We identified the mucus-activatable Shiga toxin genotype stx2d in the most common hemolytic uremic syndrome-associated Escherichia coli serotype, O157:H7. stx2d was detected in a strain isolated from ...a 2-year-old boy with bloody diarrhea in Spain, and whole-genome sequencing was used to confirm and fully characterize the strain.
•First COVID-19 outbreak in Spain.•A hotel guest from Italy presented to a hospital with symptoms of an acute respiratory infection.•The hotel was immediately placed under quarantine for 14 ...days.•Control measures employed to mitigate a large international cluster.•In total, eight hotel guests have been identified as Covid-19 cases.
Since the first accounts of SARS-CoV-2, authorities have encountered numerous unprecedented situations threatening public health. This rapid communication addresses events that led to the quarantining of a hotel in Tenerife, Spain and the effectiveness of the rapidly implemented control measures. In total, eight cases have been associated with the hotel. Due to the international nature of the guests, had these timely precautions not been in place, a multinational cluster might have formed.
Toxigenic Corynebacterium ulcerans is as an emerging zoonotic agent of diphtheria. We describe the zoonotic transmission of diphtheria caused by toxigenic C. ulcerans from domestic animals in Spain, ...confirmed by core-genome multilocus sequence typing. Alongside an increasing number of recent publications, our findings highlight the public health threat posed by diphtheria reemergence.
This study examines the microbiological and epidemiological characteristics of toxigenic and nontoxigenic
isolates submitted to the national reference laboratory in Spain, between 2014 and 2019, in ...order to describe the current situation and improve our knowledge regarding these emerging pathogens. Epidemiological information was extracted from the Spanish Surveillance System. Microbiological and molecular characterization was carried out using phenotypic methods, multilocus sequence typing (MLST), whole-genome sequencing (WGS), and core genome MLST (cgMLST). Thirty-nine isolates were analyzed. Twenty-one isolates were identified as
(6 toxigenic), 14 as
, 4 as
(3 toxigenic), and 1 as
One
isolate was identified as nontoxigenic
gene bearing (NTTB). Ages of patients ranged from 1 to 89 years, with 10% (3/30) of nontoxigenic and 22% (2/9) of toxigenic isolates collected from children less than 15 years. Twenty-five of the patients were males (17/30 in nontoxigenic; 8/9 in toxigenic). MLST identified 28 sequence types (STs), of which 7 were described for the first time in Spain. WGS analysis showed that 10 isolates, including 3 toxigenic isolates, harbored a variety of antibiotic resistance genes in addition to the high prevalence of penicillin resistance phenotypically demonstrated. Phylogenetic analysis revealed one cluster of isolates from family members. Risk information was available for toxigenic isolates (9/39); 3 patients reported recent travels to countries of endemicity and 3 had contact with cats/dogs. One unvaccinated child with respiratory diphtheria had a fatal outcome. Including nontoxigenic
infections in disease surveillance and using WGS could further improve current surveillance.
The main etiologic agent of tuberculosis (TB) in livestock is Mycobacterium bovis; human TB cases caused by M. bovis are rare. Analysis of a TB outbreak caused by polyresistant M. bovis involving a ...human and sympatric sheep in Spain suggests local circulation of drug-resistant M. bovis strains among livestock.
Introducción: datos de varios países del mundo sugieren que los niños con COVID-19 podrían presentar síntomas diferentes y menos graves que los adultos. Sin embargo, los patrones epidemiológicos y ...clínicos en este grupo poblacional son poco claros. Métodos: el presente es un estudio observacional, con una caracterización inicial transversal-analítica, y con un componente longitudinal o de seguimiento a un grupo de menores con sospecha y/o diagnóstico confirmado de COVID-19, que presentaron desenlaces como mejoría, traslado a un nivel superior de atención o defunción por sintomatología respiratoria. Los niños recibieron atención médica en el Hospital General Regional con Medicina Familiar N.o 1 (HGR C/MF N.o 1), y se les realizó prueba de reacción en cadena de la polimerasa en tiempo real (RT-PCR). Resultados: se estudiaron 98 niños como casos sospechosos para COVID-19, a quienes se les realizó RT-PCR. Del total, 24 resultaron positivos y 74 fueron negativos. La mediana de edad de los participantes fue 64,4 meses (0 a 203 meses), 55 menores eran de sexo masculino, 59 niños tuvieron manejo ambulatorio, y de estos 14 presentaron resultado positivo. Entre los que requirieron manejo hospitalario (39), 10 niños dieron positivo para SARS-CoV-2, y, de estos, 84,7% alcanzaron mejoría y fueron dados de alta; 4 fueron trasladados a hospitales de nivel superior de atención. De los 98 niños en estudio, 11 fallecieron, 7 con resultado negativo y 4 con resultado positivo para SARS-CoV-2.
We evaluated the SHIGA TOXIN QUIK CHEK (STQC) on its suitability for Shiga toxin–producing Escherichia coli (STEC) testing on human fecal samples after overnight enrichment. Our in-house PCR-based ...protocol for STEC detection was used as the standard for comparison. STQC detected all described Shiga toxin subtypes with the only exception of Stx2f. In comparison to PCR, STQC performed with an overall sensitivity of 55.4%, specificity of 100.0%, positive predictive value of 100.0%, negative predictive value of 73.0%, infinite positive likelihood ratio, and negative likelihood ratio of 0.45. We conclude that STQC may not be considered a suitable screening tool for STEC detection in human fecal samples, although it could be useful for laboratories where PCR is not a routine tool for STEC screening yet, subject to the confirmation of negative samples by a reference laboratory with full diagnostic capabilities.
