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

Rina Das,A S G Faruque,Md Ahshanul Haque,Parag Palit,Tahmeed Ahmed,Mustafa Mahfuz

doi:10.1038/s41598-021-02626-z

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.

Highlights

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
All the stool samples collected over this time from all the participants at the different study sites were assessed for the presence of strain carrying genes associated with EAEC using TaqMan Array Cards (TAC)
Overall 874 (50.96) 78.6 ± 57.7 3.0 ± 0.5 − 0.8 ± 1.1. This is the first study investigating the association between different strain carrying genes of EAEC with linear growth and enteric inflammation in children from birth until 2 years of age

Summary

Introduction

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. 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. 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. The aagR plasmid, harbored by most EAEC strains encodes a transcriptional activator of the AtaC/XylS class known as A ggR11, which in turn, regulates the expression of virulence proteins involved in the adherence to mucosal secretions and thereby promoting intestinal c olonization[12, 13]. There is a complex interplay between AggR and Aar, in relation to the virulence of EAEC and its consequent p athogenesis[16]

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