Etiology and Epidemiology of Persistent Diarrhea in Northeastern Brazil

Fang, Guodong; Lima, Aldo A. M.; Martins, Ceci V.; Nataro, James P.; Guerrant, Richard L.

doi:10.1097/00005176-199508000-00003

Cited by 120 publications

(99 citation statements)

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“…Detection of strains belonging to that E. coli virotype would have been of interest for this study, since enteroaggregative E. coli has been reported to be associated with persistent diarrhea in children (8,12). We have now prepared a specific, digoxigenin-labeled DNA probe, which will enable us to further identify these bacteria and to review past isolates that we keep as heart infusion agar stab culture tubes.…”

Section: Discussionmentioning

confidence: 99%

Etiology of Children's Diarrhea in Montevideo, Uruguay: Associated Pathogens and Unusual Isolates

et al. 2001

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We studied microorganisms associated with infant diarrhea in a group of 256 children admitted to a public pediatric hospital in Montevideo, Uruguay. Diagnostic procedures were updated to optimize detection of potential pathogens, which were found in 63.8% of cases, and to be able to define their characteristics down to molecular or antigenic type. Coinfection with two or more agents was detected in more than one-third of positive studies. Escherichia coli enteric virotypes, especially enteropathogenic E. coli (EPEC), were shown to be prevalent. Rotavirus, Cryptosporidium, Campylobacter (mainly Campylobacter jejuni), and Shigella flexneri were also often identified. Enterotoxigenic E. coli, Salmonella, and Giardia lamblia were sporadically recognized. Unusual findings included two enteroinvasive E. coli strains, one Shigella dysenteriae 2 isolate, and a non-O:1 Vibrio cholerae culture. EPEC bacteria and S. flexneri (but not Salmonella) showed unusually frequent antimicrobial resistance, especially towards beta-lactam antibiotics, which is the subject of ongoing work.

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Section: Discussionmentioning

confidence: 99%

Etiology of Children's Diarrhea in Montevideo, Uruguay: Associated Pathogens and Unusual Isolates

et al. 2001

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“…One Escherichia coli isolate from each patient was examined for HEp-2 adherence and enterotoxigenicity using established methods (Fang et al, 1995). Adherence to HEp-2 cells was scored as aggregate (AA), localized (LA) or diffuse (DA) .…”

Section: Stool Processingmentioning

confidence: 99%

“…Adherence to HEp-2 cells was scored as aggregate (AA), localized (LA) or diffuse (DA) . One E. coli strain per stool was also evaluated by oligonucleotide probe hybridization for the heat-labile (LT) and heat-stable (STa) toxins (Fang et al, 1995). Fragment probes were used to evaluate for EPEC (eae, E. coli attaching and effacing gene; Jerse et al, 1991), and EAF (EPEC adherence factor; Nataro et al, 1985), DAEC (diffusely adherent E. coli; Bilge et al, 1993), EIEC (enteroinvasive E. coli; Wood et al, 1986), EHEC (enterohaemorrhagic E. coli; Levine et al, 1987) and EAEC (enteroaggregative E. coli; Baudry et al, 1990).…”

Section: Stool Processingmentioning

confidence: 99%

Giardia duodenalis assemblage, clinical presentation and markers of intestinal inflammation in Brazilian children

Kohli

Bushen

Pinkerton

et al. 2008

Transactions of the Royal Society of Tropical Medicine and Hygi

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136

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SummaryData on the relationship between the two genotypes of Giardia duodenalis that infect humans, assemblages A and B, their clinical presentation and intestinal inflammation are limited. We analyzed 108 stool samples previously collected for a diarrhoeal study among Brazilian children, representing 71 infections in 47 children. Assemblage B was most prevalent, accounting for 43/58 (74.1%) infections, while assemblage A accounted for 9/58 (15.5%) infections and 6/58 (10.3%) infections were mixed (contained both assemblage A and B). There was no significant difference in diarrhoeal symptoms experienced during assemblage A, B or mixed infections. Children with assemblage B demonstrated greater variability in G. duodenalis cyst shedding but at an overall greater level (n = 43, mean 3.6 × 10 5 , range 5.3 × 10 2 -2.5 × 10 6 cysts/ml) than children infected with assemblage A (n = 9, mean 1.4 × 10 5 , range 1.5 × 10 4 -4.6 × 10 5 cysts/ml; P = 0.009). Children with mixed infections shed more cysts (mean 8.3 × 10 5 , range 3.1 × 10 4 -2.8 × 10 6 cysts/ml) than children with assemblage A or B alone (P = 0.069 and P = 0.046 respectively). This higher rate of cyst shedding in children with assemblage B may propagate its spread, accounting for its increased incidence. Additionally, second and third infections had decreasing faecal lactoferrin, suggesting some protection against severity, albeit not against infection, by prior infection. Authors' contributions: AAML, RLG, AK and OYB designed the study protocol; RDN, AK and OYB carried out the clinical assessment; AK carried out and EH designed and carried out the quantitative PCR of Giardia; AK, RCP, OYB, CLS and RDN carried out the analysis and interpretation of these data; AK, OYB, RDN and CLS drafted the manuscript. All authors read and approved the final manuscript. AK and RLG are guarantors of the paper.Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Conflicts of interest: None declared.Ethical approval: The study protocol and informed consent were approved by the human investigations committees of the Federal

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“…Salmonella, Shigella, Campylobacter, enterotoxigenic (ETEC), enteropathogenic (EPEC), enteroaggregative (EAggEC), enteroinvasive (EIEC), or enterohemorrhagic (EHEC) Escherichia coli (by gene probes], rotavirus, Giardia, Cyclospora, or helminths were found using standard methods as previously described. 6,7 Stool specimens were examined for Cryptosporidium oocysts by fecal concentrations followed by modified acid-fast and auramine staining.…”

Section: Volunteer Studiesmentioning

confidence: 99%

INTERLEUKIN-8, TUMOR NECROSIS FACTOR-α, AND LACTOFERRIN IN IMMUNOCOMPETENT HOSTS WITH EXPERIMENTAL AND BRAZILIAN CHILDREN WITH ACQUIRED CRYPTOSPORIDIOSIS

ALCANTARA¹,

White²,

Okhuysen³

et al. 2003

The American Journal of Tropical Medicine and Hygiene

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Etiology and Epidemiology of Persistent Diarrhea in Northeastern Brazil

Cited by 120 publications

References 0 publications

Etiology of Children's Diarrhea in Montevideo, Uruguay: Associated Pathogens and Unusual Isolates

Etiology of Children's Diarrhea in Montevideo, Uruguay: Associated Pathogens and Unusual Isolates

Giardia duodenalis assemblage, clinical presentation and markers of intestinal inflammation in Brazilian children

INTERLEUKIN-8, TUMOR NECROSIS FACTOR-α, AND LACTOFERRIN IN IMMUNOCOMPETENT HOSTS WITH EXPERIMENTAL AND BRAZILIAN CHILDREN WITH ACQUIRED CRYPTOSPORIDIOSIS

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