ABSTRACT
ABSTRACT Among the diseases which etiopathogenesis is associated with Escherichia coli, acute diarrhea stands out. Studies on the characterization of the antimicrobial susceptibility profile contribute to the selection of appropriate empirical antimicrobial therapy. In this study, the antimicrobial susceptibility profile of 98 enterotoxigenic E. coli (ETEC) and enteropathogenic E. coli (EPEC) strains isolated from fecal specimens of children with acute diarrhea was evaluated. The resistance rates to ampicillin, sulfamethoxazole/trimethoprim, amoxicillin/clavulanate, and nalidixic acid were high, ranging from 34.7% to 10.2%. The result of this research recommends the use of cefotaxime and ceftriaxone for the empirical treatment of children with acute diarrhea which the etiology suggested is ETEC or EPEC.
RESUMO Entre as doenças cuja etiopatogenia está associada à Escherichia coli, destaca-se a doença diarreica aguda. Estudos que visam à caracterização do perfil de suscetibilidade antimicrobiana contribuem para o delineamento de antibioticoterapia empírica eficaz. Neste estudo, foi avaliado o perfil de suscetibilidade a antimicrobianos de 98 amostras de E. coli enterotoxigênica (ETEC) e E. coli enteropatogênica (EPEC) isoladas de crianças com doença diarreica. As frequências de resistência a ampicilina, sulfametoxazol-trimetoprima, amoxicilina-clavulanato e ácido nalidíxico foram elevadas, variando entre 34,7% e 10,2%. Esta pesquisa recomenda o emprego de cefotaxima e ceftriaxona para o tratamento empírico de crianças com quadro de diarreia cuja etiologia sugerida seja ETEC ou EPEC.
ABSTRACT
Intimins of atypical EPEC strains from children with and without diarrhea were genotyped. κ was not found and ß was the most common. η- and ζ-alleles prevailed in strains from children without diarrhea and ι-allele among children older than 13 months. ε-allele emerged in 2006 and was the most common in 2007.
Subject(s)
Adhesins, Bacterial/genetics , Enteropathogenic Escherichia coli/classification , Enteropathogenic Escherichia coli/genetics , Escherichia coli Infections/microbiology , Escherichia coli Proteins/genetics , Alleles , Child, Preschool , Diarrhea/microbiology , Enteropathogenic Escherichia coli/isolation & purification , Female , Genotype , Humans , Infant , Infant, Newborn , MaleABSTRACT
OBJETIVO: Avaliar a distribuição e suscetibilidade a antimicrobianos de Shigella isolada de crianças com diarreia aguda e sem diarreia em Teresina (PI). MÉTODOS: Quatrocentas crianças com idade até 60 meses foram estudadas. Fezes foram coletadas de todos os pacientes entre janeiro de 2004 e agosto de 2007. Shigella foi identificada por métodos convencionais e antibiograma e pesquisa de β-lactamase de espectro ampliado (ESBL) foram realizados por difusão em ágar. RESULTADOS: Shigelose foi detectada apenas em crianças com diarreia aguda (26/250; 10,4%), especialmente naquelas entre 6 e 24 meses de idade e nos meses chuvosos. Shigella foi suscetível a ceftriaxona, ciprofloxacina e ácido nalidíxico. Mais da metade das amostras foram resistentes a sulfametoxazol-trimetoprim e ampicilina. ESBL não foi detectada. CONCLUSÕES: S. flexneri é comum em Teresina. A resistência a ampicilina e sulfametoxazol-trimetoprim é preocupante, pois estas drogas são amplamente utilizadas na prática e sulfametoxazol-trimetoprim ainda é recomendada para tratamento de crianças com suspeita de shigelose.
OBJECTIVE: To evaluate the distribution and susceptibility to antimicrobials of Shigella isolated from children with acute diarrhea and without diarrhea in Teresina, state of Piauí, Brazil. METHODS: Four hundred children aged up to 60 months were studied. Stools were collected from all the patients between January 2004 and August 2007. Shigella was identified by conventional methods and antibiogram and extended-spectrum β-lactamase (ESBL) were performed by agar diffusion. RESULTS: Shigellosis was only detected in children with acute diarrhea (26/250; 10.4%), especially in those aged from 6 to 24 months and in the rainy months. Shigella was susceptible to ceftriaxone, ciprofloxacin and nalidixic acid. More than half of the strains were resistant to sulphametoxazole-trimethoprim and ampicillin. ESBL was not detected. CONCLUSIONS: S. flexneri is common in Teresina. The resistance to ampicillin and sulphametoxazole-trimethoprim gives cause for concern, as these drugs are widely used in practice and sulphametoxazole-trimethoprim is also recommended for treating children suspected of having shigellosis.
