Gletty Oropeza-Barrios (Costa Rica)
Instituto Costarricense de Investigación y Enseñanza en Nutrición y Salud LNCRIMAAuthor Of 1 Presentation
GENOMIC SURVEILLANCE AND CLINICAL CHARACTERISTICS OF CHILDREN WITH GASTROENTERITIS PRODUCED BY SHIGA TOXIN-PRODUCING ESCHERICHIA COLI IN COSTA RICA
Abstract
Backgrounds:
Shiga-toxin producing Escherichia coli (STEC) can cause mild to bloody diarrhea and Hemolytic Uremic Syndrome (HUS). The expansion whole-genome sequencing (WGS) allows to determine characteristics such as sequence-type and phylogenetic relationship. The National Children´s Hospital of Costa Rica is a tertiary referral hospital within the socialized medical care system. Here, we provide the results of the first genomic study of STEC in Costa Rica, based on a nationwide surveillance program.
Methods
Health records between 2015 and 2020 were reviewed for each patient using a standardized form to retrieve basic, demographic, microbiologic, molecular and clinical characteristics. All stool samples were analyzed by conventional culture techniques, automated antimicrobial susceptibility tests, end-point PCR and/or Filmarray GI Panel assays targeting STEC. WGS was performed using Illumina plattform. Bioinformatic analyses were performed using BioNumerics v7.6.3 software, SPAdes and BLAST. E. coli functional genotyping plugin v1.2 was used for prediction of virulence factors, antimicrobial resistance and O/H predictions. A dendrogram was constructed using the categorical values similarity coefficient and the unweighted pair group method with arithmetic mean (UPGMA). Geographical versus phylogenetic information was visualized using TreeTom.
Results:
29 out of 3768 (0,8%) diarrheal disease studies found STEC as causative agent. The most common features were: age less than 3 years (n=22;76%), bloody diarrhea (n=19;65%), eaeA gene (n=17;59%) stx1 gene (n=22;76%), sequence type ST17 (n=9;31%), serotype O118/O151:H2 (n=7;24%). Hospitalization was required for 6 patients (20%) and 2 developed SUH (7%).
Conclusions/Learning Points:
The first genomic study of STEC in Costa Rica provides valuable information about clinical, epidemiological and microbiological aspects of this disease in the pediatric population. The circulation of serotype O118/O151:H2 seems to be relatively high in comparison with other serotypes found. The HUS development among pediatric cases remain low.