TY - JOUR
T1 - Enteroaggregative Escherichia coli Subclinical Infection and Coinfections and Impaired Child Growth in the MAL-ED Cohort Study
AU - Lima, Aldo A.M.
AU - Soares, Alberto M.
AU - Filho, José Q.S.
AU - Havt, Alexandre
AU - Lima, Ila F.N.
AU - Lima, Noélia L.
AU - Abreu, Cláudia B.
AU - Francisco, S.
AU - Mota, Rosa M.S.
AU - Pan, William K.Y.
AU - Troeger, Christopher
AU - Medeiros, Pedro H.Q.S.
AU - Veras, Herlice N.
AU - Prata, Mara A.
AU - McCormick, Ben J.J.
AU - McGrath, Monica
AU - Rogawski, Elizabeth T.
AU - Houpt, Eric R.
AU - Platts-Mills, James A.
AU - Gratz, Jean
AU - Samie, Amidou
AU - Bessong, Pascal
AU - Babji, Sudhir
AU - Kang, Gangadeep
AU - Qureshi, Shahida
AU - Shakoor, Sadia
AU - Bhutta, Zulfigar A.
AU - Haque, Rashidul
AU - Ahmed, Tahmeed
AU - Mduma, Estomih R.
AU - Svensen, Erling
AU - Kosek, Margaret
AU - Yori, Pablo P.
AU - Bodhidatta, Ladaporn
AU - Jasmin, Shrestha
AU - Mason, Carl J.
AU - Lang, Dennis
AU - Gottlieb, Michael
AU - Guerrant, Richard L.
N1 - Publisher Copyright:
Copyright © 2017 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.
PY - 2018/2/1
Y1 - 2018/2/1
N2 - Objective: We evaluated the impact of subclinical enteroaggregative Escherichia coli (EAEC) infection alone and in combination with other pathogens in the first 6 months of life on child growth. Methods: Nondiarrheal samples from 1684 children across 8 Multisite Birth Cohort Study, Malnutrition and Enteric Diseases (MAL-ED) sites in Asia, Africa, and Latin America were tested monthly; more than 90% of children were followed-up twice weekly for the first 6 months of life. Results: Children with subclinical EAEC infection did not show altered growth between enrollment and 6 months. Conversely, EAEC coinfection with any other pathogen was negatively associated with delta weight-for-length (P < 0.05) and weight-for-age (P > 0.05) z scores between 0 and 6 months. The presence of 2 or more pathogens without EAEC was not significantly associated with delta weight-for-length and weight-for-age. The most frequent EAEC coinfections included Campylobacter spp, heat-labile toxin-producing enterotoxigenic E coli, Cryptosporidium spp, and atypical enteropathogenic E coli. Myeloperoxidase levels were increased with EAEC coinfection (P < 0.05). EAEC pathogen codetection was associated with lower neopterin levels compared to those of no-pathogen control children (P < 0.05). Mothers of children with EAEC coinfections had lower levels of education, poorer hygiene and sanitation, lower socioeconomic status, and lower breast-feeding rates compared to mothers of children in whom no pathogen was detected (P < 0.05). Conclusions: 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.
AB - Objective: We evaluated the impact of subclinical enteroaggregative Escherichia coli (EAEC) infection alone and in combination with other pathogens in the first 6 months of life on child growth. Methods: Nondiarrheal samples from 1684 children across 8 Multisite Birth Cohort Study, Malnutrition and Enteric Diseases (MAL-ED) sites in Asia, Africa, and Latin America were tested monthly; more than 90% of children were followed-up twice weekly for the first 6 months of life. Results: Children with subclinical EAEC infection did not show altered growth between enrollment and 6 months. Conversely, EAEC coinfection with any other pathogen was negatively associated with delta weight-for-length (P < 0.05) and weight-for-age (P > 0.05) z scores between 0 and 6 months. The presence of 2 or more pathogens without EAEC was not significantly associated with delta weight-for-length and weight-for-age. The most frequent EAEC coinfections included Campylobacter spp, heat-labile toxin-producing enterotoxigenic E coli, Cryptosporidium spp, and atypical enteropathogenic E coli. Myeloperoxidase levels were increased with EAEC coinfection (P < 0.05). EAEC pathogen codetection was associated with lower neopterin levels compared to those of no-pathogen control children (P < 0.05). Mothers of children with EAEC coinfections had lower levels of education, poorer hygiene and sanitation, lower socioeconomic status, and lower breast-feeding rates compared to mothers of children in whom no pathogen was detected (P < 0.05). Conclusions: 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.
KW - enteroaggregative Escherichia coli
KW - gut inflammation
KW - intestinal immune responses
KW - nutritional status
KW - pathogen enteroaggregative Escherichia coli coinfection
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U2 - 10.1097/MPG.0000000000001717
DO - 10.1097/MPG.0000000000001717
M3 - Article
C2 - 29356769
AN - SCOPUS:85041555976
SN - 0277-2116
VL - 66
SP - 325
EP - 333
JO - Journal of pediatric gastroenterology and nutrition
JF - Journal of pediatric gastroenterology and nutrition
IS - 2
ER -