of food. Strengthening surveillance by stimulating research and reporting on outbreaks of foodborne diseases is important to improve the quality of information, to develop communication, prevention and intersectional coordination and manipulation measures, as well as to take the necessary actions to guarantee the safety of food and to eliminate the risk factors that may contribute to this problem.

Detección molecular de Salmonella spp., Listeria spp. y Brucella spp. en queso artesanal fresco comercializado en Barranquilla: un estudio piloto / Molecular detection of Salmonella spp., Listeria spp. and Brucella spp. in fresh artisanal cheese marketed in the city of Barranquilla: A pilot study

Introducción. Cada año mueren, aproximadamente, tres millones de personas como consecuencia de las enfermedades transmitidas por alimentos. El queso artesanal fresco que se produce y distribuye en la región Caribe colombiana es un producto autóctono de los departamentos de Córdoba, Sucre, Bolívar, Atlántico, Magdalena, Cesar y La Guajira. Su consumo masivo aumenta el riesgo de infección con salmonelosis, listeriosis y brucelosis debido a que es elaborado con una tecnología muy rústica, con leche de vaca no pasteurizada, sin procedimientos estandarizados e higiénicos, y a que su almacenamiento no es adecuado. Objetivo. Detectar la presencia de Salmonella spp., Listeria spp. y Brucella spp. en muestras de queso artesanal costeño fresco procedente de los departamentos de la región Caribe colombiana. Materiales y métodos. Mediante reacción en cadena de la polimerasa en tiempo real (qPCR), se analizaron 27 muestras de queso proveniente de cinco departamentos de la región Caribe: Atlántico (n=6), Bolívar (n=2), Córdoba (n=1), Magdalena (n=16) y Sucre (n=2). Del total de las muestras, 17 eran de queso blando, cinco de queso semiduro y cinco de queso duro. Resultados. En el 62,9 % de las muestras se detectó Salmonella spp. (17/27), en el 70,4 %, Listeria spp. (19/27), y en el 22,2 %, Brucella spp. (6/27). Las muestras provenían principalmente del departamento del Magdalena y, en 62,5 % (10/16) de ellas, se encontró Salmonella spp. y Listeria spp., en tanto que en el 50 % (3/6) de las muestras del departamento del Atlántico se detectó Brucella spp. Conclusión. Los resultados evidenciaron la presencia de estos microorganismos en todas las muestras de queso costeño blando.

Introduction: Each year approximately 3 million people die as the result of foodborne diseases. The fresh artisan (handmade) cheese produced and distributed in the Colombian Caribbean region is a native product from the departments of Córdoba, Sucre, Bolívar, Atlántico, Magdalena, Cesar, and La Guajira. Its mass consumption increases the risk of infection with Salmonella spp., Listeria spp., and Brucella spp., as it is made with a very rustic technology, with unpasteurized cow milk, without standardized and hygienic procedures and its storage is inadequate. Objective: To detect the presence of Salmonella spp., Listeria spp., and Brucella spp. in samples of fresh artisan cheese from the Colombian Caribbean region. Materials and methods: Twenty-seven samples of cheese from five departments of the Caribbean Region (Atlántico (n=6), Bolívar (n=2), Córdoba (n=1), Magdalena (n=16), and Sucre (n=2)) were analyzed by real-time polymerase chain reaction (qPCR). Seventeen of the samples corresponded to soft cheese, five to semi-hard cheese and five to hard cheese. Results: In 62.9% (17/27) of the samples we detected Salmonella spp., in 70.4% (19/27), Listeria spp., and in 22.2% (6/27), Brucella spp., mainly from the department of Magdalena. In 62.5% (10/16) of the samples we detected Salmonella spp. and Listeria spp. while in the department of Atlántico, 50% (3/6) of the samples corresponded to Brucella spp. Conclusion: The results confirmed the presence of these microorganisms in all the samples of soft cheese from the Colombian Caribbean region.

