1921
Volume 95, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract

We report the clinical findings, epidemiology, and risk factors for moderate-to-severe diarrhea (MSD) associated with species in children 0–59 months of age, from the Global Enteric Multicenter Study, conducted at three sites in south Asia and four sites in sub-Saharan Africa. Children with MSD were enrolled along with controls matched for age, gender, and neighborhood. Pooled, age-stratified conditional logistic regression models were applied to evaluate the association of infection controlling for coinfecting pathogens and sociodemographic variables. A pooled, age-stratified, multivariate logistic regression analysis was done to identify risk factors associated with positivity in MSD cases. A total of 12,110 cases and 17,291 matched controls were enrolled over a period of 48 months. was identified as a significant pathogen in 736 cases of MSD in Pakistan and Bangladesh (22.2%). remained a significant pathogen even after adjustment for the presence of other pathogens and sociodemographic factors. Odds ratio (OR) for were higher in the presence of (matched OR: 6.2, 95% confidence interval [CI]: 1.9–20.2). Cases of were likely to present with dysentery, particularly in the 0–11 months (OR: 1.4, 95% CI 1.0–2.0) and 12–23 months (OR: 1.8, 95% CI: 1.3–2.5) age group. The odds of increased with increasing degree of stunting, being highest for severe stunting (OR: 10.1, 95% CI: 3.6–28.9). is a significant pathogen for MSD in Pakistan and Bangladesh. Presence of dysentery and co-occurrence with other pathogens, notably spp. are significant features of -associated diarrhea.

Loading

Article metrics loading...

The graphs shown below represent data from March 2017
/content/journals/10.4269/ajtmh.16-0321
2016-10-05
2020-04-05
Loading full text...

Full text loading...

/deliver/fulltext/14761645/95/4/774.html?itemId=/content/journals/10.4269/ajtmh.16-0321&mimeType=html&fmt=ahah

