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Molina NB, Oderiz S, López MA, Basualdo JÁ, Sparo MD. [Molecular characterization of diarrheagenic Escherichia coli from an outpatient pediatric population with diarrhea attended in two hospitals from Buenos Aires, Argentina]. Rev Argent Microbiol 2024; 56:8-15. [PMID: 37500356 DOI: 10.1016/j.ram.2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 04/26/2023] [Accepted: 06/08/2023] [Indexed: 07/29/2023] Open
Abstract
Diarrheagenic Escherichia coli comprises a heterogeneous group of pathotypes or pathogenic variants that share phenotypic characteristics with marked differences in virulence genes, colonization sites, pathogenesis, clinical presentation, and epidemiology of infection. The most studied pathotypes are Shiga toxin-producing E.coli (STEC), enterotoxigenic E.coli (ETEC), enteropathogenic E.coli (EPEC), enteroaggregative E.coli (EAEC), and enteroinvasive E.coli (EIEC). The objective of the study was to characterize the isolates of diarrheagenic E.coli from an outpatient pediatric population with diarrhea attended in two public hospitals from Buenos Aires, Argentina. Diarrheagenic E.coli pathotypes were investigated by amplifying characteristic virulence gene fragments: intimin (eae), heat-labile toxin (lt), heat-stable toxins (stp, sth), invasion plasmid antigen H (ipaH), transcriptional activator R (aggR) and Shiga toxins (stx1, stx2). Molecular subtyping of isolates was performed using PFGE (XbaI). Diarrheagenic E.coli was detected in 14% (84/601) of cases. The EAEC pathotype was prevalent, while ETEC, STEC, EPEC and EIEC were found in a lower proportion. EAEC isolates exhibited a high degree of genetic diversity. All pathotypes were found in children under 5years of age, while only EAEC, EIEC and ETEC were detected in the older population. Future studies that include the characterization of isolates from a greater number of genes and populations from other geographical areas will be necessary to determine the relevance of diarrheagenic E.coli in Argentina.
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Affiliation(s)
- Nora Beatriz Molina
- Centro Universitario de Estudios Microbiológicos y Parasitológicos, Comisión de Investigaciones Científicas, Universidad Nacional de La Plata, La Plata, Buenos Aires , Argentina.
| | - Sebastián Oderiz
- Sala de Microbiología, Hospital Interzonal de Niños Sor María Ludovica, La Plata, Buenos Aires , Argentina
| | - Marisa Ana López
- Centro Universitario de Estudios Microbiológicos y Parasitológicos, Comisión de Investigaciones Científicas, Universidad Nacional de La Plata, La Plata, Buenos Aires , Argentina
| | - Juan Ángel Basualdo
- Centro Universitario de Estudios Microbiológicos y Parasitológicos, Comisión de Investigaciones Científicas, Universidad Nacional de La Plata, La Plata, Buenos Aires , Argentina
| | - Mónica Delfina Sparo
- Centro Universitario de Estudios Microbiológicos y Parasitológicos, Comisión de Investigaciones Científicas, Universidad Nacional de La Plata, La Plata, Buenos Aires , Argentina
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Ararsa T, Wolde D, Alemayehu H, Bizuwork K, Eguale T. Prevalence and Antimicrobial Susceptibility Profile of Salmonella and Shigella among Diarrheic Patients Attending Selected Health Facilities in Addis Ababa, Ethiopia. THE CANADIAN JOURNAL OF INFECTIOUS DISEASES & MEDICAL MICROBIOLOGY = JOURNAL CANADIEN DES MALADIES INFECTIEUSES ET DE LA MICROBIOLOGIE MEDICALE 2023; 2023:6104416. [PMID: 37867502 PMCID: PMC10590268 DOI: 10.1155/2023/6104416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Revised: 09/28/2023] [Accepted: 10/03/2023] [Indexed: 10/24/2023]
Abstract
Diarrhea is one of the important public health problems in developing countries. Salmonella and Shigella species are the major bacterial causal agents of diarrhea. The increasing burden of antimicrobial resistance is posing difficulty in the treatment of these pathogens. This study aimed to assess the occurrence of Salmonella and Shigella in the feces of diarrheic patients receiving health services in Addis Ababa, Ethiopia, and to determine their antimicrobial susceptibility profile. A cross-sectional study involving 13 health centers was conducted where 428 diarrheic patients were recruited. Standard microbiology techniques were used to isolate Salmonella and Shigella from stool samples. In addition, Salmonella isolates were confirmed by polymerase chain reaction (PCR). The Kirby-Bauer disc diffusion method was employed to assess susceptibility to 11 antimicrobials for each of the Salmonella and Shigella isolates. The prevalence of Salmonella and Shigella spp. among diarrheic patients was 8.4%; n = 36 and 5.6%; n = 24, respectively. Thirty (83.3%) of Salmonella isolates were susceptible to all antimicrobials tested, whereas 4 (10.8%) of isolates were resistant to 2 or more antimicrobials and 2 (5.6%) were multidrug resistant. Resistance to ampicillin was recorded in only one (2.7%) of Salmonella isolates; however, resistance to ampicillin was recorded in 12 (50%) of the Shigella isolates. Half of the Shigella isolates (n = 12) were resistant to 2 or more antimicrobials while 5 (20.8%) of them were resistant to 3 or more antimicrobials. The overall rate of resistance to antimicrobials was more common in Shigella compared to Salmonella isolates. In conclusion, Salmonella and Shigella were isolated from the feces of diarrheic patients, with a higher rate of antimicrobial resistance in Shigella isolates, which could make the treatment of shigellosis challenging. Therefore, increasing hygienic practices during food preparation to reduce the burden of Salmonella and Shigella infection and prudent use of antimicrobials are recommended to limit the spread of antimicrobial resistant strains.
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Affiliation(s)
- Tiruneh Ararsa
- Tikur Anbesssa Specialized Hospital, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Deneke Wolde
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wachemo University, Hossana, Ethiopia
| | - Haile Alemayehu
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Ketema Bizuwork
- Tikur Anbesssa Specialized Hospital, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tadesse Eguale
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
- The Ohio State University, Global One Health LLC, Addis Ababa, Ethiopia
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Abstract
The mammalian gastrointestinal tract (GIT) hosts a diverse and highly active microbiota composed of bacteria, eukaryotes, archaea, and viruses. Studies of the GIT microbiota date back more than a century, although modern techniques, including mouse models, sequencing technology, and novel therapeutics in humans, have been foundational to our understanding of the roles of commensal microbes in health and disease. Here, we review the impacts of the GIT microbiota on viral infection, both within the GIT and systemically. GIT-associated microbes and their metabolites alter the course of viral infection through a variety of mechanisms, including direct interactions with virions, alteration of the GIT landscape, and extensive regulation of innate and adaptive immunity. Mechanistic understanding of the full breadth of interactions between the GIT microbiota and the host is still lacking in many ways but will be vital for the development of novel therapeutics for viral and nonviral diseases alike.
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Affiliation(s)
- Danielle E Campbell
- Department of Medicine, Division of Infectious Diseases and Edison Family Center for Genome Sciences & Systems Biology, Washington University School of Medicine, St. Louis, Missouri, USA;
| | - Yuhao Li
- Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Harshad Ingle
- Department of Medicine, Division of Infectious Diseases and Edison Family Center for Genome Sciences & Systems Biology, Washington University School of Medicine, St. Louis, Missouri, USA;
| | - Megan T Baldridge
- Department of Medicine, Division of Infectious Diseases and Edison Family Center for Genome Sciences & Systems Biology, Washington University School of Medicine, St. Louis, Missouri, USA;
- Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, Missouri, USA
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Sharma B, Modgil V, Mahindroo J, Kumar A, Kaur V, Narayan C, Verma R, Mohan B, Taneja N. Are non-lactose-fermenting Escherichia coli important diarrhoeal pathogens in children and adults? Access Microbiol 2023; 5:acmi000459.v3. [PMID: 37601441 PMCID: PMC10436021 DOI: 10.1099/acmi.0.000459.v3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 01/02/2023] [Indexed: 08/22/2023] Open
Abstract
Introduction Diarrhoeagenic Escherichia coli (DEC) remains one of the major causes of acute diarrhoea episodes in developing countries. The percentage of acute diarrhoea cases caused by DEC is 30-40 % in these countries. Approximately 10% of E. coli isolates obtained from stool specimens have been reported to be non-lactose-fermenting (NLF). The available literature is sparse regarding the pathogenicity of NLF E. coli causing infectious diarrhoea. Aim We aimed to elucidate the importance of NLF E. coli in causing diarrhoea in both adults and children by detecting various DEC pathotypes among NLF E. coli in stool samples taken from gastroenteritis cases. Material and Methods A total of 376 NLF E. coli isolates from 3110 stool samples from diarrhoea/gastroenteritis patients were included in the study. Up to three NLF colonies that were not confirmed as Vibrio cholerae , Aeromonas spp., Salmonella spp. or Shigella spp., but were identified as E. coli using matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF), were carefully picked up from each MacConkey agar plate and then meticulously streaked onto freshly prepared, sterilized nutrient agar plates, and biochemical reactions were conducted. Multiplex PCR was conducted for the EAEC, EPEC, ETEC and EHEC pathotypes and PCR for the ipaH gene was conducted for EIEC. The disc diffusion method was used for antibiotic sensitivity testing. Results Using multiplex PCR and ipaH PCR, a total of 63 pathotypes of DEC were obtained, with EAEC being the most predominant (n=31) followed by EIEC (n=22), EPEC (n=8) and ETEC (n=2). To further differentiate EIEC from Shigella , additional biochemical tests were performed, including acetate utilization, mucate and salicin fermentation, and aesculin hydrolysis. Antimicrobial susceptibility testing (AST) showed that maximum resistance was seen against ciprofloxacin (82.5 %) followed by ampicillin (77.8 %) and cotrimoxazole (68.2 %), and minimum resistance was seen against ertapenem (4.8 %). Conclusion In our study two pathotypes (EAEC, EIEC) were predominant among NLF E. coli and these were not only important aetiological agents in children, but also in adults. Our study also sheds light on the epidemiology of EIEC, which is one of the most neglected DEC pathotypes, as hardly any microbiological laboratories process NLF E. coli for EIEC.
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Affiliation(s)
- Bhawna Sharma
- Department of Microbiology, All India Institute of Medical Sciences, Bathinda, India
| | - Vinay Modgil
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Jaspreet Mahindroo
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ajay Kumar
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Varpreet Kaur
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Chandradeo Narayan
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ritu Verma
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Balvinder Mohan
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Neelam Taneja
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Tatte VS, Gopalkrishna V. Circulation of unusual and diverse enteric virus strains in adults with acute gastroenteritis: a study from Pune (Maharashtra), Western India. Arch Virol 2023; 168:160. [PMID: 37169986 DOI: 10.1007/s00705-023-05771-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 02/21/2023] [Indexed: 05/13/2023]
Abstract
In India, studies on the epidemiological and genetic characteristics of enteric viruses in adults with acute gastroenteritis (AGE) are lacking. In this study, fecal samples (n = 110) from adults with acute gastroenteritis in Pune, Western India, were tested for six enteric viruses, and the prevalence of these viruses was as follows: rotavirus A (RVA), 38.5%; enterovirus (EV), 23.1%; astrovirus (AstV), 23.1%; adenovirus (AdV), 7.7%; human bocavirus (HBoV), 7.7%; norovirus (NoV), 0%. Circulation of the RVA G1P[8], G3P[8], G9P[4], CVA-10, echovirus E13, EVC-116, AstV-5, AstV-2, HBoV-1, and AdVC-2 types was observed. When compared to the RotaTeq, Rotarix, and RotaVac vaccine strains, antigenic changes were found in the A, B, C, and F regions of the RVA strains. The circulation of genetically diverse, unusual enteric virus strains, reported here for the first time in adults with acute gastroenteritis, warrants multi-center hospital-based surveillance studies across the country.
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Affiliation(s)
- Vaishali S Tatte
- Enteric Viruses Group, Indian Council of Medical Research (ICMR)-National Institute of Virology, 20-A, Dr. Ambedkar Road, Pune, Maharashtra, 411001, India
| | - Varanasi Gopalkrishna
- Enteric Viruses Group, Indian Council of Medical Research (ICMR)-National Institute of Virology, 20-A, Dr. Ambedkar Road, Pune, Maharashtra, 411001, India.
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Ndjangangoye NK, Lekana-Douki SE, Oyegue-Liabagui SL, Kouna LC, Ndong Ndong KA, Onanga R, Lekana-Douki JB. Molecular Prevalence of Diarrheal Pathogens in Children with Acute Diarrhea in Southeastern Gabon. Am J Trop Med Hyg 2023; 108:829-836. [PMID: 36848891 PMCID: PMC10077015 DOI: 10.4269/ajtmh.22-0378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 09/12/2022] [Indexed: 03/01/2023] Open
Abstract
Diarrheal diseases are a major cause of morbidity and mortality in infants and young children, particularly in sub-Saharan countries. In Gabon, there are few data on the prevalence of diarrheal pathogens in children. The aim of this study was to assess the prevalence of diarrheal pathogens in children with diarrhea in southeastern Gabon. Stool samples (n = 284) from Gabonese children 0 to 15 years of age with acute diarrhea were analyzed using polymerase chain reaction targeting 17 diarrheal pathogens. At least one pathogen was detected in 75.7% of samples (n = 215). Coinfection with multiple pathogens was observed in 44.7% of patients (n = 127). Diarrheagenic Escherichia coli was the most commonly detected pathogen (30.6%, n = 87), followed by adenovirus (26.4%, n = 75), rotavirus (16.9%, n = 48), Shigella sp. (16.5%, n = 47), Giardia duodenalis (14.4%, n = 41), norovirus GII (7.0%, n = 20), sapovirus (5.6%, n = 16), Salmonella enterica (4.9%, n = 14), astrovirus (4.6%, n = 13), Campylobacter jejuni/coli (4.6%, n = 13), bocavirus (2.8%, n = 8), and norovirus GI (2.8%, n = 8). Our study provides useful information on the possible causes of diarrheal diseases affecting children in southeastern Gabon. A similar study with a control group of healthy children is needed to assess the burden of the disease attributed to each pathogen.
