Microbiological surveillance of emerging and reemerging bacterial enteropathogens in Cuba
Keywords:
Vibrio cholerae, Vibrio cholerae O1, Escherichia coli, Aeromonas, Plesiomonas, epidemiological monitoring, Cuba.Abstract
Introduction: Microbiological surveillance and epidemiological control of acute diarrheal diseases caused by contaminated water and food are particularly important in developing countries. Shortages of clean water, poor sanitation systems, armed conflicts, natural phenomena, and migration generally cause extreme situations, that trigger epidemic outbreaks.
Objective: Summarize the diagnostic strategies developed at the National Reference Laboratory for Acute Diarrheal Diseases of the Pedro Kourí Tropical Medicine Institute for the diagnostic confirmation of emerging and re-emerging bacterial enteropathogens and their results.
Development: A compilation was made of the strategies developed for the diagnostic confirmation of emerging and re-emerging enterobacterial agents, as well as the real-time reporting of important health events caused by them in Cuba. The algorithms for microbiological surveillance as well as for phenotypic, molecular and genetic characterization were described. These algorithms were used in four studies related to the confirmation of bacterial enteropathogens as causative agents of outbreaks in Cuba from 1998 to 2015. The results led to the first national and international reports of new Plesiomonas sp. serogroups: O93, O94, O95, and O96; Plesiomonas sp. serotypes: O17:H11; O11:H2; O23:H1a1c, and O57:H3; diarrheagenic E. coli pathotypes: STEC O157:H7; and the prototype of the 7th pandemic: V. cholerae O1, serotype Ogawa, biotype El Tor.
Conclusions: The effectiveness of the employed strategy was confirmed with the implementation of conventional diagnostic techniques, molecular epidemiology and genomic methods. Greater depth, scope, coverage and immediacy in the results were achieved. This presupposes the new paradigm of international certification of results in the face of these types of events with an impact on public health.
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