Molecular characterization of virulence and antimicrobial resistance profile of Shigella species isolated from children with moderate to severe diarrhea in northeastern Brazil |
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Authors: | Pedro Henrique Quintela Soares Medeiros Aldo Ângelo Moreira Lima Marjorie Moreira Guedes Alexandre Havt Mariana Duarte Bona Luís Carlos Rey Alberto Melo Soares Richard Littleton Guerrant Bernhard H Weigl Ila Fernanda Nunes Lima |
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Institution: | 1. Institute of Biomedicine for Brazilian Semi-Arid (IBISAB), Department of Physiology and Pharmacology, Federal University of Ceara, Fortaleza, CE, Brazil;2. Center for Global Health, Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA;3. Department of Mother and Child Health, Federal University of Ceara, Fortaleza, CE, Brazil;4. Program for Appropriate Technology in Health (PATH), Seattle, WA, USA |
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Abstract: | Molecular characterization of virulence and antimicrobial resistance profiles were determined for Shigella species isolated from children with diarrhea in Fortaleza, Brazil. Fecal specimens were collected along with socioeconomic and clinical data from children with moderate to severe diarrhea requiring emergency care. Shigella spp. were isolated by standard microbiological techniques, and we developed 4 multiplex polymerase chain reaction assays to detect 16 virulence-related genes (VRGs). Antimicrobial susceptibility tests were performed using disk diffusion assays. S. flexneri and S. sonnei were the predominant serogroups. S. flexneri was associated with low monthly incomes; more severe disease; higher number of VRGs; and presence of pic, set, and sepA genes. The SepA gene was associated with more intense abdominal pain. S. flexneri was correlated with resistance to ampicillin and chloramphenicol, whereas S. sonnei was associated with resistance to azithromycin. Strains harboring higher numbers of VRGs were associated with resistance to more antimicrobials. We highlight the correlation between presence of S. flexneri and sepA, and increased virulence and suggest a link to socioeconomic change in northeastern Brazil. Additionally, antimicrobial resistance was associated with serogroup specificity in Shigella spp. and increased bacterial VRGs. |
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Keywords: | VRGs virulence-related genes mPCR multiplex polymerase chain reaction AMP ampicillin AK amikacin AMC amoxicillin/clavulanate AZT azithromycin CRO ceftriaxone CXM cefuroxime CEF cephalothin CIP ciprofloxacin CLO chloramphenicol CN gentamicin NA nalidixic acid SXT sulfamethoxazole/trimethoprim TET tetracycline CART Classification and Regression Tree Analysis RR relative risk Diarrhea Virulence-related genes Antimicrobial resistance Shigellosis pathobiology |
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