RESUMEN
Introducción: La diarrea con sangre es un motivo frecuente de admisión hospitalaria en niños, con gastroenteritis aguda; en la mayoría de los casos se tratan de infecciones leves y autolimitadas, pero pueden producirse complicaciones graves. Objetivos: Describir la etiología y características clínico- evolutivas de los niños menores de 15 años hospitalizados por diarrea con sangre en el Hospital Pediátrico, Centro Hospitalario Pereira Rossell entre los años 2012- 2023. Materiales y métodos: Estudio retrospectivo mediante revisión de historias y registros de laboratorio. Variables: demográficas, estado nutricional, hidratación, motivos de hospitalización, ingreso unidades de cuidados intensivos (UCI), enteropatógenos, tratamientos, evolución. Resultados: Se incluyeron 229 niños, mediana de edad de 8 meses; sexo masculino 61%; eutróficos 88%, bien hidratados 55%, con comorbilidades 11%, prematurez 6,5%. El motivo de hospitalización fue diarrea con sangre/disentería sin otro síntoma 45%. Se solicitó coprovirológico/coprocultivo en 98% y detección por técnicas de ácidos nucleicos en materia fecal 5,2%. Se identificó al menos un agente patógeno en 34,3%: Shigella sp. 38%; Salmonella sp. 19,5%; coinfecciones en 12%. Se indicaron antibióticos a 86%; ceftriaxona 62%, azitromicina 35%. Ingresaron a UCI 6,5% (15), presentaron complicaciones 10/14, fallo renal agudo 5 y alteraciones del medio interno 3. La mayoría presentó buena evolución. Conclusiones: La diarrea con sangre/disentería continúa siendo una causa importante de hospitalización afectando en su mayoría a niños sanos menores de 5 años. Los patógenos detectados con mayor frecuencia fueron bacterias principalmente Shigella sp., Salmonella sp. y E coli diarreogénicas. Se reportó alta prescripción de antibióticos, cumpliendo en la mayoría de los casos con las recomendaciones.
Introduction: Bloody diarrhea is a common reason for hospital admission in children with acute gastroenteritis; In most cases these are mild and self-limiting infections, but serious complications can occur. Goals: To describe the etiology and clinical-evolutionary characteristics of children under 15 years of age hospitalized for bloody diarrhea at the Pediatric Hospital, Centro Hospitalario Pereira Rossell between the years 2012-2023. Materials and methods: Retrospective study through review of histories and laboratory records. Variables: demographics, nutritional status, hydration, reason for hospitalization, intensive care unit (ICU) admission, enteropathogens, treatments, evolution. Results: 229 children were included, median age 8 months; male sex 61%; eutrophic 88%, well hydrated 55%, with comorbidities 11%, prematurity 6.5%. The reason for hospitalization was bloody diarrhea/dysentery without other symptoms 45%. Coprovirological/coproculture was requested in 98% and detection by nucleic acid techniques in fecal matter was requested in 5,2%. At least one pathogenic agent was identified in 34,3%: Shigella sp. 38%; Salmonella sp 19,5%; coinfections in 12%. Antibiotics were indicated for 86%; ceftriaxone 62%, azithromycin 35%. Were admitted to the ICU 6,5% (15), 10/14 had complications, 5 had acute kidney failure and 3 had alterations in the internal environment. The majority had a good evolution. Conclusions: Bloody diarrhea/dysentery continues to be an important cause of hospitalization, affecting mostly healthy children under 5 years of age. The most frequently detected pathogens were bacteria, mainly Shigella sp., Salmonella sp. and diarrheagenic E coli. High prescription of antibiotics was reported, complying in most cases with the recommendations.
Introdução: A diarreia com sangue é um motivo comum de internação hospitalar em crianças com gastroenterite aguda; Na maioria dos casos, estas são infecções leves e autolimitadas, mas podem ocorrer complicações graves. Metas: Descrever a etiologia e as características clínico-evolutivas de crianças menores de 15 anos internadas por diarreia sanguinolenta no Hospital Pediátrico Centro Hospitalario Pereira Rossell entre os anos de 2012-2023. Materiais e métodos: Estudo retrospectivo por meio de revisão de histórias e registros laboratoriais. Variáveis: dados demográficos, estado nutricional, hidratação, motivo da internação, internação em unidade de terapia intensiva (UTI), enteropatógenos, tratamentos, evolução. Resultados: foram incluídas 229 crianças, mediana de idade 8 meses; sexo masculino 61%; eutrófico 88%, bem hidratado 55%, com comorbidades 11%, prematuridade 6,5%. O motivo da internação foi diarreia sanguinolenta/disenteria sem outros sintomas 45%. O estudo coprovirologico/coprocultivo foi solicitado em 98% e a detecção por técnicas de ácidos nucleicos em matéria fecal foi solicitada em 5,2%. Pelo menos um agente patogênico foi identificado em 34,3%: Shigella sp. 38%; Salmonella sp. 19,5%; coinfecções em 12%. Os antibióticos foram indicados para 86%; ceftriaxona 62%, azitromicina 35%. Foram internados em UTI 6,5% (15), 10/14 apresentaram complicações, 5 tiveram insuficiência renal aguda e 3 apresentaram alterações no meio interno, a maioria teve boa evolução. Conclusões: A diarreia/disenteria com sangue continua a ser uma causa importante de hospitalização, afetando sobretudo crianças saudáveis ââcom menos de 5 anos de idade. Os patógenos mais frequentemente detectados foram bactérias, principalmente Shigella sp., Salmonella sp. e E. coli diarreiogênica. Foi relatada elevada prescrição de antibióticos, cumprindo na maioria dos casos as recomendações.
