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Diarrhea associated with Aeromonas species in children in day care centers
M L de la Morena1, R Van, K Singh
1Department of Pediatrics, University of Texas Medical School, Houston.
Insights
Aeromonas species, not previously linked to day care center (DCC) outbreaks, were identified as a cause of diarrhea in two DCC outbreaks. Chromosomal DNA analysis differentiated these Aeromonas strains effectively.
Area of Science:
- Microbiology
- Infectious Diseases
- Public Health
Background:
- Diarrheal outbreaks are common in day care centers (DCC).
- Aeromonas species are known enteropathogens but have not been previously implicated in DCC outbreaks.
- This study investigated the role of Aeromonas in pediatric diarrheal disease within DCC settings.
Purpose of the Study:
- To determine the association of Aeromonas species with diarrhea in children attending DCC.
- To characterize Aeromonas isolates from these outbreaks.
- To compare the utility of plasmid and chromosomal DNA profiling for differentiating Aeromonas strains.
Main Methods:
- Epidemiological investigation of 51 diarrheal outbreaks across four DCC.
- Isolation and identification of Aeromonas species from affected children.
- Plasmid DNA profiling and chromosomal DNA analysis (DNA fingerprinting) of Aeromonas isolates.
- Comparison with control Aeromonas strains from children with diarrhea in other locations.
Main Results:
- Aeromonas species were identified in two distinct DCC outbreaks, affecting 24% and 21% of children respectively.
- Aeromonas caviae was the predominant species identified (78% of isolates).
- Chromosomal DNA fingerprinting proved more effective than plasmid profiling in differentiating Aeromonas strains, with unique patterns observed for most isolates, including those from different geographic locations.
Conclusions:
- Aeromonas species, including multiple genospecies within single outbreaks, can cause diarrheal illness in day care center settings.
- Chromosomal DNA analysis is a valuable tool for distinguishing between Aeromonas strains.
- These findings highlight Aeromonas as an under-recognized pathogen in pediatric diarrheal outbreaks.
Abstract:
Outbreaks of diarrhea caused by enteropathogens have been reported in day care centers (DCC), but Aeromonas species have not been implicated. This study evaluated 381 children involved in 51 outbreaks in four DCC to determine the association of Aeromonas species with diarrhea and to characterize the isolates. The organism was identified in two outbreaks of diarrhea. In one, Aeromonas species were isolated from 6 (24%) of 25 children and in the other from 5 (21%) of 24 children. Seven other Aeromonas strains from children in DCC were studied. Fourteen (78%) of 18 were Aeromonas caviae and 15 were from children with diarrhea. Of the isolates, 75% did not have plasmids detected; all others had unique plasmid patterns. All strains had different DNA content. Twenty-two control isolates of Aeromonas from children with diarrhea in Mexico and Dallas had different chromosomal DNA patterns. Most Aeromonas infections were associated with symptoms. Chromosomal DNA patterns differentiated Aeromonas strains better than did plasmid DNA patterns. The outbreaks of diarrhea were unusual in that several different Aeromonas genospecies were involved in each outbreak.