Resumen En 1909, Carlos Justiniano Chagas describió por primera vez las manifestaciones clínicas de la enfermedad de Chagas. El parásito hemoflagelado Trypanosoma cruzi (agente) se caracteriza por la presencia de un flagelo, y en su citoplasma presenta organelos como el citostoma, los glicosomas, los reservosomas y un núcleo. El ciclo de vida de T. cruzi se inicia cuando el vector defeca sobre la piel del hospedero sus heces contienen tripomastigotes metacíclicos, que infectan las células del vertebrado. Los vectores de esta enfermedad pertenecen a la Subfamilia Triatominae, insectos hematófagos, nocturnos y con la capacidad de localizar a sus hospederos mediante la detección del calor. T. cruzi tiene efectos en la biología del insecto triatomino, en su comportamiento, en el funcionamiento del intestino, su sistema inmunológico y la microbiota asociada. En el hospedero mamífero, el parásito activa la respuesta inmune innata, y las citocinas tienen un papel clave para controlar la infección o bien evolucionar a la cronicidad. T. cruzi presenta una amplia diversidad genética, y bajo condiciones de laboratorio se han demostrado sus diferentes grados de virulencia y tropismo hacia los órganos blanco; sin embargo, no existe una asociación clara entre las cepas y el comportamiento clínico de la enfermedad. Esta revisión aborda la historia del descubrimiento de la enfermedad de Chagas y discute aspectos recientes sobre la biología de T. cruzi para comprender la dinámica de su transmisión.

Abstract In 1909, Carlos Justiniano Chagas first described the clinical manifestations of Chagas disease. The hemoflagellate parasite Trypanosoma cruzi (agent) is characterized by the presence of a flagellum and of a cytostome, glycosomes, reservosomes, and a nucleus in its cytoplasm. The life cycle of T. cruzi begins when a vector defecates on the skin of a host; the feces contain metacyclic trypomastigotes, which infect vertebrate cells. The vectors of this disease are members of the subfamily Triatominae, nocturnal, hematophagous insects capable of locating hosts by heat detection. T. cruzi infection has effects on the biology of the triatomine insect, its behavior, gut function, immune system, and associated microbiota. In the mammalian host, the parasite activates innate immune responses, and host cytokines are key to either control the infection or progress to chronicity. T. cruzi exhibits a wide genetic diversity, and while it has been proved under laboratory conditions to show varying degrees if virulence and organ tropism, no clear association has been found between specific strains and the clinical picture of the disease. This review addresses the history of the discovery of Chagas disease and discusses recent aspects of T. cruzi biology that provide insight into the dynamics of transmission.

Abstract Mexico is a country endemic for Chagas disease in which two thirds of the territory can be considered at risk of vector-borne infection. This means that 1.1 million people could be infected with Trypanosoma cruzi and 29.5 million at risk of infection. Dwelling characteristics of poverty in these rural areas linked with biological conditions, lifestyle, environmental and sociocultural factors are important in the morbidity and mortality of the disease. Nowadays, the screening for the parasite is mandatory and at least 92% of blood banks are covered. The inadequate knowledge of the disease by the health personnel and the population limits the possibility of the diagnosis. The acute phase of the disease courses undetected. The main affected organ in Chagas disease is the heart, with a slow evolution; the pathogenesis of chronic cardiomyopathy is complex and lesions occur mainly in the autonomic nervous system and myocardium leading to disturbances in the conductivity and contractility of the organ. The main pathogenic mechanisms involved in the development of the disease are described.

