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Colonization factors among enterotoxigenic Escherichia coli isolates from children with moderate-to-severe diarrhea and from matched controls in the Global Enteric Multicenter Study (GEMS)
BACKGROUND: Enterotoxigenic Escherichia coli (ETEC) encoding heat-stable enterotoxin (ST) alone or with heat-labile enterotoxin (LT) cause moderate-to-severe diarrhea (MSD) in developing country children. The Global Enteric Multicenter Study (GEMS) identified ETEC encoding ST among the top four ente...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6343939/ https://www.ncbi.nlm.nih.gov/pubmed/30608930 http://dx.doi.org/10.1371/journal.pntd.0007037 |
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author | Vidal, Roberto M. Muhsen, Khitam Tennant, Sharon M. Svennerholm, Ann-Mari Sow, Samba O. Sur, Dipika Zaidi, Anita K. M. Faruque, Abu S. G. Saha, Debasish Adegbola, Richard Hossain, M. Jahangir Alonso, Pedro L. Breiman, Robert F. Bassat, Quique Tamboura, Boubou Sanogo, Doh Onwuchekwa, Uma Manna, Byomkesh Ramamurthy, Thandavarayan Kanungo, Suman Ahmed, Shahnawaz Qureshi, Shahida Quadri, Farheen Hossain, Anowar Das, Sumon K. Antonio, Martin Mandomando, Inacio Nhampossa, Tacilta Acácio, Sozinho Omore, Richard Ochieng, John B. Oundo, Joseph O. Mintz, Eric D. O’Reilly, Ciara E. Berkeley, Lynette Y. Livio, Sofie Panchalingam, Sandra Nasrin, Dilruba Farag, Tamer H. Wu, Yukun Sommerfelt, Halvor Robins-Browne, Roy M. Del Canto, Felipe Hazen, Tracy H. Rasko, David A. Kotloff, Karen L. Nataro, James P. Levine, Myron M. |
author_facet | Vidal, Roberto M. Muhsen, Khitam Tennant, Sharon M. Svennerholm, Ann-Mari Sow, Samba O. Sur, Dipika Zaidi, Anita K. M. Faruque, Abu S. G. Saha, Debasish Adegbola, Richard Hossain, M. Jahangir Alonso, Pedro L. Breiman, Robert F. Bassat, Quique Tamboura, Boubou Sanogo, Doh Onwuchekwa, Uma Manna, Byomkesh Ramamurthy, Thandavarayan Kanungo, Suman Ahmed, Shahnawaz Qureshi, Shahida Quadri, Farheen Hossain, Anowar Das, Sumon K. Antonio, Martin Mandomando, Inacio Nhampossa, Tacilta Acácio, Sozinho Omore, Richard Ochieng, John B. Oundo, Joseph O. Mintz, Eric D. O’Reilly, Ciara E. Berkeley, Lynette Y. Livio, Sofie Panchalingam, Sandra Nasrin, Dilruba Farag, Tamer H. Wu, Yukun Sommerfelt, Halvor Robins-Browne, Roy M. Del Canto, Felipe Hazen, Tracy H. Rasko, David A. Kotloff, Karen L. Nataro, James P. Levine, Myron M. |
author_sort | Vidal, Roberto M. |
collection | PubMed |
description | BACKGROUND: Enterotoxigenic Escherichia coli (ETEC) encoding heat-stable enterotoxin (ST) alone or with heat-labile enterotoxin (LT) cause moderate-to-severe diarrhea (MSD) in developing country children. The Global Enteric Multicenter Study (GEMS) identified ETEC encoding ST among the top four enteropathogens. Since the GEMS objective was to provide evidence to guide development and implementation of enteric vaccines and other interventions to diminish diarrheal disease morbidity and mortality, we examined colonization factor (CF) prevalence among ETEC isolates from children age <5 years with MSD and from matched controls in four African and three Asian sites. We also assessed strength of association of specific CFs with MSD. METHODOLOGY/PRINCIPAL FINDINGS: MSD cases enrolled at healthcare facilities over three years and matched controls were tested in a standardized manner for many enteropathogens. To identify ETEC, three E. coli colonies per child were tested by polymerase chain reaction (PCR) to detect genes encoding