title: Impact of Aeromonas and diarrheagenic Escherichia coli screening in patients with diarrhea in Paraná, southern Brazil.
abstract: BACKGROUND
  A wide diversity of bacterial agents may cause diarrhea, presenting challenges to clinical laboratories to define a diagnosis. Considering that most stool cultures are negative, we screened stool samples from patients with diarrhea for the presence of 14 bacterial enteropathogens, aiming to establish which of them should be included in routine stool analysis.
  
  
  METHODS
  Stool samples from 400 patients with diarrhea were analyzed for the presence of Salmonella, Shigella, Campylobacter, Aeromonas, Plesiomonas shigelloides, Vibrio, Yersinia enterocolitica, and diarrheagenic Escherichia coli using conventional microbiological methods and PCR. Two distinct samples were studied; one included predominantly patients involved in outbreaks, and the other patients of low socioeconomic status presenting sporadic cases of diarrhea.
  
  
  RESULTS
  In total, 86 cultures (21.5%) were positive. Mixed infections were found in five patients, leading to recovery of 91 strains of enteropathogenic bacteria: Salmonella Enteritidis (9.2%), Aeromonas (7.2%), diarrheagenic E. coli (5.2%), and C. jejuni (1%). However, Salmonella predominated, with 11.5% frequency in diarrhea outbreaks, while Aeromonas predominated among patients of low socioeconomic status, with 14.6% frequency.
  
  
  CONCLUSIONS
  Aeromonas and diarrheagenic E. coli, which are not routinely screened for, deserve to be included in laboratory screening panels.
authors.affiliation: Universidade Federal do Paraná, Curitiba, PR, Brazil. flavia_emanoelli@hotmail.com.
authors.forename: Flávia E A
authors.initials: FE
authors.lastname: Assis
authors.forename: Suélen
authors.initials: S
authors.lastname: Wolf
authors.forename: Monica
authors.initials: M
authors.lastname: Surek
authors.forename: Fabiana
authors.initials: F
authors.lastname: De Toni
authors.forename: Emanuel M
authors.initials: EM
authors.lastname: Souza
authors.forename: Fábio O
authors.initials: FO
authors.lastname: Pedrosa
authors.forename: Sônia M S S
authors.initials: SM
authors.lastname: Farah
authors.forename: Geraldo
authors.initials: G
authors.lastname: Picheth
authors.forename: Cyntia M T
authors.initials: CM
authors.lastname: Fadel-Picheth
mesh_terms: D000328:Adult; D001431:Bacteriological Techniques; D001938:Brazil; D002648:Child; D002675:Child, Preschool; D003967:Diarrhea / Q000453:epidemiology* / Q000382:microbiology*; D004755:Enterobacteriaceae / Q000145:classification / Q000302:isolation & purification*; D004756:Enterobacteriaceae Infections / Q000453:epidemiology* / Q000382:microbiology*; D006801:Humans; D008403:Mass Screening; D016133:Polymerase Chain Reaction; D015995:Prevalence; D011446:Prospective Studies