Pathogens Associated With Linear Growth Faltering in Children With Diarrhea and Impact of Antibiotic Treatment: The Global Enteric Multicenter Study
The association between childhood diarrheal disease and linear growth faltering in developing countries is well described. However, the impact attributed to specific pathogens has not been elucidated, nor has the impact of recommended antibiotic treatment. The Global Enteric Multicenter Study enroll...
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| Veröffentlicht in: | The Journal of infectious diseases 2021-12, Vol.224 (12 Suppl 2), p.S848-S855 |
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| creator | Nasrin, Dilruba Blackwelder, William C Sommerfelt, Halvor Wu, Yukun Farag, Tamer H Panchalingam, Sandra Biswas, Kousick Saha, Debasish Jahangir Hossain, M Sow, Samba O Reiman, Robert F B Sur, Dipika Faruque, Abu S G Zaidi, Anita K M Sanogo, Doh Tamboura, Boubou Onwuchekwa, Uma Manna, Byomkesh Ramamurthy, Thandavarayan Kanungo, Suman Omore, Richard Ochieng, John B Oundo, Joseph O Das, Sumon K Ahmed, Shahnawaz Qureshi, Shahida Quadri, Farheen Adegbola, Richard A Antonio, Martin Mandomando, Inacio Nhampossa, Tacilta Bassat, Quique Roose, Anna O'Reilly, Ciara E Mintz, Eric D Ramakrishnan, Usha Powell, Helen Liang, Yuanyuan Nataro, James P Levine, Myron M Kotloff, Karen L |
| description | The association between childhood diarrheal disease and linear growth faltering in developing countries is well described. However, the impact attributed to specific pathogens has not been elucidated, nor has the impact of recommended antibiotic treatment.
The Global Enteric Multicenter Study enrolled children with moderate to severe diarrhea (MSD) seeking healthcare at 7 sites in sub-Saharan Africa and South Asia. At enrollment, we collected stool samples to identify enteropathogens. Length/height was measured at enrollment and follow-up, approximately 60 days later, to calculate change in height-for-age z scores (ΔHAZ). The association of pathogens with ΔHAZ was tested using linear mixed effects regression models.
Among 8077 MSD cases analyzed, the proportion with stunting (HAZ below -1) increased from 59% at enrollment to 65% at follow-up (P < .0001). Pathogens significantly associated with linear growth decline included Cryptosporidium (P < .001), typical enteropathogenic Escherichia coli (P = .01), and untreated Shigella (P = .009) among infants (aged 0-11 months) and enterotoxigenic E. coli encoding heat-stable toxin (P < .001) and Cryptosporidium (P = .03) among toddlers (aged 12-23 months). Shigella-infected toddlers given antibiotics had improved linear growth (P = .02).
Linear growth faltering among children aged 0-23 months with MSD is associated with specific pathogens and can be mitigated with targeted treatment strategies, as demonstrated for Shigella. |
| doi_str_mv | 10.1093/infdis/jiab434 |
| format | Article |
| fullrecord | <record><control><sourceid>pubmed_cross</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8958895</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>34528677</sourcerecordid><originalsourceid>FETCH-LOGICAL-c435t-ce0c214bd8f4a01e3192512672ac8af805ec60c8dc5551cbf134990e569fbf0c3</originalsourceid><addsrcrecordid>eNpVkd1qGzEQhUVoqV2nt7kMeoF1pNVqf3JRMK7jGFxaiEsvl1ntyCuzlowkt_g9-sBd4yQkF8MwzDnfDBxCbjibclaJO2N1a8LdzkCTieyKjLkURZLnXHwgY8bSNOFlVY3I5xB2jLFM5MUnMhKZTMu8KMbk30-InduiDXQWglMGIrb0t4kdXRuL4OnSu7_D9AB9RG_slhpL553pW4_2IvxmwPsOgYJt6Wp_ABWp03Rmo2mMi0bRjUeIe7Txnm46pMveNdDThT0TFf1-7AcRnif6FI_t6Zp81NAH_PLcJ-TXw2Izf0zWP5ar-WydqEzImChkKuVZ05Y6A8ZR8CqVPM2LFFQJumQSVc5U2SopJVeN5iKrKoYyr3SjmRIT8vXCPRybPbbnFzz09cGbPfhT7cDU7zfWdPXW_anLSpZDDYDpBaC8C8GjfvVyVp_zqS_51M_5DIbbtxdf5S-BiP9FoJKR</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Pathogens