Enteroaggregative <i>Escherichia coli</i> Subclinical Infection and Coinfections and Impaired Child Growth in the MAL‐ED Cohort Study

Lima, Aldo Ângelo Moreira; Soares, A; Filho, José Q.; Havt, Alexandre; Lima, Ila Fernanda Nunes; Lima, Noélia L.; Abreu, Cláudia Buhamra; Francisco, Saionara Cristina; Mota, Rosa M. S.; Pan, William; Troeger, Christopher; Medeiros, Pedro Hqs; Veras, Herlice N.; Prata, Mara A; McCormick, Benjamin; McGrath, Monica; Rogawski, Elizabeth T.; Houpt, Eric R.; Platts-Mills, James A; Gratz, Jean; Samie, Amidou; Bessong, Pascal; Babji, Sudhir; Kang, Gangadeep; Qureshi, Shahida; Shakoor, Sadia; Bhutta, Zulfiqar A; Haque, Rashidul; Ahmed, Tahmeed; Mduma, Estomih; Svensen, Erling; Kosek, Margaret; Yori, Pablo Peñataro; Bodhidatta, Ladaporn; Shrestha, Jasmin; Mason, Carl J.; Lang, Dennis; Gottlieb, Michael; Guerrant, Richard L.

doi:10.1097/mpg.0000000000001717

Cited by 36 publications

(38 citation statements)

References 34 publications

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“…Although EAEC was not associated with diarrhoea in children within the 24-60-month age group in this study, it was the most commonly detected pathotype from children with wasting. This observation is consistent with the findings of the recent the MAL-ED study, which reported that EAEC infection is associated with growth i shortfall, irrespective of disease 41 .…”

Section: Discussionsupporting

confidence: 93%

Novel multiplex real-time PCR assays reveal a high prevalence of diarrhoeagenic Escherichia coli pathotypes in healthy and diarrhoeal children in the South of Vietnam

Duong¹,

Tuyen

et al. 2020

Preprint

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Abstract BackgroundDiarrhoeagenic Escherichia coli (DEC) infections are common in children in low-middle income countries (LMICs). However, detecting the various DEC pathotypes is complex as they cannot be differentiated by classical microbiology. We developed four multiplex real-time PCR assays were to detect virulence markers of six DEC pathotypes; specificity was tested using DEC controls and other enteric pathogens. PCR amplicons from the six E. coli pathotypes were purified and amplified to be used to optimize PCR reactions and to calculate reproducibility. After validation, these assays were applied to clinical samples from healthy and diarrhoeal Vietnamese children and associated with clinical data. ResultsThe multiplex real-time PCRs were found to be reproducible, and specific. At least one DEC variant was detected in 34.7% (978/2,815) of the faecal samples from diarrhoeal children; EAEC, EIEC and atypical EPEC were most frequent Notably, 41.2% (205/498) of samples from non-diarrhoeal children was positive with a DEC pathotype. In this population, only EIEC, which was detected in 34.3% (99/289) of diarrhoeal samples vs. 0.8% (4/498) non-diarrhoeal samples (p<0.001), was significantly associated with diarrhoea. Multiplex real-time PCR when applied to clinical samples is an efficient and high-throughput approach to DEC pathotypes. ConclusionsThis approach revealed high carriage rates of DEC pathotypes among Vietnamese children. We describe a novel diagnostic approach for DEC, which provides baseline data for future surveillance studies assessing DEC burden in LMICs.

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Section: Discussionsupporting

confidence: 93%

Novel multiplex real-time PCR assays reveal a high prevalence of diarrhoeagenic Escherichia coli pathotypes in healthy and diarrhoeal children in the South of Vietnam

Duong¹,

Tuyen

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Although EAEC was not associated with diarrhoea in children within the 24-60-month age group in this study, it was the most commonly detected pathotype from children with wasting. This observation is consistent with the ndings of the recent the MAL-ED study, which reported that EAEC infection is associated with growth shortfall, irrespective of disease [32].…”

Section: Discussionsupporting

confidence: 93%

Novel multiplex real-time PCR assays reveal a high prevalence of diarrhoeagenic Escherichia coli pathotypes in healthy and diarrhoeal children in the South of Vietnam

