Seventy-six children <2 years old were prospectively followed for 1 year in a peri-urban community of Mexico City to determine asymptomatic infection and acute diarrhea associated with diarrheagenic Escherichia coli pathotypes (DEPs). By use of a pathogen-specific multiplex PCR, DEPs were sought in 795 stool samples, of which 125 (16%) were positive for DEP; of these, 4 represented shedding episodes and 4 parasite coinfections. Most single-DEP infections (85/117) were asymptomatic (P < 0.001), and of the 32 DEP diarrhea episodes, 41% were associated with atypical enteropathogenic E. coli (aEPEC), 37.5% with enterotoxigenic E. coli, 9% with typical EPEC, 9% with enteroinvasive E. coli, and 3% with Shiga toxin-producing E. coli strains. Among the 76 children, 54 had at least one stool positive for DEP, of which 23 experienced a DEP-associated diarrhea episode. In the last group of children, DEP infection was significantly associated with a diarrhea episode (relative risk [RR] ‫؍‬ 2.5; 95% confidence interval [CI], 1.79 to 3.57; P < 0.001), with ETEC (RR ‫؍‬ 2.30; 95% CI, 1.49 to 3.54; P ‫؍‬ 0.003) and aEPEC (RR ‫؍‬ 1.92; 95% CI, 1.23 to 3.0; P ‫؍‬ 0.019) being the pathotypes associated with diarrhea. aEPEC-associated diarrhea episodes were frequently in the <12-month age group (RR ‫؍‬ 2.57; 95% CI, 1.05 to 6.27; P ‫؍‬ 0.04). aEPEC infections were distributed all year round, but associated diarrheal episodes were identified from April to October, with a May-June peak (rainy season). Most ETEC infections and diarrhea episodes characteristically occurred during the summer (rainy season), with a diarrhea peak in August. Of all DEPs, only aEPEC was associated with acute diarrhea episodes lasting 7 to 12 days (P ‫؍‬ 0.019). DEPs are important causes of community-acquired enteric infection and diarrhea in Mexican children.Diarrheal diseases continue to be a health problem worldwide (4, 16), especially in developing countries, where they are estimated to be responsible for 2.5 million infant deaths per year, with an annual mortality rate of 4.9 per 1,000 children and an incidence of 3.2 episodes per child per year among children under 5 years of age (16). Diarrheagenic Escherichia coli pathotypes (DEPs) represent a leading bacterial cause of pediatric diarrhea in developing regions (21), with some responsible for traveler's diarrhea (21, 27), and are also an emerging cause of diarrhea in industrialized countries (6, 29). The DEPs that cause diarrhea include enteropathogenic E. coli (EPEC), enterotoxigenic E. coli (ETEC), enteroinvasive E. coli (EIEC), Shiga toxin-producing E. coli (STEC), diffusely adherent E. coli, and enteroaggregative E. coli (15,21). These pathotypes are defined by the presence or absence of one or more definable E. coli virulence factors. However, a less well-characterized DEP is atypical EPEC (aEPEC), which carries the attaching and effacing intimin (eaeA) gene of typical EPEC (tEPEC) strains but lacks the plasmid-mediated bundle-forming pilus (bfp) of tEPEC and Shiga toxins 1 and 2 (21, 31).Althoug...

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These results suggest that the effect of vitamin A supplementation on clinical outcomes may be pathogen dependent.

Street-vendors in Mexico City provide ready-to-eat food to a high proportion of the inhabitants. Nevertheless, their microbiological status, general hygienic and trading practices are not well known. During spring and summer 2000, five tianguis (open markets) were visited and 48 vendors in 48 stalls interviewed. A total of 103 taco dressings were sampled for E. coli and Salmonella spp.: 44 (43%) contained E. coli and 5 (5%) Salmonella (2 S. Enteritidis phage type 8, 1 S. Agona, 2 S. B group). Both E. coli and salmonellas were isolated from three samples. Of Salmonella-positive stalls 80% (4/5) had three or more food-vendors and 80% of vendors were males, compared with 37.3% (16/43) and 46.4% (20/43) in the Salmonella-negative stalls respectively. Food-vendors kept water in buckets (reusing it all day), lacked toilet facilities, and prepared taco dressings the day before which remained at the tianguis without protection for 7.8 h on average. Consumption of street-vended food by local and tourist populations poses a health risk.