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Affiliation(s)
- Nal Kennedy Ndjangangoye
- Unité d’Evolution, Epidémiologie et Résistances Parasitaires, Centre Interdisciplinaire de Recherches Médicales de Franceville, Franceville, Gabon
- Unité Émergence des Maladies Virales, Centre Interdisciplinaire de Recherches Médicales de Franceville, Franceville, Gabon
- Ecole Doctorale Régionale d’Afrique Centrale en Infectiologie Tropicale, Université des Sciences et Techniques de Masuku, Franceville, Gabon
| | - Sonia Etenna Lekana-Douki
- Unité Émergence des Maladies Virales, Centre Interdisciplinaire de Recherches Médicales de Franceville, Franceville, Gabon
| | - Sandrine Lydie Oyegue-Liabagui
- Unité d’Evolution, Epidémiologie et Résistances Parasitaires, Centre Interdisciplinaire de Recherches Médicales de Franceville, Franceville, Gabon
- Ecole Doctorale Régionale d’Afrique Centrale en Infectiologie Tropicale, Université des Sciences et Techniques de Masuku, Franceville, Gabon
- Département de Biologie, Faculté des Sciences, Université des Sciences et Techniques de Masuku, Franceville, Gabon
| | - Lady Charlene Kouna
- Unité d’Evolution, Epidémiologie et Résistances Parasitaires, Centre Interdisciplinaire de Recherches Médicales de Franceville, Franceville, Gabon
| | - Kerry Ance Ndong Ndong
- Unité d’Evolution, Epidémiologie et Résistances Parasitaires, Centre Interdisciplinaire de Recherches Médicales de Franceville, Franceville, Gabon
| | - Richard Onanga
- Unité de Recherche et d’Analyses Médicales, Laboratoire de Bactériologie, Centre Interdisciplinaire de Recherches Médicales de Franceville, Franceville, Gabon
| | - Jean Bernard Lekana-Douki
- Unité d’Evolution, Epidémiologie et Résistances Parasitaires, Centre Interdisciplinaire de Recherches Médicales de Franceville, Franceville, Gabon
- Département de Parasitologie-Mycologie Médecine Tropicale, Faculté de Médecine, Université des Sciences de la Santé, Libreville, Gabon
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High Burden of Co-Infection with Multiple Enteric Pathogens in Children Suffering with Diarrhoea from Rural and Peri-Urban Communities in South Africa. Pathogens 2023; 12:pathogens12020315. [PMID: 36839587 PMCID: PMC9959912 DOI: 10.3390/pathogens12020315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 01/22/2023] [Accepted: 01/30/2023] [Indexed: 02/17/2023] Open
Abstract
Infectious diarrhoea contributes to high morbidity and mortality in young children from sub-Saharan Africa. The aim of this study was to assess the prevalence of single and multiple diarrhoeal-causing pathogen combinations in children suffering from diarrhoea from rural and peri-urban communities in South Africa. A total of 275 diarrhoea stool specimens were collected between 2014 and 2016 from Hospitals and Primary Health Care clinics. The BioFire® FilmArray® Gastrointestinal panel was used to simultaneously detect 22 diarrhoea pathogens (viruses, bacteria, parasites) known to cause diarrhoea. A total of 82% (226/275) enteric pathogens were detected in the stool specimens. The two most detected bacterial, viral and parasitic pathogens each included: EAEC (42%), EPEC (32%), Adenovirus F40/41 (19%), Norovirus (15%), Giardia (8%) and Cryptosporidium (6%), respectively. Single enteric pathogen infections were recorded in 24% (65/275) specimens with EAEC, and Norovirus was found in 26% (17/65) and 14% (9/65) of the specimens, respectively. Multiple enteric pathogen combinations were recorded in 59% (161/275) of the stool specimens with 53% (85/161) containing two pathogens, 22% (35/161) containing three pathogens and 25% (41/161) containing four or more pathogens. The results from this study demonstrated the complex nature of pathogen co-infections in diarrhoeal episodes which could have an impact on treatment effectiveness.
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Bhat A, Rao SS, Bhat S, Vidyalakshmi K, Dhanashree B. Molecular diagnosis of bacterial and viral diarrhoea using multiplex-PCR assays: An observational prospective study among paediatric patients from India. Indian J Med Microbiol 2023; 41:64-70. [PMID: 36870754 DOI: 10.1016/j.ijmmb.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Revised: 12/24/2022] [Accepted: 01/02/2023] [Indexed: 01/24/2023]
Abstract
PURPOSE In developing countries, the aetiology of diarrhoea goes undiagnosed as only microscopy, stool culture or enzyme immunoassay are done to find the causative agent. The present study aims to detect common paediatric viral and bacterial diarrhoea pathogens by microscopy, stool culture for bacteria, and multiplex polymerase chain reaction (mPCR) for bacteria and virus detections. MATERIALS AND METHODS Diarrheal stool samples (n = 109) received at the laboratory from paediatric patients aged one month to 18 years were included in the study. They were cultured for common bacterial pathogens and simultaneously subjected to two multiplex PCRs one for the detection of Salmonella spp., Shigella spp., Enteroinvasive E.coli and Enteropathogenic E.coli, another for the detection of adenovirus, astrovirus, rotavirus and norovirus. RESULTS Of the 109 samples cultured for bacterial aetiology, 0.9% (1/109) grew Salmonella enterica ser.Typhi and 2% (2/109) Shigella flexneri. By mPCR, 16% of samples (17/109) were positive for Shigella spp., 0.9% (1/109) for Salmonella spp., and 21% (23/109) for rotavirus. One sample (0.9%) had rotavirus and Shigella spp., which indicates mixed aetiology. CONCLUSIONS Shigella spp. and rotavirus are the prime causative agents of childhood diarrhoea in our region. The rate of detection of bacterial aetiology by culture was poor. Isolation of pathogens by conventional culture helps to know the species, serotypes and antibiotic susceptibility of the pathogens. Virus isolation is cumbersome, time-consuming, and not available for routine diagnostic use. Therefore, real-time mPCR would be a better choice for early detection of pathogens, thereby ensuring timely diagnosis, treatment, and a reduction in mortality.
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Affiliation(s)
- Archana Bhat
- Department of Microbiology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India.
| | - Suchetha S Rao
- Department of Paediatrics, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India.
| | - Sevitha Bhat
- Department of Microbiology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India.
| | - Katara Vidyalakshmi
- Department of Microbiology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India.
| | - Biranthabail Dhanashree
- Department of Microbiology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India.
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Sharma AK, Gururaj K, Sharma R, Goel A, Paul S, Sharma DK. Development of duplex real-time PCR for quick detection of cryptosporidiosis in goats. Cell Biochem Funct 2023; 41:45-57. [PMID: 36254550 DOI: 10.1002/cbf.3759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Revised: 09/27/2022] [Accepted: 09/29/2022] [Indexed: 01/11/2023]
Abstract
Cryptosporidium spp. is the most important foodborne and waterborne pathogens and a leading cause of mortality from foodborne and waterborne gastrointestinal diseases. In neonates of domestic animals, it is associated with consistent diarrhea and dehydration. Cryptosporidium infection begins with the ingestion of sporulated oocytes disseminated by carrier animals that consistently contaminate the environment. Many diagnostic tests are available including microscopy and antigen trap-ELISA, but none of the diagnostic tests available currently cannot differentiate between active and passive infection in the host. In the current study, to address this challenge an mRNA-based duplex TaqMan® probe PCR was developed to target the Cryptosporidium oocyst wall protein gene and 18SSU rRNA gene in a single tube that can detect metabolically active cryptosporidial oocysts. The mRNA transcripts are the direct indicator of any actively replicating cell and they will help decipher the active stages of its lifecycle in a host. This diagnostic assay was standardized by computing transcript copy number-based limit of detection (LOD). For COWP and 18SSU rRNA genes, the LOD was 7.08 × 1004 and 5.95 × 1005 , respectively. During active infections, the oocyst wall protein will be active and so its COWP gene transcripts will act as a marker for active infection. While transcripts for 18SSU rRNA are constitutively expressed in cryptosporidial life cycle. This current diagnostic assay will be a quantitative marker that will help assess the active stages of Cryptosporidium infection in neonates. The disease dynamics will help better understand to formulate the control strategies and contain infection among healthy animals.
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Affiliation(s)
- Atul Kumar Sharma
- Division of Animal Health, ICAR-Central Institute for Research on Goats, Mathura, Uttar Pradesh, India.,Department of Biotechnology, GLA University, Mathura, Uttar Pradesh, India
| | - K Gururaj
- Division of Animal Health, ICAR-Central Institute for Research on Goats, Mathura, Uttar Pradesh, India
| | - Rama Sharma
- Department of Biotechnology, GLA University, Mathura, Uttar Pradesh, India
| | - Anjana Goel
- Department of Biotechnology, GLA University, Mathura, Uttar Pradesh, India
| | - Souvik Paul
- Animal Health Section, ICAR-National Research Centre on Pig, Guwahati, Assam, India
| | - Dinesh Kumar Sharma
- Division of Animal Health, ICAR-Central Institute for Research on Goats, Mathura, Uttar Pradesh, India
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Abbasi E, van Belkum A, Ghaznavi-Rad E. Common Etiological Agents in Adult Patients with Gastroenteritis from Central Iran. Microb Drug Resist 2022; 28:1043-1055. [PMID: 36130139 DOI: 10.1089/mdr.2021.0177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Aims: This study represents the first analysis from Iran for both the frequency of the most common causes of infectious diarrhoea and their antibiotic resistance patterns in adult patients. Methods: Adult stool specimens (n = 211) were analyzed. Stool specimens were analyzed using standard microbiological, polymerase chain reaction, and reverse transcription polymerase chain reaction tests to identify bacterial, parasitic, and viral enteropathogens. Antibiotic resistance profiles were determined. Results: Enteropathogens were identified in 46.4% (98/211) of the surveyed samples. This included 33.1% (70/211) bacterial infections, including 9.9% (21/211) diarrheagenic Escherichia coli (DEC) and 8.5% (18/211) Shigella spp. We detected 7.1% (15/211) parasitic infections (mostly Giardia lamblia) and 6.1% (13/211) viral infections (mostly adenovirus). The DEC and Shigella spp. isolates included many multi-drug resistant (MDR) isolates (95.2% and 77.7%, respectively), and extended spectrum-β-lactamase (ESBL) genes were often present (57.1% and 61.1%, respectively). The most commonly identified ESBL genes in the DEC and Shigella spp. isolates were blaTEM (100% in both species), blaCTX-M15 (91.6% and 100%, respectively), AmpC blaCIT (80% and 100%, respectively), and blaDHA (80% and 100%, respectively). Conclusions: Bacterial infection was the primary cause of infectious diarrhea, affecting one-third of the adults. The frequency of DEC and Shigella spp. was higher than for other enteropathogens. The high prevalence of MDR, the elevated incidence of ESBL genes among Shigella spp. and DEC isolates, and the presence of quinolone resistance in the Salmonella spp. isolates represent a significant challenge for gastroenteritis diagnosis and treatment in this region.
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Affiliation(s)
- Elnaz Abbasi
- Department of Microbiology & Immunology, Faculty of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Alex van Belkum
- Data Analytics Department, BioMérieux, La Balme les Grottes, France
| | - Ehsanollah Ghaznavi-Rad
- Department of Microbiology & Immunology, Faculty of Medicine, Arak University of Medical Sciences, Arak, Iran.,Department of Biotechnology, Molecular and Medicine Research Center, Faculty of Medicine, Arak University of Medical Sciences, Arak, Iran
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Kichana E, Addy F, Dufailu OA. Genetic characterization and antimicrobial susceptibility of Escherichia coli isolated from household water sources in northern Ghana. JOURNAL OF WATER AND HEALTH 2022; 20:770-780. [PMID: 35635771 DOI: 10.2166/wh.2022.197] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The microbial quality of household water is an important issue in developing countries, especially in Ghana, where many people still depend on unimproved sources of water. The present study investigated the prevalence, genetic characteristics, and antimicrobial resistance profile of Escherichia coli from surface water sources. Fifty-two water samples were analyzed by using a spread plate, a biochemical test, and multiplex polymerase chain reactions. E. coli was isolated from each of the 52 water samples. Of these isolates, 75% were noted to possess virulence genes. Approximately 54% of the isolates were characterized as follows: enterotoxigenic E. coli (ETEC, 10.26%), enteropathogenic E. coli (EPEC, 17.95%), verotoxigenic E. coli (VTEC, 23.07%), and enteroinvasive E. coli (EIEC, 2.57%). Eighteen of the fifty-two isolates could not be characterized due to heterogeneity in banding. The disc diffusion method was used to test for antimicrobial susceptibility. The isolates were most resistant to ceftazidime, augmentin, and cefuroxime. Multidrug resistance was recorded in 48.1% of the isolates. In contrast, the isolates were most susceptible to ciprofloxacin (86.5%), nitrofurantoin (84.6%), and ofloxacin (75%). These results revealed a high diversity and widespread of E. coli in northern Ghana. The study provides important data for public health nationwide surveillance of E. coli in surface water across the country.
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Affiliation(s)
- Elvis Kichana
- Regional Water Quality Laboratory, World Vision Ghana, No. 3 Kotei Robertson Road, North Industrial Area, North Kaneshie, PMB Accra, Ghana E-mail:
| | - Francis Addy
- Department of Biotechnology, University for Development Studies, Tamale NL-1142-8658, Ghana
| | - Osman Adamu Dufailu
- Department of Microbiology, University for Development Studies, Tamale NL-1142-8658, Ghana
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12
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Kumar A, Anita Pandey, Archana Dubey, Amresh Kumar Singh. Microbial aetiology of diarrhea in children less than five years of age at tertiary care hospital of Western Uttar Pradesh, India. Biomedicine (Taipei) 2022. [DOI: 10.51248/.v42i1.1606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Introduction and Aim: Diarrhoeal diseases are one of the major causes of childhood morbidity and mortality globally. Multiple aetiologies and associated risk factors are responsible for diarrhoeal diseases in children. The present study aims to determine the microbial aetiology and possible risk factors of diarrhoea in children less than five years of age at Chhatrapati Shivaji Subharti Hospital, Subharti Medical College, Meerut in Western Uttar Pradesh, India.
Materials and Methods: A total of 240 children < 5 years of age with history of acute diarrhoea of less than 7 days duration were included in the study. Microbial etiology of diarrhoea in children were looked for. Bacterial etiology was identified by standard bacteriological technique. Diarrheagenic E. coli (DEC) were identified by gene-specific polymerase chain reaction. Rotavirus (RV) antigen was detected by Enzyme Immunoassay (EIA), parasites were identified by wet mount preparation and fungal etiology was identified by microscopy and culture on Sabouraud’s Dextrose Agar.
Results: Out of 240 stool samples, 152 were identified as known aetiology of diarrhea. Microbial etiology could be established in 133/240 (55.41%) stool samples. The most common microbial etiology was bacterial 63(47.36%) followed by rotavirus 35 (17.29 %), parasitic etiology in 22 (16.54%) and least common etiology was fungal in 13 (9.77%) cases. Among other etiology, Lactose intolerance was found in 19/240 (7.91%) cases. Mixed aetiology with two or more pathogen causing diarrhoea was seen in 27% cases.
