Epidemiology of enteroaggregative Escherichia coli infections and associated outcomes in the MAL-ED birth cohort.
BACKGROUND:Enteroaggregative E. coli (EAEC) have been associated with mildly inflammatory diarrhea in outbreaks and in travelers and have been increasingly recognized as enteric pathogens in young children with and without overt diarrhea. We examined the risk factors for EAEC infections and their as...
Published in: | PLOS Neglected Tropical Diseases |
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ftdoajarticles:oai:doaj.org/article:90b9790d80644a13a01c07ad1b48c5e6 2023-05-15T15:13:44+02:00 Epidemiology of enteroaggregative Escherichia coli infections and associated outcomes in the MAL-ED birth cohort. Elizabeth T Rogawski Richard L Guerrant Alexandre Havt Ila F N Lima Pedro H Q S Medeiros Jessica C Seidman Benjamin J J McCormick Sudhir Babji Dinesh Hariraju Ladaporn Bodhidatta Jasmin Shrestha Japhat Anania Athanasia Maro Amidou Samie Pablo Peñataro Yori Shahida Qureshi Mustafa Mahfuz Pascal O Bessong Margaret N Kosek Tahmeed Ahmed Zulfiqar A Bhutta Dennis R Lang Michael Gottlieb Eric R Houpt Aldo A M Lima MAL-ED Network Investigators 2017-07-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0005798 https://doaj.org/article/90b9790d80644a13a01c07ad1b48c5e6 EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC5542697?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0005798 https://doaj.org/article/90b9790d80644a13a01c07ad1b48c5e6 PLoS Neglected Tropical Diseases, Vol 11, Iss 7, p e0005798 (2017) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2017 ftdoajarticles https://doi.org/10.1371/journal.pntd.0005798 2022-12-31T06:33:08Z BACKGROUND:Enteroaggregative E. coli (EAEC) have been associated with mildly inflammatory diarrhea in outbreaks and in travelers and have been increasingly recognized as enteric pathogens in young children with and without overt diarrhea. We examined the risk factors for EAEC infections and their associations with environmental enteropathy biomarkers and growth outcomes over the first two years of life in eight low-resource settings of the MAL-ED study. METHODS:EAEC infections were detected by PCR gene probes for aatA and aaiC virulence traits in 27,094 non-diarrheal surveillance stools and 7,692 diarrheal stools from 2,092 children in the MAL-ED birth cohort. We identified risk factors for EAEC and estimated the associations of EAEC with diarrhea, enteropathy biomarker concentrations, and both short-term (one to three months) and long-term (to two years of age) growth. RESULTS:Overall, 9,581 samples (27.5%) were positive for EAEC, and almost all children had at least one detection (94.8%) by two years of age. Exclusive breastfeeding, higher enrollment weight, and macrolide use within the preceding 15 days were protective. Although not associated with diarrhea, EAEC infections were weakly associated with biomarkers of intestinal inflammation and more strongly with reduced length at two years of age (LAZ difference associated with high frequency of EAEC detections: -0.30, 95% CI: -0.44, -0.16). CONCLUSIONS:Asymptomatic EAEC infections were common early in life and were associated with linear growth shortfalls. Associations with intestinal inflammation were small in magnitude, but suggest a pathway for the growth impact. Increasing the duration of exclusive breastfeeding may help prevent these potentially inflammatory infections and reduce the long-term impact of early exposure to EAEC. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 11 7 e0005798 |
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Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Elizabeth T Rogawski Richard L Guerrant Alexandre Havt Ila F N Lima Pedro H Q S Medeiros Jessica C Seidman Benjamin J J McCormick Sudhir Babji Dinesh Hariraju Ladaporn Bodhidatta Jasmin Shrestha Japhat Anania Athanasia Maro Amidou Samie Pablo Peñataro Yori Shahida Qureshi Mustafa Mahfuz Pascal O Bessong Margaret N Kosek Tahmeed Ahmed Zulfiqar A Bhutta Dennis R Lang Michael Gottlieb Eric R Houpt Aldo A M Lima MAL-ED Network Investigators Epidemiology of enteroaggregative Escherichia coli infections and associated outcomes in the MAL-ED birth cohort. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