Salmonella enterica serovar Enteritidis is the most common cause of human salmonellosis worldwide. In this study, all clinical isolates of Salmonella Enteritidis recovered between January 2008 and ...June 2014 in a Spanish region (491) were screened for antimicrobial drug resistance and the phage type (PT) was determined for a significant number (265). PT1, PT14b, PT56, PT6, PT4, and PT8 were the predominant PTs, accounting together for 82% of the isolates. A total of 38.3% of the isolates were susceptible to all antimicrobials tested, 46.4% and 6.1% isolates were resistant to nalidixic acid and ampicillin, respectively, and single isolates were resistant to two (ampicillin and nalidixic acid) or six (ampicillin, chloramphenicol, streptomycin, sulfonamides, tetracycline, and trimethoprim) agents. Nalidixic acid resistance was statistically associated with PT1 and PT14b (p < 0.05, 95% CI), and ampicillin resistance with PT6/PT6a (p < 0.05, 95% CI). All ampicillin-resistant isolates (30) carried a plasmid-encoded bla
. All except one harbored the virulence plasmid specific of Salmonella Enteritidis (IncFIIA + IncFIB; 28 isolates) or a bla
-positive variant herein (IncFIIA + IncFIB; 1 isolate). Five additional bla
plasmids, of the ColE1, IncX, IncF, and IncI incompatibility groups, were identified. The IncI plasmid, found in the single multidrug-resistant isolate, carried the strAB and sul2 genes together with genes of the virulence plasmid, including the spv operon. The obtained results highlight the high diversity of bla
plasmids conferring ampicillin resistance in Salmonella Enteritidis, and support clonal expansion as the main cause of nalidixic acid resistance in this serovar.
The aim of this study was to detect and characterize plasmid-mediated quinolone resistance determinants as well as genes responsible for additional resistances in Enterobacteriaceae isolates in ...Spain.
The resistance genes were identified by PCR and sequencing. Plasmid analysis was carried out by S1-PFGE and PCR-based replicon typing. Conjugation assays were performed to link resistance genes to plasmids. The genetic relationships among the strains were determined by XbaI-PFGE.
One hundred and twenty-three isolates carried qnr as the only quinolone resistance determinant. One Salmonella Bredeney was positive for qnrB2 harboured on a 320 kb conjugative IncHI2 plasmid. One Salmonella Newport was positive for qnrB4 harboured on a 70 kb conjugative IncFIIs plasmid. Twenty-five Salmonella Thompson were positive for qnrA1. Twenty-two harboured a 220 kb non-conjugative and non-typeable plasmid, two a 220 kb conjugative IncHI2 plasmid and one a 120 kb non-conjugative IncA/C plasmid. qnrS1 was always detected on non-conjugative ColE(TP) plasmids of various sizes. Thus, two Salmonella Montevideo strains carried a 20 kb plasmid while Salmonella Typhimurium strains carried plasmids of 10 kb (n = 91) or 30 kb (n = 2). One Escherichia coli was positive for qnrA1 detected on a 220 kb conjugative IncHI2 plasmid. qnr alleles and β-lactamases were associated in Salmonella Bredeney (harbouring bla(SHV-12)), Salmonella Newport (harbouring bla(DHA-1)) and E. coli (harbouring bla(CTX-M-9)).
This is the first epidemiological study of qnr genes in Enterobacteriaceae isolates from Spain. Salmonella plasmids bearing qnr alleles are not a localized phenomenon in Spain and wide variation in plasmids and co-resistance was detected. The presence of qnr determinants in Salmonella serotypes commonly reported in human disease is concerning.
Tuberculosis (TB), caused by the
complex (MTBC), is a chronic infectious disease with both pulmonary and extrapulmonary forms. This study set out to investigate and compare the genomic diversity and ...transmission dynamics of
(
) isolates obtained from tuberculous lymphadenitis (TBLN) and pulmonary TB (PTB) cases in Northwest Ethiopia.
A facility-based cross-sectional study was conducted using two groups of samples collected between February 2021 and June 2022 (Group 1) and between June 2020 and June 2022 (Group 2) in Northwest Ethiopia. Deoxyribonucleic acid (DNA) was extracted from 200 heat-inactivated
isolates. Whole-genome sequencing (WGS) was performed from 161 isolates having ≥1 ng DNA/μl using Illumina NovaSeq 6000 technology.
From the total 161 isolates sequenced, 146
isolates were successfully genotyped into three lineages (L) and 18 sub-lineages. The Euro-American (EA, L4) lineage was the prevailing (
= 100; 68.5%) followed by Central Asian (CAS, L3,
= 43; 25.3%) and then L7 (
= 3; 2.05%). The L4.2.2.ETH sub-lineage accounted for 19.9%, while Haarlem estimated at 13.7%. The phylogenetic tree revealed distinct Mtb clusters between PTB and TBLN isolates even though there was no difference at lineages and sub-lineages levels. The clustering rate (CR) and recent transmission index (RTI) for PTB were 30 and 15%, respectively. Similarly, the CR and RTI for TBLN were 31.1 and 18 %, respectively.
PTB and TBLN isolates showed no
lineages and sub-lineages difference. However, at the threshold of five allelic distances,
isolates obtained from PTB and TBLN form distinct complexes in the phylogenetic tree, which indicates the presence of
genomic variation among the two clinical forms. The high rate of clustering and RTI among TBLN implied that TBLN was likely the result of recent transmission and/or reactivation from short latency. Hence, the high incidence rate of TBLN in the Amhara region could be the result of
genomic diversity and rapid clinical progression from primary infection and/or short latency. To validate this conclusion, a similar community-based study with a large sample size and better sampling technique is highly desirable. Additionally, analysis of genomic variants other than phylogenetic informative regions could give insightful information. Combined analysis of the host and the pathogen genome (GXG) together with environmental (GxGxE) factors could give comprehensive co-evolutionary information.
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