Asunto(s)
Humanos , Masculino , Femenino , Recién Nacido , Lactante , Preescolar , Niño , Adolescente , Infecciones por Rotavirus/complicaciones , Infecciones por Campylobacter/complicaciones , Diarrea Infantil/etiología , Diarrea Infantil/sangre , Disentería/etiología , Disentería/sangre , Infecciones por Enterobacteriaceae/complicaciones , Infecciones por Rotavirus , Infecciones por Rotavirus/tratamiento farmacológico , Infecciones por Campylobacter/diagnóstico , Infecciones por Campylobacter/tratamiento farmacológico , Niño Hospitalizado/estadística & datos numéricos , Estudios Retrospectivos , Infecciones por Enterobacteriaceae/diagnóstico , Infecciones por Enterobacteriaceae/tratamiento farmacológicoRESUMEN
We report a rare case of Campylobacter fetus bacteremia in a 50-year-old woman following kidney transplantation. Bacteremia was complicated by multivisceral signs such as multiple splenic abscesses, bacterial hepatitis, erythema nodosum and reactive arthritis. Despite a prolonged diagnostic delay, the diagnosis was made on blood culture identification and the global outcome was favorable with adequate antibiotherapy. Reports in the literature describe a high rate of mortality for Campylobacter spp. septicemia, with most patients being immunocompromised. However, Campylobacter spp. has been rarely described in renal transplant patients. Moreover, a splenic septic localization due to Campylobacter spp. has been reported only once to our knowledge. Clinicians should be aware of the diagnostic difficulties related to the frequent negativity of stool samples in C. fetus septicemia, in order to implement a tailored medical strategy. Some data suggest that rapid introduction of adapted antibiotic therapy is associated with a reduction in mortality.
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Bacteriemia , Infecciones por Campylobacter , Trasplante de Riñón , Enfermedades del Bazo , Absceso/diagnóstico , Bacteriemia/diagnóstico , Bacteriemia/tratamiento farmacológico , Infecciones por Campylobacter/complicaciones , Infecciones por Campylobacter/diagnóstico , Infecciones por Campylobacter/tratamiento farmacológico , Campylobacter fetus , Diagnóstico Tardío , Femenino , Humanos , Trasplante de Riñón/efectos adversos , Persona de Mediana Edad , Enfermedades del Bazo/complicacionesRESUMEN
BACKGROUND: Acute gastroenteritis (AGE) is a major cause of morbidity and mortality in children aged less than 5 years in low- and middle-income countries where limited access to potable water, poor sanitation, deficient hygiene, and food product contamination are prevalent. Research on the changing etiology of AGE and associated risk factors in Latin America, including Colombia, is essential to understand the epidemiology of these infections. The primary objectives of this study were to describe etiology of moderate to severe AGE in children less than 5 years of age from Bucaramanga, Colombia, a middle-income country in Latin American, and to identify the presence of emerging E. coli pathotypes. METHODOLOGY/PRINCIPAL FINDINGS: This was a prospective, matched for age, case-control study to assess the etiology of moderate to severe AGE in children less than 5 years of age in Bucaramanga, Colombia, South America. We tested for 24 pathogens using locally available diagnostic testing, including stool culture, polymerase chain reaction, microscopy and enzyme-linked immunoassay. Adjusted attributable fractions were calculated to assess the association between AGE and each pathogen in this study population. The study included 861 participants, 431 cases and 430 controls. Enteric pathogens were detected in 71% of cases and in 54% of controls (p = <0.001). Co-infection was identified in 28% of cases and in 14% of controls (p = <0.001). The adjusted attributable fraction showed that Norovirus GII explained 14% (95% CI: 10-18%) of AGE, followed by rotavirus 9.3% (6.4-12%), adenovirus 3% (1-4%), astrovirus 2.9% (0.6-5%), enterotoxigenic Escherichia coli (ETEC) 2.4% (0.4-4%), Cryptosporidium sp. 2% (0.5-4%), Campylobacter sp. 2% (0.2-4%), and Salmonella sp.1.9% (0.3 to 3.5%). Except for Cryptosporidium, all parasite infections were not associated with AGE. Three emergent diarrheagenic E. coli pathotypes were identified in cases (0.7%), including an enteroaggregative/enterotoxigenic E.coli (EAEC/ETEC), an enteroaggregative/enteropathogenic E.coli (EAEC/EPEC), and an emergent enteroinvasive E. coli with a rare O96:H19. No deaths were reported among cases or controls. CONCLUSIONS/SIGNIFICANCE: Norovirus and rotavirus explained the major proportion of moderate to severe AGE in this study. Higher proportion of infection in cases, in the form of single infections or co-infections, showed association with AGE. Three novel E. coli pathotypes were identified among cases in this geographic region.