Resumen México es un país endémico para la enfermedad de Chagas, donde dos terceras partes del territorio pueden ser consideradas en riesgo de transmisión vectorial, es decir que 1’100,000 individuos podrían estar infectados con Trypanosoma cruzi y 29’500,000 en riesgo de contraer la infección. En la morbimortalidad del padecimiento son importantes las características de la vivienda, condiciones biológicas, ambientales y factores socioculturales. El tamizaje en bancos de sangre, a la fecha, es de observancia obligatoria con una cobertura mayor al 92%. El diagnóstico no se establece frecuentemente debido al desconocimiento de la enfermedad por parte del personal de salud y de la población. La fase aguda generalmente pasa desapercibida y en la crónica, la patología se presenta principalmente en el corazón, con evolución lenta. La patogénesis de la miocardiopatía crónica es muy compleja y se presentan lesiones con mayor frecuencia en el sistema nervioso autónomo y miocardio, lo que genera trastornos en la conductibilidad y contractilidad del órgano. Se describen los principales mecanismos patogénicos implicados en el desarrollo de la enfermedad.

Fifty four strains of Aeromonas spp were isolated from patients with acute diarrheic episodes by using Aerokey II and Aeroesquema methods. In vitro antimicrobial susceptibility and virulence factors were analyzed. The most frequently isolated specie was Aeromonas caviae. Over 75% of strains exhibited resistance to penicillins and ce-phalosporins; for the other antibiotic groups resistance was under 20%. Twenty six strains (48.1 %) were multiresist-ant. At least one virulence factor among those evaluated in the study was present in 53 (98.1%) of the 54 strains.

Se identificaron 54 cepas de Aeromonas aisladas de pacientes con enfermedad diarreica aguda mediante los métodos Aerokey II y Aeroesquema. Se determinó la susceptibilidad antimicrobiana y algunos factores de virulencia. La especie encontrada en mayor frecuencia fue Aeromonas caviae. Se observaron valores de resistencia por sobre 75% para penicilinas y cefalotina; para el resto de los antimicrobianos estos valores se encontraron bajo 20%>; 26 cepas (48,1%) presentaron multi-resistencia. Al menos un factor de virulencia de los investigados estuvo presente en 53 (98,1%) de las 54 cepas analizadas.

INTRODUCTION: the acute diarrheal diseases are one of the main causes of morbidity and mortality in children aged under 5 years and in the general population; this demands a great deal of care in the healthcare services. The situation worsens due to the overuse of antimicrobials and the development of bacterial resistance, being the latter an emerging health problem in different areas of the world. Among the causative microorganisms of acute diarrheal diseases are those of Aeromonas genus, recognized as second risk emerging pathogens. OBJECTIVES: to determine the most frequently isolated Aeromonas species in fecal samples from acute diarrheal patients and their antimicrobial susceptibility. METHODS: the Bauer-Kirby´s method allowed identifying the susceptibility to several antimicrobials of 100 isolated samples coming from the provincial hygiene and epidemiology centers during 2007 and 2008. RESULTS: identification of the species was accomplished in 67% of isolates, being A. caviae (33 %) y A. hydrophila (29 %) the predominant species. It was demonstrated that 100% of isolates got resistant to at least one of the studied antimicrobials. Drug resistance to cefalotine, sulfonamides and nalidixic acid showed the highest percentages. CONCLUSIONS: tetracycline and chloramphenicol are recommended as the drugs of choice for treating intestinal infections caused by these microorganisms in Cuba.

INTRODUCCIÓN: las enfermedades diarreicas agudas constituyen una de las principales causas de morbilidad y mortalidad en los niños menores de 5 años y en la población general, esto ocasiona una gran demanda de atención en los servicios de salud. La situación se agrava por el abuso de los antimicrobianos y el desarrollo de resistencia bacteriana, suceso que hoy día constituye un problema emergente de salud en diversas regiones del mundo. Entre los microorganismos causantes de enfermedades diarreicas agudas se encuentran los pertenecientes al género Aeromonas, los cuales han sido reconocidos como patógenos emergentes de riesgo II. OBJETIVOS: determinar las especies de Aeromonas más frecuentemente aisladas a partir de muestras de heces de pacientes con enfermedades diarreicas agudas y su susceptibilidad antimicrobiana. MÉTODOS: se determinó la susceptibilidad mediante el método de Bauer-Kirby frente a diferentes antimicrobianos a 100 aislamientos remitidos desde los centros provinciales de higiene y epidemiología del país durante 2007-2008. RESULTADOS: En 67 % de los aislamientos se logró la identificación hasta especie, se observó el predominio de A. caviae (33 %) y A. hydrophila (29 %). Se demostró que 100 % de los aislamientos resultaron resistentes al menos a un antimicrobiano de los investigados. El porcentaje más elevado de resistencia se observó frente a la cefalotina, las sulfonamidas y el ácido nalidíxico. CONCLUSIONES: se propone a la tetraciclina y el cloranfenicol como fármacos de elección para el tratamiento de las infecciones intestinales producidas por estos microorganismos en Cuba.

