Síndrome Hemolítico Urémico asociado a Shigatoxina: ¿Cómo prevenirlo?

Sm, Felipe Cavagnaro

doi:10.32641/rchped.v90i2.1044

Cited by 5 publications

(12 citation statements)

References 23 publications

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“…Due to the diversity of reservoirs, routes of transmission, and low infectious dose (<100 CFU/g), infection in humans is common [2,15]. STEC strains can cause moderate to severe diarrhea, hemorrhagic colitis (HC) and hemolytic uremic syndrome (HUS) in children younger than 10 years old, and thrombotic thrombocytopenic purpura in adults and elders [16].…”

Section: Introductionmentioning

confidence: 99%

Virulence Genes, Shiga Toxin Subtypes, Serogroups, and Clonal Relationship of Shiga Toxin-Producing Escherichia Coli Strains Isolated from Livestock and Companion Animals

Galarce

Escobar

Sánchez

et al. 2019

Animals

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Simple SummaryShiga toxin-producing Escherichia coli is a zoonotic pathogen that can cause severe illness in humans, and its circulating strains in the animal-human-environment interface exhibit great variability in terms of virulence and serotypes, where diverse animal species, mainly ruminants, play a fundamental role as reservoirs. Thus, the aim of this study was to characterize strains of this pathogen present in cattle, swine, dogs, and cats in the Región Metropolitana, Chile, based on virulence, serogroups, and population diversity. Based on findings, the circulating strains isolated exhibit high variability and harbor genetic determinants associated with severe illness in humans, thus highlighting that preventive and control strategies should not be focused on detecting serogroups, but instead, on detecting their determinants of virulence.AbstractShiga toxin-producing Escherichia coli (STEC) is a zoonotic pathogen that causes severe illness in humans and is an important cause of foodborne disease. In Chile, there is limited information on the virulence characteristics of this pathogen in livestock, and none in companion animals. The aim of this study was to characterize STEC strains isolated from cattle, swine, dogs, and cats, in Chile, in terms of the presence of Shiga toxin types and subtypes, virulence genes, serogroups, and clonality. One-thousand two-hundred samples were collected, isolating 54 strains (4.5%), where stx1a (68.5%) and ehxA (74.1%) were the most frequently detected virulence genes. Only one strain belonging to the most clinically relevant serogroups was identified. Pulsed field gel electrophoresis analysis showed high clonal diversity among strains isolated from cattle, while those from swine showed the same pattern. This study provides further evidence regarding cattle and swine in Chile as a potential source of a wide variety of STEC strains that could potentially cause severe illness in humans, and that companion animals do not seem to represent a relevant reservoir. It also argues that preventive and control strategies should not be focused on detecting serogroups, but instead, on detecting their determinants of virulence.

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Section: Introductionmentioning

confidence: 99%

Virulence Genes, Shiga Toxin Subtypes, Serogroups, and Clonal Relationship of Shiga Toxin-Producing Escherichia Coli Strains Isolated from Livestock and Companion Animals

Galarce

Escobar

Sánchez

et al. 2019

Animals

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“…Antibiotics were used prior to admission in 71.1% of the patients, which is lower than what has been reported in previous years in Peru (90%) 5 , and higher than in Chile (52%) 6 . Antibiotics such as β-lactams and trimethoprim/sulfamethoxazole increase the risk of HUS by inducing the expression and release of STx 11 , although the evidence is still conflicting, their use is not recommended in suspected or confirmed cases of STx-producing HUS 7 , 12 .…”

Section: Discussionmentioning

confidence: 99%

“…Diarrhea prodrome was found in 74.6% of the patients, which is less than that previously reported 5 , 6 , 10 . This symptom occurs in around 90% of the cases between day 3 to 8 after ingestion of contaminated food such as semi-cooked meats, unpasteurized dairy products, as well as contaminated water and vegetables 1 , 7 .…”

Section: Discussionmentioning

confidence: 99%

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Características del síndrome urémico hemolítico en pacientes de un hospital pediátrico de Perú, 2010-2020

