Aeromonas-Associated Diarrhea in Children Under 5 Years: The GEMS Experience

Qamar, Farah Naz; Nisar, Imran; Quadri, Farheen; Shakoor, Sadia; Sow, Samba O.; Nasrin, Dilruba; Blackwelder, William C.; Wu, Yukun; Farag, Tamer H.; Panchalingham, Sandra; Sur, Dipika; Qureshi, Shahida; Faruque, Abu Syed Golam; Saha, Debasish; Alonso, Pedro L.; Breiman, Robert F.; Bassat, Quique; Tamboura, Boubou; Ramamurthy, Thandavarayan; Kanungo, Suman; Ahmed, Shahnawaz; Hossain, Ahmed; Das, Sumon Kumar; Antonio, Martín; Hossain, M. Jahangir; Mandomando, Inácio; Tennant, Sharon M.; Kotloff, Karen L.; Levine, Myron M.; Zaidi, Anita K. M.

doi:10.4269/ajtmh.16-0321

Cited by 33 publications

(19 citation statements)

References 17 publications

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“…We designed a strict analysis to identify bacterial taxa that behaved as outliers in individual patients. The analysis identified OTUs belonging to several genera, including Treponema, Proteus, Capnocytophaga, Campylobacter, Haemophilus, Aeromonas, and Pseudomonas, some of which were previously associated with gastroenteritis (2,9). Of interest, through this analysis, we identified one case of an enrichment of Arcobacter, a genus related to Campylobacter and previously associated with gastroenteritis (10), and at least one case related to Parvimonas, a bacterium associated with colorectal cancer and an array of extragastrointestinal diseases (11)(12)(13)(14).…”

Section: Discussionmentioning

confidence: 93%

Gut Microbiome Analysis Identifies Potential Etiological Factors in Acute Gastroenteritis

et al. 2018

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The morbidity and mortality resulting from acute gastroenteritis and associated chronic sequelae represent a substantial burden on health care systems worldwide. Few studies have investigated changes in the gut microbiome following an episode of acute gastroenteritis. By using nondirected 16S rRNA gene amplicon sequencing, the fecal microbiota of 475 patients with acute gastroenteritis was examined. Patient age was correlated with the overall microbial composition, with a decrease in the abundance of being observed in older patients. We observed the emergence of a potential-dominated enterotype in a subset of patients, and this enterotype was predicted to be more proinflammatory than the other common enterotypes, with the latter being dominated by or The increased abundance of did not appear to be associated with infection with an agent of a similar sequence similarity. Stool color and consistency were associated with the diversity and composition of the microbiome, with deviations from the norm (not brown and solid) showing increases in the abundances of bacteria such as and Analysis of enriched outliers within the data identified a range of genera previously associated with gastrointestinal diseases, including, ,, ,, ,, and Our data represent the first in-depth analysis of gut microbiota in acute gastroenteritis. Phenotypic changes in stool color and consistency were associated with specific changes in the microbiota. Enriched bacterial taxa were detected in cases where no causative agent was identified by using routine diagnostic tests, suggesting that in the future, microbiome analyses may be utilized to improve diagnostics.

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Section: Discussionmentioning

confidence: 93%

Gut Microbiome Analysis Identifies Potential Etiological Factors in Acute Gastroenteritis

et al. 2018

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“…Finally, several pathogens were not sought in the original study, notably enteric viruses and Aeromonas, which has been associated with stunting. 44 …”

Section: Discussionmentioning

confidence: 99%

Impact of Childhood Nutritional Status on Pathogen Prevalence and Severity of Acute Diarrhea