Los transmisores de Trypanosoma cruzi, flagelado causante de la enfermedad, se dividen en intradomiciliados, peridomiciliados y silvestres. Entre los intradomiciliados se encuentran, Triatoma barberi y Triatoma dimidiata, que son los que representan un mayor riesgo para la Salud Pública, en México. Aunque Triatoma dimidiata se encuentra principalmente dentro de la vivienda, en Yucatán tiene un comportamiento peridomiciliar, dentro de este grupo se encuentran la mayoría de los transmisores de la enfermedad de Chagas Meccus longipennis, M. mazzottii, M. pallidipennis, M. phyllosomus, M. picturatus, Triatoma gerstaeckeri, T. mexicana, T. rubida, Dipetalogaster máxima, Panstrongylus rufotuberculatus y Rhodnius prolixus. Los transmisores peridomiciliados son de menor riesgo en la dinámica de transmisión comparados con los intradomiciliados. Para el control de los transmisores intradomiciliados, se deben emplear programas de educación para la salud, mejoramiento de vivienda e insecticidas; mientras que para los vectores visitantes o peridomiciliados, son necesarios programas de educación para la salud, uso de mosquiteros, pabellones y cementación de las bardas de piedra.

Vectors of Trypanosoma cruzi, parasite responsible for Chagas disease, are divided in intradomestic, peridomestic and sylvatic. The intradomestic are Triatoma barberi and Triatoma dimidiata, two species that represent the highest health risk among the Mexican population. Triatoma dimidiata is a species found mainly inside human habitats, but in Yucatan, it corresponds to the peridomicile vectors. Also in the peridomicile most of Chagas disease vectors are found: Meccus bassolsae, M. longipennis, M. mazzottii, M pallidipennis, M. phyllosomus, M picturata, Triatoma gerstaeckeri, T mexicana, T rubida, Dipetalogaster máxima (the last two are in the process of becoming adapted to the domicile), Panstrongylus rufotuberculatus which occasionally enters the domicile in its adult stage, and Rhodnius prolixus, which is practically controlled in the country. Peridomestic vectors are of lower risk in the transmission dynamics, as compared to the intradomestic ones. For the control of the intradomestic vectors, health education programs, improvements of housing, and the use of pesticides are essential To control the peridomestic vectors, health education programs are required, as well as the use of mosquito nets on doors and windows and around beds, aside from cementing the stone wall fences.

Objective: To compare the left ventricular function and the ventricular synchrony in patients with Chagas disease in latency stage respect to a control group. Methods: We analyze a prospective, comparative, transversal and non randomized study of the left ventricular function (LVF) and the ventricular contraction synchronicity (VCS) in 36 subjects with positive serology for Chagas disease (18 males and 18 females), with mean of 15 ± 5 years old. The findings were compared with respect to 23 control volunteers (11 males and 12 females) with mean of 28 ± 5 years old. LVF and VCS were evaluated using equilibrium radionuclide angiography images (ERNA). The comparison of both Chagas and control populations was carried out by t Student test for independent samples, considering a statistically significant value of p < 0.05. Results: The parameters of the ventricular function and the ventricular synchronicity in subjects with positive serology for Chagas disease were not statistically different with respect to the parameters of the control group. However, although they have a homogeneous contraction, the mean time of contraction for the right and the left ventricle is statistically smaller with respect to the control group. Conclusions: In clinically incipient stages of Chagas disease we do not found abnormalities in the ventricular function and the ventricular synchronicity. It's necessary to consider the follow up of the studied populations using indices for the identification of abnormalities of the autonomic nervous system.