Perfiles genéticos bacterianos y análisis de brotes de las Enfermedades Transmitidas por Alimentos empleando Electroforesis de Campo Pulsado como herramienta para la vigilancia epidemiológica molecular / Bacterial genetic profiles and analysis of outbreaks of foodborne diseases using pulsed field gel electrophoresis as a tool for molecular epidemiological surveillance

Las Enfermedades de Transmisión Alimentaria (ETA) son un problema de salud pública con altos índices de morbilidad y mortalidad a nivel global. La vigilancia y estudio de brotes de las ETA a través de Electroforesis de Campo Pulsado (PFGE) constituye un soporte fundamental para la investigación epidemiológica. El objetivo del estudio es presentar la base de datos de perfiles genéticos bacterianos y analizar brotes de enfermedades transmitidas por alimentos empleando Electroforesis de Campo Pulsado. Estudio descriptivo observacional de carácter retrospectivo, muestreo por conveniencia en el que fueron estudiados 778 aislamientos bacterianos causantes de ETA. La Base de Datos Nacional (BDN) quedó conformada por los siguientes patógenos entéricos; Salmonella spp., Shigella sonnei, Vibrio cholerae, Campylobacter spp., Escherichia coli O157:H7 y Escherichia coli no O157 caracterizados por una diversidad de patrones únicos, clusters y brotes. La BDN de Salmonella spp., quedó representada por un total de 558 cepas con 248 PUN, de las cuales 22,6% (126 cepas) corresponden a Salmonella enterica ser. Typhimurium, 20,6% (115 cepas) a Salmonella enterica ser. Enteritidis, 9,1% (51 cepas) a Salmonella enterica ser. Newport, 1,6% (9 cepas) a Salmonella enterica ser. Muenchen, que al mismo tiempo son los serotipos que están asociados a brotes. Fueron confirmados un total de 13 brotes causados por Salmonella spp.; Shigella sonnei con 113 cepas estudiadas, 57 patrones únicos y 19 clusters detectados. Se identificaron 3 patrones PYJ16X01.0012, PYJ16X01.0034 y PYJ16X01.0014 como los predominantes. Vibrio cholerae con 18 cepas estudiadas, 9 patrones únicos y 4 clusters detectados. Se pudo establecer una relación genética del 100% entre cepas de Vibrio cholerae O1 biotipo El Tor serotipo Ogawa productora de toxinas ctxA y tcpA aislada del caso índice del brote de cólera. Campylobacter spp., con 62 cepas estudiadas, 42 patrones únicos y 10 clusters detectados. La BDN de E. coli productor de toxina shiga O157 y no O157, con 9 y 20 cepas de origen humano respectivamente, caracterizadas según sus factores de virulencia y subtipos. Se reconocieron 8 patrones electroforéticos PUN y 1 cluster para E. coli productor de toxina shiga O157, y 18 PUN y 1 clúster para E. coli productor de toxina shiga no O157.La disponibilidad de una Base de Datos Nacional de patógenos bacterianos transmitidos por alimentos constituye un importante avance para la salud pública, con un gran aporte en la vigilancia y epidemiología del país permitiendo la confirmación y detección de brotes discriminando aislamientos relacionados genéticamente y por consiguiente el estudio de relaciones clonales y probable origen(AU)