Conclusion: Aetiological agents of diarrhoea could be identified in 63.3% cases. Causes of childhood diarrhoea is polymicrobial and preventable. Awareness and education especially to the mothers regarding the disease, safe drinking water, proper food intake and proper sanitation are key to overcome the burden of the preventable infectious diseases among children less than five years of age.
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Lian S, Liu J, Wu Y, Xia P, Zhu G. Bacterial and Viral Co-Infection in the Intestine: Competition Scenario and Their Effect on Host Immunity. Int J Mol Sci 2022; 23:ijms23042311. [PMID: 35216425 PMCID: PMC8877981 DOI: 10.3390/ijms23042311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 02/02/2022] [Accepted: 02/17/2022] [Indexed: 12/04/2022] Open
Abstract
Bacteria and viruses are both important pathogens causing intestinal infections, and studies on their pathogenic mechanisms tend to focus on one pathogen alone. However, bacterial and viral co-infections occur frequently in clinical settings, and infection by one pathogen can affect the severity of infection by another pathogen, either directly or indirectly. The presence of synergistic or antagonistic effects of two pathogens in co-infection can affect disease progression to varying degrees. The triad of bacterial–viral–gut interactions involves multiple aspects of inflammatory and immune signaling, neuroimmunity, nutritional immunity, and the gut microbiome. In this review, we discussed the different scenarios triggered by different orders of bacterial and viral infections in the gut and summarized the possible mechanisms of synergy or antagonism involved in their co-infection. We also explored the regulatory mechanisms of bacterial–viral co-infection at the host intestinal immune interface from multiple perspectives.
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Affiliation(s)
- Siqi Lian
- College of Veterinary Medicine (Institute of Comparative Medicine), Yangzhou University, Yangzhou 225009, China; (S.L.); (J.L.); (Y.W.); (G.Z.)
- Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou 225009, China
- Joint International Research Laboratory of Prevention and Control of Important Animal Infectious Diseases and Zoonotic Diseases of China, Yangzhou University, Yangzhou 225009, China
- Joint International Research Laboratory of Agriculture and Agri-Product Safety of Ministry of Education of China, Yangzhou University, Yangzhou 225009, China
| | - Jiaqi Liu
- College of Veterinary Medicine (Institute of Comparative Medicine), Yangzhou University, Yangzhou 225009, China; (S.L.); (J.L.); (Y.W.); (G.Z.)
- Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou 225009, China
- Joint International Research Laboratory of Prevention and Control of Important Animal Infectious Diseases and Zoonotic Diseases of China, Yangzhou University, Yangzhou 225009, China
- Joint International Research Laboratory of Agriculture and Agri-Product Safety of Ministry of Education of China, Yangzhou University, Yangzhou 225009, China
| | - Yunping Wu
- College of Veterinary Medicine (Institute of Comparative Medicine), Yangzhou University, Yangzhou 225009, China; (S.L.); (J.L.); (Y.W.); (G.Z.)
- Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou 225009, China
- Joint International Research Laboratory of Prevention and Control of Important Animal Infectious Diseases and Zoonotic Diseases of China, Yangzhou University, Yangzhou 225009, China
- Joint International Research Laboratory of Agriculture and Agri-Product Safety of Ministry of Education of China, Yangzhou University, Yangzhou 225009, China
| | - Pengpeng Xia
- College of Veterinary Medicine (Institute of Comparative Medicine), Yangzhou University, Yangzhou 225009, China; (S.L.); (J.L.); (Y.W.); (G.Z.)
- Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou 225009, China
- Joint International Research Laboratory of Prevention and Control of Important Animal Infectious Diseases and Zoonotic Diseases of China, Yangzhou University, Yangzhou 225009, China
- Joint International Research Laboratory of Agriculture and Agri-Product Safety of Ministry of Education of China, Yangzhou University, Yangzhou 225009, China
- Correspondence:
| | - Guoqiang Zhu
- College of Veterinary Medicine (Institute of Comparative Medicine), Yangzhou University, Yangzhou 225009, China; (S.L.); (J.L.); (Y.W.); (G.Z.)
- Jiangsu Co-Innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou 225009, China
- Joint International Research Laboratory of Prevention and Control of Important Animal Infectious Diseases and Zoonotic Diseases of China, Yangzhou University, Yangzhou 225009, China
- Joint International Research Laboratory of Agriculture and Agri-Product Safety of Ministry of Education of China, Yangzhou University, Yangzhou 225009, China
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Jarquin C, Morales O, McCracken JP, Lopez MR, Lopez B, Reyes L, Gómez GA, Bryan JP, Peruski LF, Pattabiraman V, Parsons MB. Burden of Diarrheagenic
Escherichia coli
in Santa Rosa, Guatemala in active health‐services surveillance during 2008‐2009 and 2014‐2015. Trop Med Int Health 2022; 27:408-417. [DOI: 10.1111/tmi.13735] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Claudia Jarquin
- Center for Health Studies Universidad del Valle de Guatemala Guatemala City Guatemala
| | - Oneida Morales
- Center for Health Studies Universidad del Valle de Guatemala Guatemala City Guatemala
| | - John P. McCracken
- Center for Health Studies Universidad del Valle de Guatemala Guatemala City Guatemala
| | - Maria R. Lopez
- Center for Health Studies Universidad del Valle de Guatemala Guatemala City Guatemala
| | - Beatriz Lopez
- US Centers for Disease Control and Prevention Central America Regional Office Center for Global Health Guatemala
| | - Lisette Reyes
- Guatemalan Ministry of Public Health and Social Welfare Guatemala
| | - Gerardo A. Gómez
- National Center for Emerging and Zoonotic Infectious Diseases US Centers for Disease Control and Prevention Atlanta USA
| | - Joe P. Bryan
- US Centers for Disease Control and Prevention Central America Regional Office Center for Global Health Guatemala
| | - Leonard F. Peruski
- US Centers for Disease Control and Prevention Central America Regional Office Center for Global Health Guatemala
| | - Vaishnavi Pattabiraman
- National Center for Emerging and Zoonotic Infectious Diseases US Centers for Disease Control and Prevention Atlanta USA
| | - Michele B. Parsons
- National Center for Emerging and Zoonotic Infectious Diseases US Centers for Disease Control and Prevention Atlanta USA
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Association between Handwashing Behavior and Infectious Diseases among Low-Income Community Children in Urban New Delhi, India: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312535. [PMID: 34886261 PMCID: PMC8657428 DOI: 10.3390/ijerph182312535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 11/20/2021] [Accepted: 11/23/2021] [Indexed: 01/02/2023]
Abstract
Diarrheal diseases and respiratory infections (RI) are two leading causes of childhood mortality in low and middle-income countries. Effective handwashing at critical time-points may mitigate these diseases. However, there is a lack of published data investigating this association in school-aged children in India. This study is part of a larger prospective handwashing intervention study in a low-income community in New Delhi, India examining the associations between handwashing behavior and diarrhea and RI in schoolchildren. This current study reports the findings of the baseline survey administered to 272 mother–child dyads. Children aged 8–12 years, and their mothers, were recruited from six schools. A baseline questionnaire was used to collect sociodemographic data, handwash behavior, and mother-reported recent diarrhea and RI incidence among the children. Handwashing before and after preparing food, after defecation, and after cleaning dishes significantly reduced the odds of diarrhea by over 70%, and of RI by over 56%. Using a clean cloth after handwashing lowered odds of diarrhea and RI by 72% and 63% respectively. Around 60% of the participants believed that handwashing could prevent diarrhea and RI in their children. There was a low prevalence of handwashing at critical time-points and a poor perception regarding handwashing benefits. To improve handwashing behavior, hygiene promotion programs need to understand what motivates and hinders handwashing in vulnerable populations.
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Huang D, Wang Z, Zhang G, Sai L. Molecular and epidemiological characterization of human adenoviruses infection among children with acute diarrhea in Shandong Province, China. Virol J 2021; 18:195. [PMID: 34579757 PMCID: PMC8474830 DOI: 10.1186/s12985-021-01666-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 09/20/2021] [Indexed: 12/30/2022] Open
Abstract
Background Human adenovirus (HAdV) had been recognized as one of the most common enteric viruses associated with acute diarrhea in children. The present study was carried out to demonstrate the molecular and epidemiological characterization of HAdV Infections among children in Shandong province in China between July 2017 and June 2018. Methods Fecal specimens were collected from children under 5 years old with acute diarrhea. DNA was extracted from the stool specimens and adenovirus DNA was detected by PCR amplification with specific primers. The amplification products were subjected to electrophoresis and visualized on a UV transilluminator. All positive RT-PCR amplification products were sequenced and the obtained sequences analyzed by MEGA (version 7.0). Demographic information and clinical manifestation data were also analyzed. Results In total, 656 fecal specimens were collected and the overall positive rate of HAdV was 7.47%. HAdV infections were detected in all age groups, in which children aged 13–24 months presented the highest positive rate. Seasonal pattern could be observed with a peak in December, January and February. Diarrhea, vomiting, dehydration and fever were the main clinical manifestations, in which vomiting was the most common accompanied symptom. By phylogenetic analysis, four species (A, B, C, and F) were detected and seven different serotypes were identified. HAdV-41 (48.98%, 24/49) was the most common serotype followed by HAdV-3 (18.37%, 9/49), HAdV-31 (14.29%, 7/49), HAdV-7 (8.16%, 4/49), HAdV-40 (4.08%, 2/49), HAdV-1 (4.08%, 2/49) and HAdV-2 (2.04%, 1/49). Conclusion This study indicated that HAdV infection was an important cause of acute diarrhea among children under 5 years old in Shandong province. The results will contribute to (a) increase understanding of the role of HAdV in diarrheal children and enhance identification of the predominant diarrhea pathogen for diagnosis; (b) avoid abuse of antibiotics; (c) monitor the change of prevalent HAdV serotypes and promote vaccine development and vaccination.
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Affiliation(s)
- Deyu Huang
- Department of Infectious Diseases, Affiliated Hospital of Qingdao University, Jiangsu Road 16, Qingdao, 266000, Shandong, China
| | - Zheng Wang
- Department of Infectious Diseases, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Wenhua Xi Road 107, Jinan, 250012, Shandong, China
| | - Guanyou Zhang
- Department of Infectious Diseases, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Wenhua Xi Road 107, Jinan, 250012, Shandong, China
| | - Lintao Sai
- Department of Infectious Diseases, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Wenhua Xi Road 107, Jinan, 250012, Shandong, China.
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17
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McFarland LV, Srinivasan R, Setty RP, Ganapathy S, Bavdekar A, Mitra M, Raju B, Mohan N. Specific Probiotics for the Treatment of Pediatric Acute Gastroenteritis in India: A Systematic Review and Meta-Analysis. JPGN REPORTS 2021; 2:e079. [PMID: 37205949 PMCID: PMC10191489 DOI: 10.1097/pg9.0000000000000079] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 03/08/2021] [Indexed: 05/21/2023]
Abstract
Pediatric acute gastroenteritis (PAGE) is a significant cause of morbidity, mortality and healthcare costs in many countries, but differences in PAGE vary from country-to-country; thus, we limited our analysis to 1 country. Probiotics have been recommended as an adjunct to standard treatment, but the choice of probiotic is unclear. PubMed, Google Scholar, and reviews were searched from inception to May 2020 for randomized controlled trials (RCTs) in India using probiotics for a treatment for PAGE. Meta-analyses using subgroups of identical probiotic types (≥2 RCT/type) were conducted for primary outcomes (duration of diarrhea, cured by day 3, rapidity of response, and length of hospital stay). Twenty-two RCTs were included in the systematic review (N = 4059 participants) including 5 single-strained probiotics and 3 multi-strained mixtures. For the meta-analyses, 17 RCT (20 treatment arms) were included. Saccharomyces boulardii CNCM I-745 had the strongest effect on shortening the duration of diarrhea (standardized mean difference, -1.86 d; 95% confidence interval, -2.8 to -0.9), while both Lactobacillus rhamnosus GG and a mixture of 4 Bacillus clausii strains (O/C, SIN, N/R, T) significantly reduced the duration of diarrhea (-1.7 and -1.4 d, respectively). S. boulardii and L. rhamnosus GG significantly reduced hospital stays (-1.8 and -1.1 d, respectively), while B. clausii had no effect. The frequency of stools/day was significantly reduced by day 4 for S. boulardii and by day 5 for L. rhamnosus GG. In India, 2 types of probiotics (S. boulardii CNCM I-745 and L. rhamnosus GG) significantly shortened both the duration of diarrhea and hospitalization stays in pediatric patients with PAGE. While these 2 probiotic strains were safe and effective for children in India, further research is needed to confirm if other probiotic strains or mixtures may be effective.
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Affiliation(s)
- Lynne V. McFarland
- From the Department of Medicinal Chemistry, University of Washington, Seattle, WA
| | - Ramesh Srinivasan
- Department of Gastroenterology, Apollo Hospitals, Jubilee Hills, Hyderabad, India
| | - Rajendra P. Setty
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Pure Bliss Hospital, Panchkula, India
| | | | | | - Monjori Mitra
- Department of Pediatrics, Institute of Child Health, Kolkata, India
| | - Bhaskar Raju
- Department of Gastroenterology, Dr. Mehta’s Children’s Hospital, Chennai, India
| | - Neelam Mohan
- Department of Pediatric Gastroenterology, Medanta Medicity, Gurgaon, India
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19
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Manouana GP, Byrne N, Mbong Ngwese M, Nguema Moure A, Hofmann P, Bingoulou Matsougou G, Lotola Mougeni F, Nnoh Dansou E, Agbanrin MD, Mapikou Gouleu CS, Ategbo S, Zinsou JF, Adegbite BR, Edoa JR, Kremsner PG, Mordmüller B, Eibach D, McCall M, Abraham A, Borrmann S, Adegnika AA. Prevalence of Pathogens in Young Children Presenting to Hospital with Diarrhea from Lambaréné, Gabon. Am J Trop Med Hyg 2021; 105:254-260. [PMID: 34232911 DOI: 10.4269/ajtmh.20-1290] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 02/08/2021] [Indexed: 11/07/2022] Open
Abstract
Diarrheal disease is the second most frequent cause of mortality in children younger than 5 years worldwide, causing more than half a million deaths each year. Our knowledge of the epidemiology of potentially pathogenic agents found in children suffering from diarrhea in sub-Saharan African countries is still patchy, and thereby hinders implementation of effective preventative interventions. The lack of cheap, easy-to-use diagnostic tools leads to mostly symptomatic and empirical case management. An observational study with a total of 241 participants was conducted from February 2017 to August 2018 among children younger than 5 years with diarrhea in Lambaréné, Gabon. Clinical and demographic data were recorded, and a stool sample was collected. The samples were examined using a commercial rapid immunoassay to detect Rotavirus/adenovirus, conventional bacterial culture for Salmonella spp., and multiplex real-time PCR for Cryptosporidium spp., Giardia lamblia, Cyclospora cayetanensis, enterotoxigenic Escherichia coli (ETEC), and enteroinvasive Escherichia coli (EIEC)/Shigella. At least one infectious agent was present in 121 of 241 (50%) samples. The most frequently isolated pathogens were EIEC/Shigella and ETEC (54/179; 30.2% and 44/179; 24.6%, respectively), followed by G. lamblia (33/241; 13.7%), Cryptosporidium spp. (31/241; 12.9%), and Rotavirus (23/241; 9.5%). Coinfection with multiple pathogens was observed in 33% (40/121) of the positive cases with EIEC/Shigella, ETEC, and Cryptosporidium spp. most frequently identified. Our results provide new insight into the possible causes of diarrheal disease in the Moyen-Ogooué region of Gabon and motivate further research on possible modes of infection and targeted preventive measures.