The street-vended food industry provides employment and cheap ready-to-eat meals to a large proportion of the population in developing countries like Mexico, yet little is known about its role in the transmission of food borne diseases (FBD). Because of its wide consumption, street-vended chili sauces in Mexico are potential vehicles of FBD. An observational study was performed in Mexico City collecting 43 street-vended chili sauces. These sauces were prepared under poor hygienic conditions of handling and selling. Consumers add 4-8 ml of chili sauce per taco, ingest 2-5 tacos per meal and on average, 50 consumers frequent a stall per day. Seventeen (40%) samples were faecally contaminated and 2(5%) sauces harboured sufficient enterotoxigenic Escherichia coli to cause disease. Weestimate that the consumption of only one of these chili sauces could result in ETEC disease inat least 21,000 consumers per year, making them important potential vehicles of FBD.

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Background: Hyperuricemia leads to insulin resistance, whereas insulin resistance decreases renal excretion of uric acid. The aim of this study was to evaluate whether there is a correlation between serum uric acid levels with homeostatic model assessment (HOMA) 1 in nondiabetic patients. Methods: We evaluated 88 nondiabetic patients, in whom uric acid levels were measured, in all of them HOMA of β-cell function (HOMA 1B) and HOMA of insulin resistance (HOMA 1IR) scores were performed. Uric acid and the HOMA 1 values were correlated using the Pearson coefficient. Results: We did not find any correlation between uric acid levels with both HOMA 1B (r = 0.102, p = 0.343), nor with HOMA 1IR (r = 0.158, p = 0.117). When patients were analyzed by sex, we found a significant correlation with HOMA 1IR (0.278, p = 0.01), but not with HOMA 1B (0.138, p = 0.257) in women. We found a correlation with HOMA 1B in men (r = 0.37, p = 0.044), but not with HOMA 1IR: 0.203, p = 0.283. The analysis performed based on body mass index did not show correlation in the patients with normal weight, (HOMA 1B r = 0.08, p = 0.5, HOMA 1IR = 0.034, p = 0.793), nor in the patients who were overweight (HOMA 1B: r = 0.05, p = 0.76, HOMA 1IR r = 0.145, p = 0.43). However, a significant correlation between uricemia with both HOMA 1B (0.559, p < 0.001), and HOMA 1IR (0.326, p < 0.05), was observed in obese patients. Conclusion: Our results suggest that serum uric acid levels seem to be associated with insulin resistance in women, and in obese patients, but not in nonobese men. Uric acid also modifies β-cell function in men and in obese patients.

Background and objectives: Type 2 diabetes (T2D) is a major problem of public health in Mexico. We investigated the influence of five polymorphisms, previously associated with obesity and cardiovascular disease in Europeans and Asians, on T2D in Mexican Mestizos. Materials and Methods: A total of 1358 subjects from 30 to 85 years old were genotyped for five loci: CXCL12 rs501120; CDNK2A/B rs1333049; HNF-1α rs2259816; FTO rs9939609; and LEP rs7799039. We used logistic regressions to test the effect of each locus on T2D in two case–control groups with obesity and without obesity. Also, linear regression models on glucose and glycated hemoglobin (HbA1c) were carried out on the whole sample, adjusted by age, gender, and body mass index. Results: The CXCL12 rs501120 C allele (OR = 1.96, p = 0.02), the FTO rs9939609 A allele (OR = 2.20, p = 0.04) and the LEP rs7799039 A allele (OR = 0.6, p = 0.03) were significantly associated with T2D in obesity case–control group. No significant association was found in the non-obesity case–control group. The linear regression model showed that CDNK2A/B rs1333049 C allele (β = 0.4, p = 0.03) and FTO rs9939609 A allele (β = 0.5, p = 0.03), were significantly associated with HbA1c, but no association was found among the loci with the glucose levels. Conclusions: Polymorphisms previously linked with obesity and cardiovascular events were also associated with T2D and high levels of HbA1c. Furthermore, we must point at the fact that this is the first report where polymorphisms CXCL12 rs501120 and LEP rs7799039 are associated with T2D in subjects with obesity.