Subject(s)
Child, Preschool , Female , Humans , Infant , Male , Anti-Bacterial Agents/pharmacology , Drug Resistance, Microbial , Diarrhea/microbiology , Feces/microbiology , Shigella flexneri/drug effects , Shigella sonnei/drug effects , Acute Disease , Ampicillin/pharmacology , Brazil , Diarrhea/drug therapy , Epidemiologic Methods , Trimethoprim, Sulfamethoxazole Drug Combination/pharmacology , beta-Lactamases/biosynthesisABSTRACT
OBJECTIVE: To evaluate the distribution and susceptibility to antimicrobials of Shigella isolated from children with acute diarrhea and without diarrhea in Teresina, state of Piauí, Brazil. METHODS: Four hundred children aged up to 60 months were studied. Stools were collected from all the patients between January 2004 and August 2007. Shigella was identified by conventional methods and antibiogram and extended-spectrum beta-lactamase (ESBL) were performed by agar diffusion. RESULTS: Shigellosis was only detected in children with acute diarrhea (26/250; 10.4%), especially in those aged from 6 to 24 months and in the rainy months. Shigella was susceptible to ceftriaxone, ciprofloxacin and nalidixic acid. More than half of the strains were resistant to sulphametoxazole-trimethoprim and ampicillin. ESBL was not detected. CONCLUSIONS: S. flexneri is common in Teresina. The resistance to ampicillin and sulphametoxazole-trimethoprim gives cause for concern, as these drugs are widely used in practice and sulphametoxazole-trimethoprim is also recommended for treating children suspected of having shigellosis.
Subject(s)
Anti-Bacterial Agents/pharmacology , Diarrhea/microbiology , Drug Resistance, Microbial , Feces/microbiology , Shigella flexneri/drug effects , Shigella sonnei/drug effects , Acute Disease , Ampicillin/pharmacology , Brazil , Child, Preschool , Diarrhea/drug therapy , Epidemiologic Methods , Female , Humans , Infant , Male , Trimethoprim, Sulfamethoxazole Drug Combination/pharmacology , beta-Lactamases/biosynthesisABSTRACT
Chronic periodontitis is a highly prevalent endogenous polymicrobial disease. To better understand the etiology of the disease a quantitative approach is mandatory and real-time PCR is the molecular technique currently preferred to achieve this purpose. Taking into account that such a kind of study is still scarce, we aimed to evaluate the association between periodontal microbiota and chronic periodontitis. A total of 60 low-income age-matched female adults, 30 with chronic periodontitis and 30 without periodontal disease, were enrolled. DNA obtained from subgingival specimens was used for quantification of Aggregatibacter actinomycetemcomitans, Eikenella corrodens, Fusobacterium nucleatum, Porphyromonas gingivalis, and Prevotella intermedia by real-time PCR. A. actinomycetemcomitans, E. corrodens, and F. nucleatum were detected in all subjects, P. gingivalis was observed in 70.0% and 46.6% and P. intermedia in 90.0% and 80.0% of chronic periodontitis patients and periodontally healthy subjects, respectively. P. gingivalis mean count was significantly higher in patients with chronic periodontitis than in periodontally healthy individuals. Accurate detection and quantification of five putative periodontal pathogens was feasible using a simple and fast real-time PCR protocol. Although P. gingivalis and P. intermedia have been found more commonly in chronic periodontitis patients, no statistical difference was observed between periodontally diseased and healthy groups. Quantitative data indicated association between P. gingivalis and chronic periodontitis. However, because of its uneven distribution, it should not be solely taken as a marker of periodontal status.
Subject(s)
Aggregatibacter actinomycetemcomitans/isolation & purification , Chronic Periodontitis/microbiology , Eikenella corrodens/isolation & purification , Fusobacterium nucleatum/isolation & purification , Porphyromonas gingivalis/isolation & purification , Prevotella intermedia/isolation & purification , Adult , Aggregatibacter actinomycetemcomitans/genetics , Colony Count, Microbial , DNA, Bacterial/genetics , Eikenella corrodens/genetics , Female , Fusobacterium nucleatum/genetics , Humans , Middle Aged , Periodontal Pocket , Polymerase Chain Reaction , Porphyromonas gingivalis/genetics , Prevotella intermedia/geneticsABSTRACT
This PCR-based analysis is the first molecular epidemiological study in Brazil testing Helicobacter pylori cagA and vacA distribution in adults with gastric complaints, that includes a large number of carcinoma patients. Multiple-strain infection was identified in 11/13.4% patients. vacA s1-m1 and cagA(+) genotypes were the most common in patients with a non-mixed infection. All vacA s1 strains were s1b, so subtyping s1 strains was not useful. vacA s1b-m1 and cagA(+) strains were associated with higher prevalence of peptic ulcer and gastric carcinoma than vacA s2-m2 and cagA(-) ones. In conclusion, cagA and vacA genotyping may have clinical relevance in Brazil.
