Enterotoxigenic Bacteroides fragilis - Associated diarrhea in children 0-2 years of age in rural Bangladesh

Preeti Pathela; K. Zahid Hasan; Eliza Roy; Korshed Alam; Fazlul Huq; A. Kasem Siddique; R. Bradley Sack

doi:10.1086/428947

Enterotoxigenic Bacteroides fragilis - Associated diarrhea in children 0-2 years of age in rural Bangladesh

Preeti Pathela, K. Zahid Hasan, Eliza Roy, Korshed Alam, Fazlul Huq, A. Kasem Siddique, R. Bradley Sack

School of Medicine

Research output: Contribution to journal › Article › peer-review

29 Scopus citations

Abstract

The burden of enterotoxigenic Bacteroides fragilis (ETBF)-related diarrhea was determined in a birth cohort of 252 children in rural Bangladesh. Isolation rates of ETBF in stool and risk factors for acquisition of ETBF and disease were established. Of 382 B. fragilis-positive specimens, 14.4% of the strains found in them produced enterotoxin, as determined by a tissue-culture assay. The overall isolation rate of ETBF was 2.3% (40/1750) from diarrheal specimens and 0.3% (15/5679) from nondiarrheal specimens collected throughout the 2 years of the study (P < .001). ETBF was isolated from 20.3% (40/197) of the B. fragilis-positive diarrheal specimens and from 8.1% (15/185) of the B. fragilis-positive nondiarrheal specimens (P < .001) and was significantly associated with acute diarrheal disease in children ≥1 year of age (P = .0001). The diarrheal illness was mild in nature. In conditional multivariate analyses that examined environmental and host risk factors, the presence of livestock in the household area was linked to the acquisition of ETBF (chickens, P < .05; cows, P = .06). ETBF was found to be a small but significant contributor to diarrheal disease in this rural community. Improved management of livestock may be useful for the prevention of ETBF infection.

Original language	English (US)
Pages (from-to)	1245-1252
Number of pages	8
Journal	Journal of Infectious Diseases
Volume	191
Issue number	8
DOIs	https://doi.org/10.1086/428947
State	Published - Apr 15 2005

ASJC Scopus subject areas

Immunology and Allergy
Infectious Diseases

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10.1086/428947

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@article{2cfa9de1eb564c2fbcbbfd8ea7204ec7,

title = "Enterotoxigenic Bacteroides fragilis - Associated diarrhea in children 0-2 years of age in rural Bangladesh",

abstract = "The burden of enterotoxigenic Bacteroides fragilis (ETBF)-related diarrhea was determined in a birth cohort of 252 children in rural Bangladesh. Isolation rates of ETBF in stool and risk factors for acquisition of ETBF and disease were established. Of 382 B. fragilis-positive specimens, 14.4% of the strains found in them produced enterotoxin, as determined by a tissue-culture assay. The overall isolation rate of ETBF was 2.3% (40/1750) from diarrheal specimens and 0.3% (15/5679) from nondiarrheal specimens collected throughout the 2 years of the study (P < .001). ETBF was isolated from 20.3% (40/197) of the B. fragilis-positive diarrheal specimens and from 8.1% (15/185) of the B. fragilis-positive nondiarrheal specimens (P < .001) and was significantly associated with acute diarrheal disease in children ≥1 year of age (P = .0001). The diarrheal illness was mild in nature. In conditional multivariate analyses that examined environmental and host risk factors, the presence of livestock in the household area was linked to the acquisition of ETBF (chickens, P < .05; cows, P = .06). ETBF was found to be a small but significant contributor to diarrheal disease in this rural community. Improved management of livestock may be useful for the prevention of ETBF infection.",

author = "Preeti Pathela and Hasan, {K. Zahid} and Eliza Roy and Korshed Alam and Fazlul Huq and Siddique, {A. Kasem} and Sack, {R. Bradley}",

note = "Funding Information: Received 12 July 2004; accepted 19 November 2004; electronically published 14 March 2005. Presented in part: The analysis and manuscript were completed as a part of a doctoral thesis project (P.P.). Financial support: US Agency for International Development (grant HRN-A-00-96-90005-02). Reprints or correspondence: Dr. R. Bradley Sack, Dept. of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Rm. 5035, Baltimore, MD 21205 (rsack@jhsph.edu).",

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T1 - Enterotoxigenic Bacteroides fragilis - Associated diarrhea in children 0-2 years of age in rural Bangladesh

AU - Pathela, Preeti

AU - Hasan, K. Zahid

AU - Roy, Eliza

AU - Alam, Korshed

AU - Huq, Fazlul

AU - Siddique, A. Kasem

AU - Sack, R. Bradley

N1 - Funding Information: Received 12 July 2004; accepted 19 November 2004; electronically published 14 March 2005. Presented in part: The analysis and manuscript were completed as a part of a doctoral thesis project (P.P.). Financial support: US Agency for International Development (grant HRN-A-00-96-90005-02). Reprints or correspondence: Dr. R. Bradley Sack, Dept. of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Rm. 5035, Baltimore, MD 21205 (rsack@jhsph.edu).

PY - 2005/4/15

Y1 - 2005/4/15

N2 - The burden of enterotoxigenic Bacteroides fragilis (ETBF)-related diarrhea was determined in a birth cohort of 252 children in rural Bangladesh. Isolation rates of ETBF in stool and risk factors for acquisition of ETBF and disease were established. Of 382 B. fragilis-positive specimens, 14.4% of the strains found in them produced enterotoxin, as determined by a tissue-culture assay. The overall isolation rate of ETBF was 2.3% (40/1750) from diarrheal specimens and 0.3% (15/5679) from nondiarrheal specimens collected throughout the 2 years of the study (P < .001). ETBF was isolated from 20.3% (40/197) of the B. fragilis-positive diarrheal specimens and from 8.1% (15/185) of the B. fragilis-positive nondiarrheal specimens (P < .001) and was significantly associated with acute diarrheal disease in children ≥1 year of age (P = .0001). The diarrheal illness was mild in nature. In conditional multivariate analyses that examined environmental and host risk factors, the presence of livestock in the household area was linked to the acquisition of ETBF (chickens, P < .05; cows, P = .06). ETBF was found to be a small but significant contributor to diarrheal disease in this rural community. Improved management of livestock may be useful for the prevention of ETBF infection.

AB - The burden of enterotoxigenic Bacteroides fragilis (ETBF)-related diarrhea was determined in a birth cohort of 252 children in rural Bangladesh. Isolation rates of ETBF in stool and risk factors for acquisition of ETBF and disease were established. Of 382 B. fragilis-positive specimens, 14.4% of the strains found in them produced enterotoxin, as determined by a tissue-culture assay. The overall isolation rate of ETBF was 2.3% (40/1750) from diarrheal specimens and 0.3% (15/5679) from nondiarrheal specimens collected throughout the 2 years of the study (P < .001). ETBF was isolated from 20.3% (40/197) of the B. fragilis-positive diarrheal specimens and from 8.1% (15/185) of the B. fragilis-positive nondiarrheal specimens (P < .001) and was significantly associated with acute diarrheal disease in children ≥1 year of age (P = .0001). The diarrheal illness was mild in nature. In conditional multivariate analyses that examined environmental and host risk factors, the presence of livestock in the household area was linked to the acquisition of ETBF (chickens, P < .05; cows, P = .06). ETBF was found to be a small but significant contributor to diarrheal disease in this rural community. Improved management of livestock may be useful for the prevention of ETBF infection.

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Enterotoxigenic Bacteroides fragilis - Associated diarrhea in children 0-2 years of age in rural Bangladesh

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