RESUMO
In 1992, a serologically novel clone of Vibrio cholerae, designated O139, caused large epidemics of diarrhea in India and Bangladesh. To determine the extent of the spread of V. cholerae O139 worldwide, 484 V. cholerae non-O1 strains isolated from different patients with diarrhea in Thailand, Indonesia, the Philippines, and Peru in 1993 were tested for agglutination in O139 antisera. One hundred fifty-one of these 484 isolates were examined for genes encoding cholera toxin, zonula occlulans toxin, the repetitive sequence 1, and the toxin coregulated pilin A (the V. cholerae virulence gene complex). Thirty-three percent (122 of 364) of V. cholerae non-O1 strains isolated from different patients with diarrhea in Thailand agglutinated in O139 antisera. Ninety-eight percent (120 of 122) of V. cholerae O139 contained the V. cholerae virulence gene complex. None of the 104 V. cholerae non-O1 strains isolated from patients with diarrhea in Indonesia or the 14 strains from patients with diarrhea in the Philippines were serotype O139. Four different ribotypes were found in V. cholerae O139 isolated in Asia. Twenty-three (47%) of 49 Thai O139 strains examined were of different ribotypes than isolates from India and Bangladesh; V. cholerae strains that were not O1 or O139 that were isolated from flies and water in Thailand 11 years previously in 1981 contained the same V. cholerae virulence gene complex found in V. cholerae O1 and O139. This suggests that other unidentified virulence determinants are involved in V. cholerae O139 pathogenesis.
Assuntos
Cólera/microbiologia , DNA Bacteriano/análise , Diarreia/microbiologia , Vibrio cholerae/genética , Cólera/epidemiologia , Toxina da Cólera/genética , Diarreia/epidemiologia , Surtos de Doenças , Endotoxinas , Feminino , Humanos , Indonésia/epidemiologia , Hibridização de Ácido Nucleico , Peru/epidemiologia , Filipinas/epidemiologia , Sequências Repetitivas de Ácido Nucleico , Sorotipagem , Tailândia/epidemiologia , Vibrio cholerae/classificação , Vibrio cholerae/patogenicidade , Virulência/genéticaRESUMO
A retrospective epidemiological study was conducted in connection with an outbreak of paratyphoid fever at a Peruvian naval installation in Callao. The study sought to determine the magnitude of the outbreak, the source of infection, the attack rates, the persistence of bacilli excretion, and the clinical picture of the disease. The source of Salmonella paratyphi B infection had been a meal of chicken and rice served to around 400 members of the naval police. Over a period of three weeks, 21 persons were hospitalized and 52 received outpatient treatment at the naval hospital. In addition, through a questionnaire it was revealed that 86 unreported cases of diarrhea related to the outbreak had occurred. The most common clinical manifestations were fever, headache, weakness, anorexia, abdominal pain, and diarrhea. The general attack rate was 39.8%. In a follow-up survey carried out 37 days after exposure, fecal cultures indicated that 8.5% of the persons affected continued to excrete the microorganism. The high rates of attack and transmission of S. paratyphi B in this outbreak point up the considerable pathogenicity and virulence of some strains of the microorganism and their impact on public health. It is suggested that preventive measures be taken at naval and other similar installations, including the education of workers who handle and prepare food, in order to ensure proper hygiene.
Assuntos
Surtos de Doenças , Militares , Febre Paratifoide/epidemiologia , Intoxicação Alimentar por Salmonella/epidemiologia , Salmonella paratyphi B/isolamento & purificação , Adulto , Animais , Galinhas , Humanos , Masculino , Carne , Febre Paratifoide/etiologia , Febre Paratifoide/microbiologia , Peru , Prevalência , Estudos Retrospectivos , Intoxicação Alimentar por Salmonella/etiologiaRESUMO
During 1984-1989, 655 diarrheic and 287 nondiarrheic stool specimens from adult U.S. citizens living in Lima, Peru were tested for presence of bacterial enteropathogens. Frequencies of isolation among diarrheic specimens were: Shigella 9.8%; Campylobacter 6.1%; enterotoxigenic Escherichia coli (ETEC) 6.0%; Plesiomonas 2.0%; Salmonella 1.4%; and Vibrio 0.6%. Isolates recovered from non-diarrheic stools were: Shigella 4.5%; Campylobacter 2.1%; Salmonella 1.0%; ETEC 0.7%; Plesiomonas 0.7%; and Vibrio 0.3%. Aeromonas, an unproven cause of diarrhea, was isolated from 9.2% of cases and 3.5% of controls. Disease occurrence was strongly associated with isolation of Shigella, ETEC, Campylobacter, or Aeromonas (p less than or equal to 0.01). During the 6-year period of study, shifts in the dominant phenotypes of Shigella and Campylobacter occurred which may have important implications for vaccine development and intervention strategies.