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Gastroenteritis/epidemiología , Gastroenteritis/etiología , Gastroenteritis/microbiología , Gastroenteritis/virología , Adenoviridae , Infecciones por Adenoviridae/complicaciones , Infecciones por Adenoviridae/epidemiología , Infecciones por Astroviridae/complicaciones , Infecciones por Astroviridae/epidemiología , Infecciones por Caliciviridae/complicaciones , Infecciones por Caliciviridae/epidemiología , Campylobacter , Infecciones por Campylobacter/complicaciones , Infecciones por Campylobacter/epidemiología , Estudios de Casos y Controles , Preescolar , Coinfección/microbiología , Coinfección/virología , Colombia/epidemiología , Criptosporidiosis/complicaciones , Criptosporidiosis/epidemiología , Cryptosporidium , Diarrea/epidemiología , Diarrea/etiología , Diarrea/microbiología , Diarrea/virología , Escherichia coli Enterotoxigénica , Infecciones por Escherichia coli/complicaciones , Infecciones por Escherichia coli/epidemiología , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Norovirus , Reacción en Cadena de la Polimerasa , Rotavirus , Infecciones por Rotavirus/complicaciones , Infecciones por Rotavirus/epidemiología , Salmonella , Infecciones por Salmonella/complicaciones , Infecciones por Salmonella/epidemiologíaAsunto(s)
Epidemias , Síndrome de Guillain-Barré/etiología , Infecciones por Arbovirus/complicaciones , Infecciones por Arbovirus/epidemiología , Infecciones por Campylobacter/complicaciones , Enfermedades Gastrointestinales/epidemiología , Enfermedades Gastrointestinales/virología , Humanos , Perú/epidemiología , Infecciones del Sistema Respiratorio/epidemiología , Infecciones del Sistema Respiratorio/virología , Infección por el Virus Zika/complicaciones , Infección por el Virus Zika/epidemiologíaRESUMEN
OBJECTIVE: The objective of this study was to describe the factors associated with the development of Guillain-Barré syndrome, both infectious and non-infectious, during and after the A(H1N1) influenza pandemic in 2009 and the recent Zika virus epidemic in the Americas. METHOD: Systematic review of literature on factors associated with the development of the Guillain-Barré syndrome published between 2007 and 2017 listed in EBSCO, MEDLINE and LILACS databases. The quality of the studies was evaluated using the Newcastle Ottawa Scale. RESULTS: Thirty-four articles met inclusion criteria and were selected for analysis. Their quality was considered good in relation to most of the items evaluated. Many aetiological agents had the results of association with Guillain-Barré syndrome, among them Campylobacter jejuni, influenza vaccine - both pandemic and seasonal vaccines, respiratory infection, gastrointestinal infection among others. The aetiological agents found are, in most part, the same reported prior to the study period. The association with surgeries, chikungunya virus (CHIKV), Zika virus and quadrivalent human papillomavirus vaccine stand out as new aetiological agents in the list of the various possible agents that trigger Guillain-Barré syndrome reported in the study period. There were no Brazilian studies identified during this period. CONCLUSIONS: The results of the review reaffirmed C. jejuni as the major trigger of GBS, whereas the association of influenza vaccines and GBS is less clear; Zika virus infection in association with GBS was found in only one study.
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Infecciones por Campylobacter/epidemiología , Síndrome de Guillain-Barré/etiología , Infección por el Virus Zika/epidemiología , Infecciones por Campylobacter/complicaciones , Campylobacter jejuni , Síndrome de Guillain-Barré/epidemiología , Humanos , Gripe Humana/epidemiología , Infección por el Virus Zika/complicacionesRESUMEN
Campylobacter spp. have been associated with anthropometric Z-score decrements, but the role of specific virulence genes associated with these outcomes has not been explored. This study aimed to investigate whether specific Campylobacter jejuni virulence-related gene and immune-inflammatory biomarkers are associated with malnutrition in children from Northeastern Brazil. A case-control study was performed in Fortaleza, Brazil. Children aging 6-24 months were characterized as malnourished (cases) if weight-for-age Z-score (WAZ) = 2 and as nourished (controls) if WAZ ≥ 1. DNA samples were extracted from stools and screened for C. jejuni/coli by real-time PCR. A subsequent C. jejuni-specific PCR was employed and positive samples were evaluated for 18 C. jejuni virulence genes by using four multiplex PCRs. C. jejuni was detected in 9.71% (33/340) of the children's samples, being 63.63% (21/33) from nourished and 37.37% (12/33) from malnourished children. The cadF, iamA, cheW, and sodB genes were the most frequent genes (100%, 90.9%, 87.9%, and 75.8%, respectively), while some others (ceuE, jlpA, pldA, and pVir) showed low rates (all below 6%). Malnourished children were significantly associated with infection with C. jejuni strains lacking cdtB gene (active subunit of cytolethal distending toxin) and harboring flgE gene (flagellar hook protein). These strains were also associated with children presenting increased serum SAA and sCD-14, but decreased IgG anti-LPS. These data reinforce the impact of Campylobacter jejuni infection on children without diarrhea and highlight the contribution of a specific virulence gene profile, cdtB(-)flgE(+) and increased systemic response in malnutrition children.