Foodborne diseases (FBD) are a problem of public health with high indexes of morbidity and mortality at global level. The surveillance and study of outbreaks of the FBD through pulsed field gel electrophoresis (PFGE) is a fundamental support for epidemiological research. The aim of the study is to present the database of bacterial genetic profiles and analyze outbreaks of FBD using PFGE. This was an observational descriptive retrospective study with convenience sampling in which 778 bacterial isolates causing FBD were studied. The National Database (NDB) was made up of the following enteric pathogens causing FBD: Salmonella spp., Shigella sonnei, Vibrio cholerae, Campylobacter spp., Escherichia coli O157: H7 and Escherichia coli no O157. Each of them was characterized by a diversity of unique patterns, clusters and outbreaks. The NDB of Salmonella spp. was represented by a total of 558 strains with 248 PUN, of which 22.6% (126 strains) correspond to Salmonella enterica ser. Typhimurium, 20.6% (115 strains) to Salmonella enterica ser. Enteritidis, 9.1% (51 strains) to Salmonella enterica ser. Newport, 1.6% (9 strains) to Salmonella enterica ser. Muenchen, which at the same time are the serotypes associated with outbreaks. A total of thirteen outbreaks caused by Salmonella spp., Shigella sonnei with 113 strains studied, 57 unique patterns and 19 clusters detected were confirmed. Three patterns PYJ16X01.0012, PYJ16X01.0034 and PYJ16X01.0014 were identified as the predominant. Vibrio cholerae with 18 strains studied, 9 unique patterns and 4 clusters were detected. A genetic relationship of 100% was established between strains of Vibrio cholerae O1 biotype El Tor serotype Ogawa toxin producer ctxA and tcpA isolated from the index case of the cholera outbreak. Campylobacter spp., with 62 strains studied, 42 unique patterns and 10 clusters were detected. The NDB of O157 and non-O157 Shiga toxin producing E. coli O157, with 9 and 20 strains of human origin respectively, were characterized according to their virulence factors and subtypes. We recognized 8 PUN electrophoretic patterns and 1 cluster for O157 Shiga toxin producing E. coli, and 18 PUN and 1 cluster for non-O157 Shiga toxin producing E. coli. The availability of a National Database of bacterial pathogens transmitted by food constitutes an important advance for public health, with a great contribution to the surveillance and epidemiology of the country allowing the confirmation and detection of outbreaks discriminating genetically related isolates and therefore, the study of clonal relationships and probable origin(AU)

Bacillus cereus as the main casual agent of foodborne outbreaks in Southern Brazil: data from 11 years / Bacillus cereus como principal agente etiológico em surtos de intoxicação alimentar no Sul do Brasil: dados de 11 anos / Bacillus cereus como el principal agente causante de brotes de enfermedades alimentarias en el Sur de Brasil: datos de 11 años

Foodborne diseases are a global concern. In Brazil, the most prevalent pathogen found in foodborne outbreaks is Salmonella sp. (14.4%), followed by Staphylococcus aureus (7.7%), Escherichia coli (6.5%), and Bacillus cereus (3.1%). With the aim to perform a regional detailed analysis of foodborne intoxication, we analyzed 253 outbreaks' profile reports to Food Surveillance team of the General Secretariat of Health Surveillance of Porto Alegre, Rio Grande do Sul State, between 2003 and 2013. In contrast to what was most notified in Brazil, in Porto Alegre the main outbreak agent identified was Bacillus cereus (32.2%) and, based on the patient symptoms, most cases were linked to enterotoxin production. The majority of the outbreaks were linked to the ingestion of food containing cereals or sauces poorly kept at environment temperature during the stock or preparation. We believe that, due to the compulsory use of pasteurized eggs in our city, Salmonella sp. outbreaks are less important here.

As doenças de veiculação alimentar representam um problema de ordem global. No Brasil, o patógeno mais prevalente em surtos de intoxicação alimentar é a Salmonella sp. (14,4%), seguido pelo Staphylococcus aureus (7,7%), Escherichia coli (6,5%) e Bacillus cereus (3,1%). Com o objetivo de realizar uma análise regional detalhada da intoxicação alimentar, examinamos os relatórios de 253 surtos, notificados à equipe de Vigilância de Alimentos da Coordenadoria Geral de Vigilância em Saúde de Porto Alegre, Rio Grande do Sul, entre 2003 e 2013. Ao contrário do que é notificado no Brasil, em Porto Alegre, identificamos como principal agente etiológico, o Bacillus cereus (32,2%) e de acordo com os sintomas dos pacientes, a maioria dos casos esteve associada à produção de enterotoxina. A maioria dos surtos foram associados à ingestão de alimentos que continham cereais ou molhos mantidos à temperatura ambiente durante o armazenamento ou preparação. O uso compulsório de ovos pasteurizados em Porto Alegre pode explicar a relativa escassez de surtos de Salmonella sp. no município.