LT, ST; confirmed ETEC were examined by PCR for major CFs (Colonization Factor Antigen I [CFA/I] or Coli Surface [CS] antigens CS1-CS6) and minor CFs (CS7, CS12, CS13, CS14, CS17, CS18, CS19, CS20, CS21, CS30). ETEC from 806 cases had a single toxin/CF profile in three tested strains per child. Major CFs, components of multiple ETEC vaccine candidates, were detected in 66.0% of LT/ST and ST-only cases and were associated with MSD versus matched controls by conditional logistic regression (p≤0.006); major CFs detected in only 25.0% of LT-only cases weren’t associated with MSD. ETEC encoding exclusively CS14, identified among 19.9% of 291 ST-only and 1.5% of 259 LT/ST strains, were associated with MSD (p = 0.0011). No other minor CF exhibited prevalence ≥5% and significant association with MSD. CONCLUSIONS/SIGNIFICANCE: Major CF-based efficacious ETEC vaccines could potentially prevent up to 66% of pediatric MSD cases due to ST-encoding ETEC in developing countries; adding CS14 extends coverage to ~77%. |
format | Online Article Text |
id | pubmed-6343939 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-63439392019-02-01 Colonization factors among enterotoxigenic Escherichia coli isolates from children with moderate-to-severe diarrhea and from matched controls in the Global Enteric Multicenter Study (GEMS) Vidal, Roberto M. Muhsen, Khitam Tennant, Sharon M. Svennerholm, Ann-Mari Sow, Samba O. Sur, Dipika Zaidi, Anita K. M. Faruque, Abu S. G. Saha, Debasish Adegbola, Richard Hossain, M. Jahangir Alonso, Pedro L. Breiman, Robert F. Bassat, Quique Tamboura, Boubou Sanogo, Doh Onwuchekwa, Uma Manna, Byomkesh Ramamurthy, Thandavarayan Kanungo, Suman Ahmed, Shahnawaz Qureshi, Shahida Quadri, Farheen Hossain, Anowar Das, Sumon K. Antonio, Martin Mandomando, Inacio Nhampossa, Tacilta Acácio, Sozinho Omore, Richard Ochieng, John B. Oundo, Joseph O. Mintz, Eric D. O’Reilly, Ciara E. Berkeley, Lynette Y. Livio, Sofie Panchalingam, Sandra Nasrin, Dilruba Farag, Tamer H. Wu, Yukun Sommerfelt, Halvor Robins-Browne, Roy M. Del Canto, Felipe Hazen, Tracy H. Rasko, David A. Kotloff, Karen L. Nataro, James P. Levine, Myron M. PLoS Negl Trop Dis Research Article BACKGROUND: Enterotoxigenic Escherichia coli (ETEC) encoding heat-stable enterotoxin (ST) alone or with heat-labile enterotoxin (LT) cause moderate-to-severe diarrhea (MSD) in developing country children. The Global Enteric Multicenter Study (GEMS) identified ETEC encoding ST among the top four enteropathogens. Since the GEMS objective was to provide evidence to guide development and implementation of enteric vaccines and other interventions to diminish diarrheal disease morbidity and mortality, we examined colonization factor (CF) prevalence among ETEC isolates from children age <5 years with MSD and from matched controls in four African and three Asian sites. We also assessed strength of association of specific CFs with MSD. METHODOLOGY/PRINCIPAL FINDINGS: MSD cases enrolled at healthcare facilities over three years and matched controls were tested in a standardized manner for many enteropathogens. To identify ETEC, three E. coli colonies per child were tested by polymerase chain reaction (PCR) to detect genes encoding LT, ST; confirmed ETEC were examined by PCR for major CFs (Colonization Factor Antigen I [CFA/I] or Coli Surface [CS] antigens CS1-CS6) and minor CFs (CS7, CS12, CS13, CS14, CS17, CS18, CS19, CS20, CS21, CS30). ETEC from 806 cases had a single toxin/CF profile in three tested strains per child. Major