RETRACTED: Tropheryma whipplei associated with diarrhoea in young children

Abstract

Tropheryma whipplei was detected in preliminary studies in faeces of young children with diarrhoea and also in faeces of asymptomatic persons, not only in Europe but also in Africa. In this study, the link between this bacterium and the presence of acute diarrhoea was evaluated in a large group of children. From December 2009 to January 2013, rectal swabs collected from 3796 children in the emergency departments of university hospitals in Marseille, France, were analysed: 555 children (245 female and 310 male, from 6 days to 6 years old) with acute diarrhoea defined as at least three loose stools per day for <1 week and 3241 children (1444 female and 1797 male, from 22 days to 6 years old) without diarrhoea. Specific quantitative real-time PCR was performed to detect the presence of T. whipplei and of two enteric pathogens Clostridium difficile and Giardia duodenalis. Tropheryma whipplei was significantly more common in children with diarrhoea (22/555, 4%) than without (56/3241, 1.7%; p 0.001). Neither C. difficile nor G. duodenalis showed this association. For C. difficile, 39 of 531 (7.3%) children with diarrhoea were positive versus 184 of 3119 (5.9%) of children without diarrhoea (p 0.25). For G. duodenalis, 2 of 529 (0.37%) children with diarrhoea were positive versus 5 of 3119 (0.16%) children without diarrhoea (p 0.26). Tropheryma whipplei was found more commonly in autumn. Tropheryma whipplei is significantly associated with diarrhoea in children, suggesting that the bacterium may be a cause of acute diarrhoea.

Acute Infections Caused by Tropheryma Whipplei

“…was only observed in four cases. The incidence of diarrhea associated with T. whipplei varied from year to year, from 2% in 2012 [18], 15% in 2006-2008 [21], to 16% in 2009 [18]. In this large cohort, the seasonal circulation of T. whipplei was mainly observed during autumn [18].…”

“…The involvement of T. whipplei in acute infections is definitively based on strong evidence, at least in cases of acute gastroenteritis for which there is strong epidemiological and clinical data as well as an experimental model [18,21,22]. Further larger studies will be needed to support the hypothesis that T. whipplei is a causative agent of traveler's diarrhea [23,24].…”

“…Indeed, we consider that T. whipplei is one of the main significant examples of the absolute need to use controls in the study of epidemiological acute infectious diseases [40]. Tropheryma whipplei is a proof of this concept, whether on stool samples or in BAL fluids samples, or in blood samples where this bacterium was sometimes detected in totally asymptomatic individuals [16][17][18].…”

“…In a subsequent study performed between 2009 and 2013, the link between T. whipplei and acute diarrhea was investigated in a larger cohort of children [18]. A total of 3796 rectal swabs were collected from the emergency departments of hospitals in Marseille, France and were tested for T. whipplei.…”

“…However, in addition to these chronic infections and asymptomatic carriage, acute T. whipplei infections may be sometimes encountered [2] (Figure 2). Recently, new data were made available on T. whipplei bacteremia in febrile Senegalese patients, on T. whipplei acute gastroenteritis as well as on T. whipplei pneumonia [16][17][18]. In this paper, we propose focusing on these acute infections, highlighting the possible natural history of this surprising bacterium.…”