Las enfermedades transmitidas a través de la comida son una preocupación de carácter global. En Brasil, el patógeno encontrado de forma más prevalente en los brotes de epidemias alimentarias es la Salmonella sp. (14,4%), seguida por el Staphylococcus aureus (7,7%), Escherichia coli (6,5%), y el Bacillus cereus (3,1%). Con el fin de realizar un análisis regional detallado de los brotes de infecciones alimentarias, analizamos el perfil de 253 brotes, registrados por el servicio de Vigilancia Alimentaria de la Secretaría General de Vigilancia en Salud de Porto Alegre, Rio Grande do Sul, entre 2003 y 2013. En contraste con lo que fue más notificado en Brasil, en Porto Alegre el principal agente causante de brotes fue identificado como el Bacillus cereus (32.2%) y, basado en los síntomas del paciente, la mayoría de los casos estaban relacionados con la producción de la enterotoxina. Muchos de los brotes estaban relacionados con la ingesta de comida que contenía cereales o salsas mal conservadas a temperatura ambiente durante el almacenaje o la preparación. Creemos que, debido a la utilización obligatoria de huevos pasteurizados en nuestra ciudad, los brotes de Salmonella sp. son menos relevantes aquí.

Problemas medioambientales y transmisión de enfermedades por alimentos / Environmental problems and the transmission of illnesses for foods

Se realizó un estudio bibliográfico dentro del Proyecto Investigativo Institucional para el desarrollo sociohumanista de los profesionales de la salud durante el período mayo 2016-junio2017, centrado en la relación entre agroecosistemas frágiles afectados por intensas sequías y la transmisión de enfermedades por alimentos, ante el aumento de su incidencia en el estado de salud de la población guantanamera, dirigido a elevar el nivel de conocimientos de profesionales la salud y población en general acerca de este tema. Se estudiaron sus causas, diferentes manifestaciones y sus efectos en la producción, tratamiento y distribución de alimentos, información primaria para el diseño de plegables, póster y mini monografías con información actualizada acerca de la relación antes citada. Las acciones de promoción de salud propuestas favorecen el logro de integralidad en el manejo de los alimentos, así como calidad en la gestión ambiental en agroecosistemas frágiles, según el criterio de especialistas(AU)

It was carried out a bibliographical study inside the Institutional Investigative Project for the socio humanist development of the professionals of the health during the May 2016 - June 2017, centered in the relationship among fragile agro ecosystems affected by intense droughts and the transmission of illnesses by foods, before the increase of their incidence in the state of the population's of Guantanamo health, directed to elevate the level of professionals' knowledge the health and population in general about this topic. These causes' different manifestations and their effects were studied in the production, treatment and distribution of foods, primary information for the design of folding, poster and mini monographs with up-to-date information about the relationship before mentioned. The proposed actions of promotion of health favor the integrality achievement in the handling of the foods as well as quality in the environmental administration in fragile agriculture ecosystems, according to the approach of specialists(AU)

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)

Shigella sp: um problema de saúde pública / Shigella sp: a public health problem

O aumento do consumo de refeições fora de casa está associado ao aumento das Doenças Veiculadas por Alimentos (DVA), que são provenientes do consumo de alimentos e água contaminados, principalmente, devido à falta de higiene no preparo dos alimentos e à ausência, em muitos casos, do tratamento da água usada no preparo destes alimentos. A shigelose é uma DVA que se caracteriza como uma doença inflamatória do trato gastrointestinal causada pela Shigella cujos sintomas e características se assemelham à salmonelose. O gênero Shigella possui quatro espécies: S. dysenteriae, S. flexneri, S. boydii e S. sonnei. Para a realização deste trabalho foi realizado levantamento de artigos publicados em revistas científicas sobre o tema, com o objetivo de verificar a incidência de Shigella em alimentos abordando suas características e danos provocados à saúde.(AU)