Assuntos
Diarreia/microbiologia , Adolescente , Adulto , Idoso , Fezes/microbiologia , Humanos , Pessoa de Meia-Idade , Peru , Viagem , Estados Unidos/etnologiaRESUMO
As a humanitarian civic action project, American and Peruvian military medical personnel established a temporary clinic in Dos Palos, Peru. Fecal specimens from 20 diarrheic children and 10 non-diarrheic controls were tested for common agents of diarrhea. Enteropathogens detected in diarrheic stools were enterotoxigenic Escherichia coli (ETEC; 30%), Aeromonas (20%), enteropathogenic E. coli (15%), and Campylobacter (15%). Isolates from control specimens were Aeromonas (10%) and Campylobacter (10%). ETEC-associated diarrhea was more common in this study (30%) than in three similar populations studied in Lima (2-16%). The results suggest that the northern coastal area of Peru is a relatively high-risk area for diarrhea caused by ETEC.
Assuntos
Diarreia Infantil/microbiologia , Pré-Escolar , Escherichia coli/isolamento & purificação , Fezes/microbiologia , Feminino , Humanos , Lactente , Cooperação Internacional , Masculino , Missões Médicas , Medicina Militar , Peru , Estados UnidosRESUMO
Rectal swabs from 391 infants less than 18 months of age who were hospitalized with acute diarrhea and from 138 similarly aged healthy infants were examined for the etiologic agents of diarrhea. Aeromonas spp. were recovered from 205 of 391 (52.4%) diarrheic patients, whereas they were recovered from 12 of 138 (8.7%) controls (P less than 10(-11). Among the 205 Aeromonas-positive diarrheic patients, 118 (57.6%) were found to be coinfected with other common enteropathogens. Of the 164 Aeromonas-positive initial diarrheic specimens, 82 (50.0%) had one or more other enteropathogens present; 30 patients were coinfected with rotavirus, 20 with enterotoxigenic Escherichia coli, 16 with Campylobacter spp., 14 with Shigella spp., 13 with enteropathogenic E. coli, 4 with Vibrio spp., 1 with Salmonella spp., and 1 with Plesiomonas spp. of Aeromonas strains from cases compared with that from controls supports an etiologic role for this organism. However, frequent concomitant infections with other well-recognized enteropathogens and a lack of disease correlation with common Aeromonas phenotypes suggest that only a subset of Aeromonas strains may be diarrhea causing and that such strains may be common to several of the existing species.
Assuntos
Aeromonas , Infecções Bacterianas/microbiologia , Diarreia/microbiologia , Aeromonas/isolamento & purificação , Aeromonas/metabolismo , Aeromonas/patogenicidade , Infecções Bacterianas/epidemiologia , Diarreia/epidemiologia , Feminino , Humanos , Lactente , Masculino , Peru/epidemiologia , Fenótipo , Estações do Ano , VirulênciaRESUMO
The intestinal colonization rate of Aeromonas spp. was determined for 52 cesarean-born Peruvian neonates. Rectal swabs were obtained daily from newborns during their postdelivery hospitalization (mean = 5.5 days), and the gross appearances of their feces (blind determinations) were recorded. Aeromonas spp. were recovered from rectal swabs of 12 of 52 (23.1%) infants during their first week of life; the isolates were obtained from 5 of 9 (55.6%) infants with at least one stool with a watery consistency and from 7 of 43 (16.3%) neonates with no watery stools (P = 0.022). None of the infected infants became clinically ill. No other commonly recognized enteropathogens were detected in watery stools. An environmental survey indicated that hospital water was the probable source of infection. These and other data indicated that Aeromonas colonization occurs transiently at a very early age in Peruvian neonates and that in some instances, initial infection may be followed several days later by one or more watery stools of normal volume.
Assuntos
Enterite/diagnóstico , Infecções por Enterobacteriaceae/diagnóstico , Aeromonas/isolamento & purificação , Cesárea , Estudos de Coortes , Enterite/complicações , Enterite/epidemiologia , Infecções por Enterobacteriaceae/complicações , Infecções por Enterobacteriaceae/epidemiologia , Fezes/microbiologia , Feminino , Humanos , Incidência , Recém-Nascido , Consentimento Livre e Esclarecido , Entrevistas como Assunto , Peru/epidemiologia , Gravidez , Fatores de RiscoRESUMO
Twelve Aeromonas strains were tested for virulence by using the removable intestinal tie adult rabbit diarrhea model. Mortality was 50% or greater for 7 of 12 strains; 23 of 37 rabbits that died developed diarrhea before death, and 11 of 27 surviving rabbits developed diarrhea. Aeromonas bacteremia was detected in 36 of 37 (97%) animals that died, but only in 2 of 27 (7%) survivors. Death, diarrhea, and bacteremia were all strongly strain dependent. Gastrointestinal lesions varied from moderate focal enteritis to severe multifocal necrosis and hemorrhage of the ileal mucosa, often accompanied by hepatic and splenic lesions. Intestinal colonization assays performed after infection indicated that the ileum was the most heavily colonized portion of the gut and the probable site of invasion. The application of the removable intestinal tie adult rabbit diarrhea model for intestinal challenge with Aeromonas strains has shown that some isolates are capable of invading the mucosa of rabbits, causing diarrhea and bacteremia. These data suggest that such strains may be important in causing human invasive diarrhea.