Duong¹,

Tuyen

et al. 2020

Preprint

View full text Add to dashboard Cite

Abstract Background: Diarrhoeagenic Escherichia coli (DEC) infections are common in children in low-middle income countries (LMICs). However, detecting the various DEC pathotypes is complex as they cannot be differentiated by classical microbiology. We developed four multiplex real-time PCR assays were to detect virulence markers of six DEC pathotypes; specificity was tested using DEC controls and other enteric pathogens. PCR amplicons from the six E. coli pathotypes were purified and amplified to be used to optimize PCR reactions and to calculate reproducibility. After validation, these assays were applied to clinical samples from healthy and diarrhoeal Vietnamese children and associated with clinical data. Results: The multiplex real-time PCRs were found to be reproducible, and specific. At least one DEC variant was detected in 34.7% (978/2,815) of the faecal samples from diarrhoeal children; EAEC, EIEC and atypical EPEC were most frequent Notably, 41.2% (205/498) of samples from non-diarrhoeal children was positive with a DEC pathotype. In this population, only EIEC, which was detected in 34.3% (99/289) of diarrhoeal samples vs. 0.8% (4/498) non-diarrhoeal samples (p<0.001), was significantly associated with diarrhoea. Multiplex real-time PCR when applied to clinical samples is an efficient and high-throughput approach to DEC pathotypes. Conclusions: This approach revealed high carriage rates of DEC pathotypes among Vietnamese children. We describe a novel diagnostic approach for DEC, which provides baseline data for future surveillance studies assessing DEC burden in LMICs.

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“…We found an association with hospital admission for severe pneumonia, but the occurrence of malaria was too rare to be included in our analyses separately. However, in a multicountry birth cohort in low/middle-income countries, while diarrhoea was not a risk factor for poor linear growth, but presence of higher enteropathogen load in non-diarrhoea stools was associated with poor length growth 32 33…”

Section: Discussionmentioning

confidence: 80%

Linear growth following complicated severe malnutrition: 1-year follow-up cohort of Kenyan children

et al. 2018

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BackgroundStunting is the most common manifestation of childhood undernutrition worldwide. Children presenting with severe acute malnutrition (SAM) are often also severely stunted. We evaluated linear growth and its determinants after medically complicated SAM.MethodsWe performed secondary analysis of clinical trial data (NCT00934492) from HIV-uninfected Kenyan children aged 2–59 months hospitalised with SAM. Outcome was change in height/length-for-age z-score (HAZ) between enrolment and 12 months later. Exposures were demographic, clinical, anthropometric characteristics and illness episodes during follow-up.ResultsAmong 1169 children with HAZ values at month 12 (66% of those in original trial), median (IQR) age 11 (7–17) months and mean (SD) HAZ −2.87 (1.6) at enrolment, there was no change in mean HAZ between enrolment and month 12: −0.006Z (95% CI −0.07 to 0.05Z). While 262 (23%) children experienced minimal HAZ change (within ±0.25 HAZ), 472 (40%) lost >0.25 and 435 (37%) gained >0.25 HAZ. After adjusting for regression to the mean, inpatient or outpatient episodes of diarrhoea and inpatient severe pneumonia during follow-up were associated with HAZ loss. Premature birth and not being cared by the biological parent were associated with HAZ gain. Increases in mid-upper arm circumference and weight-for-age were associated with HAZ gain and protected against HAZ loss. Increase in weight-for-height was not associated with HAZ gain but protected against HAZ loss. No threshold of weight gain preceding linear catch-up growth was observed.ConclusionsInterventions to improve dietary quality and prevent illness over a longer period may provide opportunities to improve linear growth.

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Enteroaggregative Escherichia coli Subclinical Infection and Coinfections and Impaired Child Growth in the MAL‐ED Cohort Study

Abstract: These data emphasize the public health importance of subclinical EAEC infection in early infancy in association with other pathogens and the need for improved maternal and child care, hygiene, sanitation, and socioeconomic factors.

Cited by 36 publications

References 34 publications

Novel multiplex real-time PCR assays reveal a high prevalence of diarrhoeagenic Escherichia coli pathotypes in healthy and diarrhoeal children in the South of Vietnam

Novel multiplex real-time PCR assays reveal a high prevalence of diarrhoeagenic Escherichia coli pathotypes in healthy and diarrhoeal children in the South of Vietnam

Novel multiplex real-time PCR assays reveal a high prevalence of diarrhoeagenic Escherichia coli pathotypes in healthy and diarrhoeal children in the South of Vietnam

Linear growth following complicated severe malnutrition: 1-year follow-up cohort of Kenyan children

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