Associated With Linear Growth Faltering in Children With Diarrhea and Impact of Antibiotic Treatment: The Global Enteric Multicenter Study</title><source>Oxford University Press Journals All Titles (1996-Current)</source><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>Nasrin, Dilruba ; Blackwelder, William C ; Sommerfelt, Halvor ; Wu, Yukun ; Farag, Tamer H ; Panchalingam, Sandra ; Biswas, Kousick ; Saha, Debasish ; Jahangir Hossain, M ; Sow, Samba O ; Reiman, Robert F B ; Sur, Dipika ; Faruque, Abu S G ; Zaidi, Anita K M ; Sanogo, Doh ; Tamboura, Boubou ; Onwuchekwa, Uma ; Manna, Byomkesh ; Ramamurthy, Thandavarayan ; Kanungo, Suman ; Omore, Richard ; Ochieng, John B ; Oundo, Joseph O ; Das, Sumon K ; Ahmed, Shahnawaz ; Qureshi, Shahida ; Quadri, Farheen ; Adegbola, Richard A ; Antonio, Martin ; Mandomando, Inacio ; Nhampossa, Tacilta ; Bassat, Quique ; Roose, Anna ; O'Reilly, Ciara E ; Mintz, Eric D ; Ramakrishnan, Usha ; Powell, Helen ; Liang, Yuanyuan ; Nataro, James P ; Levine, Myron M ; Kotloff, Karen L</creator><creatorcontrib>Nasrin, Dilruba ; Blackwelder, William C ; Sommerfelt, Halvor ; Wu, Yukun ; Farag, Tamer H ; Panchalingam, Sandra ; Biswas, Kousick ; Saha, Debasish ; Jahangir Hossain, M ; Sow, Samba O ; Reiman, Robert F B ; Sur, Dipika ; Faruque, Abu S G ; Zaidi, Anita K M ; Sanogo, Doh ; Tamboura, Boubou ; Onwuchekwa, Uma ; Manna, Byomkesh ; Ramamurthy, Thandavarayan ; Kanungo, Suman ; Omore, Richard ; Ochieng, John B ; Oundo, Joseph O ; Das, Sumon K ; Ahmed, Shahnawaz ; Qureshi, Shahida ; Quadri, Farheen ; Adegbola, Richard A ; Antonio, Martin ; Mandomando, Inacio ; Nhampossa, Tacilta ; Bassat, Quique ; Roose, Anna ; O'Reilly, Ciara E ; Mintz, Eric D ; Ramakrishnan, Usha ; Powell, Helen ; Liang, Yuanyuan ; Nataro, James P ; Levine, Myron M ; Kotloff, Karen L</creatorcontrib><description>The association between childhood diarrheal disease and linear growth faltering in developing countries is well described. However, the impact attributed to specific pathogens has not been elucidated, nor has the impact of recommended antibiotic treatment.
The Global Enteric Multicenter Study enrolled children with moderate to severe diarrhea (MSD) seeking healthcare at 7 sites in sub-Saharan Africa and South Asia. At enrollment, we collected stool samples to identify enteropathogens. Length/height was measured at enrollment and follow-up, approximately 60 days later, to calculate change in height-for-age z scores (ΔHAZ). The association of pathogens with ΔHAZ was tested using linear mixed effects regression models.
Among 8077 MSD cases analyzed, the proportion with stunting (HAZ below -1) increased from 59% at enrollment to 65% at follow-up (P < .0001). Pathogens significantly associated with linear growth decline included Cryptosporidium (P < .001), typical enteropathogenic Escherichia coli (P = .01), and untreated Shigella (P = .009) among infants (aged 0-11 months) and enterotoxigenic E. coli encoding heat-stable toxin (P < .001) and Cryptosporidium (P = .03) among toddlers (aged 12-23 months). Shigella-infected toddlers given antibiotics had improved linear growth (P = .02).
