Las carcasas ovinas como fuente de infección de Escherichia coli shigatoxigénico en Tierra del Fuego / Sheep carcasses as a source of infection of shigatoxigenic Escherichia coli in Tierra del Fuego

La provincia de Tierra del Fuego, Antártida e Islas del Atlántico Sur en Argentina, se caracteriza por altas tasas de diarreas y síndrome urémico hemolítico. El principal agente asociado a dichas patologías es Escherichia coli shigatoxigénico (STEC). En la isla de Tierra del Fuego (TDF) el 90% de la producción ovina es destinada al consumo local alcanzando un consumo de 25-30 kg/h/año. El objetivo del presente trabajo fue determinar el grado de contaminación con STEC de las carcasas ovinas, identificar el perfil de virulencia de las cepas y la relación témporo espacial con las aisladas de casos clínicos. Se realizó un estudio observacional en los tres frigoríficos ovinos de la isla con muestreos proporcionales a la faena histórica por sitio, y en cada sitio un muestreo aleatorio simple sin reposición. Se recolectaron 382 esponjados de carcasas ovinas entre el 5 y 20 de diciembre de 2018. La prevalencia de carcasas contaminadas por STEC fue del 4,7%, no se detectaron los serogrupos O26, O45, O121, O145, O103, O104, O111 ni O174. En seis muestras se identificó la presencia del antígeno O157 por inmunocromatografía. Por PCR en 2/6 de las muestras O157 positivas se detectaron los amplicones stx1/stx2. Las dos muestras sospechosas a STEC O157 procedían de la misma estancia, y se faenaron en el frigorífico privado de Rio Grande, las otras 4/6 muestras O157 no-STEC procedían de 3 estancias diferentes e ingresaron a faena en Rio Grande. Se aislaron 6 cepas no-O157 que presentaron el perfil stx1c (1), stx2b (2), stx2NT (2) y stx1c/stx2b/ehxA (1). Los aislamientos fueron saa y eae negativos. Los cinco casos de SUH registrados en el año de estudio no se relacionaron temporalmente con los aislamientos ovinos obtenidos. Pese a no existir relación epidemiológica entre los casos y la contaminación en carne ovina, este es el primer registro de sospecha de STEC O157 en una fuente de infección en TDF y señala la importancia de considerar la carne ovina como un factor de riesgo en la región

[Candida albicans outbreak in a neonatal intensive care unit]. / Brote de candidemia por Candida albicans en neonatología.

The appearance of Candida albicans in three patients made physicians investigate an outbreak. Outbreak description and microbiologic screening: Case 1 developed C. albicans in the placenta culture and in the blood culture carried out on the 8th day of birth. Four days after this candidemia, C. albicans was recovered in a catheter tip of a second neonate (case 2) and finally five days later other newborn (case 3) developed C. albicans in the hemoculture. After that, the hands of all caregivers as well as case 3's incubator, case 1's mother, and from all nine neonates in the unit were studied with swabs. A wet mount was done to all swabs and then they were cultured in Chromagar Candida and SDA. All C. albicans were studied by RAPD. RAPD study showed that C. albicans recovered from placenta and blood cultures of case 1, the catheter tip of case 2 and the blood culture of case 3, resulted to be identical and these yeasts were related to the C. albicans from the mouth of case 1 mother and the mouth of another colonized newborn. C. albicans was not found in the others swabs. The isolations of identical C. albicans allowed to suppose the horizontal transmission from the case 1, that had acquired it congenitally. Not only isolation of unusual Candida species would be an alert. Despite patients' personal factors to justify a fungal infection, the recovery of C. albicans in a short period of time should warn physicians about the possibility of a horizontal transmission.

Brote de candidemia por Candida albicans en neonatología / Candida albicans outbreak in a neonatal intensive care unit

El aislamiento de Candida albicans en tres pacientes (dos en hemocultivos)sugirió la existencia de un brote epidémico. En el caso 1 se aisló C. albicans dela placenta de la madre, así como de una muestra de sangre del recién nacidotomada a los ocho días de vida. Cuatro días después del diagnóstico de estacandidemia, se aisla C. albicans en la punta del catéter de otro neonato (caso 2),y cinco días después en los hemocultivos de un tercer neonato (caso 3). Antela sospecha de un brote epidémico, se investigó la existencia de colonización.Se tomaron mediante hisopo muestras de las manos del personal, la cuna delcaso 3, la madre del caso 1 y los nueve neonatos internados. Cada hisopo sesembró en Chromagar Candida® y agar glucosado de Sabouraud.Los aislamientos de C. albicans recuperados fueron estudiados por RAPD.El estudio por RAPD mostró que los aislamientos de C. albicans de la placenta,los de los hemocultivos de los casos 1 y 3, y el de la punta de catéter del caso2 eran genotípicamente idénticos. Se aisló C. albicans de otros dos neonatos(boca e ingle en uno e ingle en el otro) y de la boca de la madre del caso 1.Esta última cepa y la de la boca del neonato colonizado estarían genéticamenterelacionadas con la de los casos mencionados. No se aisló C. albicans delresto de los hisopos. Los aislamientos de C. albicans idénticos permitieronsuponer la trasmisión horizontal a partir del caso 1, quien la había adquiridocongénitamente. Aunque los pacientes tengan factores de riesgo quejustifiquen una infección por Candida, el aislamiento de C. albicans en variasmuestras en un tiempo corto, debe hacer sospechar la posibilidad de latrasmisión horizontal de la infección(AU)

