Age-related susceptibility to infection with diarrheagenic Escherichia coli among infants from Periurban areas in Lima, Peru

2.50
Hdl Handle:
http://hdl.handle.net/10757/556074
Title:
Age-related susceptibility to infection with diarrheagenic Escherichia coli among infants from Periurban areas in Lima, Peru
Authors:
Ochoa, Theresa J.; Ecker, Lucie; Barletta, Francesca; Mispireta, Mónica L.; Gil, Ana I.; Contreras, Carmen; Molina, Margarita; Amemiya, Isabel; Verastegui, Hector; Hall, Eric R.; Cleary, Thomas G.; Lanata, Claudio F.
Publisher:
Oxford University Press
Journal:
Clinical Infectious Diseases (Clin Infect Dis)
Issue Date:
30-May-2015
URI:
http://hdl.handle.net/10757/556074
DOI:
10.1086/648069.
PubMed ID:
19857163
PubMed Central ID:
PMC2779581
Additional Links:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2779581/
Abstract:
BACKGROUND: Diarrheagenic Escherichia coli strains are being recognized as important pediatric enteropathogens worldwide. However, it is unclear whether there are differences in age-related susceptibility to specific strains, especially among infants. METHODS: We conducted a passive surveillance cohort study of diarrhea that involved 1034 children aged 2-12 months in Lima, Peru. Control stool samples were collected from randomly selected children without diarrhea. All samples were analyzed for common enteric pathogens and for diarrheagenic E. coli with use of multiplex real-time polymerase chain reaction. RESULTS: The most frequently isolated pathogens in 1065 diarrheal episodes were diarrheagenic E. coli strains (31%), including enteroaggregative (15.1%) and enteropathogenic E. coli (7.6%). Diarrheagenic E. coli, Campylobacter species, and rotavirus were more frequently isolated from infants aged >or=6 months. Among older infants, diffusely adherent E. coli and enterotoxigenic E. coli were more frequently isolated from diarrheal samples than from control samples (P <.05). Children aged >or=6 months who were infected with enterotoxigenic E. coli had a 4.56-fold increased risk of diarrhea (95% confidence interval, 1.20-17.28), compared with younger children. Persistent diarrhea was more common in infants aged <6 months (13.5% vs 3.6%; P <.001). Among children with diarrheagenic E. coli-positive samples, coinfections with other pathogens were more common in children with diarrhea than in control children (40.1% vs 15.6%; P <.001). CONCLUSIONS: Diarrheagenic E. coli strains were more frequently isolated in samples from older infants. In this setting with high frequency of pathogen exposure and high frequency of breastfeeding, we hypothesize that the major age-related differences result from decreased exposure to milk-related protective factors and from increased exposure to contaminated food and water.
Type:
info:eu-repo/semantics/article
Rights:
info:eu-repo/semantics/openAccess
Language:
eng
Description:
Theresa.J.Ochoa@uth.tmc.edu; Article
Keywords:
Diarrheagenic E. coli; Age-related susceptibility; Diarrhea; Infants; Peru
ISSN:
1058-4838
EISSN:
1537-6591