Linear growth faltering among children aged 0-23 months with MSD is associated with specific pathogens and can be mitigated with targeted treatment strategies, as demonstrated for Shigella.</description><identifier>ISSN: 0022-1899</identifier><identifier>EISSN: 1537-6613</identifier><identifier>DOI: 10.1093/infdis/jiab434</identifier><identifier>PMID: 34528677</identifier><language>eng</language><publisher>United States: Oxford University Press</publisher><subject>Anti-Bacterial Agents - therapeutic use ; Case-Control Studies ; Child ; Cryptosporidiosis - drug therapy ; Cryptosporidium - isolation & purification ; Cryptosporidium - pathogenicity ; Diarrhea - drug therapy ; Diarrhea - epidemiology ; Diarrhea - microbiology ; Enteric Diseases and Nutritional Disorders: Persisting Challenges for LMICs ; Escherichia coli - isolation & purification ; Escherichia coli - pathogenicity ; Female ; Growth Disorders - etiology ; Humans ; Infant ; Male ; Shigella - isolation & purification ; Shigella - pathogenicity</subject><ispartof>The Journal of infectious diseases, 2021-12, Vol.224 (12 Suppl 2), p.S848-S855</ispartof><rights>The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America.</rights><rights>The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America. 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c435t-ce0c214bd8f4a01e3192512672ac8af805ec60c8dc5551cbf134990e569fbf0c3</citedby><cites>FETCH-LOGICAL-c435t-ce0c214bd8f4a01e3192512672ac8af805ec60c8dc5551cbf134990e569fbf0c3</cites><orcidid>0000-0003-1694-1238 ; 0000-0003-0875-7596</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34528677$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nasrin, Dilruba</creatorcontrib><creatorcontrib>Blackwelder, William C</creatorcontrib><creatorcontrib>Sommerfelt, Halvor</creatorcontrib><creatorcontrib>Wu, Yukun</creatorcontrib><creatorcontrib>Farag, Tamer H</creatorcontrib><creatorcontrib>Panchalingam, Sandra</creatorcontrib><creatorcontrib>Biswas, Kousick</creatorcontrib><creatorcontrib>Saha, Debasish</creatorcontrib><creatorcontrib>Jahangir Hossain, M</creatorcontrib><creatorcontrib>Sow, Samba O</creatorcontrib><creatorcontrib>Reiman, Robert F B</creatorcontrib><creatorcontrib>Sur, Dipika</creatorcontrib><creatorcontrib>Faruque, Abu S G</creatorcontrib><creatorcontrib>Zaidi, Anita K M</creatorcontrib><creatorcontrib>Sanogo, Doh</creatorcontrib><creatorcontrib>Tamboura, Boubou</creatorcontrib><creatorcontrib>Onwuchekwa, Uma</creatorcontrib><creatorcontrib>Manna, Byomkesh</creatorcontrib><creatorcontrib>Ramamurthy, Thandavarayan</creatorcontrib><creatorcontrib>Kanungo, Suman</creatorcontrib><creatorcontrib>Omore, Richard</creatorcontrib><creatorcontrib>Ochieng, John B</creatorcontrib><creatorcontrib>Oundo, Joseph O</creatorcontrib><creatorcontrib>Das, Sumon K</creatorcontrib><creatorcontrib>Ahmed, Shahnawaz</creatorcontrib><creatorcontrib>Qureshi, Shahida</creatorcontrib><creatorcontrib>Quadri, Farheen</creatorcontrib><creatorcontrib>Adegbola, Richard A</creatorcontrib><creatorcontrib>Antonio, Martin</creatorcontrib><creatorcontrib>Mandomando, Inacio</creatorcontrib><creatorcontrib>Nhampossa, Tacilta</creatorcontrib><creatorcontrib>Bassat, Quique</creatorcontrib><creatorcontrib>Roose, Anna</creatorcontrib><creatorcontrib>O'Reilly, Ciara E</creatorcontrib><creatorcontrib>Mintz, Eric D</creatorcontrib><creatorcontrib>Ramakrishnan, Usha</creatorcontrib><creatorcontrib>Powell, Helen</creatorcontrib><creatorcontrib>Liang, Yuanyuan</creatorcontrib><creatorcontrib>Nataro, James P</creatorcontrib><creatorcontrib>Levine, Myron M</creatorcontrib><creatorcontrib>Kotloff, Karen L</creatorcontrib><title>Pathogens Associated With Linear Growth Faltering in Children With Diarrhea and Impact of Antibiotic Treatment: The Global Enteric Multicenter Study</title><title>The Journal of infectious diseases</title><addtitle>J Infect Dis</addtitle><description>The association between childhood diarrheal disease and linear growth faltering in developing countries is well described. However, the impact attributed to specific pathogens has not been elucidated, nor has the impact of recommended antibiotic treatment.
The Global Enteric Multicenter Study enrolled children with moderate to severe diarrhea (MSD) seeking healthcare at 7 sites in sub-Saharan Africa and South Asia. At enrollment, we collected stool samples to identify enteropathogens. Length/height was measured at enrollment and follow-up, approximately 60 days later, to calculate change in height-for-age z scores (ΔHAZ). The association of pathogens with ΔHAZ was tested using linear mixed effects regression models.
Among 8077 MSD cases analyzed, the proportion with stunting (HAZ below -1) increased from 59% at enrollment to 65% at follow-up (P < .0001). Pathogens significantly associated with linear growth decline included Cryptosporidium (P < .001), typical enteropathogenic Escherichia coli (P = .01), and untreated Shigella (P = .009) among infants (aged 0-11 months) and enterotoxigenic E. coli encoding heat-stable toxin (P < .001) and Cryptosporidium (P = .03) among toddlers (aged 12-23 months). Shigella-infected toddlers given antibiotics had improved linear growth (P = .02).
