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Mulu W, Joossens M, Kibret M, Van den Abeele AM, Houf K. Campylobacter occurrence and antimicrobial resistance profile in under five-year-old diarrheal children, backyard farm animals, and companion pets. PLoS Negl Trop Dis 2024; 18:e0012241. [PMID: 38833441 PMCID: PMC11178231 DOI: 10.1371/journal.pntd.0012241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 06/14/2024] [Accepted: 05/22/2024] [Indexed: 06/06/2024] Open
Abstract
Campylobacteriosis disproportionately affects children under five in low-income countries. However, epidemiological and antimicrobial resistance (AMR) information at the children-animal interface is lacking. We hypothesized that Campylobacter is a major cause of enteritis in children in Ethiopia, and contact with animals is a potential source of transmission. The objective of the study was to determine Campylobacter occurrence and its AMR in children under five with diarrhea, backyard farm animals, and companion pets. Stool from 303 children and feces from 711 animals were sampled. Campylobacter was isolated through membrane filtration on modified charcoal cefoperazone deoxycholate agar plates under microaerobic incubation, and the technique showed to be feasible for use in regions lacking organized laboratories. Typical isolates were characterized with MALDI-TOF MS and multiplex PCR. Of 303 children, 20% (n = 59) were infected, with a higher proportion in the 6 to 11-month age group. Campylobacter occurred in 64% (n = 14) of dogs and 44% (n = 112) of poultry. Campylobacter jejuni was present in both a child and animal species in 15% (n = 23) of 149 households positive for Campylobacter. MICs using the gradient strip diffusion test of 128 isolates displayed resistance rates of 20% to ciprofloxacin and 11% to doxycycline. MICs of ciprofloxacin and doxycycline varied between C. coli and C. jejuni, with higher resistance in C. coli and poultry isolates. Campylobacter infection in children and its prevalent excretion from backyard poultry and dogs is a understudied concern. The co-occurrence of C. jejuni in animals and children suggest household-level transmission As resistance to ciprofloxacin and doxycycline was observed, therapy of severe campylobacteriosis should consider susceptibility testing. Findings from this study can support evidence-based diagnosis, antimicrobial treatment, and further investigations on the spread of AMR mechanisms for informed One Health intervention.
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Affiliation(s)
- Wondemagegn Mulu
- Laboratory of Microbiology, Department of Biochemistry and Microbiology, Ghent University, Ghent, Belgium
- Department of Medical Laboratory Science, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Marie Joossens
- Laboratory of Microbiology, Department of Biochemistry and Microbiology, Ghent University, Ghent, Belgium
| | - Mulugeta Kibret
- Department of Biology, Science College, Bahir Dar University, Bahir Dar, Ethiopia
| | - Anne-Marie Van den Abeele
- Laboratory of Microbiology, Sint-Lucas Hospital, Ghent, Belgium
- Department of Veterinary and Biosciences, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
| | - Kurt Houf
- Laboratory of Microbiology, Department of Biochemistry and Microbiology, Ghent University, Ghent, Belgium
- Department of Veterinary and Biosciences, Faculty of Veterinary Medicine, Ghent University, Ghent, Belgium
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Adams NL, Rose TC, Hawker J, Violato M, O’Brien SJ, Barr B, Howard VJK, Whitehead M, Harris R, Taylor-Robinson DC. Relationship between socioeconomic status and gastrointestinal infections in developed countries: A systematic review and meta-analysis. PLoS One 2018; 13:e0191633. [PMID: 29360884 PMCID: PMC5779704 DOI: 10.1371/journal.pone.0191633] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 12/26/2017] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The association between socioeconomic status (SES) and health is well-documented; however limited evidence on the relationship between SES and gastrointestinal (GI) infections exists, with published studies producing conflicting results. This systematic review aimed to assess the association between SES and GI infection risk, and explore possible sources of heterogeneity in effect estimates reported in the literature. METHODS MEDLINE, Scopus, Web of Science and grey literature were searched from 1980 to October 2015 for studies reporting an association between GI infections and SES in a representative population sample from a member-country of the Organisation for Economic Co-operation and Development. Harvest plots and meta-regression were used to investigate potential sources of heterogeneity such as age; level of SES variable; GI infection measurement; and predominant mode of transmission. The protocol was registered on PROSPERO: CRD42015027231. RESULTS In total, 6021 studies were identified; 102 met the inclusion criteria. Age was identified as the only statistically significant potential effect modifier of the association between SES and GI infection risk. For children, GI infection risk was higher for those of lower SES versus high (RR 1.51, 95% CI;1.26-1.83), but there was no association for adults (RR 0.79, 95% CI;0.58-1.06). In univariate analysis, the increased risk comparing low and high SES groups was significantly higher for pathogens spread by person-to-person transmission, but lower for environmental pathogens, as compared to foodborne pathogens. CONCLUSIONS Disadvantaged children, but not adults, have greater risk of GI infection compared to their more advantaged counterparts. There was high heterogeneity and many studies were of low quality. More high quality studies are needed to investigate the association between SES and GI infection risk, and future research should stratify analyses by age and pathogen type. Gaining further insight into this relationship will help inform policies to reduce inequalities in GI illness in children.