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Infecciones por Campylobacter/epidemiología , Campylobacter jejuni/genética , Campylobacter jejuni/patogenicidad , Desnutrición/microbiología , Toxinas Bacterianas/genética , Biomarcadores/análisis , Biomarcadores/orina , Brasil , Infecciones por Campylobacter/complicaciones , Infecciones por Campylobacter/microbiología , Preescolar , Diarrea/microbiología , Heces/microbiología , Femenino , Trastornos del Crecimiento/microbiología , Humanos , Lactante , Receptores de Lipopolisacáridos/sangre , Receptores de Lipopolisacáridos/inmunología , Masculino , Desnutrición/inmunología , Virulencia/genéticaRESUMEN
En los últimos años se ha observado un aumento en la incidencia de Campylobacter spp (CSSP) como agente de diarrea, enteritis y disentería. Constituye una zoonosis así como una enfermedad trasmitida por alimentos. El diagnóstico de GEA por CSPP se realiza por identificación del agente etiológico en las heces del paciente. El objetivo de la siguiente observación es presentar dos casos clínicos de GEA en niños con diagnóstico etiológico de colitis causada probablemente por Campylobacter spp mediante la utilización de examen directo de materia fecal. El cultivo de la bacteria es el gold standard; en Uruguay sólo está disponible con fines de investigación. El método más fácil de poner en práctica en los laboratorios clínicos es la tinción y observación directa con un Gram modificado el cual sumado a la clínica, permite un diagnóstico con alto grado de presunción. En ambos pacientes el resultado motivó la instauración de un tratamiento antibiótico específico que determinó una buena evolución.
In recent years an increase in the incidence of Campylobacter spp (CSSP) as the agent of diarrhea, enteritis and dysentery was observed. It constitutes a zoonosis, as well as a food transmitted disease. Diagnosis of acute gastroenteritis by CSPP is done by identifying the etiological agent on the patients’ feces. The objective of the following observation is to present two clinical cases of acute gastroenteritis in children with an etiological diagnosis of colitis, probably caused by Campylobacter spp by means of a direct study of the stool. Culture of the bacteria is the gold standard, although in Uruguay it is only available for research purposes. The easiest method to put into practice in the clinical laboratories is staining and the direct observation with a modified Gram, which, together with the clinical examination, enables diagnosis with a high degree of presumption. In both patients, the result caused the adoption of a specific antibiotic, which determined a good evolution.
Asunto(s)
Humanos , Masculino , Lactante , Niño , Infecciones por Campylobacter , Infecciones por Campylobacter/complicaciones , Infecciones por Campylobacter/diagnóstico , Técnicas y Procedimientos Diagnósticos , Disentería/etiología , Gastroenteritis/etiología , Campylobacter/patogenicidadRESUMEN
En los últimos años se ha observado un aumento en la incidencia de Campylobacter spp (CSSP) como agente de diarrea, enteritis y disentería. Constituye una zoonosis así como una enfermedad trasmitida por alimentos. El diagnóstico de GEA por CSPP se realiza por identificación del agente etiológico en las heces del paciente. El objetivo de la siguiente observación es presentar dos casos clínicos de GEA en niños con diagnóstico etiológico de colitis causada probablemente por Campylobacter spp mediante la utilización de examen directo de materia fecal. El cultivo de la bacteria es el gold standard; en Uruguay sólo está disponible con fines de investigación. El método más fácil de poner en práctica en los laboratorios clínicos es la tinción y observación directa con un Gram modificado el cual sumado a la clínica, permite un diagnóstico con alto grado de presunción. En ambos pacientes el resultado motivó la instauración de un tratamiento antibiótico específico que determinó una buena evolución.
Asunto(s)
Humanos , Masculino , Lactante , Niño , Infecciones por Campylobacter/complicaciones , Infecciones por Campylobacter/diagnóstico , Técnicas y Procedimientos Diagnósticos , Disentería/etiología , Gastroenteritis/etiología , Infecciones por Campylobacter/tratamiento farmacológico , Campylobacter/patogenicidadRESUMEN
INTRODUCTION: Campylobacteriosis is one of the leading causes of gastroenteritis worldwide. This study describes the epidemiology of laboratory-confirmed Campylobacter diarrheal infections in two facility-based surveillance sites in Guatemala. METHODS: Clinical, epidemiologic, and laboratory data were collected on patients presenting with acute diarrhea from select healthcare facilities in the departments of Santa Rosa and Quetzaltenango, Guatemala, from January 2008 through August 2012. Stool specimens were cultured for Campylobacter and antimicrobial susceptibility testing was performed on a subset of isolates. Multidrug resistance (MDR) was defined as resistance to ≥3 antimicrobial classes. RESULTS: Campylobacter was isolated from 306 (6.0%) of 5137 stool specimens collected. For children <5 years of age, annual incidence was as high as 1288.8 per 100,000 children in Santa Rosa and 185.5 per 100,000 children in Quetzaltenango. Among 224 ambulatory care patients with Campylobacter, 169 (75.5%) received metronidazole or trimethoprim-sulfamethoxazole, and 152 (66.7%) received or were prescribed oral rehydration therapy. Antimicrobial susceptibilities were tested in 96 isolates; 57 (59.4%) were resistant to ciprofloxacin and 12 (12.5%) were MDR. CONCLUSION: Campylobacter was a major cause of diarrhea in children in two departments in Guatemala; antimicrobial resistance was high, and treatment regimens in the ambulatory setting which included metronidazole and trimethoprim-sulfamethoxazole and lacked oral rehydration were sub-optimal.