Linear growth faltering among children aged 0-23 months with MSD is associated with specific pathogens and can be mitigated with targeted treatment strategies, as demonstrated for Shigella.</description><subject>Anti-Bacterial Agents - therapeutic use</subject><subject>Case-Control Studies</subject><subject>Child</subject><subject>Cryptosporidiosis - drug therapy</subject><subject>Cryptosporidium - isolation & purification</subject><subject>Cryptosporidium - pathogenicity</subject><subject>Diarrhea - drug therapy</subject><subject>Diarrhea - epidemiology</subject><subject>Diarrhea - microbiology</subject><subject>Enteric Diseases and Nutritional Disorders: Persisting Challenges for LMICs</subject><subject>Escherichia coli - isolation & purification</subject><subject>Escherichia coli - pathogenicity</subject><subject>Female</subject><subject>Growth Disorders - etiology</subject><subject>Humans</subject><subject>Infant</subject><subject>Male</subject><subject>Shigella - isolation & purification</subject><subject>Shigella - 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However, the impact attributed to specific pathogens has not been elucidated, nor has the impact of recommended antibiotic treatment.
The Global Enteric Multicenter Study enrolled children with moderate to severe diarrhea (MSD) seeking healthcare at 7 sites in sub-Saharan Africa and South Asia. At enrollment, we collected stool samples to identify enteropathogens. Length/height was measured at enrollment and follow-up, approximately 60 days later, to calculate change in height-for-age z scores (ΔHAZ). The association of pathogens with ΔHAZ was tested using linear mixed effects regression models.
Among 8077 MSD cases analyzed, the proportion with stunting (HAZ below -1) increased from 59% at enrollment to 65% at follow-up (P < .0001). Pathogens significantly associated with linear growth decline included Cryptosporidium (P < .001), typical enteropathogenic Escherichia coli (P = .01), and untreated Shigella (P = .009) among infants (aged 0-11 months) and enterotoxigenic E. coli encoding heat-stable toxin (P < .001) and Cryptosporidium (P = .03) among toddlers (aged 12-23 months). Shigella-infected toddlers given antibiotics had improved linear growth (P = .02).
Linear growth faltering among children aged 0-23 months with MSD is associated with specific pathogens and can be mitigated with targeted treatment strategies, as demonstrated for Shigella.</abstract><cop>United States</cop><pub>Oxford University Press</pub><pmid>34528677</pmid><doi>10.1093/infdis/jiab434</doi><orcidid>https://orcid.org/0000-0003-1694-1238</orcidid><orcidid>https://orcid.org/0000-0003-0875-7596</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0022-1899 |
| ispartof | The Journal of infectious diseases, 2021-12, Vol.224 (12 Suppl 2), p.S848-S855 |
| issn | 0022-1899 1537-6613 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8958895 |
| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; Alma/SFX Local Collection |
| subjects | Anti-Bacterial Agents - therapeutic use Case-Control Studies Child Cryptosporidiosis - drug therapy Cryptosporidium - isolation & purification Cryptosporidium - pathogenicity Diarrhea - drug therapy Diarrhea - epidemiology Diarrhea - microbiology Enteric Diseases and Nutritional Disorders: Persisting Challenges for LMICs Escherichia coli - isolation & purification Escherichia coli - pathogenicity Female Growth Disorders - etiology Humans Infant Male Shigella - isolation & purification Shigella - pathogenicity |
| title | Pathogens Associated With Linear Growth Faltering in Children With Diarrhea and Impact of Antibiotic Treatment: The Global Enteric Multicenter Study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-08T18%3A55%3A56IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-pubmed_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Pathogens%20Associated%20With%20Linear%20Growth%20Faltering%20in%20Children%20With%20Diarrhea%20and%20Impact%20of%20Antibiotic%20Treatment:%20The%20Global%20Enteric%20Multicenter%20Study&rft.jtitle=The%20Journal%20of%20infectious%20diseases&rft.au=Nasrin,%20Dilruba&rft.date=2021-12-20&rft.volume=224&rft.issue=12%20Suppl%202&rft.spage=S848&rft.epage=S855&rft.pages=S848-S855&rft.issn=0022-1899&rft.eissn=1537-6613&rft_id=info:doi/10.1093/infdis/jiab434&rft_dat=%3Cpubmed_cross%3E34528677%3C/pubmed_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_id=info:pmid/34528677&rfr_iscdi=true |