Disease burden due to enterotoxigenic Escherichia coli in the first 2 years of life in an urban community in Bangladesh

被引:180
作者
Qadri, Firdausi
Saha, Amit
Ahmed, Tanvir
Al Tarique, Abdullah
Begum, Yasmin Ara
Svennerholm, Ann-Mari
机构
[1] ICDDR B, Div Sci Lab, Dhaka 1000, Bangladesh
[2] GUVAX, S-40530 Gothenburg, Sweden
[3] Univ Gothenburg, Dept Microbiol & Immunol, Sahlgrenska Acad, S-40530 Gothenburg, Sweden
关键词
D O I
10.1128/IAI.00459-07
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
A cohort of 321 children was followed from birth up to 2 years of age to determine the incidence of enterotoxigenic Escherichia coli (ETEC) in Bangladesh. The average number of diarrheal days and incidence rates were 6.6 and 2.3/child/year, respectively. ETEC was the most common pathogen and was isolated in 19.5% cases, with an incidence of 0.5 episode/child/year. The prevalence of rotavirus diarrhea was lower (10%). ETEC expressing the heat-stable enterotoxin (ST) was predominant. Strains isolated from diarrheal cases were positive for colonization factors (CFs) in higher frequency (66%) than from healthy children (33%) (P < 0.001). The heat-labile toxin (LT)-positive strains from healthy children were more often CF negative (92%) than those isolated from children with diarrhea (73%) (P < 0.001). In children with symptomatic or asymptomatic infections by CFA/I, CS1 plus CS3, CS2 plus CS3, or CS5 plus CS6 strains, a repeat episode of diarrhea or infection by the homologous CF type was uncommon. Repeat symptomatic infections were noted mostly for LT-and ST-expressing ETEC. ETEC diarrhea was more prevalent in children in the A and AB groups than in those in the 0 blood group (P = 0.032 to 0.023). Children with ETEC diarrhea were underweight and growth stunted at the 2-year follow-up period, showing the importance of strategies to prevent and decrease ETEC diarrheal morbidity in children.
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页码:3961 / 3968
页数:8
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