Shiga Toxin-Producing Escherichia coli Outbreaks in the United States, 2010–2017

Shiga toxin-producing Escherichia coli (STEC) cause illnesses ranging from mild diarrhea to ischemic colitis and hemolytic uremic syndrome (HUS); serogroup O157 is the most common cause. We describe the epidemiology and transmission routes for U.S. STEC outbreaks during 2010–2017. Health departments reported 466 STEC outbreaks affecting 4769 persons; 459 outbreaks had a serogroup identified (330 O157, 124 non-O157, 5 both). Among these, 361 (77%) had a known transmission route: 200 foodborne (44% of O157 outbreaks, 41% of non-O157 outbreaks), 87 person-to-person (16%, 24%), 49 animal contact (11%, 9%), 20 water (4%, 5%), and 5 environmental contamination (2%, 0%). The most common food category implicated was vegetable row crops. The distribution of O157 and non-O157 outbreaks varied by age, sex, and severity. A significantly higher percentage of STEC O157 than non-O157 outbreaks were transmitted by beef (p = 0.02). STEC O157 outbreaks also had significantly higher rates of hospitalization and HUS (p < 0.001).

Lethal infection caused by Tetratrichomonas gallinarum in black swans (Cygnus atratus)

Background Tetratrichomonas gallinarum is parasitic protozoa with a wide host range. However, its lethal infection is rare reported. Case presentation Here, we described the first lethal cases of T. gallinarum infection in black swans in China. Five black swans died within a week in succession without obvious symptoms except mild diarrhea. At necropsy, severe lesions were observed in caeca with thickened caecal walls and hemorrhages in the mucosa. A large number of moving trophozoites were found in the contents of the cecum by microscopic examination. The livers were enlarged with multiple bleeding spots on the surface. Histopathology of the livers showed mononuclear cell infiltration and moderate hyperplasia of fibrous tissue. The histopathology of the cecum showed that the villi of the cecum were edematous. Finally, the presence of T. gallinarum was determined by specific PCR andin-situ hybridization assay. Additionally, common pathogens that can cause similar symptoms were excluded. Conclusions The death of the black swan was caused by T. gallinarum, suggesting that the parasite might be a new threat to the Cygnus birds.

Treatment of copper deficiency in Texel-crossbred sheep by the feeding of a concentrate formulated for dairy cows

Six Texel-crossbred sheep, from a flock with a history of a dull appearance and mild diarrhea, were presented to the faculty of veterinary medicine (University of Utrecht) . The clinical signs were found to be related to Copper (Cu) deficiency as indicated by low hepatic Cu values. It was decided to treat the animals by feeding them concentrates specifically formulated for dairy cows because such concentrates have a rather high Cu content compared to concentrates designed for sheep. Sheep Cu status was monitored by measuring liver Cu concentrations. Current results indicate the potential of feeding cow concentrate as a practical method to treat Cu deficiency in Texel-crossbred sheep. In contrast to hepatic Cu concentrations, serum Ceruloplasmin concentration (Cp) values did not respond to the treatment thereby indicating that serum Cp is inferior to evaluate Cu status in sheep compared to liver Cu measurements.

The Gut Microbiome Is Associated With Therapeutic Responses and Toxicities of Neoadjuvant Chemoradiotherapy in Rectal Cancer Patients—A Pilot Study

Responses to neoadjuvant chemoradiotherapy (nCRT) and therapy-related toxicities in rectal cancer vary among patients. To provide the individualized therapeutic option for each patient, predictive markers of therapeutic responses and toxicities are in critical need. We aimed to identify the association of gut microbiome with and its potential predictive value for therapeutic responses and toxicities. In the present study, we collected fecal microbiome samples from patients with rectal cancer at treatment initiation and just after nCRT. Taxonomic profiling via 16S ribosomal RNA gene sequencing was performed on all samples. Patients were classified as responders versus non-responders. Patients were grouped into no or mild diarrhea and severe diarrhea. STAMP and high-dimensional class comparisons via linear discriminant analysis of effect size (LEfSe) were used to compare the compositional differences between groups. Phylogenetic Investigation of Communities by Reconstruction of Unobserved States (PICRUSt) was utilized to predict differences in metabolic function between groups. Ten patients were classified as responders and 12 patients were classified as non-responders. Fourteen patients experienced no or mild diarrhea and 8 patients experienced severe diarrhea. Several bacteria taxa with significantly different relative abundances before and after nCRT were identified. Similarly, several baseline bacteria taxa and predicted pathways with significantly different relative abundances between responders and non-responders or between patients no or mild diarrhea and severe diarrhea were identified. Specifically, Shuttleworthia was identified as enriched in responders and several bacteria taxa in the Clostridiales order etc. were identified as enriched in non-responders. Pathways including fatty acid metabolism were predicted to be enriched in responders. In addition, Bifidobacterium, Clostridia, and Bacteroides etc. were identified as enriched in patients with no or mild diarrhea. Pathways including primary bile acid biosynthesis were predicted to be enriched in patients with no or mild diarrhea. Together, the microbiota and pathway markers identified in this study may be utilized to predict the therapeutic responses and therapy-related toxicities of nCRT in patients with rectal cancer. More patient data is needed to verify the current findings and the results of metagenomic, metatranscriptomic, and metabolomic analyses will further mine key biomarkers at the compositional and functional level.