BACKGROUND:Enteroaggregative E. coli (EAEC) have been associated with mildly inflammatory diarrhea in outbreaks and in travelers and have been increasingly recognized as enteric pathogens in young children with and without overt diarrhea. We examined the risk factors for EAEC infections and their associations with environmental enteropathy biomarkers and growth outcomes over the first two years of life in eight low-resource settings of the MAL-ED study. METHODS:EAEC infections were detected by PCR gene probes for aatA and aaiC virulence traits in 27,094 non-diarrheal surveillance stools and 7,692 diarrheal stools from 2,092 children in the MAL-ED birth cohort. We identified risk factors for EAEC and estimated the associations of EAEC with diarrhea, enteropathy biomarker concentrations, and both short-term (one to three months) and long-term (to two years of age) growth. RESULTS:Overall, 9,581 samples (27.5%) were positive for EAEC, and almost all children had at least one detection (94.8%) by two years of age. Exclusive breastfeeding, higher enrollment weight, and macrolide use within the preceding 15 days were protective. Although not associated with diarrhea, EAEC infections were weakly associated with biomarkers of intestinal inflammation and more strongly with reduced length at two years of age (LAZ difference associated with high frequency of EAEC detections: -0.30, 95% CI: -0.44, -0.16). CONCLUSIONS:Asymptomatic EAEC infections were common early in life and were associated with linear growth shortfalls. Associations with intestinal inflammation were small in magnitude, but suggest a pathway for the growth impact. Increasing the duration of exclusive breastfeeding may help prevent these potentially inflammatory infections and reduce the long-term impact of early exposure to EAEC. |
format |
Article in Journal/Newspaper |
author |
Elizabeth T Rogawski Richard L Guerrant Alexandre Havt Ila F N Lima Pedro H Q S Medeiros Jessica C Seidman Benjamin J J McCormick Sudhir Babji Dinesh Hariraju Ladaporn Bodhidatta Jasmin Shrestha Japhat Anania Athanasia Maro Amidou Samie Pablo Peñataro Yori Shahida Qureshi Mustafa Mahfuz Pascal O Bessong Margaret N Kosek Tahmeed Ahmed Zulfiqar A Bhutta Dennis R Lang Michael Gottlieb Eric R Houpt Aldo A M Lima MAL-ED Network Investigators |
author_facet |
Elizabeth T Rogawski Richard L Guerrant Alexandre Havt Ila F N Lima Pedro H Q S Medeiros Jessica C Seidman Benjamin J J McCormick Sudhir Babji Dinesh Hariraju Ladaporn Bodhidatta Jasmin Shrestha Japhat Anania Athanasia Maro Amidou Samie Pablo Peñataro Yori Shahida Qureshi Mustafa Mahfuz Pascal O Bessong Margaret N Kosek Tahmeed Ahmed Zulfiqar A Bhutta Dennis R Lang Michael Gottlieb Eric R Houpt Aldo A M Lima MAL-ED Network Investigators |
author_sort |
Elizabeth T Rogawski |
title |
Epidemiology of enteroaggregative Escherichia coli infections and associated outcomes in the MAL-ED birth cohort. |
title_short |
Epidemiology of enteroaggregative Escherichia coli infections and associated outcomes in the MAL-ED birth cohort. |
title_full |
Epidemiology of enteroaggregative Escherichia coli infections and associated outcomes in the MAL-ED birth cohort. |
title_fullStr |
Epidemiology of enteroaggregative Escherichia coli infections and associated outcomes in the MAL-ED birth cohort. |
title_full_unstemmed |
Epidemiology of enteroaggregative Escherichia coli infections and associated outcomes in the MAL-ED birth cohort. |
title_sort |
epidemiology of enteroaggregative escherichia coli infections and associated outcomes in the mal-ed birth cohort. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2017 |
url |
https://doi.org/10.1371/journal.pntd.0005798 https://doaj.org/article/90b9790d80644a13a01c07ad1b48c5e6 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 11, Iss 7, p e0005798 (2017) |
op_relation |
http://europepmc.org/articles/PMC5542697?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0005798 https://doaj.org/article/90b9790d80644a13a01c07ad1b48c5e6 |
op_doi |
https://doi.org/10.1371/journal.pntd.0005798 |
container_title |
PLOS Neglected Tropical Diseases |
container_volume |
11 |
container_issue |
7 |
container_start_page |
e0005798 |
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1766344266725982208 |