Objetivo: Comparar la función ventricular izquierda y la sincronía de la contracción ventricular en un grupo de sujetos con enfermedad de Chagas en estadio de latencia respecto a un grupo de individuos control. Método: Se realizó un estudio prospectivo, transversal, comparativo y no aleatorio de la función ventricular izquierda (FVI) y la sincronía de la contracción ventricular (SCV) en 36 personas con serología positiva de enfermedad de Chagas (18 varones y 18 mujeres) cuya edad promedio fue de 15 ± 5 años. Los hallazgos se compararon respecto a un grupo de 23 voluntarios considerados normales (11 varones y 12 mujeres) con edad promedio de 28 ± 5 años. La FVI y la SCV fueron evaluadas mediante la modalidad de imagen denominada ventriculografía radioisotópica en equilibrio (VRIE). Para comparar las poblaciones se utilizó la prueba estadística t de Student para muestras independientes, y se consideró un valor de significancia de p < 0.05. Resultados: Los parámetros utilizados para evaluar la FVI y la SCV en los sujetos con serología positiva para enfermedad de Chagas no fueron diferentes desde el punto de vista estadístico a los calculados para los sujetos control. Sin embargo, aunque la contracción es homogénea, el tiempo promedio en que se realiza la contracción del ventrículo derecho (VD) y del ventrículo izquierdo (VI) sí es menor estadísticamente respecto al grupo de sujetos control. Conclusiones: En estadios clínicamente incipientes de la enfermedad de Chagas no se detectaron anormalidades en la FVI ni signos de asincronía interventricular o intraventricular. Es necesario realizar el seguimiento de la población estudiada con índices que permitan identificar anormalidades en el sistema nervioso autónomo.

Several biological parameters related to the Triatoma mexicana life-cycle were evaluated in this study. Three cohorts were maintained under different combinations of temperature and relative humidity (RH): 25ºC/50% RH; 25ºC/75% RH; and 30ºC/75% RH. Observed hatching rates varied from 49-57.5% whereas the average time of hatching varied from 19.5-22.7 days. In the three cohorts studied, the mean time-lapse between presentation of the blood meal and the beginning of feeding was less than 5 min in all instars; the mean feeding time was longer than 10 min in all the instars; the post-feed defecation delay was over 10 min in all the instars. Less than 50% of nymphs in each cohort completed the cycle and the average time from 1st instar nymph to adult was more than 255 days for the three cohorts. The number of blood meals before molt at each nymphal instar varied from 1-9. Our results appear to indicate a lack of influence of temperature and RH on the biological parameters of T. mexicana that were studied, which could reflect the adaptation capacity of this species. We also conclude that T. mexicana can not be considered an effective transmitter of Trypanosoma cruzi to human populations in areas where this species is currently present.

Objective: A study was carried out in Aeromonas strains isolated from patients with acute diarrheas in Cuba to find out the phenotypical expression of the cytotoxin and the enterotoxin as virulence factors. Methods: Forty six strains of the genus Aeromonas (A. hydrophila, A. veronii bv sobria, A. caviae, A. veronii bv veronii and Aeromonas spp.) isolated from stool specimens taken form patients with acute diarrheal disease were studied from 2005 to 2006. All the strains had their pattern of antimicrobial susceptibility pattern identified. The phenotypic expression of the cytotoxin and the enterotoxin in the Vero cell line was checked. Results: It was demonstrated that 91,31 % of the strains showed cytotoxic activity and 43,48 % of them enterotoxic activity. Regarding multiresistant strains, 93,75 % presented with at least one of the studied virulence factors. Conclusions: these results proved that the two researched virulence factors did exist in the studied strains, thus contributing to the many efforts that are being made to learn about the mechanisms of enteropathogenicity of this bacterial genus.

