EHEC O111:H8 strain and norovirus GII.4 Sydney [P16] causing an outbreak in a daycare center, Brazil, 2019

Author(s)

Spano, Liliana Cruz ^[1] ; Guerrieri, Caroline Gastaldi ^[1] ; Bondi Volpini, Lays Paula ^[1] ; Schuenck, Ricardo Pinto ^[1] ; Goulart, Jaqueline Pegoretti ^[2] ; Boina, Elizabeth ^[2] ; Nascimento Recco, Celia Regina ^[3] ; Ribeiro-Rodrigues, Rodrigo ^{[1, 2]} ; dos Santos, Luis Fernando ^[4] ; Fumian, Tulio Machado ^[5]

Affiliation

^[1] Univ Fed Espirito Santo, Dept Pathol, Hlth Sci Ctr, Vitoria, ES - Brazil

^[2] Cent Publ Hlth Lab, State Hlth Secretariat, Vitoria, ES - Brazil

^[3] Municipal Hlth Secretariat, Epidemiol Serv, Espirito Santo - Brazil

^[4] Adolfo Lutz Inst, Ctr Bacteriol, Natl Reference Lab Escherichia Coli Enter Infect, Sao Paulo - Brazil

^[5] Fiocruz MS, Lab Comparat & Environm Virol, Oswaldo Cruz Inst, Rio De Janeiro - Brazil

• Document type: Journal article
• Source: BMC Microbiology; v. 21, n. 1 MAR 29 2021.
• Web of Science Citations: 0

Abstract

BackgroundThis study describes the investigation of an outbreak of diarrhea, hemorrhagic colitis (HC), and hemolytic uremic syndrome (HUS) at a daycare center in southeastern Brazil, involving fourteen children, six staff members, six family members, and one nurse. All bacterial and viral pathogens detected were genetically characterized.ResultsTwo isolates of a strain of enterohemorrhagic Escherichia coli (EHEC) serotype O111:H8 were recovered, one implicated in a case of HUS and the other in a case of uncomplicated diarrhea. These isolates had a clonal relationship of 94% and carried the stx2a and eae virulence genes and the OI-122 pathogenicity island. The EHEC strain was determined to be a single-locus variant of sequence type (ST) 327. EHEC isolates were resistant to ofloxacin, doxycycline, tetracycline, ampicillin, and trimethoprim-sulfamethoxazole and intermediately resistant to levofloxacin and ciprofloxacin. Rotavirus was not detected in any samples, and norovirus was detected in 46.7% (14/30) of the stool samples, three of which were from asymptomatic staff members. The noroviruses were classified as the recombinant GII.4 Sydney {[}P16] by gene sequencing.ConclusionIn this outbreak, it was possible to identify an uncommon stx2a +EHEC O111:H8 strain, and the most recent pandemic norovirus strain GII.4 Sydney {[}P16]. Our findings reinforce the need for surveillance and diagnosis of multiple enteric pathogens by public health authorities, especially during outbreaks. (AU)

• FAPESP's process: 17/00411-1 - Search for new genetic markers and multi locus sequence typing (MLST) of atypical enteropathogenic and Shiga toxin-producing Escherichia coli strains isolated in Brazil
• Grantee: Luis Fernando dos Santos
• Support Opportunities: Regular Research Grants