Automated use of WHONET and SaTScan to detect outbreaks of Shigella spp. using antimicrobial resistance phenotypes.

Antimicrobial resistance is a priority emerging public health threat, and the ability to detect promptly outbreaks caused by resistant pathogens is critical for resistance containment and disease control efforts. We describe and evaluate the use of an electronic laboratory data system (WHONET) and a space-time permutation scan statistic for semi-automated disease outbreak detection. In collaboration with WHONET-Argentina, the national network for surveillance of antimicrobial resistance, we applied the system to the detection of local and regional outbreaks of Shigella spp. We searched for clusters on the basis of genus, species, and resistance phenotype and identified 19 statistical 'events' in a 12-month period. Of the six known outbreaks reported to the Ministry of Health, four had good or suggestive agreement with SaTScan-detected events. The most discriminating analyses were those involving resistance phenotypes. Electronic laboratory-based disease surveillance incorporating statistical cluster detection methods can enhance infectious disease outbreak detection and response.

Characterization and subtyping of Cronobacter spp. from imported powdered infant formulae in Argentina.

Cronobacter spp. (Enterobacter sakazakii), have been associated with severe foodborne infections in neonates and immunocompromised infants. In Argentina, we have isolated Cronobacter spp. from three different brands of imported powdered infant formulae (PIF). The objectives of this work were to characterize the recovered isolates phenotypically and to evaluate the use of a Pulsed-Field Gel Electrophoresis (PFGE) protocol for Cronobacter spp. subtyping. Out of 23 isolates studied from three brands of PIF (20 of brand A, 1 of brand B and 2 of brand C), 22 were identified as C. sakazakii and 1 as C. malonaticus. All isolates were susceptible to twelve antimicrobial agents assayed. The 19 C. sakazakii isolates of brand A showed five XbaI-PFGE patterns and the genetic clusters revealed by XbaI were confirmed with a second restriction enzyme, SpeI. The isolate from brand B showed the same XbaI and SpeI patterns as those of a group of isolates of brand A, suggesting a possible common source of contamination. The C. sakazakii isolates of brand C exhibited two unique XbaI-PFGE patterns, unrelated to the rest. Different genetic subtypes were found among isolates of a single batch of PIF from brand A and the single C. malonaticus strain also showed a distinct XbaI-PFGE pattern.

Short report: analysis of clonal relationship among Shigella sonnei isolates circulating in Argentina.

Thirty-five isolates of Shigella sonnei from patients with diarrhoea in three geographic regions of Argentina were examined for genetic diversity by pulsed-field gel electrophoresis (PFGE) and plasmid profile. PFGE of XbaI and BlnI DNA digests confirmed the occurrence of outbreaks in two regions caused by two separate predominant clones of S. sonnei. The third region was characterized by three circulating clones, one of which was possibly associated with an outbreak. Similar plasmids were found in distinct clones and in one outbreak clone five different plasmid profiles were identified. Antimicrobial resistance of the isolates varied from fully susceptible to the agents tested, to resistance to cotrimoxazole, ampicillin and ciprofloxacin. Antibiotic resistance did not correlate with plasmid content. This information will form the basis for active surveillance of shigellosis in Argentina and elsewhere in the region through the PulseNet International Network.

[Serotypes of Salmonella isolated from the Luján River, Argentina]. / Serotipos de Salmonella aislados del Río Luján, Argentina.

In this work, the serotypes of Salmonella genus polluting the waters of Lujan River, situated in the north east of the province of Buenos Aires, Argentina, were studied. A total of 690 samples of water were collected and analysed from February 1988 through December 1989, at three different sites. They were obtained according to the Moore technique and then preenriched in buffered peptone water and enriched in Rappaport-Vassiliadis Soya peptone broth was carried out. The isolations were realised in brilliant green-desoxycholate agar and bismuth sulphite agar and the presumptive colonies to be Salmonella were tested by the standard biochemical identification. Salmonella spp. was isolated in 434 samples (62.9%). The predominant serotype was S. Anatum, followed in a decreasing order by S. Montevideo, S. Newport and S. Bredeney. A large amount of serotypes that are isolated with very low frequency and very rarely in other hidric courses in the country were: S. Westhampton, S. Poona and S. Saintpaul were found.