Objetivo: se realizó un estudio en cepas de Aeromonas aisladas de pacientes con enfermedad diarreica aguda en Cuba, para conocer la expresión fenotípica de la citotoxina y la enterotoxina como factores de virulencia. Métodos: se investigaron 46 cepas (A. hydrophila, A. veronii biovar sobria, A. caviae, A. veronii biovar veronii y Aeromonas spp.), aisladas de heces de pacientes con enfermedad diarreica aguda, en el período comprendido entre 2005 y 2006. Todas las cepas tenían identificado su patrón de susceptibilidad antimicrobiana. Se comprobó la expresión fenotípica de la citotoxina y la enterotoxina en la línea celular Vero. Resultados: el estudio demostró que 91,31 % de las cepas mostraron actividad citotóxica y 43,48 % actividad enterotóxica. De las cepas multirresistentes, 93,75 % presentó al menos un factor de virulencia estudiado. Conclusiones: los resultados demostraron que los 2 factores de virulencia investigados estuvieron presentes en las cepas estudiadas, contribuyendo así a los múltiples esfuerzos que se realizan para conocer los mecanismos de enteropatogenicidad de este género bacteriano.

Triatoma mexicana was described by Herrich-Schaeffer in 1848. In 1940, a male specimen was found in Hidalgo. In 1970, this species was recorded in the state of Queretaro. Later, it was registered in Guanajuato and San Luis Potosi. In the present paper we performed an investigation in 545 dwellings from three counties in the state of Guanajuato, Mexico, from March 2003 to May 2004. The search and capture of triatomines were seasonally performed indoors and outdoors. Entomological indexes were calculated. The risk and no risk relations between triatomine presence and housing construction materials were analyzed. Fourteen triatomines were collected indoors and 151 outdoors. The vectors were collected in houses built with either risky and non-risky materials. Adults go indoors but do not settle there, hence, no relationship was found between the building materials and infestation of houses. Conventional interventions like house improvement or insecticide spraying are not efficient for the control of T. mexicana, because its developmental cycle is accomplished outdoors in the area surrounding the houses.

Extraintestinal infections caused by the genera Aeromonas, Vibrio and Plesiomonas have high morbidity and mortality rates in different areas of world. From January 2002 to December 2003, the National Reference Laboratory for Acute Diarrhoeal Diseases of the Pedro Kourí Tropical Medicine Institute received 95 gramnegative, facultative anaerobic, oxidase positive bacilli strains from different extraintestinal specimen (blood, ear exudates, infected wounds, conjunctive exudates, urine, and catheters, among others) sent by different provincial laboratories along the country. Aeromonas caviae, Aeromonas veronii bv sobria, Aeromonas jandaei, Vibrio cholerae no-O1, Vibrio vulnificus, Vibrio fluvialis and Plesiomonas shigelloides were the species most frequently found in the sample analysed

Las infecciones extra-intestinales producidas por los géneros Aeromonas, Vibrio y Plesiomonas presentan una elevada tasa de morbimortalidad en diferentes áreas geográficas. De enero 2002 a diciembre 2003 se recibieron en el Laboratorio Nacional de Referencia de Enfermedades Diarreicas Agudas del Instituto de Medicina Tropical Pedro Kourí, 95 cepas de bacilos gramnegativos, anaerobios facultativos, oxi-dasa positiva, procedentes de muestras extra-intestinales (hemocultivos, exudados óticos, pus de heridas, exudados conjuntivales, urocultivos, catéter, entre otras) remitidas de diferentes provincias del país. Se demostró la presencia de Aeromonas caviae, Aero-monas veronii bv sobria, Aeromonas jandaei, Vibrio cholerae no -O1, Vibrio vulnificus, Vibrio fluvialis y Plesiomonas shigelloides en las muestras estudiadas

A case of waterborne otitis in a patient with AIDS was report, who got infected with Vibrio fluvialis by swimming in a pool sea water. This is the first case reported in Cuba and as far as we know in the world. We describe the clinical features associated with this an unusual case and discuss its significance.