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Antibacterianos/uso terapéutico , Infecciones por Campylobacter/epidemiología , Diarrea/epidemiología , Farmacorresistencia Bacteriana Múltiple , Combinación Trimetoprim y Sulfametoxazol/uso terapéutico , Adolescente , Adulto , Instituciones de Atención Ambulatoria , Campylobacter/aislamiento & purificación , Infecciones por Campylobacter/complicaciones , Infecciones por Campylobacter/tratamiento farmacológico , Niño , Preescolar , Ciprofloxacina/uso terapéutico , Control de Enfermedades Transmisibles/métodos , Costo de Enfermedad , Diarrea/tratamiento farmacológico , Diarrea/microbiología , Heces/microbiología , Femenino , Fluidoterapia , Guatemala/epidemiología , Humanos , Lactante , Recién Nacido , Masculino , Metronidazol/uso terapéutico , Pruebas de Sensibilidad Microbiana , Persona de Mediana Edad , Soluciones para Rehidratación/administración & dosificación , Vigilancia de Guardia , Adulto JovenRESUMEN
In June 2011, a cluster of suspected cases of Guillain-Barré syndrome (GBS), which can follow Campylobacter jejuni infection, was identified in San Luis Río Colorado (SLRC), Sonora, Mexico and Yuma County, Arizona, USA. An outbreak investigation identified 26 patients (18 from Sonora, eight from Arizona) with onset of GBS 4 May-21 July 2011, exceeding the expected number of cases (n = 1-2). Twenty-one (81%) patients reported antecedent diarrhoea, and 61% of 18 patients tested were seropositive for C. jejuni IgM antibodies. In a case-control study matched on age group, sex, ethnicity, and neighbourhood of residence, all Arizona GBS patients travelled to SLRC during the exposure period vs. 45% of matched controls (matched odds ratio 8·1, 95% confidence interval 1·5-∞). Exposure information and an environmental assessment suggested that GBS cases resulted from a large outbreak of C. jejuni infection from inadequately disinfected tap water in SLRC. Binational collaboration was essential in investigating this cross-border GBS outbreak, the first in mainland North America since 1976.
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Infecciones por Campylobacter/complicaciones , Infecciones por Campylobacter/epidemiología , Campylobacter jejuni/aislamiento & purificación , Brotes de Enfermedades , Síndrome de Guillain-Barré/epidemiología , Síndrome de Guillain-Barré/microbiología , Anticuerpos Antibacterianos/sangre , Arizona/epidemiología , Infecciones por Campylobacter/transmisión , Estudios de Casos y Controles , Microbiología de Alimentos , Humanos , México/epidemiología , Vigilancia en Salud Pública , Estudios Retrospectivos , Microbiología del AguaRESUMEN
BACKGROUND: Although diarrheal illnesses are recognized as both a cause and effect of undernutrition, evidence for the effect of specific enteropathogens on early childhood growth remains limited. We estimated the effects of undernutrition as a risk factor for campylobacteriosis, as well as associations between symptomatic and asymptomatic Campylobacter infections and growth. METHODOLOGY/PRINCIPAL FINDINGS: Using data from a prospective cohort of 442 children aged 0-72 months, the effect of nutritional status on the incidence of Campylobacter infection was estimated using uni- and multivariate Poisson models. Multivariate regression models were developed to evaluate the effect of Campylobacter infection on weight gain and linear growth. Overall, 8.3% of diarrheal episodes were associated with Campylobacter (crude incidence rate = 0.37 episodes/year) and 4.9% of quarterly asymptomatic samples were Campylobacter positive. In univariate models, the incidence of Campylobacter infection was marginally higher in stunted than non-stunted children (IRR 1.270, 95% CI (0.960, 1.681)(p = 0.095). When recent diarrheal burdens were included in the analysis, there was no difference in risk between stunted and unstunted children. Asymptomatic and symptomatic Campylobacter infections were associated with reduced weight gain over a three-month period (65.5 g (95% CI: -128.0, -3.0)(p = 0.040) and 43.9 g (95% CI:-87.6, -1.0)(p = 0.049) less weight gain, respectively). Symptomatic Campylobacter infections were only marginally associated with reduced linear growth over a nine month period (-0.059 cm per episode, 95% CI: -0.118, 0.001)(p = 0.054), however relatively severe episodes were associated with reduced linear growth (-0.169 cm/episode, 95% CI -0.310, -0.028)(p = 0.019). CONCLUSIONS/SIGNIFICANCE: Our findings suggest that Campylobacter is not as benign as commonly assumed, and that there is evidence to support expanding the indications for antibiotic therapy in campylobacteriosis in children.