[Agglutination of hen egg-yolk immunoglobulins (IgY) against Salmonella enterica, serovar enteritidis]. / Aglutinación de inmunoglobulinas de yema de huevo de gallina (IgY) contra Salmonella enterica serovariedad enteritidis.

Two groups of 6 laying hens were used to produce IgY. In the vaccinated group (V), hens were injected by intramuscular route with two doses of a Salmonella enterica serovar Enteritidis bacterin at 20-day interval. In the control group (T) hens remained unvaccinated. Four IgY extractions were performed on the egg production of both groups. The first two extractions were carried out using the yolks obtained from the eggs produced during the 4th and 5th post-vaccination week (extracts 1V and 1T) and the other two using the ones from the 6th, 7th and 8th week (2V and 2T). Starting from the extracts 1V and 1T other products were obtained by freezing-thawing (1V-A and 1T-A) and simple (1V-B and 1T-B) or double (1V-C and 1T-C) flow capillary dialysis concentration. All these products were compared using an ELISA test specific for the detection of chicken antibodies against flagellar antigens of S. Enteritidis. In this test, V extracts were positive whereas T extracts were negative. The extract 1V was more positive than the extract 2V. The extract 1V-C was the most positive and was therefore selected to be used as an antiserum in the agglutination tests. This extract contained 1.9 g/dl of total proteins, 0.028 g/dl of triglycerides and 0.012 g/dl of cholesterol and showed an electrophoretic pattern characteristic of IgY. The 1T-C extract was used as a negative control in the agglutination tests. Slide somatic and tube flagellar agglutination tests were simultaneously carried out using both IgY extracts and a standard rabbit anti-Salmonella (IgG) sera. Overall 367 strains from the Enterobacteriaceae family were tested together with two other strains belonging to the Vibrionaceae family. The 1V-C extract specifically agglutinated S. Enteritidis strains in the same way as the rabbit sera. This extract also agglutinated other Salmonella strains antigenically related to S. Enteritidis. Salmonella which did not share somatic or flagellar antigens with S. Enteritidis, other different species of the Enterobacteriaceae family and the two strains of the Vibrionaceae family were all negative. None of the strains tested was agglutinated by the 1T-C extract. This paper show that it is possible to use specific IgY to identify S. enterica serovars. The more extended use of IgY for diagnostic purposes may be a convenient way to complement the current use of mammal polyclonal antibodies.

Aglutinación de inmunoglobulinas de yema de huevo de gallina (IgY) contra Salmonella enterica serovariedad Enteritidis / Agglutination of chicken egg yolk immunoglobulins (IgY) against Salmonella enterica serovar Enteriditis

Para producir extractos de IgY se emplearon dos lotes de 6 gallinas ponedoras cada uno. En el lote vacunado (V) las aves se inocularon por vía intramuscular con dos dosis de una bacterina contra Salmonella enterica serovariedad Enteritidis. En el lote testigo (T) las aves no se vacunaron. Con las yemas de ambos lotes se efectuaron 4 extracciones de IgY. Las dos primeras se realizaron con las yemas de los huevos producidos durante la 4§ y 5§ semana post-vacunación (extractos 1V y 1T) y las otras dos con las de la 6§, 7§ y 8§ semana (2V y 2T). Los extractos 1V y 1T se congelaton y descongelaron (1V-A y 1T-A) y se concentraron por diálisis simple (1V-B y 1T-B) o doble (1V-C y 1T-C). Mediante una prueba de ELISA para detectar antígenos flagelares de S. Enteritidis, los extractos V fueron positivos y los T negativos. El extracto 1V-C fue el más positivo y se seleccionó para realizar las aglutinaciones. Este extracto contenía 1,9 g/dl de proteínas totales y presentó bandas electroforéticas características de IgY. El extracto 1T-C fue usado como control negativo de aglutinación. Emplenado ambos extractos IgY y antisueros policlonales de conejo (IgG) se efectuaron aglutinaciones somáticas en placa y flagelares en tubo. Se estudiaron 357 cepas de S. enterica, 10 cepas de diferentes especies de la familia Enterobacteriaceae y dos cepas de la familia Vibrionaceae. El extracto 1V-C aglutinó a distintas cepas de Salmonella con estructura antigénica somática o flagelar relacionada con la cepa vacunal, mientras que las salmonelas con antígenos diferentes y otras especies de la familia Enterobacteriaceae y Vibrionaceae fueron negativas. Este trabajo demuestra que es posible emplear las IgY para identificar serovariedades de S. enterica