CFs, components of multiple ETEC vaccine candidates, were detected in 66.0% of LT/ST and ST-only cases and were associated with MSD versus matched controls by conditional logistic regression (p≤0.006); major CFs detected in only 25.0% of LT-only cases weren’t associated with MSD. ETEC encoding exclusively CS14, identified among 19.9% of 291 ST-only and 1.5% of 259 LT/ST strains, were associated with MSD (p = 0.0011). No other minor CF exhibited prevalence ≥5% and significant association with MSD. CONCLUSIONS/SIGNIFICANCE: Major CF-based efficacious ETEC vaccines could potentially prevent up to 66% of pediatric MSD cases due to ST-encoding ETEC in developing countries; adding CS14 extends coverage to ~77%. Public Library of Science 2019-01-04 /pmc/articles/PMC6343939/ /pubmed/30608930 http://dx.doi.org/10.1371/journal.pntd.0007037 Text en https://creativecommons.org/publicdomain/zero/1.0/ This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 (https://creativecommons.org/publicdomain/zero/1.0/) public domain dedication. |
spellingShingle | Research Article Vidal, Roberto M. Muhsen, Khitam Tennant, Sharon M. Svennerholm, Ann-Mari Sow, Samba O. Sur, Dipika Zaidi, Anita K. M. Faruque, Abu S. G. Saha, Debasish Adegbola, Richard Hossain, M. Jahangir Alonso, Pedro L. Breiman, Robert F. Bassat, Quique Tamboura, Boubou Sanogo, Doh Onwuchekwa, Uma Manna, Byomkesh Ramamurthy, Thandavarayan Kanungo, Suman Ahmed, Shahnawaz Qureshi, Shahida Quadri, Farheen Hossain, Anowar Das, Sumon K. Antonio, Martin Mandomando, Inacio Nhampossa, Tacilta Acácio, Sozinho Omore, Richard Ochieng, John B. Oundo, Joseph O. Mintz, Eric D. O’Reilly, Ciara E. Berkeley, Lynette Y. Livio, Sofie Panchalingam, Sandra Nasrin, Dilruba Farag, Tamer H. Wu, Yukun Sommerfelt, Halvor Robins-Browne, Roy M. Del Canto, Felipe Hazen, Tracy H. Rasko, David A. Kotloff, Karen L. Nataro, James P. Levine, Myron M. Colonization factors among enterotoxigenic Escherichia coli isolates from children with moderate-to-severe diarrhea and from matched controls in the Global Enteric Multicenter Study (GEMS) |
title | Colonization factors among enterotoxigenic Escherichia coli isolates from children with moderate-to-severe diarrhea and from matched controls in the Global Enteric Multicenter Study (GEMS) |
title_full | Colonization factors among enterotoxigenic Escherichia coli isolates from children with moderate-to-severe diarrhea and from matched controls in the Global Enteric Multicenter Study (GEMS) |
title_fullStr | Colonization factors among enterotoxigenic Escherichia coli isolates from children with moderate-to-severe diarrhea and from matched controls in the Global Enteric Multicenter Study (GEMS) |
title_full_unstemmed | Colonization factors among enterotoxigenic Escherichia coli isolates from children with moderate-to-severe diarrhea and from matched controls in the Global Enteric Multicenter Study (GEMS) |
title_short | Colonization factors among enterotoxigenic Escherichia coli isolates from children with moderate-to-severe diarrhea and from matched controls in the Global Enteric Multicenter Study (GEMS) |
title_sort | colonization factors among enterotoxigenic escherichia coli isolates from children with moderate-to-severe diarrhea and from matched controls in the global enteric multicenter study (gems) |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6343939/ https://www.ncbi.nlm.nih.gov/pubmed/30608930 http://dx.doi.org/10.1371/journal.pntd.0007037 |
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