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Infecciones por Campylobacter/epidemiología , Infecciones por Campylobacter/etiología , Trastornos del Crecimiento/epidemiología , Trastornos del Crecimiento/etiología , Enfermedades Asintomáticas/epidemiología , Campylobacter/aislamiento & purificación , Infecciones por Campylobacter/complicaciones , Niño , Preescolar , Femenino , Trastornos del Crecimiento/complicaciones , Humanos , Lactante , Recién Nacido , Masculino , Perú , Estudios ProspectivosRESUMEN
BACKGROUND: The direct effect of periodontal pathogens on atherosclerotic plaque development has been suggested as a potential mechanism for the observed association between periodontal disease and coronary heart disease, but few studies have tested this theory. OBJECTIVES: (i) To assess the association of periodontal pathogens in periodontal pockets with the risk of myocardial infarction (MI) and (ii) to assess whether an increase in the number of periodontal bacterial species increases the risk of MI. METHODS: A total of 313 cases and 747 controls, consisting of Caucasian men and women from Western New York, aged 35 to 69 years, were recruited for this study. The presence of microorganisms was assessed by indirect immunofluorescence microscopy, using species-specific polyclonal and monoclonal serodiagnostic reagents. The presence of six periodontal pathogens, Porphyromonas gingivalis (Pg), Tannerella forsythensis (Tf), Prevotella intermedia (Pi), Campylobacter recta (Cr), Fusobacterium nucleatum (Fn), and Eubacterium saburreum (Es), and their co-occurrence (0-6) was compared with the odds of having myocardial infarction. RESULTS: Univariate analyses revealed a higher percentage of the presence of each bacterium in cases compared to controls. In multivariate analyses, only Tf and Pi were statistically associated with an increase in the odds of having MI [Odds ratio OR=1.62; 95% CI (1.18-2.22); and 1.40; 95% (1.02-1.92), respectively] after adjusting for age, gender, education, cholesterol, high blood pressure, diabetes, and total pack-years of cigarette smoking. An increase in the number of different periodontal bacteria in pockets was also found to increase the odds of MI [adjusted OR=1.14; 95% CI (1.03-1.26)]. Participants who had three species or more of periodontal pathogens had about 2-fold increase in odds of having nonfatal MI than those who did not have any type of bacterial species [OR=2.01 (1.31-3.08)]. CONCLUSION: The presence of periodontal pathogens, specifically Tf or Pi, and an increase in total burden of periodontal pathogenic species were both associated with increased odds of having MI. However, further studies are needed to better assess any causal relationship, as well as the biological mechanisms underlying this association.
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Infarto del Miocardio/etiología , Bolsa Periodontal/microbiología , Adulto , Anciano , Infecciones por Bacteroidaceae/complicaciones , Infecciones por Campylobacter/complicaciones , Campylobacter rectus , Estudios de Casos y Controles , Intervalos de Confianza , Femenino , Infecciones por Fusobacterium/complicaciones , Fusobacterium nucleatum , Humanos , Masculino , Microscopía Fluorescente , Persona de Mediana Edad , Análisis Multivariante , Infarto del Miocardio/epidemiología , Oportunidad Relativa , Bolsa Periodontal/complicaciones , Periodontitis/complicaciones , Periodontitis/microbiología , Porphyromonas gingivalis , Prevotella intermedia , Factores de RiesgoRESUMEN
OBJECTIVE: To assess the relationship between bacterial enteritis and intussusception. STUDY DESIGN: The Patient Administration Systems and Biostatistics Activity database from January 2002 to December 2005 was examined for clinic visits or hospital admission to a Department of Defense medical facility for children age 0-5 years. The study included the International Statistical Classification of Diseases and Related Health Problems diagnosis-related group (DRG) codes for infections with Yersinia enterocolitica, Escherichia coli, Shigella species, Salmonella species, and Campylobacter. Identified patients were then assessed for the intussusception DRG code for 0-180 days postinfection. The total number of children enrolled in military treatment facilities in the same age group (denominator) was obtained. RESULTS: Bacterial enteritis significantly increased the relative risk of intussusception. An increased risk was found following infection with Salmonella, E coli, Shigella, and Campylobacter. The relative risk for intussusception following any bacterial enteritis was 40.6 (95% confidence interval = 28.6-57.5; P < .0001). CONCLUSIONS: Bacterial enteritis is a significant risk factor for the subsequent development of intussusception in children.