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Affiliation(s)
- Gédéon Prince Manouana
- 1Centre de Recherche Médicales de Lambaréné, Lambaréné, Gabon.,2Institut für Tropenmedizin, Eberhad Karls Universität Tübingen, Tübingen, Germany
| | - Natalie Byrne
- 2Institut für Tropenmedizin, Eberhad Karls Universität Tübingen, Tübingen, Germany
| | | | | | - Philipp Hofmann
- 3German Center for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Greifswald - Insel Riems, Germany
| | - Gedeon Bingoulou Matsougou
- 1Centre de Recherche Médicales de Lambaréné, Lambaréné, Gabon.,4Département de Pédiatrie, Faculté de Médecine, Université des Sciences de la Santé (USS), Libreville, Gabon
| | | | | | | | | | - Simon Ategbo
- 4Département de Pédiatrie, Faculté de Médecine, Université des Sciences de la Santé (USS), Libreville, Gabon
| | | | - Bayode Romeo Adegbite
- 1Centre de Recherche Médicales de Lambaréné, Lambaréné, Gabon.,5Department of Infectious Diseases, Center of Tropical Medicine and Travel Medicine, Amsterdam University Medical Centers, Location Amsterdam, Amsterdam, The Netherlands.,6Amsterdam Infection and Immunity, Amsterdam Public Health, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Peter Gottfried Kremsner
- 1Centre de Recherche Médicales de Lambaréné, Lambaréné, Gabon.,2Institut für Tropenmedizin, Eberhad Karls Universität Tübingen, Tübingen, Germany.,7German Center for Infection Research (DZIF), Tübingen, Germany
| | - Benjamin Mordmüller
- 1Centre de Recherche Médicales de Lambaréné, Lambaréné, Gabon.,2Institut für Tropenmedizin, Eberhad Karls Universität Tübingen, Tübingen, Germany.,7German Center for Infection Research (DZIF), Tübingen, Germany
| | - Daniel Eibach
- 3German Center for Infection Research (DZIF), Hamburg-Borstel-Lübeck-Riems, Greifswald - Insel Riems, Germany.,8Infectious Disease Epidemiology, Bernhard Nocht Insitute for Tropical Medicine, Hamburg, Germany
| | - Matthew McCall
- 1Centre de Recherche Médicales de Lambaréné, Lambaréné, Gabon.,2Institut für Tropenmedizin, Eberhad Karls Universität Tübingen, Tübingen, Germany.,9Department of Medical Microbiology, Radboudumc, Nijmegen, The Netherlands
| | - Alabi Abraham
- 1Centre de Recherche Médicales de Lambaréné, Lambaréné, Gabon
| | - Steffen Borrmann
- 1Centre de Recherche Médicales de Lambaréné, Lambaréné, Gabon.,2Institut für Tropenmedizin, Eberhad Karls Universität Tübingen, Tübingen, Germany.,7German Center for Infection Research (DZIF), Tübingen, Germany
| | - Ayola Akim Adegnika
- 1Centre de Recherche Médicales de Lambaréné, Lambaréné, Gabon.,2Institut für Tropenmedizin, Eberhad Karls Universität Tübingen, Tübingen, Germany.,7German Center for Infection Research (DZIF), Tübingen, Germany
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Mizutani T, Aboagye SY, Ishizaka A, Afum T, Mensah GI, Asante-Poku A, Asandem DA, Parbie PK, Abana CZY, Kushitor D, Bonney EY, Adachi M, Hori H, Ishikawa K, Matano T, Taniguchi K, Opare D, Arhin D, Asiedu-Bekoe F, Ampofo WK, Yeboah-Manu D, Koram KA, Anang AK, Kiyono H. Gut microbiota signature of pathogen-dependent dysbiosis in viral gastroenteritis. Sci Rep 2021; 11:13945. [PMID: 34230563 PMCID: PMC8260788 DOI: 10.1038/s41598-021-93345-y] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 06/23/2021] [Indexed: 01/04/2023] Open
Abstract
Acute gastroenteritis associated with diarrhea is considered a serious disease in Africa and South Asia. In this study, we examined the trends in the causative pathogens of diarrhea and the corresponding gut microbiota in Ghana using microbiome analysis performed on diarrheic stools via 16S rRNA sequencing. In total, 80 patients with diarrhea and 34 healthy adults as controls, from 2017 to 2018, were enrolled in the study. Among the patients with diarrhea, 39 were norovirus-positive and 18 were rotavirus-positive. The analysis of species richness (Chao1) was lower in patients with diarrhea than that in controls. Beta-diversity analysis revealed significant differences between the two groups. Several diarrhea-related pathogens (e.g., Escherichia-Shigella, Klebsiella and Campylobacter) were detected in patients with diarrhea. Furthermore, co-infection with these pathogens and enteroviruses (e.g., norovirus and rotavirus) was observed in several cases. Levels of both Erysipelotrichaceae and Staphylococcaceae family markedly differed between norovirus-positive and -negative diarrheic stools, and the 10 predicted metabolic pathways, including the carbohydrate metabolism pathway, showed significant differences between rotavirus-positive patients with diarrhea and controls. This comparative study of diarrheal pathogens in Ghana revealed specific trends in the gut microbiota signature associated with diarrhea and that pathogen-dependent dysbiosis occurred in viral gastroenteritis.
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Affiliation(s)
- Taketoshi Mizutani
- The Institute of Medical Science, The University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo, 108-8639, Japan.
| | - Samuel Yaw Aboagye
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Aya Ishizaka
- The Institute of Medical Science, The University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo, 108-8639, Japan
| | - Theophillus Afum
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Gloria Ivy Mensah
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Adwoa Asante-Poku
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Diana Asema Asandem
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Prince Kofi Parbie
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
- Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan
- AIDS Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | | | - Dennis Kushitor
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Evelyn Yayra Bonney
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | | | | | - Koichi Ishikawa
- AIDS Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Tetsuro Matano
- The Institute of Medical Science, The University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo, 108-8639, Japan
- Joint Research Center for Human Retrovirus Infection, Kumamoto University, Kumamoto, Japan
- AIDS Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | | | | | | | | | | | - Dorothy Yeboah-Manu
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | - Kwadwo Ansah Koram
- Noguchi Memorial Institute for Medical Research, University of Ghana, Accra, Ghana
| | | | - Hiroshi Kiyono
- The Institute of Medical Science, The University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo, 108-8639, Japan
- Institute for Global Prominent Research, Graduate School of Medicine, Chiba University, Chiba, Japan
- CU-UCSD Center for Mucosal Immunology, Allergy and Vaccines (cMAV), Department of Medicine, University of California San Diego, San Diego, CA, USA
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Ghapoutsa RN, Boda M, Gautam R, Ndze VN, Mugyia AE, Etoa FX, Bowen MD, Esona MD. Detection of diarrhoea associated rotavirus and co-infection with diarrhoeagenic pathogens in the Littoral region of Cameroon using ELISA, RT-PCR and Luminex xTAG GPP assays. BMC Infect Dis 2021; 21:614. [PMID: 34182936 PMCID: PMC8237514 DOI: 10.1186/s12879-021-06318-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 06/14/2021] [Indexed: 12/16/2022] Open
Abstract
Background Despite the global roll-out of rotavirus vaccines (RotaTeq/Rotarix / ROTAVAC/Rotasiil), mortality and morbidity due to group A rotavirus (RVA) remains high in sub-Saharan Africa, causing 104,000 deaths and 600,000 hospitalizations yearly. In Cameroon, Rotarix™ was introduced in March 2014, but, routine laboratory diagnosis of rotavirus infection is not yet a common practice, and vaccine effectiveness studies to determine the impact of vaccine introduction have not been done. Thus, studies examining RVA prevalence post vaccine introduction are needed. The study aim was to determine RVA prevalence in severe diarrhoea cases in Littoral region, Cameroon and investigate the role of other diarrheagenic pathogens in RVA-positive cases. Methods We carried out a study among hospitalized children < 5 years of age, presenting with acute gastroenteritis in selected hospitals of the Littoral region of Cameroon, from May 2015 to April 2016. Diarrheic stool samples and socio-demographic data including immunization and breastfeeding status were collected from these participating children. Samples were screened by ELISA (ProSpecT™ Rotavirus) for detection of RVA antigen and by gel-based RT-PCR for detection of the VP6 gene. Co-infection was assessed by multiplexed molecular detection of diarrheal pathogens using the Luminex xTAG GPP assay. Results The ELISA assay detected RVA antigen in 54.6% (71/130) of specimens, with 45, positive by VP6 RT-PCR and 54, positive using Luminex xTAG GPP. Luminex GPP was able to detect all 45 VP6 RT-PCR positive samples. Co-infections were found in 63.0% (34/54) of Luminex positive RVA infections, with Shigella (35.3%; 12/34) and ETEC (29.4%; 10/34) detected frequently. Of the 71 ELISA positive RVA cases, 57.8% (41/71) were fully vaccinated, receiving two doses of Rotarix. Conclusion This study provides insight on RVA prevalence in Cameroon, which could be useful for post-vaccine epidemiological studies, highlights higher than expected RVA prevalence in vaccinated children hospitalized for diarrhoea and provides the trend of RVA co-infection with other enteric pathogens. RVA genotyping is needed to determine circulating rotavirus genotypes in Cameroon, including those causing disease in vaccinated children.
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Affiliation(s)
- Rahinatou N Ghapoutsa
- Department of Biochemistry, Faculty of Science, The University of Yaoundé 1, Yaoundé, Cameroon
| | - Maurice Boda
- Department of Microbiology, Faculty of Science, The University of Yaoundé 1, Yaoundé, Cameroon.
| | - Rashi Gautam
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Diseases Control and Prevention, Atlanta, Georgia, USA
| | | | - Akongnwi E Mugyia
- Department of Microbiology and Parasitology, Faculty of Science, University of Buea, Buea, Cameroon
| | - Francois-Xavier Etoa
- Department of Microbiology, Faculty of Science, The University of Yaoundé 1, Yaoundé, Cameroon
| | - Michael D Bowen
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Diseases Control and Prevention, Atlanta, Georgia, USA
| | - Mathew D Esona
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, Centers for Diseases Control and Prevention, Atlanta, Georgia, USA
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Chandra P, Lo M, Mitra S, Banerjee A, Saha P, Okamoto K, Deb AK, Ghosh SK, Manna A, Dutta S, Chawla-Sarkar M. Genetic characterization and phylogenetic variations of human adenovirus-F strains circulating in eastern India during 2017-2020. J Med Virol 2021; 93:6180-6190. [PMID: 34138479 DOI: 10.1002/jmv.27136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 05/10/2021] [Accepted: 06/05/2021] [Indexed: 01/27/2023]
Abstract
Human adenovirus-F (HAdV-F) (genotype 40/41) is the second-most leading cause of pediatric gastroenteritis after rotavirus, worldwide, accounting for 2.8%-11.8% of infantile diarrheal cases. Earlier studies across eastern India revealed a shift in the predominance of genotypes from HAdV41 in 2007-09 to HAdV40 in 2013-14. Thus, the surveillance for HAdV-F genotypes in this geographical setting was undertaken over 2017-2020 to analyze the viral evolutionary dynamics. A total of 3882 stool samples collected from children (≤5 years) were screened for HAdV-F positivity by conventional PCR. The hypervariable regions of the hexon and the partial shaft region of long fiber genes were amplified, sequenced, and phylogenetically analyzed with respect to the prototype strains. A marginal decrease in enteric HAdV prevalence was observed (9.04%, n = 351/3882) compared to the previous report (11.8%) in this endemic setting. Children <2 years were found most vulnerable to enteric HAdV infection. Reduction in adenovirus-rotavirus co-infection was evident compared to the sole adenovirus infection. HAdV-F genotypes 40 and 41 were found to co-circulate, but HAdV41 was predominant. HAdV40 strains were genetically conserved, whereas HAdV41 strains accumulated new mutations. On the basis of a different set of mutations in their genome, HAdV41 strains segregated into 2 genome type clusters (GTCs). Circulating HAdV41 strains clustered with GTC1 of the fiber gene, for the first time during this study period. This study will provide much-needed baseline data on the emergence and circulation of HAdV40/41 strains for future vaccine development.