Carrasco-Oros,

Atamari-Anahui,

Goñi-Fano

et al. 2023

Rev Peru Med Exp Salud Publica

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El propósito del presente estudio fue describir las características clínicas, epidemiológicas, laboratoriales, tratamiento y seguimiento de pacientes con síndrome urémico hemolítico (SUH). Se revisaron las historias clínicas de los pacientes con SUH hospitalizados en el Instituto Nacional de Salud del Niño-Breña (INSN-B) de Lima, Perú. Se incluyeron a 83 pacientes. La mediana de edad fue de 22 meses. El 71,1% (n=59) registró uso previo de antibióticos. El 86,8% (n=72) tuvieron oligoanuria y el 74,6% (n=62) diarrea.Cinco cultivos fueron positivos (dos Escherichia coli enterohemorrágica). Cuarenta y nueve (59%) requirieron terapia de reemplazo renal. Ningún paciente falleció durante la hospitalización. Al año del seguimiento, siete pacientes presentaron nefropatía pos-SUH. En conclusión, en el INSN-B, la mediana de edad fue similar que años anteriores y hubo una mayor frecuencia de oligoanuria y terapia de reemplazo renal en comparación con reportes previos.

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“…In Latin America, STEC is endemic and represents 2% of cases of acute diarrhea and up to 30% of bloody diarrhea, and Chile, Uruguay, and Argentina are the most affected countries in the area (Torres et al, 2018). STEC is considered an emergent pathogen in Chile; the main transmission route is through contaminated foods affecting mainly children between 6 months and 4 years, and mortality rates reach 3% (Vidal et al, 2010;ISP, 2017;Cavagnaro, 2019). Chilean law dictates that STEC is a pathogen under mandatory laboratory surveillance, so every clinical laboratory must send their isolates to the National Public Health laboratory (ISP) for confirmation.…”

Section: Introductionmentioning

confidence: 99%

Whole-Genome Phylogenetic Analysis Reveals a Wide Diversity of Non-O157 STEC Isolated From Ground Beef and Cattle Feces

et al. 2021

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Shiga toxin-producing Escherichia coli (STEC) causes foodborne outbreaks that can lead to complications such as hemolytic uremic syndrome. Their main reservoir is cattle, and ground beef has been frequently associated with disease and outbreaks. In this study, we attempted to understand the genetic relationship among STEC isolated in Chile from different sources, their relationship to STEC from the rest of the world, and to identify molecular markers of Chilean STEC. We sequenced 62 STEC isolated in Chile using MiSeq Illumina. In silico typing was determined using tools of the Center Genomic Epidemiology, Denmark University (CGE/DTU). Genomes of our local STEC collection were compared with 113 STEC isolated worldwide through a core genome MLST (cgMLST) approach, and we also searched for distinct genes to be used as molecular markers of Chilean isolates. Genomes in our local collection were grouped based on serogroup and sequence type, and clusters were formed within local STEC. In the worldwide STEC analysis, Chilean STEC did not cluster with genomes of the rest of the world suggesting that they are not phylogenetically related to previously described STEC. The pangenome of our STEC collection was 11,650 genes, but we did not identify distinct molecular markers of local STEC. Our results showed that there may be local emerging STEC with unique features, nevertheless, no molecular markers were detected. Therefore, there might be elements such as a syntenic organization that might explain differential clustering detected between local and worldwide STEC.

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Síndrome Hemolítico Urémico asociado a Shigatoxina: ¿Cómo prevenirlo?

Cited by 5 publications

References 23 publications

Virulence Genes, Shiga Toxin Subtypes, Serogroups, and Clonal Relationship of Shiga Toxin-Producing Escherichia Coli Strains Isolated from Livestock and Companion Animals

Virulence Genes, Shiga Toxin Subtypes, Serogroups, and Clonal Relationship of Shiga Toxin-Producing Escherichia Coli Strains Isolated from Livestock and Companion Animals

Características del síndrome urémico hemolítico en pacientes de un hospital pediátrico de Perú, 2010-2020

Whole-Genome Phylogenetic Analysis Reveals a Wide Diversity of Non-O157 STEC Isolated From Ground Beef and Cattle Feces

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