Current view on Blastocystis species: clinical forms, diagnosis and treatment

The symptomatic form of Blastocystis spp. infection not only with mild diarrhea or dysentery-like syndrome, but also with the development of severe ulcerative necrotic lesions of the intestine. Meanwhile, the pathogenicity of these microorganisms should not be exaggerated, due to majority asymptomatic cases or infection transmission with minor impaired bowel function.

An Atypical Case of Cluster Convulsions with Gastroenteritis in a child harboring a likely benign heterozygous variant of the NTRK2 gene

Convulsions in the context of mild diarrhea were first described in 1982 by Morooka K. There is a description of seasonal, etiological and age distribution of cases. The role of genetic involvement in the mechanism of CwG is not yet well understood. In this report we present a case of a 3-year-old boy with convulsions with mild gastroenteritis and “de novo” heterozygous variant in NTRK2 gene that was classified as benign. The clinical context with developmental delay and dysmorphic features suggests, however, a possible genetic cause in this case. Further comprehensive re-evaluation of sequencing data, possibly with additional clinical information, is advised.

Yersinia enterocolitica Infection in Patients Undergoing Intermittent Hemodialysis

End-stage renal disease is the last stage of chronic kidney disease and affects more than 2 million patients worldwide. The infection-related hospitalization is an important cause of excess morbidity and mortality in this group of patients. Yersinia enterocolitica (YE) is one of the bacteria that hemodialysis (HD) patients can occasionally be infected with. The most common symptoms are fever and mild diarrhea, which is self-limited. However, in HD patients, especially in iron overloaded cases, severe watery or bloody diarrhea can occur. The consumption of undercooked food by patients should sensitize the physician to the possibility of YE infection. Clinically, YE is difficult to diagnose due to nonspecific symptoms and the relatively low prevalence of yersiniosis, compared to other causative pathogens in dialysis patients. There is little information about yersiniosis in HD patients. For this reason, this review aims to summarize the current knowledge on YE infection in HD patients, with the main objective of expounding the problems in identifying, diagnosing, and treating yersiniosis in HD patients.

Diarrhea in Farmed White-tailed Deer Fawns

Diarrheal diseases, commonly called scour, are common in newborn ruminant farm animals including deer fawns. The clinical presentation can range from mild diarrhea without systemic disease to profuse, acute diarrhea associated with rapid dehydration and death, sometimes within hours of onset. Determining the particular agents associated with an outbreak of diarrhea is important for both prevention and treatment. This 5-page fact sheet written by Juan M. Campos Krauer and Samantha M. Wisely and published by the UF/IFAS Department of Wildlife Ecology and Conservation focuses on disease in fawns caused by pathogenic types of Escherichia coli, describes the pathogens and how they infect fawns, and includes advice about treatment and prevention.https://edis.ifas.ufl.edu/uw463

Clinical manifestation of norovirus infection in children aged less than five years old admitted with acute diarrhea in Surabaya, Indonesia: a cross-sectional study

Background: The objective of this study was to investigate the clinical manifestation of norovirus infection between norovirus genogroup and severity of acute diarrhea in pediatric patients at the Dr. Soetomo Hospital, Surabaya, Indonesia. Methods: This cross-sectional study involved 31 participants aged 1-60 months admitted to the hospital with acute diarrhea from April 2012 to March 2013. Norovirus genogroups (GI and II) were identified from patient stool using reverse transcription polymerase chain reaction (RT-PCR). Severity was measured using the Ruuska and Vesikari scoring system. Results: In total, 94 stool samples were obtained, of which 31 (19%) were norovirus positive. Norovirus GI was found in one sample with mild diarrhea. Norovirus GII was found in 30 samples (96.8%); one sample with mild diarrhea (3.3%), 20 samples with moderate diarrhea (66.7%), and nine samples with severe diarrhea (30%). Conclusion: Norovirus GII was the most prevalent cause of acute diarrhea and 30% of the cases manifested as severe diarrhea.

Ocena aktywności biologicznej cynamonu w badaniach in vivo

Cinnamon, the bark of different species of cinnamon, is a food spice used all over the world. In medicine, cinnamon is recommended for dyspeptic conditions, fullness and flatulence, for symptomatic treatment of mild diarrhea and for the support of diabetes treatment. Cinnamon contains essential oil, whose main active ingredient is cinnamaldehyde, as well as procyanidins and terpenes. The paper presents the results of experiments performed on animals with induced diabetes assessing the antidiabetic activity of the extract, cinnamon bark oil and cinnamaldehyde. They are also described regarding spasmolytic, analgesic and cardiovascular stimulating activity.