Observations made in the field and in the laboratory on three vectors of Trypanosoma cruzi: Triatoma barberi, T. pallidipennis and T. dimidiata are here presented. Results are compared in relation with their ecotopes, vectorial capacity, biological characteristic, entomological indexes and capture places. In relation with their ecotopos T. barberi has preference for the interior of the human home, in walls, directly in contact with beds; T. pallidipennis, when it is inside the houses, prefers floors and among clothes, although their main ecotope is wild; T. dimidiata has localization in floors, specially under the beds, in the angle between wall and floor; T. barberi and T. dimidiata are attracted by the light. The cycles of life were of 523, 171 and 510 days, respectively for Triatoma barberi, T. pallidipennis and T. dimidiata. The vectorial capacity was determined according to the time taken in defecating during or after its sucking blood: T. barberi defecates during its feeding, while T. pallidipennis and T. dimidiata make it from 10 to 20 and of 20 to 30 minutes after starting the process, respectively. The indexes of natural infection were of 56.6 for T.barberi, 29 for T.pallidipennis and 15.6 for T. dimidiata, The metacyclogenics indexes that indicate percentages of metacyclics trypomastigotes in later intestine of vectors was in T. barberi 76.6, T. pallidipennis 15 and T. dimidiata 26, with what it can be concluded that the first species is the best transmitter of T. cruzi in Mexico.

Se presentan observaciones hechas en el campo y en el laboratorio sobre tres vectores de Trypanosoma cruzi: Triatoma barberi, T. pallidipennis y T. dimidiata. Se comparan resultados en relación con sus ecotopos, capacidad vectorial, características biológicas, índices entomológicos y sitios de captura. En relación con sus ecotopos, T. barberi tiene preferencia por el interior del domicilio humano, en paredes, directamente en contacto con las camas; T. pallidipennis, cuando se encuentra dentro de las casas, prefiere pisos y entre la ropa, aunque su principal ecotopo es silvestre; T. dimidiata tiene localización en pisos, especialmente bajo las camas, en el ángulo entre pared y piso; T. barberi y T. dimidiata son atraídas por la luz. Los ciclos de vida fueron de 523, 171 y 510 días, respectivamente para Triatoma barberi, T. pallidipennis y T. dimidiata. La capacidad vectorial se determinó según el tiempo que tarda en defecar durante o después de su ingesta de sangre: T. barberi defeca durante su alimentación, mientras que T. pallidipennis y T. dimidiata lo hacen de 10 a 20 y de 20 a 30 minutos después de iniciado el proceso, respectivamente. Los índices de infección natural fueron de 56.6 para T.barberi, 29 para T. pallidipennis y 15.6 para T. dimidiata. Los índices metaciclogénicos, que indican porcentajes de tripomastigotes metacíclicos en intestino posterior de los vectores fueron en T. barberi 76.6, T. pallidipennis 15 y T. dimidiata 26, con lo que se concluye que la primera especie es el mejor transmisor de T. cruzi en México.

Three different interventions to control Triatoma dimidiata in the State of Veracruz were implemented: X-1 = whole dwelling spraying, X-2 = middle wall spraying, X-3 = household cleaning. Cyfluthrin was sprayed 3 times with 8 month intervals. After each spraying, insects were collected and sent to the laboratory to be recorded and to determine genus and species of the adult triatomine bugs, and nymphs were counted. Trypanosoma cruzi presence was determined. With X-1, the infestation, colonization, and natural infection indexes were reduced to 0% in the 3 localities, with respect to t0. With X-2, the infestation index was reduced to 10% at t3 in 3 localities; the colonization index was reduced to 0% in only 1 locality at t3, and the natural infection index was reduced to 0% at t3. With X-3 the 3 indexes were not effectively reduced but they decreased with respect to the baseline study. Insecticide application to the whole dwelling is a more efficient intervention than its application to only the lower half of the walls and to the cleaning of houses.

