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      Detection of non-enterotoxigenic and enterotoxigenic Bacteroides fragilis in stool samples from children in São Paulo, Brazil Translated title: Detecção de Bacteroides fragilis enterotoxigênicos e não enterotoxigênicos de amostras fecais de crianças em São Paulo, Brasil

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          Abstract

          Non-enterotoxigenic bacteria of the Bacteroides fragilis group and enterotoxigenic B. fragilis were identified from children with and without aqueous acute diarrhea. In this study, 170 stool samples from 96 children with and 74 without diarrhea were analyzed. Enterotoxin production and the toxin gene detection were detected by cytotoxicity assay on HT-29/C1 cells and by PCR, respectively. B. fragilis species was prevalent in both groups and enterotoxigenic B. fragilis strains were isolated from two children with diarrhea. More studies are important to evaluate the role of each bacteria of the B. fragilis group, including enterotoxigenic strains play in the diarrheal processes in children.

          Translated abstract

          Bactérias não enterotoxigênicas do grupo Bacteroides fragilis e B. fragilis enterotoxigênicas foram isoladas e identificadas de crianças com e sem diarréia aguda aquosa. Neste estudo, 170 amostras fecais de 96 e 74 crianças, com e sem diarréia, respectivamente, foram analisadas. A produção de enterotoxina e a detecção do gene que media a produção da toxina foram determinadas por ensaios citotóxicos em células HT-29/C1 e por PCR, respectivamente. A espécie B. fragilis foi prevalente em ambos os grupos, e cepas de B. fragilis enterotoxigênicas foram isoladas de duas crianças com diarréia aquosa aguda. Maiores estudos são necessários para avaliar o papel de cada bactéria desse importante grupo bacteriano, incluindo-se o papel que as cepas enterotoxigênicas, desempenham no processo diarréico em crianças.

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          Most cited references20

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          Virulence factors in anaerobes.

          B Duerden (1994)
          Among the broad spectrum of species of anaerobic bacteria in the normal flora of humans, a few exhibit marked pathogenic potential and are responsible for the majority of infections. The factors that determine the virulence of particular species are varied and probably interrelated. Just as most anaerobic infections are polymicrobial and depend on interactions of a combination of species, the virulence of a species probably depends on a combination of properties, including surface structures, metabolic functions, ability to avoid the host's defenses, and capacity to damage tissues. Thus, the production of each virulence factor--adhesins that attach to epithelial and red blood cells and to other bacteria, producing metabolically interdependent ecosystems; capsules that protect against phagocytosis and induce abscess formation; lipopolysaccharide; proteases, including those that degrade immunoglobulins and complement components; and other hydrolytic enzymes--represents only a component of virulence, but a consideration of these factors in combination begins to clarify the mechanisms by which anaerobes cause disease.
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            Host factors predisposing to anaerobic infections.

            S Finegold (1993)
            Factors that predispose to infection in general, of course, may predispose to infection with anaerobes. Included in this category are diabetes mellitus, neutropenia, hypogammaglobulinaemia, malignancy, splenectomy, collagen vascular disease, cytotoxic drug therapy, corticosteroid therapy and other immunosuppression. However, even with these situations there may be certain, more specific, associations: anaerobic cholecystitis and anaerobic osteomyelitis in diabetics, neutropenic colitis, and the increased incidence of local anaerobic infections associated with carcinoma of the lung, colon and uterus. Conditions that lead to decreased redox potential more specifically predispose to infection with anaerobes. Included in this category are obstruction and stasis, tissue anoxia, tissue destruction, vascular insufficiency, prior aerobic infection, burns, foreign body implantation, and calcium salts in a wound (in association with fractures). Other specific clinical situations that predispose to anaerobic infections include leukaemia; oral, gastrointestinal, and female pelvic surgery; trauma at other sites; childbirth; aspiration pneumonia; human and animal bites; and therapy with agents with poor activity against anaerobes (e.g. aminoglycosides, quinolones). AIDS patients appear to be predisposed to severe periodontal disease and its complications.
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              Association of Bacteroides fragilis with childhood diarrhea.

              Enterotoxigenic strains of Bacteriodes fragilis (ETBF) have recently been found to be associated with diarrheal illness in Apache and Bangladeshi children. This study was conducted to define the role of ETBF in diarrhea of children in an urban setting. Fecal specimens from 991 children with diarrhea and 581 asymptomatic age-matched controls were cultured for B. fragilis (BF). The isolates were tested for enterotoxin production using a human colonic epithelial cell line. BF was isolated from 318 (32.1%) of the patients and 123 (21.2%) of the controls (p or = 1 year (37.6% vs 16.5%; p = < 0.001). Overall, ETBF were identified in 4.4% of patients and 3.1% of controls (p = 0.2). However, ETBF were significantly associated with diarrheal disease in children 1-5 years (5.4% vs 1.8%; p = 0.033) and 1-10 years (4.8% vs 1.5%; p = 0.021) in age. ETBF were isolated the year round and comprised 14.4% and 15% of the BF isolated from the patients and controls, respectively, suggesting that part of the indigenous BF are inherently enterotoxin producers. In this study, BF and ETBF were associated with diarrheal illness in children 1-10 years old.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Journal
                rimtsp
                Revista do Instituto de Medicina Tropical de São Paulo
                Rev. Inst. Med. trop. S. Paulo
                Instituto de Medicina Tropical (São Paulo )
                1678-9946
                August 2003
                : 45
                : 4
                : 225-227
                Article
                S0036-46652003000400010
                10.1590/S0036-46652003000400010
                14502352
                64bf1785-7a8e-4ea1-b816-cae22a0f7111

                http://creativecommons.org/licenses/by/4.0/

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                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=0036-4665&lng=en
                Categories
                TROPICAL MEDICINE

                Infectious disease & Microbiology
                Bacteroides fragilis group,ETBF,Acute diarrhea,Children
                Infectious disease & Microbiology
                Bacteroides fragilis group, ETBF, Acute diarrhea, Children

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