Site specific incidence rate of virulence related genes of enteroaggregative Escherichia coli and association with enteric inflammation and growth in children

Abstract

There is a lack of information highlighting the possible association between strain carrying genes of enteroaggregative Escherichia coli (EAEC) and environmental enteric dysfunction (EED) and on linear growth during childhood. Strain carrying genes of EAEC from stool samples collected from 1705 children enrolled in the MAL-ED birth cohort were detected by TaqMan Array Cards. We measured site-specific incidence rate by using Poisson regression models, identified the risk factors and estimated the associations of strain carrying genes of EAEC with the composite EED score and linear growth at 24 months of age. Overall highest incidence rate (43.3%) was found among children having infection with the aggR gene, which was the greatest in Tanzania (56.7%). Low maternal education, lack of improved floor, and ownership of domestic cattle were found to be risk factors for EAEC infection. In the multivariate models, after adjusting the potential covariates, strain carrying genes of EAEC showed strong positive associations with the EED scores and with poor linear growth at 24 months of age. Our analyses may lay the cornerstone for a prospective epidemiologic investigation for a potential vaccine development aimed at reducing the burden of EAEC infections and combat childhood malnutrition.

Association between Pathogenic Variants of Diarrheagenic Escherichia coli and Growth in Children under 5 Years of Age in the Global Enteric Multicenter Study

“… 41 A multicountry cohort study, MAL-ED, found that EAEC had an inverse association with linear growth at 24 months of age. 16 The increased prevalence of the aaiC pathogenic variant in our study compared with other EAEC variants may provide more evidence for the plasmid aggregative adherence (pAA’s) gene transfer. Our findings show that aaiC is an incongruent marker for EAEC identification and our findings are consistent with those of research conducted in southern Mozambique.…”

“…However, in the MAL-ED study, the presence of EAEC variants harboring both aaiC and aatA was linked to a higher risk of growth failure in Bangladeshi children. 16 Other studies suggested that the presence of different virulence genes from within and outside the plasmid AA is necessary for complete EAEC virulence. 43 In the case of EAEC, malnutrition and growth impairment may be due to intestinal inflammation or to the thick mucosal gel with which they are associated in human intestinal explants, which could theoretically impair absorption of nutrients.…”

“… 15 The eae serotype of EAEC exhibited positive relationships with poor linear development at 24 months of age in the MAL-ED study (Malnutrition and Enteric Disease Study). 16 …”

Association of Secretor Status with Enteropathy and Growth among Children in Bangladesh Aged 1–24 Months

“…1 Concurrent reports from studies carried out in the settings of the MAL-ED study have shown that asymptomatic infection by diarrheal enteropathogens such as Campylobacter jejuni/coli, EAEC, enterotoxigenic Bacteroides fragilis contribute to enteric inflammation. [5][6][7] Upper gastrointestinal (GI) endoscopy is widely regarded as the gold standard for the diagnosis of EED. 8 Although a few studies have used upper GI endoscopy to study the pathophysiology of EED, 9,10 the invasive nature of the procedure and the requirement of specialized clinical settings and expertise renders it infeasible to be carried out among children in resource-limited settings.…”

“… 1 Concurrent reports from studies carried out in the settings of the MAL-ED study have shown that asymptomatic infection by diarrheal enteropathogens such as Campylobacter jejuni/coli , EAEC, enterotoxigenic Bacteroides fragilis contribute to enteric inflammation. 5 – 7 …”