Shiga-Toxin Producing Escherichia Coli in Brazil: A Systematic Review

Abstract

Shiga-toxin producing E. coli (STEC) can cause serious illnesses, including hemorrhagic colitis and hemolytic uremic syndrome. This is the first systematic review of STEC in Brazil, and will report the main serogroups detected in animals, food products and foodborne diseases. Data were obtained from online databases accessed in January 2019. Papers were selected from each database using the Mesh term entries. Although no human disease outbreaks in Brazil related to STEC has been reported, the presence of several serogroups such as O157 and O111 has been verified in animals, food, and humans. Moreover, other serogroups monitored by international federal agencies and involved in outbreak cases worldwide were detected, and other unusual strains were involved in some isolated individual cases of foodborne disease, such as serotype O118:H16 and serogroup O165. The epidemiological data presented herein indicates the presence of several pathogenic serogroups, including O157:H7, O26, O103, and O111, which have been linked to disease outbreaks worldwide. As available data are concentrated in the Sao Paulo state and almost completely lacking in outlying regions, epidemiological monitoring in Brazil for STEC needs to be expanded and food safety standards for this pathogen should be aligned to that of the food safety standards of international bodies.

Biofilm formation by South African non-O157 Shiga toxigenic Escherichia coli on stainless steel coupons

“…STEC have been associated with foodborne disease outbreaks worldwide (Castro et al 2019;Heredia and García 2018). The biofilm-forming potential of non-O157 STEC on stainless steel have been investigated.…”

Prevalence and antibiotic resistance profile of Shiga toxin-producing Escherichia coli isolated from diarrheal samples

“…Similar studies in Kenya also indicated the low prevalence (0.2%) of E. coli O157: H7 in hospitalized diarrheic children ( 21 ). But in some countries high prevalence rate of STEC was reported, Ifeanyi in Nigeria ( 22 ) and Dambrozio in Brazil (2014) ( 23 ) identified EHEC pathotypes in 12.6% and 21.2% of children with diarrhea, respectively. Pourakbari et al (2013) studied 50 children with diarrhea and 50 healthy ones referring to a medical center in Iran, E. coli was isolated in 90% of patients and 20% of healthy controls, also, EHEC strains were identified in 14% and 3% of patients and controls, respectively ( 24 ).…”

Comment on “Shiga-Toxin Producing Escherichia coli in Brazil: A Systematic Review. Microorganisms 2019, 7, 137”

“…Castro et al wrote a systematic review on STEC in Brazil by selecting papers from online databases (according to Prisma guidelines), and limiting their search for articles published between January 2000 and December 2018 [1]. Collecting data produced by others is not an easy task; and the authors should be very cautious when making statements and concluding remarks that are not supported by the selection of references and parameters used.…”

“…Moreover, in an attempt to explain that there were no reports of outbreaks involving STEC, Castro et al [1] stated two untrue hypotheses “(i): Disease outbreaks are not recorded by lack of centralized reporting system or (ii) disease outbreaks are not being recognized as there are no surveillance systems for STEC ”. In fact, in São Paulo, the active surveillance of HUS, bloody diarrhea, and E. coli are part of the active surveillance system for foodborne diseases (DTA), the Monitoring of Acute Diarrheal Diseases (MDDA), and the surveillance of outbreaks of DTA [4].…”

“…Furthermore, due to the importance of STEC infections in public health, HUS surveillance is compulsorily notified at a national level, and surveillance is based on a sentinel system [5]. Possible explanations on the low incidence of STEC outbreaks in Brazil is beyond the revision made by Castro et al [1], and has been explored in other publications [6,7].…”