Aglutinación de inmunoglobulinas de yema de huevo de gallina (IgY) contra Salmonella enterica serovariedad Enteritidis / Agglutination of chicken egg yolk immunoglobulins (IgY) against Salmonella enterica serovar Enteriditis

Para producir extractos de IgY se emplearon dos lotes de 6 gallinas ponedoras cada uno. En el lote vacunado (V) las aves se inocularon por vía intramuscular con dos dosis de una bacterina contra Salmonella enterica serovariedad Enteritidis. En el lote testigo (T) las aves no se vacunaron. Con las yemas de ambos lotes se efectuaron 4 extracciones de IgY. Las dos primeras se realizaron con las yemas de los huevos producidos durante la 4º y 5º semana post-vacunación (extractos 1V y 1T) y las otras dos con las de la 6º, 7º y 8º semana (2V y 2T). Los extractos 1V y 1T se congelaton y descongelaron (1V-A y 1T-A) y se concentraron por diálisis simple (1V-B y 1T-B) o doble (1V-C y 1T-C). Media

The silent victims of domestic violence--who will speak?

TOPIC: Children who witness domestic violence are themselves victims of abuse. Unless directly abused, they are often overlooked and do not receive adequate services. PURPOSE: The authors contend that helping professionals as well as the state must attend to the ethical principles of beneficence, autonomy, and justice in dealing with these children. Children, who witness violence at home, must receive top priority in the allocation of scarce resources. SOURCES: Published literature, clinical experience. CONCLUSION: Diagnostic screening and assessment efforts must incorporate standard questions about family violence into all mental health and school counseling interviews. Sensitive intervention and referral, linking victims and witnesses with intervention specialists, will do much to limit the sequelae often seen with family violence. Nurses must advocate for and support primary prevention programs in elementary and secondary school systems.

Salmonella Freetown: primer aislamiento en Argentina / Salmonella Freetown: first report in Argentina

En el presente trabajo se comunica el primer aislamiento de Salmonella Freetown en Argentina. Se obtuvo a partir de un coprocultivo de una paciente de 1 mes y 7 días, cuya madre consultó por un cuadro de diarrea aguda en el Hospital de Niños Dr. Ricardo Gutiérrez de la ciudad de Santa Fe. Por sus características bioquímicas y su fórmula antigénica, esta nueva serovariedad se ubica dentro de la especie Salmonella enterica subespecie enterica

Salmonella Freetown: primer aislamiento en Argentina / Salmonella Freetown: first report in Argentina

En el presente trabajo se comunica el primer aislamiento de Salmonella Freetown en Argentina. Se obtuvo a partir de un coprocultivo de una paciente de 1 mes y 7 días, cuya madre consultó por un cuadro de diarrea aguda en el Hospital de Niños Dr. Ricardo Gutiérrez de la ciudad de Santa Fe. Por sus características bioquímicas y su fórmula antigénica, esta nueva serovariedad se ubica dentro de la especie Salmonella enterica subespecie enterica (AU)

[Salmonella Freetown: 1st isolation in Argentina]. / Salmonella Freetown: primer aislamiento en Argentina.

In this paper we report the first case of Salmonella Freetown in Argentina. It was isolated from a stool sample of a child of 1 month and 7 days, assisted as outpatient in the Hospital de Niños Dr. Ricardo Gutiérrez of the city of Santa Fe. On the basis of the biochemical characteristics and antigenic formulae, this new serovar belongs to the species Salmonella enterica subspecies enterica.