Use of TaqMan Array Cards to investigate the aetiological agents of diarrhoea among young infants with severe acute malnutrition

Abstract

Objectives: Studies involving less sensitive conventional microscopy and culture-based approaches have identified distinct differences in diarrhoeal aetiology in childhood malnutrition. Our study involved the use of an advanced molecular biology technique, the TaqMan Array Cards (TAC), to elucidate the diarrhoeal aetiology among young infants with severe acute malnutrition (SAM). Method: A total of 113 faecal samples was collected from SAM infants, aged 2-6 months, upon admission to the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) with complications of diarrhoea and related comorbidities. We used TAC for the detection of 29 different diarrhoeal enteropathogens from a single faecal sample. For comparison, we also analysed 25 diarrhoeal samples from wellnourished infants of similar age.Results: Higher odds of detection of all bacterial enteropathogens were associated with diarrhoea among SAM infants. In particular, the detection of Aeromonas sp (aOR: 25.7, p = 0.011), Campylobacter sp (aOR: 9.6, p < 0.01) and ETEC (aOR: 5.2, p = 0.022) was significantly associated with diarrhoea among SAM infants in comparison to wellnourished infants. 80% higher odds of detection of rotavirus and norovirus GII were associated with diarrhoea among well-nourished infants in comparison to SAM infants (aOR: 0.2, p < 0.05). Conclusion:Our study findings demonstrate a difference in diarrhoeal aetiology among SAM and well-nourished young infants, which may be useful in providing an evidence-based logic for possible revision of treatment guidelines for treatment of young diarrhoeal infants with SAM in the early management of the menace of antimicrobial resistance.

Infection With Escherichia Coli Pathotypes Is Associated With Biomarkers of Gut Enteropathy and Nutritional Status Among Malnourished Children in Bangladesh

“…A recent study conducted among Bangladeshi children dwelling in an urban slum found that the most frequently found pathogens in the children with EED and healthy children were EAEC, ETEC, and EPEC ( Chen et al., 2020 ). Prior study in Bangladesh also showed that the detection of EAEC was highest in both severely acute malnourished and well-nourished groups followed by EPEC and ETEC in the malnourished group which is in line with our current findings ( Palit et al., 2021 ). Moreover, a systematic review of the ailment in underdeveloped countries depicted that EAEC, ETEC, and EPEC are the primary pathogens and are accountable for 30-40% of all persistent diarrhea among children ( Abba et al., 2009 ).…”

“…In underdeveloped nations, diarrhoeagenic strains of Escherichia coli (E. coli) are the prevalent cause of childhood diarrhea, with a higher frequency during the first two years of life ( Gomes et al., 2016 ). They are subdivided into several pathotypes on the basis of their virulence genes which include enteroaggregative (EAEC), enterotoxigenic (ETEC), enteropathogenic (EPEC), shiga toxin–producing (STEC), and enteroinvasive (EIEC), among which EAEC, ETEC, and EPEC are mostly prevalent in developing countries ( Gomes et al., 2016 ; Palit et al., 2021 ). Recent studies found the interaction effect of EAEC with other pathogens on gut inflammation and significant development impairments in children, with MPO concentrations being significantly higher with EAEC coinfection ( Fahim et al., 2018 ; Lima et al., 2018 ).…”

Site-Specific Analysis of the Incidence Rate of Enterotoxigenic Escherichia coli Infection Elucidates an Association with Childhood Stunting, Wasting, and Being Underweight: A Secondary Analysis of the MAL-ED Birth Cohort

“…9 In particular, TaqMan array cards provide a very sensitive method for detecting a wide range of enteropathogens. [10][11][12][13] A study conducted earlier by Rogawski et al assessed the site-specific prevalence of the asymptomatic ETEC infection and its association with LAZ in children at 2 years of age; it is unclear whether the analysis was longitudinal. 8 Moreover, the literature also did not investigate the association between all forms of malnutrition (LAZ, WAZ, and WLZ) and the two pathovariants of ETEC (ST-ETEC and LT-ETEC).…”

“… 9 In particular, TaqMan array cards provide a very sensitive method for detecting a wide range of enteropathogens. 10 – 13 A study conducted earlier by Rogawski et al. assessed the site-specific prevalence of the asymptomatic ETEC infection and its association with LAZ in children at 2 years of age; it is unclear whether the analysis was longitudinal.…”

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“…In underdeveloped nations, diarrhoeagenic strains of Escherichia coli (E. coli) are the prevalent cause of childhood diarrhea, with a higher frequency during the first two years of life (Gomes et al, 2016). They are subdivided into several pathotypes on the basis of their virulence genes which include enteroaggregative (EAEC), enterotoxigenic (ETEC), enteropathogenic (EPEC), shiga toxinproducing (STEC), and enteroinvasive (EIEC), among which EAEC, ETEC, and EPEC are mostly prevalent in developing countries (Gomes et al, 2016;Palit et al, 2021). Recent studies found the interaction effect of EAEC with other pathogens on gut inflammation and significant development impairments in children, with MPO concentrations being significantly higher with EAEC coinfection (Fahim et al, 2018;Lima et al, 2018).…”