Enteroaggregative Escherichia coli as etiological agent of endemic diarrhea in Spain: A prospective multicenter prevalence study with molecular characterization of isolates.

Background: Enteroaggregative Escherichia coli (EAEC) is increasingly associated with domestically acquired diarrheal episodes in high-income countries, particularly among children. However, its specific role in endemic diarrhea in this setting remains under-recognized and information on molecular characteristics of such EAEC strains is limited. We aimed to investigate the occurrence of EAEC in patients with non-travel related diarrhea in Spain and molecularly characterize EAEC strains associated with illness acquired in this high-income setting. Methods: In a prospective multicenter study, stool samples from diarrheal patients with no history of recent travel abroad (n = 1,769) were collected and processed for detection of EAEC and other diarrheagenic E. coli (DEC) pathotypes by PCR. An additional case-control study was conducted among children ≤5 years old. Whole-genome sequences (WGS) of the resulting EAEC isolates were obtained. Results: Detection of DEC in the study population. DEC was detected in 23.2% of patients aged from 0 to 102 years, with EAEC being one of the most prevalent pathotypes (7.8%) and found in significantly more patients ≤5 years old (9.8% vs. 3.4%, p < 0.001). Although not statistically significant, EAEC was more frequent in cases than in controls. WGS-derived characterization of EAEC isolates. Sequence type (ST) 34, ST200, ST40, and ST10 were the predominant STs. O126:H27, O111:H21, and O92:H33 were the predominant serogenotypes. Evidence of a known variant of aggregative adherence fimbriae (AAF) was found in 89.2% of isolates, with AAF/V being the most frequent. Ten percent of isolates were additionally classified as presumptive extraintestinal pathogenic E. coli (ExPEC), uropathogenic E. coli (UPEC), or both, and belonged to clonal lineages that could be specifically associated with extraintestinal infections. Conclusion: EAEC was the only bacterial enteric pathogen detected in a significant proportion of cases of endemic diarrhea in Spain, especially in children ≤5 years old. In particular, O126:H27-ST200, O111:H21-ST40, and O92:H33-ST34 were the most important subtypes, with all of them infecting both patients and asymptomatic individuals. Apart from this role as an enteric pathogen, a subset of these domestically acquired EAEC strains revealed an additional urinary/systemic pathogenic potential.

Is it necessary to shave the pubic and genital regions of patients undergoing endoscopic urological surgery?

To determine whether postoperative urinary infections were related to shaving before undergoing endoscopic urological surgery, 90 patients were randomly assigned to shaving or not shaving. Urinary cultures revealed infection in 10 patients. Half of them had been shaved, suggesting that this practice does not affect the incidence of urinary infections.

Clinical case of endocarditis due to Trichosporon inkin and antifungal susceptibility profile of the organism.

A fatal case of Trichosporon inkin prosthetic endocarditis is reported. The isolation sites and susceptibility profiles of 10 other isolates are also reviewed. Four strains were recovered from cutaneous or subcutaneous samples, four were recovered from urine, one was recovered from peritoneal liquid, and one was recovered from bone. Voriconazole and amphotericin B had the most potent activities in vitro against the isolates, with MIC geometric means of 0.11 and 0.30 microg/ml, respectively.

Endocarditis por Erysipelothrix rhusiopathiae: una enfermedad profesional poco frecuente y de diagnóstico difícil / Endocarditis caused by Erysipelothrix rhusiopathiae: a rare professional disease difficult to diagnose

No disponible

Infecciones extraintestinales producidas por serotipos no tifoideos de Salmonella. experiencia de nueve años / Extraintestinal infections produced by non-typhoid Salmonella serotypes. Nine years of experience

Fundamento: La manifestación más característica de la infección por serotipos no tifoideos de Salmonella es la gastroenteritis aguda, generalmente benigna y autolimitada, aunque en algunas ocasiones pueden aparecer manifestaciones extraintestinales más graves, como bacteriemias e infecciones focales localizadas en cualquier órgano. Pacientes y método: El objetivo de nuestro trabajo es describir las características más importantes de las infecciones extraintestinales producidas por serotipos no tifoideos de Salmonella aislados en nuestro hospital entre diciembre de 1991 y agosto de 1999. Para ello, revisamos las historias clínicas de pacientes en los que se aislaron estos serotipos extraintestinales, aplicando un protocolo clinicomicrobiológico. resultados: Se aisló Salmonella enterica en 1.543 ocasiones; de éstas 25 (1,6 por ciento) fueron Salmonella serotipo typhi y 1.518 (98,3 por ciento) serotipos no tifoideos. De los pacientes con infecciones por serotipos no tifoideos, 28 presentaron infección extraintestinal (1,8 por ciento). El serotipo typhimurium fue el más frecuentemente aislado, en un 50 por ciento, seguido de enteritidis en el 28,6 por ciento y hadar en el 7,1 por ciento. En cuanto a los cuadros clínicos, aparecen con la misma frecuencia las bacteriemias secundarias a gastroenteritis y las infecciones focales (35,7 por ciento); el resto son bacteriemias primarias. Ocho pacientes tenían una edad ó 10 años y 15 pacientes >= 60 años. En un 57,1 por ciento de ellos existía una enfermedad de base. Conclusiones: Las infecciones extraintestinales por serotipos no tifoideos de Salmonella representan el 1,8 por ciento del total de salmonelosis, y la mayoría de ellas suceden en edades extremas de la vida. Las bacteriemias transitorias en el seno de una gastroenteritis aguda se producen principalmente en niños. El mayor riesgo de adquisición de infecciones focales se asocia con la existencia de enfermedad de base o inmunodepresión (AU)