The antimicrobial susceptibility and the presence of a heat-stable toxin were researched into 100 Non-01 Vibrio cholerae strains sent by 7 different health centers to the National Reference Laboratory of Acute Diarrheal Diseases in "Pedro Kourí" Tropical Medicine Institute. The presence of 20% toxigen Non-01 Vibrio cholerae was detected, a figure substantially higher than that reported in other geographic areas, except for endemic areas. This result will make it possible to set epidemiological alert in Cuba because these strains can be infected by CTX phages (element transporting gens that encode for choleric toxin) which will give such strains an epidemic potential similar to that of the etiologic agent of cholera. The identified strains could be studied as possible cholera vaccine candidates.

Se investigó la susceptibilidad antimicrobiana y la presencia de toxina termoestable en 100 cepas de Vibrio cholerae No-01 remitidas de 7 diferentes centros de salud del país al Laboratorio Nacional de Referencia de Enfermedades Diarreicas Agudas del Instituto de Medicina Tropical "Pedro Kourí". Se demostró la presencia de 20 % Vibrio cholerae No-01 toxigénico, esta cifra resultó considerablemente más alta que la reportada en otras áreas geográficas, excepto en zonas epidémicas. Este resultado permitirá establecer una alerta epidemiológica en Cuba, pues estas cepas pueden ser infectadas por el fago CTX (elemento que transporta los genes que codifican para la toxina colérica); lo que les conferiría un potencial epidémico similar al del agente etiológico del cólera. Las cepas identificadas podrían estudiarse como posibles candidatas a la vacuna del cólera.

The antigenic structure and antimicrobial susceptibility were studied in 99 strains isolated from patients with acute diarrhea (6 strains from an outbreak of digestive transmission disease in Santiago de Cuba) and a strain isolated from a patient who died from infections neurological syndrome (INS, meningitis). Four new serotypes (093, 994, 095, 096), wich had not been described in the world clasification, were identified from the Cuban isolated strains and were included in the International Serotyping Scheme by the International Reference Center located in Prague, Czeck Republic. For the first time in Cuba, the circulation of serotypes 017.H11, 011: H2, 023. H1a1c, 057: H3 which show cross reaction to Shiguella species was proved. Those strains from the outbreak of digestive disease belonged to serotype 050: H11 and had a thermostable toxin. The first case of infectious neurologic syndrome with Plesionomas shigelloides etiology reported in Cuba was described; the strain corresponded to serotype 050: H11. The worldwide reported pattern of antimicrobial resistance was demostrated.

Se investigó la estructura antigénica y la susceptibilidad antimicrobiana en 99 cepas aisladas de pacientes con enfermedad diarreica aguda (6 procedentes de un brote de enfermedad de transmisión digestiva en Santiago de Cuba) y en una cepa aislada de un paciente fallecido por síndrome neurológico infeccioso (SNI, meningitis). Se identificaron de las cepas cubanas aisladas 4 nuevos serotipos no descritos con anterioridad en la clasificación mundial (093, 094, 095, 096) los que fueron incluidos en el Esquema de Serotipaje Internacional, por el Centro de Referencia Internacional, Praga, República Checa. Se demostró por primera vez en Cuba la circulación de los serotipos 017: H11, 011: H2, 023: H1a1c, 057: H3 que presentan reacción cruzada con el género Shigella. Las cepas procedentes del brote de enfermedad de transmisión digestiva correspondieron al serotipo 050: H11, en ellas se evidenció la presencia de toxina termoestable. Se describió el primer caso reportado en Cuba de síndrome neurológico infeccioso con etiología a Plesiomonas shigelloides, la cepa correspondió al serotipo 050: H11. Se demostró el patrón de resistencia antimicrobiana reportado internacionalmente.