Asunto(s)
Infecciones Bacterianas/complicaciones , Enteritis/complicaciones , Intususcepción/etiología , Infecciones por Campylobacter/complicaciones , Preescolar , Disentería Bacilar/complicaciones , Infecciones por Escherichia coli/complicaciones , Femenino , Humanos , Lactante , Masculino , Factores de Riesgo , Infecciones por Salmonella/complicaciones , Yersiniosis/complicacionesRESUMEN
OBJECTIVES: Mini-implants are used for orthodontic bone anchorage. The reasons for a potential instability or loss of the mini-implants during treatment are multiple. Among other factors, colonization of implants with pathogenic bacteria is discussed. Therefore, the microflora associated with successful and failed mini-implants has been screened. MATERIAL AND METHODS: A total of 76 mini-implants collected from 25 patients were observed during regular orthodontic treatment. Bacterial samples of eight failed and - exemplarily - four successful (control) cases were subjected to a universal Bacteria-directed real-time quantitative polymerase chain reaction for quantification in combination with a microarray-based identification of 20 selected species. RESULTS: The failure rate in the present investigation was 10.5%. The bacterial analysis did not reveal any major difference in the total amount or species composition between control and failed mini-implants. However, Actinomyces viscosus was found in four (100%) and Campylobacter gracilis in three (75%) stable controls, whereas both species were rarely found (12.5%) in failed implants. CONCLUSIONS: In the present study, the peri-implant sulcus surrounding failed orthodontic mini-implants did not show a specific aggressive bacterial flora.
Asunto(s)
Actinomicosis/complicaciones , Infecciones por Campylobacter/complicaciones , Implantes Dentales/microbiología , Métodos de Anclaje en Ortodoncia/instrumentación , Periodontitis/microbiología , Actinomyces viscosus/aislamiento & purificación , Adolescente , Campylobacter coli/aislamiento & purificación , ADN Bacteriano/análisis , Implantes Dentales/efectos adversos , Fracaso de la Restauración Dental , Femenino , Humanos , Masculino , Análisis por Micromatrices , Periodontitis/etiología , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Adulto JovenRESUMEN
A busca de novos mercados e alimentos mais seguros tem levado as indústrias de carnes a implementar uma melhoria contínua na qualidade microbiológica dos produtos. Entre os microrganismos patogênicos emergentes, encontra-se o Campylobacter jejuni, causador da campilobacteriose e ligado ao aparecimento da Síndrome de Guillian-Barre nos humanos. No abate de frangos, a escaldagem, a depenagem e o resfriamento têm sido apontados como as etapas de maior risco de contaminação. Diante disto, os pesquisadores têm testado diversos meios que inibam a proliferação ou a contaminação cruzada, com métodos físicos e agentes químicos. Para os diversos pesquisadores da área, os controles no campo, aliados aos adequados procedimentos no abatedouro, tais como BPF, PPHO, APPCC e controle de pragas, são os principais meios para inviabilizar a sobrevivência e disseminação do Campylobacter.
Asunto(s)
Humanos , Animales , Campylobacter jejuni/patogenicidad , Industria de Alimentos , Pollos/microbiología , Infecciones por Campylobacter/complicaciones , Manipulación de Alimentos/métodos , Aves de Corral , Brasil , Contaminación de Alimentos/prevención & control , Microbiología de Alimentos , Control de CalidadRESUMEN
Campylobacter is an important agent of illness in human beings. Bacteremia occurs principally in the immunocompromissed host and is frequently due to C. fetus. Nevertheless bacteremia also has been observed in patients with enteritis due to C. jejuni. We refer two cases of patients with severe enteritis and bacteremia, both of them with immunosupressive concomitant diseases such as nephrotic syndrome and chronic cirrotic hepatopathy. Both patients presented hemathemesis.
Asunto(s)
Bacteriemia/microbiología , Infecciones por Campylobacter/complicaciones , Campylobacter jejuni , Enteritis/microbiología , Dolor Abdominal/microbiología , Adulto , Diarrea/microbiología , Femenino , Hematemesis/microbiología , Humanos , Inmunocompetencia , Masculino , Persona de Mediana EdadRESUMEN
Campylobacter es un importante agente causante de enfermedad en el ser humano en nuestro medio. Los casos de bacteriemia ocurren principalmente en pacientes inmunosuprimidos y sondebidos frecuentemente a C. fetus. Sin embargo la bacteriemia es un episodio que también se ha observado enpacientes con enteritis por C. jejuni. Referimos dos pacientes con enteritis grave y bacteriemia, ambos con enfermedades concomitantes compatibles con inmunodepresión: uno con síndrome nefrótico de larga data y otro con hepatopatía crónica con cirrosis. Destacamos que los dos casos presentaron hematemesis y uno de ellos,enterorragia. Sugerimos prestar atención a la coloración de Gram durante el subcultivo de los caldos conhemocultivos, en busca de formas características de esta especie, y en ese caso emplear medios de cultivo enmicroaerofilia a 37 y 42 ºC (AU)
Campylobacter is an importantagent of illness in human beings. Bacteremia occurs principally in the immunocompromissed host and is frequently due to C. fetus. Nevertheless bacteremia also has been observed in patients with enteritis due to C. jejuni. We refer two cases of patients with severe enteritis and bacteremia, both of them with immunosupressive concomitant diseases such as nephrotic syndrome and chronic cirrotic hepatopathy. Both patients presented hemathemesis (AU)