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Affiliation(s)
- Pritam Chandra
- Division of Virology, National Institute of Cholera and Enteric Diseases, Beliaghata, Kolkata, West Bengal, India
| | - Mahadeb Lo
- Division of Virology, National Institute of Cholera and Enteric Diseases, Beliaghata, Kolkata, West Bengal, India
| | - Suvrotoa Mitra
- Division of Virology, National Institute of Cholera and Enteric Diseases, Beliaghata, Kolkata, West Bengal, India
| | - Anindita Banerjee
- Division of Virology, National Institute of Cholera and Enteric Diseases, Beliaghata, Kolkata, West Bengal, India
| | - Priyanka Saha
- Division of Virology, National Institute of Cholera and Enteric Diseases, Beliaghata, Kolkata, West Bengal, India
| | - Keinosuke Okamoto
- Collaborative Research Centre of Okayama University for Infectious Disease at Indian ICMR-National Institute of Cholera and Enteric Diseases, Beliaghata, Kolkata, West Bengal, India
| | - Alok Kumar Deb
- Division of Epidemiology, ICMR-National Institute of Cholera and Enteric Diseases, Beliaghata, Kolkata, West Bengal, India
| | - Sanat Kumar Ghosh
- Dr. B.C. Roy Post Graduate Institute of Pediatric Sciences, Kolkata, West Bengal, India
| | - Asis Manna
- Infectious diseases and Beliaghata General (ID & BG) Hospital, Beliaghata, Kolkata, West Bengal, India
| | - Shanta Dutta
- Regional Virus Research and Diagnostic Laboratory, ICMR-National Institute of Cholera and Enteric Diseases, Beliaghata, Kolkata, West Bengal, India
| | - Mamta Chawla-Sarkar
- Division of Virology, National Institute of Cholera and Enteric Diseases, Beliaghata, Kolkata, West Bengal, India
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Mouafo HT, Tchuenchieu ADK, Nguedjo MW, Edoun FLE, Tchuente BRT, Medoua GN. In vitro antimicrobial activity of Millettia laurentii De Wild and Lophira alata Banks ex C. F. Gaertn on selected foodborne pathogens associated to gastroenteritis. Heliyon 2021; 7:e06830. [PMID: 33981891 PMCID: PMC8082555 DOI: 10.1016/j.heliyon.2021.e06830] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 12/17/2020] [Accepted: 04/13/2021] [Indexed: 12/14/2022] Open
Abstract
This study aimed at evaluating the antimicrobial potential of aqueous, ethanolic and methanolic extracts of two Cameroonian plants against selected foodborne pathogens. Bioactive compounds were extracted from Millettia laurentii De Wild seeds and Lophira alata Banks ex. C. F. Gaertn leaves using distilled water, ethanol and methanol as solvents. The extracts were tested against Escherichia coli O157, Bacillus cereus, Staphylococcus aureus, Pseudomonas aeruginosa, Proteus mirabilis, Moraxella morganii, Salmonella enteritidis, Klebsiella pneumoniae and Listeria monocytogenes using the microdilution method. The results showed that distilled water extracted a more important mass of phytochemical compounds (18.0–24.60%) compared to ethanol (4.80–5.0%) and methanol (4.20–4.60%). All the extracts exhibited significant antimicrobial activity with MIC values ranging from 5 to 20 μg/mL for M. laurentii seeds extracts and from 1.0 to 20 μg/mL for L. alata leaves extracts. The different plant extracts were ten times less active than gentamicin. The most active extracts were obtained using ethanol as solvent and K. pneumoniae was the most resistant pathogen to all extracts (MBC>20 μg/mL). M. laurentii extracts were bactericidal against L. monocytogenes and P. mirabilis while the reference antibiotic (gentamicin) was bacteriostatic against these pathogens. The results obtained from this study suggest the studied local plant materials as a source of antimicrobial compounds which can be valorized in the medical field as substitute of antibiotics for which many microorganisms have nowadays developed resistance mechanisms. Further studies need to be performed in order to characterize and identify these antimicrobial active molecules.
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Affiliation(s)
- Hippolyte Tene Mouafo
- Centre for Food and Nutrition Research, Institute of Medical Research and Medicinal Plants Studies, POBOX 13033, Yaoundé Cameroon
| | - Alex Dimitri Kamgain Tchuenchieu
- Centre for Food and Nutrition Research, Institute of Medical Research and Medicinal Plants Studies, POBOX 13033, Yaoundé Cameroon
| | - Maxwell Wandji Nguedjo
- Centre for Food and Nutrition Research, Institute of Medical Research and Medicinal Plants Studies, POBOX 13033, Yaoundé Cameroon.,Department of Biochemistry, Faculty of Sciences, University of Yaoundé 1, POBOX 812, Yaoundé Cameroon
| | - Ferdinand Lanvin Ebouel Edoun
- Centre for Food and Nutrition Research, Institute of Medical Research and Medicinal Plants Studies, POBOX 13033, Yaoundé Cameroon.,Department of Biochemistry, Faculty of Sciences, University of Yaoundé 1, POBOX 812, Yaoundé Cameroon
| | - Boris Ronald Tonou Tchuente
- Centre for Food and Nutrition Research, Institute of Medical Research and Medicinal Plants Studies, POBOX 13033, Yaoundé Cameroon.,Department of Biochemistry, Faculty of Sciences, University of Yaoundé 1, POBOX 812, Yaoundé Cameroon
| | - Gabriel Nama Medoua
- Centre for Food and Nutrition Research, Institute of Medical Research and Medicinal Plants Studies, POBOX 13033, Yaoundé Cameroon
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Molina NB, Oderiz S, Vescina C, Córdoba A, Basualdo JÁ, Sparo MD. [First report of diarrheagenic Escherichia coli in pediatric outpatient population with diarrhea in La Plata, Argentina]. Rev Argent Microbiol 2021; 54:15-21. [PMID: 33875293 DOI: 10.1016/j.ram.2021.02.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 11/11/2020] [Accepted: 02/12/2021] [Indexed: 11/30/2022] Open
Abstract
Diarrheagenic Escherichia coli is a heterogeneous group of strains that presents various virulence factors and causes different diarrheal syndromes. The most studied pathotypes are enteropathogenic Escherichia coli (EPEC), enterotoxigenic Escherichia coli (ETEC), enteroaggregative Escherichia coli (EAEC), enteroinvasive Escherichia coli (EIEC) and Shiga toxin-producing Escherichia coli (STEC). The objective was to estimate the frequency of infection of diarrheagenic E. coli pathotypes in children with diarrhea, attended at the Sor María Ludovica Hospital in La Plata, Argentina, during the period May-October 2017. E. coli pathotypes were detected by molecular amplification of eight characteristic virulence genes. The feces of 211 children (76% under 5 years) were studied. Infection with diarrheagenic E. coli was detected in 12.3% of the samples. The pathotypes were EAEC (10.43%), ETEC (1.42%, all of them positive for thermolabile toxin), EPEC (0.95%) and STEC (0.47%, positive for Shiga toxin 2). The EAEC pathotype was prevalent in children of all age groups, while ETEC, EPEC and STEC were only observed in children under 5 years of age. This study constitutes the first report of diarrheagenic Escherichia coli detection in an outpatient pediatric population with diarrhea from La Plata, using molecular amplification techniques. Broader future studies, including the characterization of the isolates with the largest number of genes, asymptomatic controls, different times of the year and population from different geographic areas will be necessary to clarify the relevance of diarrheagenic E. coli infection in children from Argentina.
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Affiliation(s)
- Nora Beatriz Molina
- Centro Universitario de Estudios Microbiológicos y Parasitológicos (CUDEMYP)-CIC, Universidad Nacional de La Plata, La Plata, Argentina.
| | - Sebastián Oderiz
- Sala de Microbiología, Hospital Interzonal de Niños Sor María Ludovica, La Plata, Argentina
| | - Cecilia Vescina
- Sala de Microbiología, Hospital Interzonal de Niños Sor María Ludovica, La Plata, Argentina
| | - Alejandra Córdoba
- Centro Universitario de Estudios Microbiológicos y Parasitológicos (CUDEMYP)-CIC, Universidad Nacional de La Plata, La Plata, Argentina
| | - Juan Ángel Basualdo
- Centro Universitario de Estudios Microbiológicos y Parasitológicos (CUDEMYP)-CIC, Universidad Nacional de La Plata, La Plata, Argentina
| | - Mónica Delfina Sparo
- Centro Universitario de Estudios Microbiológicos y Parasitológicos (CUDEMYP)-CIC, Universidad Nacional de La Plata, La Plata, Argentina
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Heinemann M, Strauchs C, Lütgehetmann M, Aepfelbacher M, Klupp EM, Owusu-Dabo E, Rolling T, Cramer JP, Vinnemeier CD. Polymicrobial enteric infections in African infants with diarrhoea-results from a longitudinal prospective case-control study. Clin Microbiol Infect 2021; 27:1792-1798. [PMID: 33813114 DOI: 10.1016/j.cmi.2021.03.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 03/05/2021] [Accepted: 03/08/2021] [Indexed: 12/20/2022]
Abstract
OBJECTIVES This longitudinal case-control study aimed to determine the frequency of polymicrobial enteric detections in Ghanaian infants with and without diarrhoea. METHODS Infants aged 1-12 months with and without diarrhoea attending the outpatient department of a peri-urban Ghanaian hospital were prospectively assessed and stool samples were collected on days 0, 6 and 28 and analysed for 18 enteric pathogens with PCR. RESULTS At least one enteric pathogen was detected in 100 of 107 cases with diarrhoea (93%) and in 82 of 97 controls (85%). The number of pathogens was higher in cases than in controls (median three versus two pathogens, p 0.001). The adjusted attributable fraction (AF) for diarrhoea was highest for enterotoxigenic Escherichia coli (7.2%, 95% CI -2.0% to 16.3%), rotavirus (4.1%, 95% CI 0.6%-7.5%), Giardia lamblia (2.3%, 95% CI -0.7 to 5.3%) and astrovirus (2.3%, 95% CI -2.9 to 7.5%). In cases, a higher pathogen number was significantly associated with watery stool consistency (median 3, interquartile range (IQR) 2-5 versus median 2.5, IQR 1-4, p 0.014), stool frequency five or more per day (median 4, IQR 3-5 versus median 3, IQR 2-4, p 0.048) and vomiting (median 4, IQR 3-5 versus median 3, IQR 2-4, p 0.025). During follow-up, 94% (78/83) of cases and 85% (67/79) of controls had acquired at least one new pathogen without developing a new episode of diarrhoea. CONCLUSION Enteric pathogens could be identified in the stool of the vast majority of Ghanaian infants, whereby pathogens were very frequently acquired without resulting in new episodes of diarrhoea during follow-up. A higher number of co-occurring pathogens may increase the risk of diarrhoea and disease severity.
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Affiliation(s)
- Melina Heinemann
- Division of Infectious Diseases, I. Department of Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Germany
| | - Cornelia Strauchs
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I. Department of Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Marc Lütgehetmann
- Institute of Medical Microbiology, Virology and Hygiene, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Martin Aepfelbacher
- Institute of Medical Microbiology, Virology and Hygiene, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Eva-Maria Klupp
- Institute of Medical Microbiology, Virology and Hygiene, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Ellis Owusu-Dabo
- Kumasi Centre for Collaborative Research in Tropical Medicine, Kumasi, Ghana
| | - Thierry Rolling
- Division of Infectious Diseases, I. Department of Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; German Centre for Infection Research (DZIF), Hamburg-Lübeck-Borstel-Riems Site, Germany; Immunology Program, Sloan Kettering Institute, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Jakob P Cramer
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I. Department of Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; Coalition for Epidemic Preparedness Innovation (CEPI), London, UK
| | - Christof D Vinnemeier
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine & I. Department of Medicine, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany; German Centre for Infection Research (DZIF), Hamburg-Lübeck-Borstel-Riems Site, Germany.
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Tiwari V, Anand Y, Gupta A, Divyaveer S, Bhargava V, Malik M, Gupta A, Bhalla AK, Rana DS. Etiological Spectrum of Infective Diarrhea in Renal Transplant Patient by Stool PCR: An Indian Perspective. Indian J Nephrol 2021; 31:245-253. [PMID: 34376938 PMCID: PMC8330656 DOI: 10.4103/ijn.ijn_169_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 06/19/2020] [Accepted: 07/05/2020] [Indexed: 11/04/2022] Open
Abstract
Introduction: Diarrhea is a common cause of morbidity and mortality among renal transplant patients. The etiological spectrum of pathogens varies with regional diversity, socioeconomic conditions, sanitation, and eating habits. We aimed to delineate the etiological profile of gastrointestinal pathogens in renal transplant patients using the stool Polymerase chain reaction. Methods: In this single-center, retrospective analysis of patients from January 2016 to January 2018, all renal transplant patients who were admitted with severe diarrhea and underwent the stool Polymerase chain reaction (PCR) were included. In the control group, we included patients from the general population who were admitted with similar complaints in the general medicine ward and underwent stool PCR over the same duration. Results: One hundred ten admissions occurred over 2 years in the transplant group. 86% of samples were positive for infection. More than one organism was seen in 68% of the patient. Norovirus was the most common organism isolated. Giardia lamblia with Norovirus was the most common coinfection among the transplant population. In the control group, 87% of samples tested positive, with 53% of patients having more than one organism. Enteroaggregative E. coli was the common organism, Enteroaggregative E. coli with Enteropathogenic E. coli and Enterotoxigenic E. coli were the most common organism in combination. Both the groups had similar incidence of infection with multiple organisms. Conclusion: The etiological profile of gastrointestinal pathogens differs significantly between the transplant and general population. Coinfections are common in both populations. Norovirus is the most common pathogen in the transplant population, presenting as isolated as well as in coinfections.
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Affiliation(s)
- Vaibhav Tiwari
- Department of Nephrology, Sir Ganga Ram Hospital, New Delhi, India
| | - Yogeshman Anand
- Department of Nephrology, Sir Ganga Ram Hospital, New Delhi, India
| | - Anurag Gupta
- Department of Nephrology, Sir Ganga Ram Hospital, New Delhi, India
| | | | - Vinant Bhargava
- Department of Nephrology, Sir Ganga Ram Hospital, New Delhi, India
| | - Manish Malik
- Department of Nephrology, Sir Ganga Ram Hospital, New Delhi, India
| | - Ashwani Gupta
- Department of Nephrology, Sir Ganga Ram Hospital, New Delhi, India
| | | | - D S Rana
- Department of Nephrology, Sir Ganga Ram Hospital, New Delhi, India
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Getaneh DK, Hordofa LO, Ayana DA, Tessema TS, Regassa LD. Prevalence of Escherichia coli O157:H7 and associated factors in under-five children in Eastern Ethiopia. PLoS One 2021; 16:e0246024. [PMID: 33508023 PMCID: PMC7842931 DOI: 10.1371/journal.pone.0246024] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 01/12/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Escherichia coli O157:H7 (E. coli O157:H7) is one of the most potent zoonotic pathogens that causes mild diarrhea and leads to hemolytic uremic syndrome or death. This study was aimed to assess the prevalence and determinants of E. coli O157:H7 related to diarrhea among under-five children with acute diarrhea. METHODS A cross-sectional study design was carried out in 2018 on 378 under-five-year children recruited randomly from hospitals in Eastern Ethiopia. Stool specimens were collected and processed using enrichment, differential and selective medium. Among isolates, E. coli O157:H7 was confirmed using latex test (Oxoid, Basingstoke, Hants, England). Factors associated with E. coli O157:H7 infection were identified using binary and multivariable logistic regression. Associations were reported by odds ratio with 95% confidence interval. RESULTS The prevalence of E. coli O157:H7 related diarrhea was 15.3% (95%CI: 11.8-19.5). The E. coli O157:H7 infection was positively associated with rural residence (AOR;3.75, 95%CI:1.26-11.20), consumption of undercooked meat (AOR;3.95, 95%CI: 1.23-12.67), raw vegetables and/or fruit juice (AOR;3.37, 95%CI:1.32-8.62), presence of bloody diarrhea (AOR;4.42, 95% CI:1.78-10.94), number of under-five children in a household (AOR;7.16, 95%CI: 2.90-17.70), presence of person with diarrhea in a household (AOR;4.22, 95% CI: 1.84-12.69), owning domestic animal (AOR;3.87, 95% CI: 1.48-10.12) and uneducated mother (AOR;3.14, 95%CI: 1.05-9.42). CONCLUSION The Prevalence of E. coli O157:H7 related diarrhea among under-five children is relatively high in Eastern Ethiopia. The E. coli infection was associated with sanitation and hygiene in a household. Thus, education focused on food cooking and handling, child care, and household sanitation associated with animal manure in rural resident children are helpful in.