References

  1. Ghenghesh KS, Ahmed SF, El-Khalek RA, Al-Gendy A, Klena J, 2008. Aeromonas-associated infections in developing countries. J Infect Dev Ctries 2: 8198.[Crossref]
    [Google Scholar]
  2. Lautrop H, 1961. Aeromonas hydrophila isolated from human feces and its possible pathological significance. Acta Path Microbiol Scand 51 (Suppl 144): 299301.
    [Google Scholar]
  3. Burke V, Gracey M, Robinson J, Peck D, Beaman J, Bundell C, 1983. The microbiology of childhood gastroenteritis: Aeromonas species and other infective agents. J Infect Dis 148: 6874.[Crossref]
    [Google Scholar]
  4. Pazzaglia G, Sack RB, Salazar E, Yi A, Chea E, Leon-Barua R, Guerrero CE, Palomino J, 1991. High frequency of coinfecting enteropathogens in Aeromonas-associated diarrhea of hospitalized Peruvian infants. J Clin Microbiol 29: 11511156.
    [Google Scholar]
  5. Kotloff KL, Wasserman SS, Steciak JY, Tall BD, Losonsky GA, Nair P, Morris JG Jr, Levine MM, 1988. Acute diarrhea in Baltimore children attending an outpatient clinic. Pediatr Infect Dis J 7: 753759.[Crossref]
    [Google Scholar]
  6. Von Graevenitz A, 2007. The role of Aeromonas in diarrhea: a review. Infection 35: 5964.[Crossref]
    [Google Scholar]
  7. Albert MJ, Ansaruzzaman M, Talukder KA, Chopra AK, Kuhn I, Rahman M, Faruque ASG, Islam MS, Sack RB, Mollby R, 2000. Prevalence of enterotoxin genes in Aeromonas spp. isolated from children with diarrhea, healthy controls, and the environment. J Clin Microbiol 38: 37853790.
    [Google Scholar]
  8. Janda JM, Abbott SL, 2010. The genus Aeromonas: taxonomy, pathogenicity, and infection. Clin Microbiol Rev 23: 3573.[Crossref]
    [Google Scholar]
  9. Kotloff KL, Blackwelder WC, Nasrin D, Nataro JP, Farag TH, van Eijk A, Adegbola RA, Alonso PL, Breiman RF, Faruque ASG, 2012. The Global Enteric Multicenter Study (GEMS) of diarrheal disease in infants and young children in developing countries: epidemiologic and clinical methods of the case/control study. Clin Infect Dis 55: S232S245.[Crossref]
    [Google Scholar]
  10. Kotloff KL, Nataro JP, Blackwelder WC, Nasrin D, Farag TH, Panchalingam S, Wu Y, Sow SO, Sur D, Breiman RF, 2013. Burden and aetiology of diarrhoeal disease in infants and young children in developing countries (the Global Enteric Multicenter Study, GEMS): a prospective, case-control study. Lancet 382: 209222.[Crossref]
    [Google Scholar]
  11. Panchalingam S, Antonio M, Hossain A, Mandomando I, Ochieng B, Oundo J, Ramamurthy T, Tamboura B, Zaidi AKM, Petri W, 2012. Diagnostic microbiologic methods in the GEMS-1 case/control study. Clin Infect Dis 55: S294S302.[Crossref]
    [Google Scholar]
  12. Blackwelder WC, Biswas K, Wu Y, Kotloff KL, Farag TH, Nasrin D, Graubard BI, Sommerfelt H, Levine MM, 2012. Statistical methods in the Global Enteric Multicenter Study (GEMS). Clin Infect Dis 55: S246S253.[Crossref]
    [Google Scholar]
  13. Figura N, Marri L, Verdiani S, Ceccherini C, Barberi A, 1986. Prevalence, species differentiation, and toxigenicity of Aeromonas strains in cases of childhood gastroenteritis and in controls. J Clin Microbiol 23: 595599.
    [Google Scholar]
  14. Dixit S, Bhandari GP, Karmacharya DB, Shrestha S, Manandhar S, Maskey MK, 2011. Molecular screening of major bacterial enteropathogens in human stool samples from diarrhoeal outbreak sites. J Nepal Health Res Counc 9: 181185.
    [Google Scholar]
  15. Sinha S, Shimada T, Ramamurthy T, Bhattacharya SK, Yamasaki S, Takeda Y, Nair GB, 2004. Prevalence, serotype distribution, antibiotic susceptibility and genetic profiles of mesophilic Aeromonas species isolated from hospitalized diarrhoeal cases in Kolkata, India. J Med Microbiol 53: 527534.[Crossref]
    [Google Scholar]
  16. Soltan Dallal MM, Moezardalan K, 2004. Aeromonas spp associated with children's diarrhoea in Tehran: a case-control study. Ann Trop Paediatr 24: 4551.[Crossref]
    [Google Scholar]
  17. Klontz EH, Faruque AS, Das SK, Malek MA, Islam Z, Luby SP, Klontz KC, 2012. Clinical and epidemiologic features of diarrheal disease due to Aeromonas hydrophila and Plesiomonas shigelloides infections compared with Those due to Vibrio cholerae Non-O1 and Vibrio parahaemolyticus in Bangladesh. ISRN Microbiol 2012: 654819.[Crossref]
    [Google Scholar]
  18. Lawson MA, Burke V, Chang BJ, 1985. Invasion of HEp-2 cells by fecal isolates of Aeromonas hydrophila . Infection and Immunity 47: 680683.
    [Google Scholar]
  19. Xu X-J, Ferguson MR, Popov VL, Houston CW, Peterson JW, Chopra AK, 1998. Role of a cytotoxic enterotoxin in Aeromonas-mediated infections: development of transposon and isogenic mutants. Infection and Immunity 66: 35013509.
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.16-0321
Loading
/content/journals/10.4269/ajtmh.16-0321
Loading

Data & Media loading...

Supplementary PDF

  • Received : 25 Apr 2016
  • Accepted : 15 Jun 2016
  • Published online : 05 Oct 2016

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error