Subject(s)
Antigens, Bacterial , Bacterial Proteins/genetics , Duodenal Ulcer/microbiology , Gastritis/microbiology , Helicobacter Infections/microbiology , Helicobacter pylori/classification , Stomach Neoplasms/microbiology , Adolescent , Adult , Aged , Bacterial Typing Techniques , Brazil/epidemiology , Duodenal Ulcer/epidemiology , Female , Gastritis/epidemiology , Genotype , Helicobacter Infections/epidemiology , Helicobacter pylori/genetics , Helicobacter pylori/isolation & purification , Humans , Male , Middle Aged , Polymerase Chain Reaction , Stomach Neoplasms/epidemiologyABSTRACT
A reaçäo inflamatória da gastrite por H. pylori é pouco estudada em crianças. Objetivos: Analisar a reaçäo inflamatória e imune da gastrite por H. pylori em adultos e crianças, 15 com ulcera duodenal (UD) e 47 adultos, 21 com UD. A análise histológica foi feita, segundo o Sistema Sydney; o exsudato imune foi semi-quantificado; o microrganismo foi pesquisado por cultura, urease e histologia. Os genes ureA e cagA foram pesquisados por Elisa. Resultados: Em crianças, a reaçäo inflamatória predominou nos casos com UD em relaçäo àqueles sem UD (p<0,01). Nos dois grupos, a inflamaçäo predominou no antro (p<0,01), mas a atividade foi semelhante no antro e corpo. A resposta imune foi idêntica no antro e no corpo dos casos com UD. Nos adultos com UD, a inflamaçäo e a atividade foram mais intensas no antro do que no corpo (P<0,0007). A reaçäo imune predominou no antro (p<0,032) em ambos os grupos. Näo houve correlaçäo entre a colonizaçäo bacteriana e a reaçäo inflamatória e imune. Nos casos com UD, isolaram-se predominantemente cepas cagA+, em crianças (93 por cento) e adultos (83 por cento). A infecçäo por cepas cagA+ correlacionou-se com o exsudato plasmocitário (p<0,03) e com a inflamaçäo e a atividade (p<0,04) em crianças. Conclusäo: A resposta inflamatória na gastrite associada ao H. pylori é diferente em adultos e crianças. Conclusäo A resposta inflamatória na gastrite associada ao H. pylori é diferente em adultos e crianças. Conclusäo, o que pode estar relacionado com diferenças na secreçäo ácida e com aspectos evolutivos da infecçäo
Subject(s)
Humans , Adult , Child , Adolescent , Antigens, Bacterial/metabolism , Gastritis/microbiology , Helicobacter pylori/genetics , Helicobacter pylori/isolation & purification , Helicobacter Infections/microbiology , Bacterial Proteins/metabolism , Bacterial Typing Techniques , Duodenal Neoplasms/microbiology , Gastric Mucosa/immunology , Polymerase Chain ReactionABSTRACT
This study evaluated the sensitivity of serological and direct methods for the diagnosis of Helicobacter pylori infection in 127 patients with gastric carcinoma and in 127 controls without this disease, matched for age and sex. Antral and oxyntic mucosal specimens were obtained from all patients, at operation in patients with gastric carcinoma and at endoscopy from controls. The urease test, microscopy of stained smears and culture for H. pylori were performed on all specimens. Sera from all patients were tested for antibodies to H. pylori by a highly sensitive and specific IgG-ELISA. Culture, urease test, stained smear and ELISA were significantly less sensitive in the patients with gastric carcinoma than in control subjects. However, the combination of several methods improved the diagnosis of H. pylori infection in the gastric carcinoma group. Infection was significantly more frequent in the gastric carcinoma patients than in the controls. H. pylori infection was associated with an increased risk of developing gastric carcinoma.
Subject(s)
Carcinoma/microbiology , Helicobacter Infections/blood , Helicobacter pylori/isolation & purification , Stomach Neoplasms/microbiology , Adult , Aged , Aged, 80 and over , Antibodies, Bacterial/blood , Carcinoma/complications , Case-Control Studies , Cross-Sectional Studies , Enzyme-Linked Immunosorbent Assay/methods , Female , Helicobacter Infections/complications , Helicobacter Infections/epidemiology , Humans , Male , Middle Aged , Sensitivity and Specificity , Stomach Neoplasms/complicationsABSTRACT
C. jejuni foi pesquisado em carcaças de frango prontas para consumo e em fezes de magatrial, tendo sido isolado em 19 (38,0%) dentre 50 carcaças e em 2 (13,3%) dentre 15 amostras de fezes provenientes dos abatedouros näo industriais e em 1(2,0%) dentre 50 carcaças do abatedouro industrializado. Neste último, o microrganismo näo foi isolado de nenhuma das 40 amostras de fezes examinadas. O perfil eletroforético em gel de poliacrilamida, as características bioquímicas e o padräo de susceptibilidade aos isolados das carcaças foram muito semelhantes aos das amostras isoladas das fezes de magarefes, o que sugere que as galinhas podem ser a fonte de C. jejuni para os magarefes e que ambos podem estar envolvidos na transmissäo do microorganismo
