Abstract
Pathogens in the gastrointestinal tract exist within a vast population of microbes. We examined associations between pathogens and composition of gut microbiota as they relate to Shigella spp./enteroinvasive Escherichia coli infection. We analyzed 3,035 stool specimens (1,735 nondiarrheal and 1,300 moderate-to-severe diarrheal) from the Global Enteric Multicenter Study for 9 enteropathogens. Diarrheal specimens had a higher number of enteropathogens (diarrheal mean 1.4, nondiarrheal mean 0.95; p<0.0001). Rotavirus showed a negative association with Shigella spp. in cases of diarrhea (odds ratio 0.31, 95% CI 0.17-0.55) and had a large combined effect on moderate-to-severe diarrhea (odds ratio 29, 95% CI 3.8-220). In 4 Lactobacillus taxa identified by 16S rRNA gene sequencing, the association between pathogen and disease was decreased, which is consistent with the possibility that Lactobacillus spp. are protective against Shigella spp.-induced diarrhea. Bacterial diversity of gut microbiota was associated with diarrhea status, not high levels of the Shigella spp. ipaH gene.
Highlights
Pathogens in the gastrointestinal tract exist within a vast population of microbes
Study Design and Participants We used stool specimens collected from children
A total of 3,035 (1,735 nondiarrheal and 1,300 diarrheal) stool specimens from children
Summary
Pathogens in the gastrointestinal tract exist within a vast population of microbes. We examined associations between pathogens and composition of gut microbiota as they relate to Shigella spp./enteroinvasive Escherichia coli infection. Platts-Mills et al, in a study of populations with a high prevalence of malnutrition and enteric infections in Tanzania, compared samples taken before and during diarrheal episodes [8] They did not find an association between the presence of any pathogen and diarrhea for 15 pathogens studied (rotavirus, adenovirus, astrovirus, norovirus, sapovirus, Cryptosporidium spp., Giardia lamblia, Campylobacter jejuni, Clostridium difficile, Salmonella spp., Shiga-toxigenic Escherichia coli, Shigella spp./enteroinvasive E. coli [EIEC], enterotoxigenic E. coli [ETEC], typical enteropathogenic E. coli [tEPEC], and enteroaggregative E. coli [EAEC]). A recent study by Taniuchi et al reported the etiology of diarrheal episodes by using molecular methods in Bangladeshi children during their first year of life They found that multiple enteropathogens were present by the first month of life in stool specimens from healthy children and from children with diarrhea [4]. We examined relationships between Shigella spp./ EIEC, microbiota, and diarrhea by using 16S rRNA marker gene surveys of stool specimens from a large international study of diarrhea in children
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