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Zhang L, Gu X, Wang J, Liao S, Duan Y, Li H, Song Z, He X, Fan Z. Effects of Dietary Isomaltooligosaccharide Levels on the Gut Microbiota, Immune Function of Sows, and the Diarrhea Rate of Their Offspring. Front Microbiol 2021; 11:588986. [PMID: 33488538 PMCID: PMC7820075 DOI: 10.3389/fmicb.2020.588986] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 12/11/2020] [Indexed: 02/02/2023] Open
Abstract
To investigate the effects of dietary isomaltooligosaccharide (IMO) levels on the gut microbiota, immune function of sows, and the diarrhea rate of their offspring, 120 multiparous gestating pig improvement company (PIC) sows with similar body conditions were selected and fed 1 of 6 diets: a basal diet with no supplement (control, CON), or a diet supplemented with 2.5 g/kg, 5.0 g/kg, 10.0 g/kg, 20.0 g/kg, or 40.0 g/kg IMO (IMO1, IMO2, IMO3, IMO4, or IMO5 group, respectively). Results showed that dietary treatments did not affect the reproductive performance and colostrum composition of sows (P > 0.05). However, compared to the CON, IMO reduced the diarrhea rate of suckling piglets (P < 0.05) and improved the concentrations of colostrum IgA, IgG, and IgM (P < 0.05). Moreover, IMO decreased the concentrations of serum D-lactate (D-LA) and lipopolysaccharides (LPS) at farrowing and day 18 of lactation (L18) (P < 0.05). High-throughput pyrosequencing of the 16S rRNA demonstrated that IMO shaped the composition of gut microbiota in different reproductive stages (day 107 of gestation, G107; day 10 of lactation, L10) (P < 0.05). At the genus level, the relative abundance of g_Parabacteroides and g_Slackia in G107 and g_Unclassified_Peptostreptococcaceae, g_Turicibacter, g_Sarcina, and g_Coprococcus in L10 was increased in IMO groups but the g_YRC22 in G107 was decreased in IMO groups relative to the CON group (P < 0.05). Furthermore, the serum D-LA and LPS were negatively correlated with the genus g_Akkermansia and g_Parabacteroides but positively correlated with the genus g_YRC22 and g_Unclassified_Peptostreptococcaceae. Additionally, the colostrum IgA, IgG, and IgM of sows were positively correlated with the genus g_Parabacteroides, g_Sarcina, and g_Coprococcus but negatively correlated with the genus g_YRC22. These findings indicated that IMO could promote the immune activation and had a significant influence in sows' gut microbiota during perinatal period, which may reduce the diarrhea rate of their offspring.
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Affiliation(s)
- Longlin Zhang
- College of Animal Science and Technology, Hunan Agricultural University, Changsha, China
- Hunan Co-Innovation Center of Animal Production Safety, Hunan Agricultural University, Changsha, China
| | - Xueling Gu
- College of Animal Science and Technology, Hunan Agricultural University, Changsha, China
- Hunan Co-Innovation Center of Animal Production Safety, Hunan Agricultural University, Changsha, China
| | - Jie Wang
- College of Animal Science and Technology, Hunan Agricultural University, Changsha, China
- Hunan Co-Innovation Center of Animal Production Safety, Hunan Agricultural University, Changsha, China
| | - Shuang Liao
- College of Animal Science and Technology, Hunan Agricultural University, Changsha, China
- Hunan Co-Innovation Center of Animal Production Safety, Hunan Agricultural University, Changsha, China
| | - Yehui Duan
- Hunan Provincial Key Laboratory of Animal Nutritional Physiology and Metabolic Process, Key Laboratory of Agro-ecological Processes in Subtropical Region, Institute of Subtropical Agriculture, Chinese Academy of Sciences, Hunan Provincial Engineering Research Center for Healthy Livestock and Poultry Production, Scientific Observing and Experimental Station of Animal Nutrition and Feed Science in South-Central, Ministry of Agriculture, National Engineering Laboratory for Pollution Control and Waste Utilization in Livestock and Poultry Production, Changsha, China
| | - Hao Li
- College of Animal Science and Technology, Hunan Agricultural University, Changsha, China
- Hunan Co-Innovation Center of Animal Production Safety, Hunan Agricultural University, Changsha, China
| | - Zehe Song
- College of Animal Science and Technology, Hunan Agricultural University, Changsha, China
- Hunan Co-Innovation Center of Animal Production Safety, Hunan Agricultural University, Changsha, China
| | - Xi He
- College of Animal Science and Technology, Hunan Agricultural University, Changsha, China
- Hunan Co-Innovation Center of Animal Production Safety, Hunan Agricultural University, Changsha, China
| | - Zhiyong Fan
- College of Animal Science and Technology, Hunan Agricultural University, Changsha, China
- Hunan Co-Innovation Center of Animal Production Safety, Hunan Agricultural University, Changsha, China
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Greig DR, Mikhail AFW, Dallman TJ, Jenkins C. Analysis Shiga Toxin-Encoding Bacteriophage in a Rare Strain of Shiga Toxin-Producing Escherichia coli O157:H7 stx2a/stx2c. Front Microbiol 2020; 11:577658. [PMID: 33193199 PMCID: PMC7609406 DOI: 10.3389/fmicb.2020.577658] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 09/09/2020] [Indexed: 02/05/2023] Open
Abstract
In December 2015, six cases of Shiga toxin (Stx)-producing Escherichia coli (STEC) O157:H7 stx2a/stx2c phage type (PT) 24 were identified by the national gastrointestinal disease surveillance system at Public Health England (PHE). Frozen grated coconut imported from India was implicated as the vehicle of infection. Short and long read sequencing data were interrogated for genomic markers to provide evidence that the outbreak strain was from an imported source. The outbreak strain belonged to a sub-lineage (IIa) rare in domestically acquired infection in the United Kingdom, and indicative of an imported strain. Phylogenetic analysis identified the most closely related isolates to the outbreak strain were from cases reporting recent travel not to India, but to Uganda. Phylo-geographical signals based on travel data may be confounded by the failure of local and/or global monitoring systems to capture the full diversity of strains in a given country. This may be due to low prevalence strains circulating in-country under the surveillance radar, or a recent importation event involving the migration of animals and/or people. Comparison of stx2a-encoding prophage harbored by the outbreak strain with publicly available stx2a-encoding prophage sequences revealed that it was most closely related to stx2a-encoding prophage acquired by STEC O157:H7 that caused the first outbreak of STEC-hemolytic uremic syndrome (HUS) in England in 1982–83. Animal and people migration events may facilitate the transfer of stx2a-encoding prophage from indigenous STEC O157:H7 to recently imported strains, or vice versa. Monitoring the global transmission of STEC O157:H7 and tracking the exchange of stx2a-encoding phage between imported and indigenous strains may provide an early warning of emerging threats to public health.
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Affiliation(s)
- David R Greig
- National Infection Service, Public Health England, London, United Kingdom.,Division of Infection and Immunity, The Royal (Dick) School of Veterinary Studies, The Roslin Institute, The University of Edinburgh, Easter Bush, United Kingdom
| | - Amy F W Mikhail
- National Infection Service, Public Health England, London, United Kingdom
| | - Timothy J Dallman
- National Infection Service, Public Health England, London, United Kingdom.,Division of Infection and Immunity, The Royal (Dick) School of Veterinary Studies, The Roslin Institute, The University of Edinburgh, Easter Bush, United Kingdom
| | - Claire Jenkins
- National Infection Service, Public Health England, London, United Kingdom
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Duong VT, Tu LTP, Tuyen HT, Nhi LTQ, Campbell JI, Van Minh P, Le Phuc H, Chau TTH, Ngoc NM, Vi LL, Jenkins C, Okeke I, Higginson E, Baker S. Novel multiplex real-time PCR assays reveal a high prevalence of diarrhoeagenic Escherichia coli pathotypes in healthy and diarrhoeal children in the south of Vietnam. BMC Microbiol 2020; 20:192. [PMID: 32620076 PMCID: PMC7333254 DOI: 10.1186/s12866-020-01878-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 06/25/2020] [Indexed: 08/30/2023] Open
Abstract
Background Diarrhoeagenic Escherichia coli (DEC) infections are common in children in low-middle income countries (LMICs). However, detecting the various DEC pathotypes is complex as they cannot be differentiated by classical microbiology. We developed four multiplex real-time PCR assays were to detect virulence markers of six DEC pathotypes; specificity was tested using DEC controls and other enteric pathogens. PCR amplicons from the six E. coli pathotypes were purified and amplified to be used to optimize PCR reactions and to calculate reproducibility. After validation, these assays were applied to clinical samples from healthy and diarrhoeal Vietnamese children and associated with clinical data. Results The multiplex real-time PCRs were found to be reproducible, and specific. At least one DEC variant was detected in 34.7% (978/2815) of the faecal samples from diarrhoeal children; EAEC, EIEC and atypical EPEC were most frequent Notably, 41.2% (205/498) of samples from non-diarrhoeal children was positive with a DEC pathotype. In this population, only EIEC, which was detected in 34.3% (99/289) of diarrhoeal samples vs. 0.8% (4/498) non-diarrhoeal samples (p < 0.001), was significantly associated with diarrhoea. Multiplex real-time PCR when applied to clinical samples is an efficient and high-throughput approach to DEC pathotypes. Conclusions This approach revealed high carriage rates of DEC pathotypes among Vietnamese children. We describe a novel diagnostic approach for DEC, which provides baseline data for future surveillance studies assessing DEC burden in LMICs.
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Affiliation(s)
- Vu Thuy Duong
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam.,Children's Hospital 1, Ho Chi Minh City, Vietnam
| | - Le Thi Phuong Tu
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Ha Thanh Tuyen
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Le Thi Quynh Nhi
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam.,University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Vietnam
| | - James I Campbell
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Pham Van Minh
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | | | - Tran Thi Hong Chau
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | | | - Lu Lan Vi
- The Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Claire Jenkins
- National Infection Service, Public Health England, England, UK
| | - Iruka Okeke
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, University of Ibadan, Ibadan, Nigeria
| | - Ellen Higginson
- Cambridge Institute of Therapeutic Immunology & Infectious Disease (CITIID) Department of Medicine, Cambridge Biomedical Campus, University of Cambridge, Cambridge, CB2 0AW, UK
| | - Stephen Baker
- Cambridge Institute of Therapeutic Immunology & Infectious Disease (CITIID) Department of Medicine, Cambridge Biomedical Campus, University of Cambridge, Cambridge, CB2 0AW, UK.
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Shrivastava AK, Panda S, Kumar S, Sahu PS. Two novel genomic DNA sequences as common diagnostic targets to detect Cryptosporidium hominis and Cryptosporidium parvum: Development of quantitative polymerase chain reaction assays, and clinical evaluation. Indian J Med Microbiol 2020; 38:430-439. [PMID: 33154258 DOI: 10.4103/ijmm.ijmm_20_114] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Introduction Cryptosporidium is an intestinal parasite responsible for gastroenteritis. Conventional diagnosis of Cryptosporidium is made by microscopy. The most frequent molecular detection method for this parasite is polymerase chain reaction (PCR). The objective of the present study was to identify the novel DNA targets and development of PCR-based assays for the specific detection of two major human infecting species Cryptosporidium parvum and Cryptosporidium hominis. Methodology Sensitive and specific SYBR green quantitative PCR (qPCR) and TaqMan qPCR assays were developed and validated at both diagnostic and analytical level using the new identified targets TU502HP-1 and TU502HP-2. Results Assay validation results showed that the newly developed real-time PCR assays are 100% specific with a reliable limit of detection. Overall repeatability and reproducibility of these assays showed good quality results over intra- and inter-laboratory analysis. Conclusion Novel target-based qPCR assays can be rapid an efficient tool for simultaneous detection of a C. parvum and C. hominis. These genes could also be utilized for the development of innovative DNA-based Point-of-Care test development.
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Affiliation(s)
- Arpit Kumar Shrivastava
- Infection Biology Laboratory, School of Biotechnology, KIIT Deemed to be University, Bhubaneswar, Odisha; Department of Microbiology, Virus Research and Diagnostic Laboratory, Atal Bihari Vajpayee Government Medical College, Vidisha, Madhya Pradesh, India
| | - Swagatika Panda
- Infection Biology Laboratory, School of Biotechnology, KIIT Deemed to be University; Department of Infectious Disease Biology, Institute of Life Sciences, Bhubaneswar, Odisha, India
| | - Subrat Kumar
- Infection Biology Laboratory, School of Biotechnology, KIIT Deemed to be University, Bhubaneswar, Odisha, India
| | - Priyadarshi Soumyaranjan Sahu
- Infection Biology Laboratory, School of Biotechnology, KIIT Deemed to be University, Bhubaneswar, Odisha, India; Department of Microbiology and Immunology, Medical University of the Americas (R3 Education Inc), MA, USA
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Shrivastava AK, Mohakud NK, Panda S, Patra SD, Kumar S, Sahu PS. Major enteropathogens in humans, domestic animals, and environmental soil samples from the same locality: prevalence and transmission considerations in coastal Odisha, India. Epidemiol Health 2020; 42:e2020034. [PMID: 32512665 PMCID: PMC7644938 DOI: 10.4178/epih.e2020034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 05/24/2020] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVES Regions with limited sanitation facilities have higher rates of infections with various enteric pathogens. It is therefore important to identify different hosts and their relative contribution to pathogen shedding into the environment, and to assess the subsequent health risks to humans.
METHODS In this study, human faecal (n=310), animal faecal (n=150), and environmental (soil) samples (n=40) were collected from the same locality and screened for selected enteric pathogens by immunochromatography and/or polymerase chain reaction.
RESULTS At least 1 microbial agent was detected in 49.0%, 44.7%, and 40.0% of the samples from human, animals, and soil, respectively. Among humans, rotavirus was predominantly detected (17.4%) followed by enteropathogenic Escherichia coli (EPEC) (15.4%), Shigella (13.8), and Shiga toxin-producing E. coli (STEC) (9.7%). Among animals, STEC was detected most frequently (28.0%), and EPEC was the major enteric pathogen detected in soil (30.0%). The detection rate of rotavirus was higher among younger children (≤2 years) than among older children. Single infections were more commonly detected than multiple infections in humans (p<0.01), unlike the observations in animal and soil samples. For diarrhoeagenic E. coli and Shigella, most of the human and animal isolates showed close relatedness, suggesting possible cross-infection between humans and domesticated animals in the area studied.
CONCLUSIONS The present study provides an improved understanding of the distribution of major enteric pathogens coexisting in humans and animals in the region, thereby suggesting a high potential for possible transmission among livestock and communities residing in the studied locality.
