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      Adenitis mesentérica por Yersinia enterocolítica

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          Abstract

          Resumen Se presenta por primera vez en nuestro país un caso de adenitis mesentérica en una niña de 3 años asociado a infección por Yersinia enterocolítica. La cepa recuperada del coprocultivo correspondió al bioserotipo patogénico 4/O:3 y presentó además el plásmido de virulencia.

          Translated abstract

          Résumé Pour la première fois dans notre pays, on présente un cas d’adénite mésentérique chez une petite fille de 3 ans associée à infection par Yersinia enterocolitica. La cèpe récupérée de la coproculture correspond au biosérotype pathogénique 4/O:3, et présente d’ailleurs le plasmide de virulence.

          Translated abstract

          Summary The first case of mesenteric adenitis in our country was reported in a 3-year old girl infected by Yersinia enterocolítica. A stool culture was obtained and we recovered pathogenic bioserotype 4/O:3 strains, having also found virulence plasmid.

          Translated abstract

          Resumo Descreve-se pela primeira vez no Uruguai um caso de adenite mesentérica. A paciente era uma menina de 3 anos de idade e a adenite estava associada a uma infecçao por Yersinia enterocolítica. A cepa recuperada do coprocultivo correspondia ao sorotipo patogênico 4/O:3, apresentando também o plasmidio de virulência.

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          The virulence plasmid of Yersinia, an antihost genome.

          The 70-kb virulence plasmid enables Yersinia spp. (Yersinia pestis, Y. pseudotuberculosis, and Y. enterocolitica) to survive and multiply in the lymphoid tissues of their host. It encodes the Yop virulon, an integrated system allowing extracellular bacteria to disarm the cells involved in the immune response, to disrupt their communications, or even to induce their apoptosis by the injection of bacterial effector proteins. This system consists of the Yop proteins and their dedicated type III secretion apparatus, called Ysc. The Ysc apparatus is composed of some 25 proteins including a secretin. Most of the Yops fall into two groups. Some of them are the intracellular effectors (YopE, YopH, YpkA/YopO, YopP/YopJ, YopM, and YopT), while the others (YopB, YopD, and LcrV) form the translocation apparatus that is deployed at the bacterial surface to deliver the effectors into the eukaryotic cells, across their plasma membrane. Yop secretion is triggered by contact with eukaryotic cells and controlled by proteins of the virulon including YopN, TyeA, and LcrG, which are thought to form a plug complex closing the bacterial secretion channel. The proper operation of the system also requires small individual chaperones, called the Syc proteins, in the bacterial cytosol. Transcription of the genes is controlled both by temperature and by the activity of the secretion apparatus. The virulence plasmid of Y. enterocolitica and Y. pseudotuberculosis also encodes the adhesin YadA. The virulence plasmid contains some evolutionary remnants including, in Y. enterocolitica, an operon encoding resistance to arsenic compounds.
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            Yersinia enterocolitica: the charisma continues.

            Yersinia enterocolitica, a gram-negative coccobacillus, comprises a heterogeneous group of bacterial strains recovered from animal and environmental reservoirs. The majority of human pathogenic strains are found among distinct serogroups (e.g. O:3, O:5,27, O:8, O:9) and contain both chromosome- and plasmid (60 to 75 kb)-mediated virulence factors that are absent in "avirulent" strains. While Y. enterocolitica is primarily a gastrointestinal tract pathogen, it may produce extraintestinal infections in hosts with underlying predisposing factors. Postinfection sequelae include arthritis and erythema nodosum, which are seen mainly in Europe among patients with serogroups O:3 and O:9 infection and HLA-B27 antigen. Y. enterocolitica is acquired through the oral route and is epidemiologically linked to porcine sources. Bacteremia is prominent in the setting of immunosuppression or in patients with iron overload or those being treated with desferrioxamine. metastatic foci following bacteremia are common and often involve the liver and spleen. Of particular concern is blood transfusion-related bacteremia. Evidence has accumulated substantiating the role of Y. enterocolitica as a food-borne pathogen that has caused six major outbreaks in the United States. The diagnosis of Y. enterocolitica gastroenteritis is best achieved through isolation of the bacterium on routine or selective bacteriologic media. When necessary, serogrouping, biogrouping, and assessment for plasmid-encoded virulence traits may aid in distinguishing virulent from "avirulent" strains. Epidemiologically, outside of identified food-borne outbreaks, the source (reservoir) of Y. enterocolitica in sporadic cases is speculative. Therefore, prevention and control measures are difficult to institute.
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              Etiology of children's diarrhea in Montevideo, Uruguay: associated pathogens and unusual isolates.

              We studied microorganisms associated with infant diarrhea in a group of 256 children admitted to a public pediatric hospital in Montevideo, Uruguay. Diagnostic procedures were updated to optimize detection of potential pathogens, which were found in 63.8% of cases, and to be able to define their characteristics down to molecular or antigenic type. Coinfection with two or more agents was detected in more than one-third of positive studies. Escherichia coli enteric virotypes, especially enteropathogenic E. coli (EPEC), were shown to be prevalent. Rotavirus, Cryptosporidium, Campylobacter (mainly Campylobacter jejuni), and Shigella flexneri were also often identified. Enterotoxigenic E. coli, Salmonella, and Giardia lamblia were sporadically recognized. Unusual findings included two enteroinvasive E. coli strains, one Shigella dysenteriae 2 isolate, and a non-O:1 Vibrio cholerae culture. EPEC bacteria and S. flexneri (but not Salmonella) showed unusually frequent antimicrobial resistance, especially towards beta-lactam antibiotics, which is the subject of ongoing work.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                rmu
                Revista Médica del Uruguay
                Rev. Méd. Urug.
                Sindicato Médico del Uruguay (Montevideo )
                1688-0390
                December 2007
                : 23
                : 4
                : 383-386
                Affiliations
                [1 ] Universidad de la República Uruguay
                [2 ] Universidad de la República
                Article
                S1688-03902007000400007
                acd674d0-2cd7-4d35-9494-73b7b3490789

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

                History
                Product

                SciELO Uruguay

                Self URI (journal page): http://www.scielo.edu.uy/scielo.php?script=sci_serial&pid=1688-0390&lng=en
                Categories
                MEDICAL LABORATORY TECHNOLOGY
                MEDICINE, GENERAL & INTERNAL
                MEDICINE, LEGAL
                MEDICINE, RESEARCH & EXPERIMENTAL
                ONCOLOGY
                SURGERY

                Oncology & Radiotherapy,Social law,Medicine,Surgery,Clinical chemistry,Internal medicine
                YERSINIA ENTEROCOLITICA,MESENTERIC LYMPHADENITIS.,YERSINIA INFECTIONS.,PLASMIDS,VIRULENCE,CHILD, PRESCHOOL,LINFADENITIS MESENTÉRICA.,YERSINIOSIS,YERSINIA ENTEROCOLÍTICA,PLÁSMIDOS,VIRULENCIA,PREESCOLAR

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