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Coinfection with Enteric Pathogens in East African Children with Acute Gastroenteritis-Associations and

Maria Andersson1, Jean-Claude Kabayiza2, Kristina Elfving1

  • 1Department of Infectious Diseases, University of Gothenburg, Gothenburg, Sweden.

The American Journal of Tropical Medicine and Hygiene
|April 26, 2018
PubMed

Insights

Coinfections are common in children with diarrhea, but specific combinations matter. Some pathogen pairs were less common, while *Shigella* and enteropathogenic *E. coli* showed a positive association, potentially worsening symptoms.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Pediatrics

Background:

  • Enteric coinfections are frequent in young children in low-income settings.
  • Understanding pathogen combinations and their clinical significance is crucial.

Purpose of the Study:

  • To investigate associations between specific enteric pathogen combinations in children under five.
  • To determine the clinical importance of these coinfections.

Main Methods:

  • Real-time polymerase chain reaction (PCR) was used to analyze fecal samples from children in Rwanda and Zanzibar.
  • Pathogen co-detection and mono-detection frequencies were compared to identify pairwise associations.
  • Analysis included children with and without acute diarrhea.

Main Results:

  • Over 65% of samples showed multiple pathogen detections.
  • Negative associations were found between rotavirus and *Shigella*, *Campylobacter*, or norovirus in patients.
  • Positive associations were observed between enteropathogenic *E. coli* virulence genes and enterotoxigenic *E. coli* toxin genes.
  • A significant positive association between *Shigella* and enteropathogenic *E. coli* (EPEC) *eae* was noted in patients, suggesting enhanced symptoms.

Conclusions:

  • Coinfection interpretation depends on positive or negative associations.
  • Specific pathogen interactions, like *Shigella*-EPEC, may influence disease severity.
  • Further research is needed to understand the clinical impact of enteric coinfections.

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