Caracterização dos fatores de virulência e do perfil de resistência a antibióticos de Cepas de shigella associadas à diarréia infantil, isoladas em Manaus-AM no período entre 2007 a 2009

Abstract

Shigellosis is a disease manifested from mild diarrhea to severe ysentery. The ability to invade cells, cause injury and imbalance in the homeostasis to the intestinal mucosa and modulate the inflammatory response has been attributed to several factors of pathogenicity of Shigella spp. In this study, thirty-six isolates of Shigella were identified from an etiologic study of childhood diarrhea in 1,500 children aged 0-10 years who were admitted to hospitals in Manaus (East-South-and-West Zones) between August 2007 and July 2009. Shigella flexneri was the most common (65%), followed by Shigella sonnei (20%), Shigella boydii (12.5%) and Shigella dysenteriae (2.5%). Among the isolates, one isolate (intermediate) resistant to ciprofloxacin and 1 (intermediate) to ceftriaxone, which are antibiotics recommended by WHO. Molecular typing of the pathogenicity factors showed evidence of the pathogenic potential of shet- 1B subunit of Shigella and can lead to complications related to dehydration. Frequencies of the IpaBCD (the most prevalent factors among isolates) followed by IpaH suspect associations to fever and bowel injury. The IpaH was clearly associated to bloody diarrhea. And finally, differences in the frequencies of Shet-2 positives between febrile-based groups reinforce its role in the inflammatory response. This study has contributed to the few data in the literature on the pathogenicity of wild Shigella isolates associated to shigellosis and consolidate the importance of finding ways to block the toxicity of these major pathogenicity factors