Enteropathogens Associated with Acute Diarrhea in Children from Households with High Socioeconomic Level in Uruguay

Abstract

Infectious diarrhea, a common disease of children, deserves permanent monitoring in all social groups. To know the etiology and clinical manifestations of acute diarrhea in children up to 5 years of age from high socioeconomic level households, we conducted a descriptive, microbiological, and clinical study. Stools from 59 children with acute community-acquired diarrhea were examined, and their parents were interviewed concerning symptoms and signs. Rotavirus, adenovirus, and norovirus were detected by commercially available qualitative immunochromatographic lateral flow rapid tests. Salmonella, Campylobacter, Yersinia, and Shigella were investigated by standard bacteriological methods and diarrheagenic E. coli by PCR assays. We identified a potential enteric pathogen in 30 children. The most frequent causes of diarrhea were enteropathogenic E. coli (EPEC), viruses, Campylobacter, Salmonella, and Shiga-toxin-producing E. coli (STEC). Only 2 patients showed mixed infections. Our data suggest that children with viral or Campylobacter diarrhea were taken to the hospital earlier than those infected with EPEC. One child infected with STEC O26 developed “complete” HUS. The microbiological results highlight the importance of zoonotic bacteria such as atypical EPEC, Campylobacter, STEC, and Salmonella as pathogens associated with acute diarrhea in these children. The findings also reinforce our previous communications about the regional importance of non-O157 STEC strains in severe infant food-borne diseases.

Human enteric viruses in a wastewater treatment plant: evaluation of activated sludge combined with UV disinfection process reveals different removal performances for viruses with different features

“…Despite the lack of studies describing in depth the impact of NoV and HAdV in the health of Uruguayan children, all the above-mentioned viruses have been reported as acute gastroenteritis causing agents in Uruguayan paediatric population, with incidences according the expected for RVA (37%) and HAstV (10%). Moreover, a wide dispersion as well as a wide genetic diversity in the Uruguayan environment has been recently reported for these viral pathogens (Victoria et al 2014(Victoria et al , 2016Lizasoain et al 2015;Tort et al 2015;Varela et al 2015;Lopez et al 2017). This information raises the need to evaluate the wastewater treatment process existing in the country to assure viral removal from wastewater and reach effluent of good quality.…”

Clinical and Laboratory Characteristics of Pediatric Campylobacter spp. Acute Gastroenteritis

“…Dallal identified a frequency of 0.9% for Campylobacter strains in acute diarrhea among children younger than 5 years of age in south Tehran (19). Various studies have reported Campylobacter frequencies, such as 3.0% in Senegal, 8.4% in Uruguay, 9.6% in Egypt, 9.7% in Tanzania, 9.3% in Uganda, 10.5% in Romania, 11.0% in Sudan, 12.7% in Ethiopia, and 22.6% in Ghana (11,12,15,(20)(21)(22)(23)(24)(25). Therefore, the average contribution of Campylobacter strains to AGE in children was about 9% in most studies.…”

Síndrome urémico hemolítico en Uruguay. Aspectos microbiológicos y clínicos, aportes para su conocimiento regional

“…Sin embargo, en un estudio que incluyó 59 niños con diarrea aguda, sin tratamiento antibiótico previo, tampoco recuperamos STEC O157 y en cambio se identificaron cepas de los serogrupos O26 y O153. Algo similar ocurrió en otro estudio que incluyó a 249 niños con diarrea aguda sanguinolenta (19,31).…”

“…Para la extracción del ADN bacteriano se utilizó el procedimiento de lisis por calor ya descrito (19).…”

“…Los cebadores utilizados y el tamaño de los amplicones se muestran en la Tabla 2. El subtipo o variante del gen eae se determinó por PCR de acuerdo al procedimiento descrito previamente (19).…”