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Affiliation(s)
- Arpit Kumar Shrivastava
- Infection Biology Laboratory, School of Biotechnology, Kalinga Institute of Industrial Technology (KIIT) Deemed to be University, Bhubaneswar, India
| | - Nirmal Kumar Mohakud
- Kalinga Institute of Medical Sciences, Kalinga Institute of Industrial Technology (KIIT) University, Bhubaneswar, India
| | - Swagatika Panda
- Infection Biology Laboratory, School of Biotechnology, Kalinga Institute of Industrial Technology (KIIT) Deemed to be University, Bhubaneswar, India
| | - Saumya Darshana Patra
- Infection Biology Laboratory, School of Biotechnology, Kalinga Institute of Industrial Technology (KIIT) Deemed to be University, Bhubaneswar, India
| | - Subrat Kumar
- Infection Biology Laboratory, School of Biotechnology, Kalinga Institute of Industrial Technology (KIIT) Deemed to be University, Bhubaneswar, India
| | - Priyadarshi Soumyaranjan Sahu
- Infection Biology Laboratory, School of Biotechnology, Kalinga Institute of Industrial Technology (KIIT) Deemed to be University, Bhubaneswar, India.,Department of Microbiology and Immunology, Medical University of the Americas, Nevis, West Indies
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Abbasi E, Mondanizadeh M, van Belkum A, Ghaznavi-Rad E. Multi-Drug-Resistant Diarrheagenic Escherichia coli Pathotypes in Pediatric Patients with Gastroenteritis from Central Iran. Infect Drug Resist 2020; 13:1387-1396. [PMID: 32523359 PMCID: PMC7234969 DOI: 10.2147/idr.s247732] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 04/28/2020] [Indexed: 12/15/2022] Open
Abstract
Background Diarrheagenic Escherichia coli (DEC) is a significant cause of gastroenteritis and a major public health problem. This study investigates the prevalence and the antibiotic resistance patterns of DEC that were isolated from infectious diarrhea samples of pediatric patients from central Iran. Patients and Methods Pediatric diarrhea samples were collected from 230 pediatric patients visiting the hospital. E. coli pathotypes were diagnosed by using conventional culture methods and PCR. Antibiotic resistance profiles, the frequency of multi-drug resistance (MDR), and the phenotypic and genotypic characteristics of extended spectrum-β-lactamase (ESBL), AmpC and integron-associated genes were analyzed. Results Of the 230 samples of infectious diarrhea, 91 (39.5%) produced E. coli isolates. Of these, 32 cases (35.1%) were identified as DEC by culture and PCR. The frequency of the E. coli pathotypes obtained was as follows: EAEC 11/32 (34.3%), EPEC 9/32 (28.1%), ETEC 6/32 (18.7%), EIEC 3/32 (9.3%), and EHEC 3/32 (9.3%). The antibiotic resistance rates were greater for nalidixic acid (30/32; 93.7%), ampicillin (29/32; 90.6%), and tetracycline (25/32; 78.1%) than for any of the other tested antibiotics. High levels of MDR (25/32; 78.1%) and the presence of ESBL (18/32; 56.2%) and AmpC (9/32; 28.1%) were observed in the DEC isolates. The isolates showed a higher frequency of the ESBL genes [blaTEM (18/18; 100%), blaCTX-M15 (17/18; 94.4%)], and AmpC [bla CIT (4/9; 44.4%) and blaDHA (4/9; 44.4%)] than of the other ESBL and AmpC genes. Conclusion Compared to the previous study, DEC appeared to be the second-most abundant agent of diarrhea in pediatric patients after Campylobacter jejuni, with frequent MDR and ESBL presence.
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Affiliation(s)
- Elnaz Abbasi
- Department of Microbiology & Immunology, Faculty of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Mahdieh Mondanizadeh
- Department of Biotechnology and Molecular Medicine, Faculty of Medicine, Arak University of Medical Sciences, Arak, Iran
| | - Alex van Belkum
- Data Analytics Department, BioMérieux, La Balme les Grottes, France
| | - Ehsanollah Ghaznavi-Rad
- Molecular and Medicine Research Center, Faculty of Medicine Arak University of Medical Sciences, Arak, Iran.,Department of Medical Laboratory Sciences, Arak School of Paramedicine, Arak University of Medical Sciences, Arak, Iran
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Singh P, Metgud SC, Roy S, Purwar S. Evolution of diarrheagenic Escherichia coli pathotypes in India. J Lab Physicians 2020; 11:346-351. [PMID: 31929702 PMCID: PMC6943867 DOI: 10.4103/jlp.jlp_58_19] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
CONTEXT: Diarrheagenic Escherichia coli (DEC) is the leading cause of infectious diarrhea in developing countries. On the basis of virulence and phenotypic characteristics, the DEC is categorized into multiple pathotypes. Each pathotype has different pathogenesis and geographical distribution. Thus, the proper management of disease relies on rapid and accurate identification of DEC pathotypes. AIMS: The aim of the study was to determine the prevalence of DEC pathotypes in India. MATERIALS AND METHODS: A cross-sectional study was carried out between January 2008 and December 2012 at Jawaharlal Nehru Medical College and KLES Dr. Prabhakar Kore Hospital and Medical Research Center, Belgaum (Karnataka), India. A total of 300 stool samples were collected from diarrhea patients with age >3 months. The DEC was identified by both conventional and molecular methods. RESULTS: Of 300 samples, E. coli were detected in 198 (66%) and 170 (56.6%) samples by culture and polymerase chain reaction, respectively. Among DEC (n = 198) isolates, eae gene (59.5%) was the most prevalent followed by stx (27.7%), east (27.2%), elt (12.6%), est (10.6%), ipaH (5.5%), and eagg (1.5%) genes. On the basis of virulence genes, enteropathogenic E. coli (33.8%) was the most common pathotype followed by Shiga toxin-producing E. coli (STEC, 23.2%), enterotoxigenic E. coli (ETEC, 13.6%), enteroinvasive E. coli (5.5%), enteroaggregative heat-stable enterotoxin 1-harboring E. coli (EAST1EC, 4.5%), STEC/ETEC (3.5%), STEC/enteroaggregative E. coli (STEC/EAEC, 1.0%), and EAEC (0.05%). CONCLUSIONS: The hybrid DEC is potentially more virulent than basic pathotypes. The pathotyping should be included in clinical settings for the proper management of DEC-associated diarrhea.
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Affiliation(s)
- Pankaj Singh
- Department of Medical Microbiology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Sharda C Metgud
- Department of Microbiology, Jawaharlal Nehru Medical College, Belgaum, Karnataka, India
| | | | - Shashank Purwar
- Department of Medical Microbiology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
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Bhattarai V, Sharma S, Rijal KR, Banjara MR. Co-infection with Campylobacter and rotavirus in less than 5 year old children with acute gastroenteritis in Nepal during 2017-2018. BMC Pediatr 2020; 20:68. [PMID: 32054497 PMCID: PMC7020500 DOI: 10.1186/s12887-020-1966-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 02/10/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Diarrhoea, although easily curable, is a global cause of death for a half million children every year. Rotavirus and Campylobacter are the most common etiological agents of diarrhoea in children less than 5 years of age. However, in Nepal, these causative agents are not routinely examined for the diagnosis and treatment. The main objective of this study was to determine Campylobacter co-infection associated with rotavirus diarrhoea in children less than 5 years of age. METHODS A cross-sectional study was conducted at Kanti Children's Hospital (KCH), Kathmandu, Nepal from November 2017 to April 2018. A total of 303 stool specimens from children affected with diarrhoea were processed to detect rotavirus using a rapid rotavirus antigen detection test kit, and Campylobacter by microscopy, culture and biochemical tests. Antibiotic susceptibility tests of Campylobacter isolates were performed according to European Committee on Antimicrobial Susceptibility Testing (EUCAST) guidelines 2015. RESULTS Of 303 samples, 91 (30.0%) were positive for co-infection with rotavirus and Campylobacter. Rotavirus mono-infection was detected in 61 (20.1%), and Campylobacter mono-infection was detected in 81 (26.7%) samples. Patient's age, month of infection, untreated water and frequent soil contact were the major risk factors for infections. Clinical features such as > 9 loose motions per day, fever, vomiting, mild to moderate dehydration, diarrhea persisting 6-9 days and presence of mucus in stool were significant (p < 0.05) clinical features, and were more severe in coinfection compared to mono-infections in multivariate analysis. CONCLUSION The study shows a high rate of rotavirus and Campylobacter coinfection in children with diarrhoea. Diagnosis based management of diarrhoeal cases can guide the specific treatment.
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Affiliation(s)
- Vishnu Bhattarai
- Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal
| | - Saroj Sharma
- Kanti Children's Hospital, Maharajgunj, Kathmandu, Nepal
| | - Komal Raj Rijal
- Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal
| | - Megha Raj Banjara
- Central Department of Microbiology, Tribhuvan University, Kirtipur, Kathmandu, Nepal.
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Lima FM, de Paulo Daurelio F, Mucci ER, Ahagon CM, Dos Santos Carmo AM, Eterovic A, Fernando Dos Santos L, Tiba-Casas MR, Camargo CH, Cergole-Novella MC. Epidemiology and genetic screening of diarrheagenic Escherichia coli among symptomatic and asymptomatic children. J Med Microbiol 2019; 68:1033-1041. [PMID: 31199225 DOI: 10.1099/jmm.0.001020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
PURPOSE Enteropathogens are frequently associated with diarrheal disease. Knowledge of their etiology and epidemiology is essential for the prevention and control of the sickness. This study describes the microbiological and epidemiological features of diarrheal disease in 197 symptomatic and 223 asymptomatic under-five-year-old children from southeastern Brazil, between January 2015 and September 2016. METHODS Isolation of Escherichia coli, Salmonella, Shigella and Campylobacter was realized by culture. E. coli strains were screened by multiplex PCR, PFGE and O:H serotyping. Antimicrobial susceptibility testing was also performed. RESULTS Most of the 127 enteropathogens isolated were diarrheagenic E. coli (96.1 %), with predominance of several serotypes of enteropathogenic E. coli (EPEC) and enteroaggregative E. coli (EAEC). Age, sex, rotavirus vaccination, recent use of antibiotics and previous contact with pets, were factors that revealed no significant effects on the probability of infection by the predominant pathogens. Even so, higher incomes could be related to a lesser chance of testing positive for EPEC. Evidence of possible EAEC clonal spread was detected, as well as genetic similarity among strains from both symptomatic and asymptomatic children. Resistance to antimicrobial agents was more pronounced among EAEC than EPEC. CONCLUSION The occurrence of genetically similar diarrheagenic E. coli in both groups of children, likewise resistant to these agents, underscores the importance of establishing strategies for the prevention of outbreaks, especially among low-income households.
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Affiliation(s)
| | | | | | | | | | - André Eterovic
- Center for Natural and Human Sciences, Federal University of ABC (UFABC), Santo André, SP, Brazil
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Salami A, Fakih H, Chakkour M, Salloum L, Bahmad HF, Ghssein G. Prevalence, risk factors and seasonal variations of different Enteropathogens in Lebanese hospitalized children with acute gastroenteritis. BMC Pediatr 2019; 19:137. [PMID: 31039787 PMCID: PMC6489254 DOI: 10.1186/s12887-019-1513-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 04/12/2019] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Acute gastroenteritis (AGE) is a major cause of pediatric morbidity and mortality around the world. It remains a frequent reason for infection-related admissions to emergency units among all age groups. Following the Syrian refugee crisis and insufficient clean water in our region, we sought to assess the etiological and epidemiological factors pertaining to AGE in South Lebanon. METHODS In this multi-center cross sectional clinical study, we analyzed the demographic, clinical and laboratory data of 619 Lebanese children from the age of 1 month to 5 years old who were admitted with AGE to pediatrics departments of three tertiary care centers in South Lebanon. RESULTS Our results revealed that males had a higher incidence of AGE (57.3%) than females. Enteropathogens were identified in 332/619 (53.6%) patients. Single pathogens were found in 294/619 (47.5%) patients, distributed as follows: Entamoeba histolytica in 172/619 (27.8%) patients, rotavirus in 84/619 (13.6%), and adenovirus in 38/619 (6.1%). Mixed co-pathogens were identified in 38/619 (6.1%) patients. Analyzing the clinical manifestations indicated that E. histolytica caused the most severe AGE. In addition, children who received rotavirus vaccine were significantly less prone to rotavirus infection. CONCLUSIONS Our findings alluded to the high prevalence of E. histolytica and other unidentified enteropathogens as major potential causes of pediatric AGE in hospitalized Lebanese children. This should drive us to widen our diagnostic panel by adopting new diagnostic techniques other than the routinely used ones (particularly specific for the pathogenic amoeba E. histolytica and for the unidentified enteropathogens), and to improve health services in this unfortunate area of the world where insanitary water supplies and lack of personal hygiene represent a major problem.
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Affiliation(s)
- Ali Salami
- Rammal Hassan Rammal Research Laboratory, Physio-toxicity (PhyTox) Research Group, Lebanese University, Faculty of Sciences (V), Nabatieh, Lebanon.
| | - Hadi Fakih
- Department of Pediatrics, Faculty of Medical Sciences, Lebanese University, Beirut, Lebanon
| | - Mohamed Chakkour
- Department of Biology, Faculty of Arts and Sciences, American University of Beirut, Beirut, Lebanon
| | - Lamis Salloum
- Rammal Hassan Rammal Research Laboratory, Physio-toxicity (PhyTox) Research Group, Lebanese University, Faculty of Sciences (V), Nabatieh, Lebanon
| | - Hisham F Bahmad
- Faculty of Medicine, Beirut Arab University, Beirut, Lebanon
- Department of Anatomy, Cell Biology, and Physiological Sciences, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Ghassan Ghssein
- Rammal Hassan Rammal Research Laboratory, Physio-toxicity (PhyTox) Research Group, Lebanese University, Faculty of Sciences (V), Nabatieh, Lebanon.
