Aeromonas spp asociada a enfermedad diarreica aguda en Cuba: estudios de casos y controles

Abstract

Aeromonas spp asociated to acute diarrheic disease in Cuba: case-control studyThe members of the genus Aeromonas are currently considered important gastrointestinal pathogens in different geographical areas. From February 1985 to January 2005 several case-control studies were coordinated by the National Reference Laboratory for Diarrheal Diseases from the Pedro Kouri Institute. The study purpose was to analyze a possible pathogenic role for Aeromonas spp in Cuban children with acute diarrhea. In that period 2,322 children less than 5 years old with acute diarrhea were studied for diarhoeal pathogens and another group of 2,072 non hospitalized children without diarrhea during the similar time from the same geographical areas and matched by ages were recruited. In the group of children with diarrheas (cases), Aeromonas spp. was isolated in 166 (7.15%) and in the control group the microorganism was found in only 35 (1.76%). When Aeromonas isolation rates were compared between both groups, we found that probability to isolate this specie was signifi cantly higher in cases than in controls (OR = 4.48, 95% IC: 3.05-6.60; P < 0.001). The Aeromonas species more frequently isolated were A. caviae, A. hydrophila, and A. veronii bv sobria. Other enteric pathogens detected in children with diarrhea were: Shigella spp in 418 (18%) (P < 0.0001), Salmonella spp in 53 (2.3%) (P < 0.01), and enteropathogenic E. coli in 58 (2.49%) (P < 0.05).Key words: Intestinal infection, Aeromonas, case-control study. . Las infecciones entéricas causadas por Aeromonas son comunes y se describen en el mundo entero; pero su detección no es similar a la obtenida con otros patógenos entéricos, ya sea en pacientes con síntomas crónicos, en niños, individuos inmunocomprometidos, ancianos o en pacientes que estando hospitalizados desarrollan síntomas gastrointestinales 5 . La diarrea asociada con este agente, así como la ocasionada por virus y otras bacterias, es normalmente un proceso autolimitado aunque en algunos casos el curso clínico se torna grave y necesita tratamiento antimicrobiano 6 . Se ha sugerido que muchos casos de diarrea asociados con Aeromonas pueden pasar desapercibidos, pues muchas veces no se realiza el adecuado estudio microbiológico de las heces y ésta pudiera ser una de las razones por las que se notifi can tan pocos casos de brotes de diarrea causados por estos microorganismos 7 . Estudios recientes que evalúan los agentes etiológicos de EDA en los niños, indican que la incidencia de Aeromonas en relación con el total de casos estudiados representa alrededor de 2,3% en Taiwán y de 13% en Nigeria, constituyendo el microorganismo más común después de Salmonella y Campylobacter 8 . La mayoría de las veces cuando se requiere una decisión inmediata para el tratamiento de un caso grave de diarrea, resultan innecesarios los estudios completos de laboratorio pero, desde el punto de vista epidemiológico, es indispensable identifi car cuáles son los agentes causales que prevalecen en un área, su distribución etaria, cuáles ameritan un m...

An Update on the Genus Aeromonas: Taxonomy, Epidemiology, and Pathogenicity

“…Gastroenteritis caused by Aeromonas is a problem among the pediatric population, occuring mainly in children under three years with an incidence between 2.3% and 13% in countries like Taiwan and Nigeria, respectively [3,196]. However, studies by Bravo et al [197] and Mansou et al [194] showed a 7.5% and 1.4% incidence of Aeromonas children's diarrhea, respectively, in Spain. Between 2-20% of gastroenteritis cases are monomicrobial and only 0-2% of children are asymptomatic carriers [198]; the diarrhea might last for one or two weeks and feces shows a liquid consistency [5,196].…”