Torti Jeronimo F, Cuervo Paula, Nardello Andrea, Pizarro Marcela
Biochemistry, National University of Cuyo, Mendoza, ARG.
Cureus. 2021 Aug 16;13(8):e17213. doi: 10.7759/cureus.17213. eCollection 2021 Aug.
Argentina has one of the highest prevalence in Shiga toxin-producing (STEC) and the high rate of hemolytic uremic syndrome (HUS) in the world. Though preventive steps such as food safety have been implemented as a way to reduce STEC infections, these have proven to be insufficient. STEC's pathogenesis, virulence factors, relationship with the environment, and emerging strains have been studied in the past few years in the country. Many factors that contribute to the morbidity and mortality of STEC infections include the expression of pathologic genes, alternative characteristics (inhibition of phagocytosis, invasion, cytotoxicity, and bacterial attachment), and host factors (age, immune status, treatments, medical history). However, research studies in combination with epidemiological data suggest trends of the prognosis, with the relationship between and genetic combinations of adherence, Shiga toxin (Stx) genes, and virulence genes, which significantly influence disease outcomes. This review explains the characteristics and epidemiology of STEC in Argentina. All these facts show that the application of molecular subtyping techniques in real-time is essential for detecting and controlling outbreaks. Applying molecular subtyping techniques in hemorrhagic diarrhea can avoid severe consequences caused by progression to HUS, and help the epidemiological analysis of the outbreak.
阿根廷是世界上产志贺毒素大肠杆菌（STEC）患病率最高、溶血性尿毒症综合征（HUS）发病率最高的国家之一。尽管已采取食品安全等预防措施以减少STEC感染，但事实证明这些措施并不充分。过去几年，该国对STEC的发病机制、毒力因子、与环境的关系以及新出现的菌株进行了研究。导致STEC感染发病和死亡的许多因素包括病理基因的表达、其他特征（抑制吞噬作用、侵袭、细胞毒性和细菌黏附）以及宿主因素（年龄、免疫状态、治疗、病史）。然而，结合流行病学数据的研究表明了预后趋势，以及黏附、志贺毒素（Stx）基因和毒力基因的遗传组合之间的关系，这些因素对疾病结果有显著影响。本综述解释了阿根廷STEC的特征和流行病学。所有这些事实表明，实时应用分子分型技术对于检测和控制疫情至关重要。在出血性腹泻中应用分子分型技术可以避免因进展为HUS而导致的严重后果，并有助于疫情的流行病学分析。