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Bacteriemia/microbiología , Infecciones por Campylobacter/complicaciones , Campylobacter jejuni/patogenicidad , Enteritis/microbiología , Dolor Abdominal/microbiología , Dolor Abdominal/fisiopatología , Bacteriemia/fisiopatología , Infecciones por Campylobacter/fisiopatología , Campylobacter jejuni/aislamiento & purificación , Diarrea/microbiología , Diarrea/fisiopatología , Enteritis/fisiopatología , Hematemesis/microbiología , Hematemesis/fisiopatología , InmunocompetenciaRESUMEN
Campylobacter es un importante agente causante de enfermedad en el ser humano en nuestro medio. Los casos de bacteriemia ocurren principalmente en pacientes inmunosuprimidos y sondebidos frecuentemente a C. fetus. Sin embargo la bacteriemia es un episodio que también se ha observado enpacientes con enteritis por C. jejuni. Referimos dos pacientes con enteritis grave y bacteriemia, ambos con enfermedades concomitantes compatibles con inmunodepresión: uno con síndrome nefrótico de larga data y otro con hepatopatía crónica con cirrosis. Destacamos que los dos casos presentaron hematemesis y uno de ellos,enterorragia. Sugerimos prestar atención a la coloración de Gram durante el subcultivo de los caldos conhemocultivos, en busca de formas características de esta especie, y en ese caso emplear medios de cultivo enmicroaerofilia a 37 y 42 ºC (AU)
Campylobacter is an importantagent of illness in human beings. Bacteremia occurs principally in the immunocompromissed host and is frequently due to C. fetus. Nevertheless bacteremia also has been observed in patients with enteritis due to C. jejuni. We refer two cases of patients with severe enteritis and bacteremia, both of them with immunosupressive concomitant diseases such as nephrotic syndrome and chronic cirrotic hepatopathy. Both patients presented hemathemesis (AU)
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Bacteriemia/microbiología , Infecciones por Campylobacter/complicaciones , Campylobacter jejuni/patogenicidad , Enteritis/microbiología , Dolor Abdominal/microbiología , Dolor Abdominal/fisiopatología , Bacteriemia/fisiopatología , Infecciones por Campylobacter/fisiopatología , Campylobacter jejuni/aislamiento & purificación , Diarrea/microbiología , Diarrea/fisiopatología , Enteritis/fisiopatología , Hematemesis/microbiología , Hematemesis/fisiopatología , InmunocompetenciaRESUMEN
Campylobacter es un importante agente causante de enfermedad en el ser humano en nuestro medio. Los casos de bacteriemia ocurren principalmente en pacientes inmunosuprimidos y sondebidos frecuentemente a C. fetus. Sin embargo la bacteriemia es un episodio que también se ha observado enpacientes con enteritis por C. jejuni. Referimos dos pacientes con enteritis grave y bacteriemia, ambos con enfermedades concomitantes compatibles con inmunodepresión: uno con síndrome nefrótico de larga data y otro con hepatopatía crónica con cirrosis. Destacamos que los dos casos presentaron hematemesis y uno de ellos,enterorragia. Sugerimos prestar atención a la coloración de Gram durante el subcultivo de los caldos conhemocultivos, en busca de formas características de esta especie, y en ese caso emplear medios de cultivo enmicroaerofilia a 37 y 42 °C
Campylobacter is an importantagent of illness in human beings. Bacteremia occurs principally in the immunocompromissed host and is frequently due to C. fetus. Nevertheless bacteremia also has been observed in patients with enteritis due to C. jejuni. We refer two cases of patients with severe enteritis and bacteremia, both of them with immunosupressive concomitant diseases such as nephrotic syndrome and chronic cirrotic hepatopathy. Both patients presented hemathemesis
Asunto(s)
Humanos , Masculino , Femenino , Adulto , Persona de Mediana Edad , Bacteriemia/microbiología , Infecciones por Campylobacter/complicaciones , Campylobacter jejuni/patogenicidad , Enteritis/microbiología , Dolor Abdominal/microbiología , Dolor Abdominal/fisiopatología , Bacteriemia/fisiopatología , Infecciones por Campylobacter/fisiopatología , Campylobacter jejuni/aislamiento & purificación , Diarrea/microbiología , Diarrea/fisiopatología , Enteritis/fisiopatología , Hematemesis/microbiología , Hematemesis/fisiopatología , InmunocompetenciaRESUMEN
Guillain-Barre Syndrome (GBS) is a neuromuscular disorder and campylobacteriosis is known to trigger the onset of the disorder. A polymerase chain reaction (PCR) protocol was developed that could specifically amplify a 497-bp region of the UDP-galactose 4-epimerase (galE) gene sequence in campylobacters responsible for triggering the onset of GBS. The identity of the PCR product was confirmed by Hind III endonuclease restriction digestion, which produced the predicted 430 and 67-bp DNA fragments. The assay could detect the presence of the gene in Campylobacter suspensions containing as few as 5 cells ml(-1). The assay detected the presence of the gene in 17 of the 20 campylobacters isolated from chicken, 9 of the 13 campylobacters isolated from turkey and 7 of the 7 campylobacters isolated from human stools. All Campylobacter strains isolated from chicken, turkey and clinical samples were resistant to multiple antibiotics. The assay failed to detect the presence of the gene in five different microaerophilic strains of Helicobacter spp., E. coli and Salmonella spp. The entire diagnostic assay, including template preparation, amplification and electrophoresis, can be completed within 6 h.