Tickell

Pavlinac

John‐Stewart

et al. 2017

The American Journal of Tropical Medicine and Hygiene

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Abstract.Children with acute and chronic malnutrition are at increased risk of morbidity and mortality following a diarrheal episode. To compare diarrheal disease severity and pathogen prevalence among children with and without acute and chronic malnutrition, we conducted a cross-sectional study of human immunodeficiency virus-uninfected Kenyan children aged 6–59 months, who presented with acute diarrhea. Children underwent clinical and anthropometric assessments and provided stool for bacterial and protozoal pathogen detection. Clinical and microbiological features were compared using log binomial regression among children with and without wasting (mid-upper arm circumference ≤ 125 mm) or stunting (height-for-age z score ≤ −2). Among 1,363 children, 7.0% were wasted and 16.9% were stunted. After adjustment for potential confounders, children with wasting were more likely than nonwasted children to present with at least one Integrated Management of Childhood Illness danger sign (adjusted prevalence ratio [aPR]: 1.3, 95% confidence interval [CI]: 1.0 to 1.5, P = 0.05), severe dehydration (aPR: 2.4, 95% CI: 1.5 to 3.8, P < 0.01), and enteroaggregative Escherichia coli recovered from their stool (aPR: 1.8, 1.1–2.8, P = 0.02). There were no differences in the prevalence of other pathogens by wasting status after confounder adjustment. Stunting was not associated with clinical severity or the presence of specific pathogens. Wasted children with diarrhea presented with more severe disease than children without malnutrition which may be explained by a delay in care-seeking or diminished immune response to infection. Combating social determinants and host risk factors associated with severe disease, rather than specific pathogens, may reduce the disparities in poor diarrhea-associated outcomes experienced by malnourished children.

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“…The first documented isolation of Aeromonas in feces dates from 1961, although Aeromonas was already isolated as a causative agent of myositis in a Jamaican woman in 1954 [189]. Several studies have associated Aeromonas with gastroenteritis [3,[189][190][191][192][193][194][195]. Nausea, vomiting, fever, and abdominal cramps occur only in a fraction of patients, while colitis occurs in a third of diarrhea cases caused by Aeromonas [189].…”

Section: Gastroenteritismentioning

confidence: 99%

An Update on the Genus Aeromonas: Taxonomy, Epidemiology, and Pathogenicity

2020

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The genus Aeromonas belongs to the Aeromonadaceae family and comprises a group of Gram-negative bacteria widely distributed in aquatic environments, with some species able to cause disease in humans, fish, and other aquatic animals. However, bacteria of this genus are isolated from many other habitats, environments, and food products. The taxonomy of this genus is complex when phenotypic identification methods are used because such methods might not correctly identify all the species. On the other hand, molecular methods have proven very reliable, such as using the sequences of concatenated housekeeping genes like gyrB and rpoD or comparing the genomes with the type strains using a genomic index, such as the average nucleotide identity (ANI) or in silico DNA–DNA hybridization (isDDH). So far, 36 species have been described in the genus Aeromonas of which at least 19 are considered emerging pathogens to humans, causing a broad spectrum of infections. Having said that, when classifying 1852 strains that have been reported in various recent clinical cases, 95.4% were identified as only four species: Aeromonas caviae (37.26%), Aeromonas dhakensis (23.49%), Aeromonas veronii (21.54%), and Aeromonas hydrophila (13.07%). Since aeromonads were first associated with human disease, gastroenteritis, bacteremia, and wound infections have dominated. The literature shows that the pathogenic potential of Aeromonas is considered multifactorial and the presence of several virulence factors allows these bacteria to adhere, invade, and destroy the host cells, overcoming the immune host response. Based on current information about the ecology, epidemiology, and pathogenicity of the genus Aeromonas, we should assume that the infections these bacteria produce will remain a great health problem in the future. The ubiquitous distribution of these bacteria and the increasing elderly population, to whom these bacteria are an opportunistic pathogen, will facilitate this problem. In addition, using data from outbreak studies, it has been recognized that in cases of diarrhea, the infective dose of Aeromonas is relatively low. These poorly known bacteria should therefore be considered similarly as enteropathogens like Salmonella and Campylobacter.

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Aeromonas-Associated Diarrhea in Children Under 5 Years: The GEMS Experience

Cited by 33 publications

References 17 publications

Gut Microbiome Analysis Identifies Potential Etiological Factors in Acute Gastroenteritis

Gut Microbiome Analysis Identifies Potential Etiological Factors in Acute Gastroenteritis

Impact of Childhood Nutritional Status on Pathogen Prevalence and Severity of Acute Diarrhea

An Update on the Genus Aeromonas: Taxonomy, Epidemiology, and Pathogenicity

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