Full metadata record

DC FieldValue Language
dc.contributor.authorOchoa, Theresa J.es_PE
dc.contributor.authorEcker, Luciees_PE
dc.contributor.authorBarletta, Francescaes_PE
dc.contributor.authorMispireta, Mónica L.es_PE
dc.contributor.authorGil, Ana I.es_PE
dc.contributor.authorContreras, Carmenes_PE
dc.contributor.authorMolina, Margaritaes_PE
dc.contributor.authorAmemiya, Isabeles_PE
dc.contributor.authorVerastegui, Hectores_PE
dc.contributor.authorHall, Eric R.es_PE
dc.contributor.authorCleary, Thomas G.es_PE
dc.contributor.authorLanata, Claudio F.es_PE
dc.date.accessioned2015-05-30T17:22:20Zes_PE
dc.date.available2015-05-30T17:22:20Zes_PE
dc.date.issued2015-05-30es_PE
dc.identifier.issn1058-4838es_PE
dc.identifier.pmid19857163es_PE
dc.identifier.doi10.1086/648069.es_PE
dc.identifier.urihttp://hdl.handle.net/10757/556074es_PE
dc.descriptionTheresa.J.Ochoa@uth.tmc.edues_PE
dc.descriptionArticlees_PE
dc.description.abstractBACKGROUND: Diarrheagenic Escherichia coli strains are being recognized as important pediatric enteropathogens worldwide. However, it is unclear whether there are differences in age-related susceptibility to specific strains, especially among infants. METHODS: We conducted a passive surveillance cohort study of diarrhea that involved 1034 children aged 2-12 months in Lima, Peru. Control stool samples were collected from randomly selected children without diarrhea. All samples were analyzed for common enteric pathogens and for diarrheagenic E. coli with use of multiplex real-time polymerase chain reaction. RESULTS: The most frequently isolated pathogens in 1065 diarrheal episodes were diarrheagenic E. coli strains (31%), including enteroaggregative (15.1%) and enteropathogenic E. coli (7.6%). Diarrheagenic E. coli, Campylobacter species, and rotavirus were more frequently isolated from infants aged >or=6 months. Among older infants, diffusely adherent E. coli and enterotoxigenic E. coli were more frequently isolated from diarrheal samples than from control samples (P <.05). Children aged >or=6 months who were infected with enterotoxigenic E. coli had a 4.56-fold increased risk of diarrhea (95% confidence interval, 1.20-17.28), compared with younger children. Persistent diarrhea was more common in infants aged <6 months (13.5% vs 3.6%; P <.001). Among children with diarrheagenic E. coli-positive samples, coinfections with other pathogens were more common in children with diarrhea than in control children (40.1% vs 15.6%; P <.001). CONCLUSIONS: Diarrheagenic E. coli strains were more frequently isolated in samples from older infants. In this setting with high frequency of pathogen exposure and high frequency of breastfeeding, we hypothesize that the major age-related differences result from decreased exposure to milk-related protective factors and from increased exposure to contaminated food and water.eng
dc.formatapplication/pdfes_PE
dc.language.isoenges_PE
dc.publisherOxford University Presses_PE
dc.relation.urlhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC2779581/es_PE
dc.rightsinfo:eu-repo/semantics/openAccesses_PE
dc.sourceUniversidad Peruana de Ciencias Aplicadas (UPC)es_PE
dc.sourceRepositorio Académico - UPCes_PE
dc.subjectDiarrheagenic E. colies_PE
dc.subjectAge-related susceptibilityes_PE
dc.subjectDiarrheaes_PE
dc.subjectInfantses_PE
dc.subjectPerues_PE
dc.titleAge-related susceptibility to infection with diarrheagenic Escherichia coli among infants from Periurban areas in Lima, Perues_PE
dc.typeinfo:eu-repo/semantics/articlees_PE
dc.identifier.eissn1537-6591es_PE
dc.identifier.journalClinical Infectious Diseases (Clin Infect Dis)es_PE
dc.identifier.pmcidPMC2779581es_PE
dc.description.fundingDr. T. Ochoa is supported by 1K01TW007405; Dr. T. Cleary is supported by R01-HD051716. This work has been partially funded by Dr. C. Lanata's Institutional Research Funds and by the United States Military Infectious Disease Research Program (MIDRP), work unit number 60000.000.0.B0017. The views expressed in this article are those of the author and do not necessarily reflect the official policy or position of the Department of the Navy, Department of Defense, the U.S. Government, nor the National Institutes of Health and other funding institutions. Financial Support: This work has been partially funded by 1K01TW007405 grant (Dr. Ochoa); R01-HD051716 grant (Dr. Cleary); by Dr. Lanata's Institutional Research Funds and by the United States Military Infectious Disease Research Program (MIDRP), work unit number 60000.000.0.B0017.es_PE
dc.description.peer-reviewRevisión por pareses_PE
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