Laboratorio de Patogénesis e Inmunología de Procesos Infecciosos, Instituto de Medicina Experimental (IMEX)-CONICET, Academia Nacional de Medicina, J.A. Pacheo de Melo 3081, C1425 CABA, Argentina.
Laboratorio de Fisiopatogenia, IFIBIO-Houssay (UBA-CONICET), Facultad de Medicina, Universidad de Buenos Aires, Paraguay 2155, C1121 CABA, Argentina.
Rev Argent Microbiol. 2024 Jan-Mar;56(1):25-32. doi: 10.1016/j.ram.2023.05.006. Epub 2023 Sep 12.
In Argentina, hemolytic uremic syndrome (HUS) caused by EHEC has the highest incidence in the world. EHEC infection has an endemo-epidemic behavior, causing 20-30% of acute bloody diarrhea syndrome in children under 5 years old. In the period 2016-2020, 272 new cases per year were notified to the National Health Surveillance System. Multiple factors are responsible for HUS incidence in Argentina including person-to-person transmission. In order to detect possible EHEC carriers, we carried out a preliminary study of the frequency of kindergarten teachers with anti-LPS antibodies against the most prevalent EHEC serotypes in Argentina. We analyzed 61 kindergarten teachers from 26 institutions from José C. Paz district, located in the suburban area of Buenos Aires province, Argentina. Fifty-one percent of the plasma samples had antibodies against O157, O145, O121 and O103 LPS: 6.4% of the positive samples had IgM isotype (n=2), 61.3% IgG isotype (n=19) and 32.3% IgM and IgG (n=10). Given that antibodies against LPS antigens are usually short-lived specific IgM detection may indicate a recent infection. In addition, the high percentage of positive samples may indicate a frequent exposure to EHEC strains in the cohort studied, as well as the existence of a large non-symptomatic population of adults carrying pathogenic strains that could contribute to the endemic behavior through person-to-person transmission. The improvement of continuous educational programs in kindergarten institutions could be a mandatory measure to reduce HUS cases not only in Argentina but also globally.
在阿根廷，产志贺样毒素大肠杆菌（EHEC）引起的溶血性尿毒综合征（HUS）的发病率居世界首位。EHEC 感染具有地方性流行特征，导致 5 岁以下儿童急性血性腹泻综合征的发病率为 20%-30%。在 2016-2020 年期间，国家卫生监测系统每年通报 272 例新病例。导致阿根廷 HUS 发病率的多种因素包括人际传播。为了检测可能的 EHEC 携带者，我们对阿根廷最常见的 EHEC 血清型的抗 LPS 抗体在幼儿园教师中的频率进行了初步研究。我们分析了来自阿根廷布宜诺斯艾利斯省郊区何塞·C·帕斯区 26 个机构的 61 名幼儿园教师的血浆样本。51%的血浆样本对 O157、O145、O121 和 O103 LPS 有抗体：6.4%的阳性样本为 IgM 同型（n=2），61.3%为 IgG 同型（n=19），32.3%为 IgM 和 IgG（n=10）。鉴于 LPS 抗原的抗体通常是短暂的，特异性 IgM 的检测可能表明近期感染。此外，高比例的阳性样本可能表明在研究队列中经常接触 EHEC 菌株，以及存在大量携带致病性菌株的无症状成年人，他们可能通过人际传播导致地方性流行。在幼儿园机构中持续开展教育项目可能是一项强制性措施，不仅可以减少阿根廷的 HUS 病例，还可以减少全球的 HUS 病例。