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Liu CS, Liang X, Wei XH, Jin Z, Chen FL, Tang QF, Tan XM. Gegen Qinlian Decoction Treats Diarrhea in Piglets by Modulating Gut Microbiota and Short-Chain Fatty Acids. Front Microbiol 2019; 10:825. [PMID: 31057525 PMCID: PMC6482297 DOI: 10.3389/fmicb.2019.00825] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 04/01/2019] [Indexed: 12/22/2022] Open
Abstract
Gut microbiota and its metabolites, short-chain fatty acids (SCFAs), play important roles in diarrheal diseases. Gegen Qinlian decoction (GQD), a Chinese herb formula, has been widely used to treat infectious diarrhea for centuries. However, little is known about the mechanism underlying its efficacy and whether it is mediated by gut microbiota and SCFAs. In this study, the composition of gut microbiota from bacterial diarrheal piglets was assessed using 16S rRNA analysis. The concentrations of fecal SCFAs were determined using a gas chromatography-mass spectrometer (GC-MS). The expression of mucosal pro-inflammatory cytokines in the colon was ascertained. Results showed that GQD reverses the reduction in the richness of gut microbiota, changes its structure, and significantly increases the relative abundances of SCFA-producing bacteria, including Akkermansia, Bacteroides, Clostridium, Ruminococcus, and Phascolarctobacterium. Moreover, GQD increased the levels of fecal SCFAs, including acetic acid, propionic acid, and butyric acid. GQD thus attenuates diarrhea in piglets. Further, our results suggest that the SCFAs could help to attenuate mucosal pro-inflammatory responses following GQD treatment by inhibiting histone deacetylase and the NF-κB pathway. We thus suggseted that gut microbiota play an important role during diarrhea treatment, an effect may be promoted by the GQD-induced structural changes of the gut microbial community and production of SCFAs. The increased levels of SCFAs probably provide further help to attenuate mucosal inflammation and diarrhea. In conclusion, our study might provide evidence that GQD treats diarrhea maybe involved in modulating gut microbiota and increasing SCFA levels.
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Affiliation(s)
- Chang-Shun Liu
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Chinese Medicine Pharmaceutics, Southern Medical University, Guangzhou, China.,Guangdong Provincial Engineering Laboratory of Chinese Medicine Preparation Technology, Guangzhou, China
| | - Xiao Liang
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Chinese Medicine Pharmaceutics, Southern Medical University, Guangzhou, China.,Guangdong Provincial Engineering Laboratory of Chinese Medicine Preparation Technology, Guangzhou, China
| | - Xiao-Han Wei
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Chinese Medicine Pharmaceutics, Southern Medical University, Guangzhou, China.,Guangdong Provincial Engineering Laboratory of Chinese Medicine Preparation Technology, Guangzhou, China
| | - Zhen Jin
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Chinese Medicine Pharmaceutics, Southern Medical University, Guangzhou, China.,Guangdong Provincial Engineering Laboratory of Chinese Medicine Preparation Technology, Guangzhou, China
| | - Fei-Long Chen
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Chinese Medicine Pharmaceutics, Southern Medical University, Guangzhou, China.,Guangdong Provincial Engineering Laboratory of Chinese Medicine Preparation Technology, Guangzhou, China
| | - Qing-Fa Tang
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Chinese Medicine Pharmaceutics, Southern Medical University, Guangzhou, China.,Guangdong Provincial Engineering Laboratory of Chinese Medicine Preparation Technology, Guangzhou, China
| | - Xiao-Mei Tan
- School of Traditional Chinese Medicine, Southern Medical University, Guangzhou, China.,Guangdong Provincial Key Laboratory of Chinese Medicine Pharmaceutics, Southern Medical University, Guangzhou, China.,Guangdong Provincial Engineering Laboratory of Chinese Medicine Preparation Technology, Guangzhou, China
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40
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Pielok Ł, Nowak S, Kłudkowska M, Frąckowiak K, Kuszel Ł, Zmora P, Stefaniak J. Massive Cryptosporidium infections and chronic diarrhea in HIV-negative patients. Parasitol Res 2019; 118:1937-1942. [PMID: 30976968 PMCID: PMC6520477 DOI: 10.1007/s00436-019-06302-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 03/25/2019] [Indexed: 12/15/2022]
Abstract
Protozoa of the genus Cryptosporidium are common parasites of domestic and wild animals—mammals, birds, reptiles, and fishes. The invasive forms are thick-walled oocysts, which can be present in water supplies, on fruits, vegetables, or in the soil contaminated with feces. In this work, we describe three cases of middle-aged persons with massive Cryptosporidium hominis infection and chronic diarrhea with no immunological abnormalities and no history of previous travels to tropical countries. The lesions discovered during colonoscopy within the large intestine–cryptitis and the histopathological changes were related to massive cryptosporidiosis. All these statements indicate necessity of parasitological stool examination in cases with chronic diarrhea in which no etiological agents are detected, but not only in HIV positive individuals. Parasite’s eradication leads to symptom disappearance as well as improvement of histopathological mucosa alterations.
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Affiliation(s)
- Łukasz Pielok
- Department and Clinic of Tropical and Parasitic Diseases, Poznań University of Medical Sciences, Przybyszewskiego Street, 60-355, Poznań, Poland.
| | - Szymon Nowak
- Department and Clinic of Tropical and Parasitic Diseases, Poznań University of Medical Sciences, Przybyszewskiego Street, 60-355, Poznań, Poland
| | - Matylda Kłudkowska
- Department and Clinic of Tropical and Parasitic Diseases, Poznań University of Medical Sciences, Przybyszewskiego Street, 60-355, Poznań, Poland.,Central Laboratory of Microbiology, H. Święcicki University Hospital, Poznań, Poland
| | - Krystyna Frąckowiak
- Central Laboratory of Microbiology, H. Święcicki University Hospital, Poznań, Poland
| | - Łukasz Kuszel
- Department of Medical Genetics, Poznań University of Medical Sciences, Poznań, Poland
| | - Paweł Zmora
- Institute of Bioorganic Chemistry Polish Academy of Sciences, Poznań, Poland
| | - Jerzy Stefaniak
- Department and Clinic of Tropical and Parasitic Diseases, Poznań University of Medical Sciences, Przybyszewskiego Street, 60-355, Poznań, Poland
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The landscape of enteric pathogen exposure of young children in public domains of low-income, urban Kenya: The influence of exposure pathway and spatial range of play on multi-pathogen exposure risks. PLoS Negl Trop Dis 2019; 13:e0007292. [PMID: 30917117 PMCID: PMC6453472 DOI: 10.1371/journal.pntd.0007292] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Revised: 04/08/2019] [Accepted: 03/12/2019] [Indexed: 11/19/2022] Open
Abstract
Young children are infected by a diverse variety of enteric pathogens in low-income, high-burden countries. Little is known about which conditions pose the greatest risk for enteric pathogen exposure and infection. Young children frequently play in residential public areas around their household, including areas contaminated by human and animal feces, suggesting these exposures are particularly hazardous. The objective of this study was to examine how the dose of six types of common enteric pathogens, and the probability of exposure to one or multiple enteric pathogens for young children playing at public play areas in Kisumu, Kenya is influenced by the type and frequency of child play behaviors that result in ingestion of soil or surface water. Additionally, we examine how pathogen doses and multi-pathogen exposure are modified by spatial variability in the number of public areas children are exposed to in their neighborhood. A Bayesian framework was employed to obtain the posterior distribution of pathogen doses for a certain number of contacts. First, a multivariate mixed effects tobit model was used to obtain the posterior distribution of pathogen concentrations, and their interdependencies, in soil and surface water, based upon empirical data of enteric pathogen contamination in three neighborhoods of Kisumu. Then, exposure doses were estimated using behavioral contact parameters from previous studies and contrasted under different exposure conditions. Pathogen presence and concentration in soil varied widely across local (< 25 meter radius area) and neighborhood-level scales, but pathogens were correlated among distinct surface water samples collected near to each other. Multi-pathogen exposure of children at public play areas was common. Pathogen doses and the probability of multi-pathogen ingestion increased with: higher frequency of environmental contact, especially for surface water; larger volume of soil or water ingested; and with play at multiple sites in the neighborhood versus single site play. Child contact with surface water and soil at public play areas in their neighborhood is an important cause of exposure to enteric pathogens in Kisumu, and behavioral, environmental, and spatial conditions are determinants of exposure.
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Co-Infection by Waterborne Enteric Viruses in Children with Gastroenteritis in Nepal. Healthcare (Basel) 2019; 7:healthcare7010009. [PMID: 30642113 PMCID: PMC6473710 DOI: 10.3390/healthcare7010009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Revised: 12/22/2018] [Accepted: 01/08/2019] [Indexed: 12/20/2022] Open
Abstract
Enteric viruses are highly contagious and a major cause of waterborne gastroenteritis in children younger than five years of age in developing world. This study examined the prevalence of enteric virus infection in children with gastroenteritis to identify risk factors for co-infections. In total, 107 stool samples were collected from patients with acute gastroenteritis along with samples of their household drinking water and other possible contamination sources, such as food and hand. The presence of major gastroenteritis-causing enteric virus species (group A rotaviruses, enteroviruses, adenoviruses, and noroviruses of genogroup I) in stool and water samples was examined using quantitative polymerase chain reaction. Among the 107 stool samples tested, 103 (96%) samples contained at least one of the four tested enteric viruses, and the combination of group A rotaviruses and enteroviruses was the most common co-infection (52%, n = 54/103). At least one viral agent was detected in 16 (16%) of 103 drinking water samples. Identical enteric viruses were detected in both the stool and water samples taken from the same patients in 13% of cases (n = 13/103). Group A rotaviruses were most frequently found in children suffering from acute diarrhea. No socio-demographic and clinical factors were associated with the risk of co-infection compared with mono-infection. These less commonly diagnosed viral etiological agents in hospitals are highly prevalent in patients with acute gastroenteritis.
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van Hattem JM, Cabal A, Arcilla MS, Alvarez J, de Jong MD, Melles DC, Penders J, Schmidt CG, Schultsz C. Risk of acquisition of human diarrhoeagenic Escherichia coli virulence genes in intercontinental travellers: A prospective, multi-centre study. Travel Med Infect Dis 2019; 31:101362. [PMID: 30609386 DOI: 10.1016/j.tmaid.2018.12.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 12/11/2018] [Accepted: 12/14/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND We studied geographic distribution of diarrhoeagenic Escherichia coli virulence genes (DEC VGs) acquisition in travellers and investigated if they acquired highly virulent EAEC/STEC hybrid strains. METHODS From the prospective, multicentre COMBAT study among 2001 Dutch travellers, 491 travellers were selected based on travel destination to 7 subregions. Faecal samples taken directly before and after travel were screened for nine DEC VGs with real-time PCR. Incidence proportions and rates were calculated for each gene and subregion. RESULTS 479 travellers were analysed. 21.8% acquired aggR (EAEC), with highest acquisition rates in Northern and Western Africa and 15.3% acquired eae (STEC/EPEC) with highest rates in travellers to Western and Eastern Africa. ETEC (elt or est gene) was acquired by 4.2% of travellers and acquisition of est was associated with traveller's diarrhoea. Overall, the risk of acquiring DEC VGs was low in Southern Africa and South America. Although the combination of aggR (EAEC) and stx1/2 (STEC) was acquired by 3 travellers, these genes could not be detected together in a single E. coli strain. CONCLUSIONS The risk of acquisition of DEC VGs strongly depends on the travel destination, with those travelling to Africa - except Southern Africa - having a higher risk.
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Affiliation(s)
- Jarne M van Hattem
- Department of Medical Microbiology, Academic Medical Center, Amsterdam, Netherlands.
| | - Adriana Cabal
- VISAVET Health Surveillance Centre, Universidad Complutense, Madrid, Spain; SaBio IREC, National Wildlife Research Institute (CSIC-UCLM-JCCM), Ciudad Real, Spain
| | - Maris S Arcilla
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Centre, Rotterdam, Netherlands
| | - Julio Alvarez
- VISAVET Health Surveillance Centre, Universidad Complutense, Madrid, Spain; Departmento de Sanidad Animal, Facultad de Veterinaria, Universidad Complutense, Madrid, Spain
| | - Menno D de Jong
- Department of Medical Microbiology, Academic Medical Center, Amsterdam, Netherlands
| | - Damian C Melles
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Centre, Rotterdam, Netherlands
| | - John Penders
- Department of Medical Microbiology, Maastricht University, Maastricht, the Netherlands; School for Nutrition and Translational Research in Metabolism (NUTRIM), Care and Public Health Research Institute (Caphri), Maastricht University, Maastricht, the Netherlands
| | | | - Constance Schultsz
- Department of Medical Microbiology, Academic Medical Center, Amsterdam, Netherlands; Department of Global Health-Amsterdam-Institute for Global Health and Development, AMC, Amsterdam, the Netherlands
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Abstract
Antibiotic therapy is not necessary for acute diarrhea in children, as rehydration is the key treatment and symptoms resolve generally without specific therapy. Searching for the etiology of gastroenteritis is not usually needed; however, it may be necessary if antimicrobial treatment is considered. The latter is left to the physician evaluation in the absence of clear indications. Antimicrobial treatment should be considered in severely sick children, in those who have chronic conditions or specific risk factors or in specific settings. Traveler’s diarrhea, prolonged diarrhea, and antibiotic-associated diarrhea may also require antibiotic therapy. Depending on the severity of symptoms or based on risk of spreading, empiric therapy may be started while awaiting the results of microbiological investigations. The choice of antibiotic depends on suspected agents, host conditions, and local epidemiology. In most cases, empiric therapy should be started while awaiting such results. Empiric therapy may be started with oral co-trimoxazole or metronidazole, but in severe cases parenteral treatment with ceftriaxone or ciprofloxacin might be considered.
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Affiliation(s)
- Eugenia Bruzzese
- Department of Translational Medical Sciences-Section of Pediatrics, University of Naples Federico II, Via S. Pansini 5, Naples, 80131, Italy
| | - Antonietta Giannattasio
- Department of Translational Medical Sciences-Section of Pediatrics, University of Naples Federico II, Via S. Pansini 5, Naples, 80131, Italy
| | - Alfredo Guarino
- Department of Translational Medical Sciences-Section of Pediatrics, University of Naples Federico II, Via S. Pansini 5, Naples, 80131, Italy
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Antidiarrheal Activity of 80% Methanolic Leaf Extract of Justicia schimperiana. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018. [PMID: 29541140 PMCID: PMC5818970 DOI: 10.1155/2018/3037120] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background Diarrhea is one of the leading causes of preventable death in developing countries and mainly affects children and infants. It has been reported that the leaf of Justicia schimperiana is used as an antidiarrheal agent in Libo Kemekem district, northwest Ethiopia. Method The 80% methanolic leaf extract of J. schimperiana was evaluated for its activity against castor oil-induced diarrhea, enteropooling, and gastrointestinal motility in mice. Results Significant reduction (p < 0.001) in the total defecation and diarrheal drops was produced by all the test doses of the extract. Percentage inhibition of wet feces was 42.58, 65.07, and 74.96% at 100, 200, and 400 mg/kg doses of the extract, respectively. The extract also significantly inhibited castor oil-induced enteropooling at all test doses. The percent reduction in mean weight of intestinal contents was 66.96, 67.83, and 76.52% at 100, 200, and 400 mg/kg doses of the extract, respectively. The extract significantly reduced gastrointestinal movement of charcoal meal as well at 200 (p < 0.01) and 400 mg/kg (p < 0.001) doses. Conclusion In conclusion, the methanolic leaf extract of J. schimperiana has an antidiarrheal activity and this supports the use of this plant in the treatment of diarrhea in the traditional settings.
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