The appearance of Candida albicans in three patients made physiciansinvestigate an outbreak. Outbreak description and microbiologic screening:Case 1 developed C. albicans in the placenta culture and in the blood culturecarried out on the 8th day of birth. Four days after this candidemia, C. albicanswas recovered in a catheter tip of a second neonate (case 2) and finally fivedays later other newborn (case 3) developed C. albicans in the hemoculture.After that, the hands of all caregivers as well as case 3’s incubator, case 1’smother, and from all nine neonates in the unit were studied with swabs. A wetmount was done to all swabs and then they were cultured in ChromagarCandida and SDA. All C. albicans were studied by RAPD. RAPD study showedthat C. albicans recovered from placenta and blood cultures of case 1, thecatheter tip of case 2 and the blood culture of case 3, resulted to be identicaland these yeasts were related to the C. albicans from the mouth of case 1mother and the mouth of another colonized newborn. C. albicans was notfound in the others swabs. The isolations of identical C. albicans allowed tosuppose the horizontal transmission from the case 1, that had acquired itcongenitally. Not only isolation of unusual Candida species would be an alert.Despite patients’ personal factors to justify a fungal infection, the recovery ofC. albicans in a short period of time should warn physicians about thepossibility of a horizontal transmission(AU)

[Infective endocarditis with perivalvular abscess in a patient with Erysipelothrix rhusiopathiae bacteremia]. / Endocarditis infecciosa con absceso perivalvular en un paciente con bacteriemia por Erysipelothrix rhusiopathiae.

The bacterial species Erysipelothrix rhusiopathiae is found worldwide as a commensal or a pathogen in a variety of animals. One well-defined pattern of human infection is an uncommon bacteremic form, with or without cutaneous involvement, usually complicated by endocarditis. We report the case of a 38-year-old male butcher with E. rhusiopathiae bacteremia, native aortic valve endocarditis and perivalvular abscess. The patient was released after six weeks of intravenous ceftriaxone and aortic valve replacement because of severe regurgitation.

Endocarditis infecciosa con absceso perivalvular en un paciente con bacteriemia por Erysipelothrix rhusiopathiae / Infective endocarditis with perivalvular abscess in a patient with Erysipelothrix rhusiopathiae bacteremia

The bacterial species Erysipelothrix rhusiopathiae is found worldwide as a commensal or a pathogen in a variety of animals. One well-defined pattern of human infection is an uncommon bacteremic form, with or without cutaneous involvement, usually complicated by endocarditis. We report the case of a 38-year-old male butcher with E. rhusiopathiae bacteremia, native aortic valve endocarditis and perivalvular abscess. The patient was released after six weeks of intravenous ceftriaxone and aortic valve replacement because of severe regurgitation

Endocarditis infecciosa con absceso perivalvular en un paciente con bacteriemia por Erysipelothrix rhusiopathiae / Infective endocarditis with perivalvular abscess in a patient with Erysipelothrix rhusiopathiae bacteremia

The bacterial species Erysipelothrix rhusiopathiae is found worldwide as a commensal or a pathogen in a variety of animals. One well-defined pattern of human infection is an uncommon bacteremic form, with or without cutaneous involvement, usually complicated by endocarditis. We report the case of a 38-year-old male butcher with E. rhusiopathiae bacteremia, native aortic valve endocarditis and perivalvular abscess. The patient was released after six weeks of intravenous ceftriaxone and aortic valve replacement because of severe regurgitation (AU)

Endocarditis infecciosa con absceso perivalvular en un paciente con bacteriemia por Erysipelothrix rhusiopathiae. / [Infective endocarditis with perivalvular abscess in a patient with Erysipelothrix rhusiopathiae bacteremia]

The bacterial species Erysipelothrix rhusiopathiae is found worldwide as a commensal or a pathogen in a variety of animals. One well-defined pattern of human infection is an uncommon bacteremic form, with or without cutaneous involvement, usually complicated by endocarditis. We report the case of a 38-year-old male butcher with E. rhusiopathiae bacteremia, native aortic valve endocarditis and perivalvular abscess. The patient was released after six weeks of intravenous ceftriaxone and aortic valve replacement because of severe regurgitation.