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Affiliation(s)
- Natalie L. Adams
- NIHR Health Protection Research Unit in Gastrointestinal Infections, Liverpool, United Kingdom
- Department of Public Health and Policy, University of Liverpool, Liverpool, United Kingdom
- National Infection Service, Public Health England, London, United Kingdom
| | - Tanith C. Rose
- NIHR Health Protection Research Unit in Gastrointestinal Infections, Liverpool, United Kingdom
- Department of Public Health and Policy, University of Liverpool, Liverpool, United Kingdom
| | - Jeremy Hawker
- NIHR Health Protection Research Unit in Gastrointestinal Infections, Liverpool, United Kingdom
- National Infection Service, Public Health England, London, United Kingdom
| | - Mara Violato
- NIHR Health Protection Research Unit in Gastrointestinal Infections, Liverpool, United Kingdom
- Health Economics Research Centre, University of Oxford, Oxford, United Kingdom
| | - Sarah J. O’Brien
- NIHR Health Protection Research Unit in Gastrointestinal Infections, Liverpool, United Kingdom
- Department of Public Health and Policy, University of Liverpool, Liverpool, United Kingdom
| | - Benjamin Barr
- NIHR Health Protection Research Unit in Gastrointestinal Infections, Liverpool, United Kingdom
- Department of Public Health and Policy, University of Liverpool, Liverpool, United Kingdom
| | - Victoria J. K. Howard
- Department of Public Health and Policy, University of Liverpool, Liverpool, United Kingdom
| | - Margaret Whitehead
- NIHR Health Protection Research Unit in Gastrointestinal Infections, Liverpool, United Kingdom
- Department of Public Health and Policy, University of Liverpool, Liverpool, United Kingdom
| | - Ross Harris
- National Infection Service, Public Health England, London, United Kingdom
| | - David C. Taylor-Robinson
- NIHR Health Protection Research Unit in Gastrointestinal Infections, Liverpool, United Kingdom
- Department of Public Health and Policy, University of Liverpool, Liverpool, United Kingdom
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Glennie SJ, Nyirenda M, Williams NA, Heyderman RS. Do multiple concurrent infections in African children cause irreversible immunological damage? Immunology 2012; 135:125-32. [PMID: 22044389 DOI: 10.1111/j.1365-2567.2011.03523.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Much of the developing world, particularly sub-Saharan Africa, has high levels of morbidity and mortality associated with infectious diseases. The greatest risk of invasive disease is in the young, the malnourished and HIV-infected individuals. In many regions in Africa these vulnerable groups and the wider general population are under constant immune pressure from a range of environmental factors, under-nutrition and multiple concurrent infections from birth through to adulthood. Intermittent microbial exposure during childhood is required for the generation of naturally acquired immunity capable of protection against a range of infectious diseases in adult life. However, in the context of a resource-poor setting, the heavy burden of malarial, diarrhoeal and respiratory infections in childhood may subvert or suppress immune responses rather than protect, resulting in sub-optimal immunity. This review will explore how poor maternal health, HIV exposure, socio-economic and seasonal factors conspire to weaken childhood immune defences to disease and discuss the hypothesis that recurrent infections may drive immune dysregulation, leading to relative immune senescence and premature immunological aging.
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Affiliation(s)
- Sarah J Glennie
- Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi.
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Bacterial Isolates and Antibiotic Sensitivity among Gambian Children with Severe Acute Malnutrition. Int J Pediatr 2011; 2011:825123. [PMID: 21785610 PMCID: PMC3139120 DOI: 10.1155/2011/825123] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2011] [Accepted: 05/19/2011] [Indexed: 11/17/2022] Open
Abstract
Background. Establishing the pattern of infection and antimicrobial sensitivities in the local environment is critical to rational use of antibiotics and the development of management algorithms. Methods. Morbidity history and physical examination of 140 children with severe acute malnutrition were recorded. Their blood, stool, and urine samples were cultured and antibiotic sensitivity patterns determined for any bacterial pathogens isolated. Results. Thirty-eight children had a pathogen isolated from blood culture, 60% of which were considered contaminants. Coagulase negative staphylococcus was the predominant contaminant, while the major causes of bacteraemia were nontyphoidal Salmonella (13%), S. pneumoniae (10%), and E. coli (8%). E. coli accounted for 58% of the urinary isolates. No pathogen was isolated from stool. In vitro sensitivity by disk diffusion showed that 87.5% of the isolates were sensitive to ampicillin and/or gentamicin and 84.4% (27/32) to penicillin and/or gentamicin. Conclusions. A combination of ampicillin and gentamicin provides adequate antibiotic cover for severely malnourished children in The Gambia.
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da Silva Quetz J, Lima IFN, Havt A, de Carvalho EB, Lima NL, Soares AM, Mota RMS, Guerrant RL, Lima AAM. Campylobacter jejuni and Campylobacter coli in children from communities in Northeastern Brazil: molecular detection and relation to nutritional status. Diagn Microbiol Infect Dis 2010; 67:220-7. [PMID: 20542202 DOI: 10.1016/j.diagmicrobio.2010.02.025] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2009] [Revised: 02/20/2010] [Accepted: 02/28/2010] [Indexed: 11/16/2022]
Abstract
This study determined the prevalence of Campylobacter jejuni/coli and its relation with nutritional status in children from Northeastern Brazil. This was a case-control study design. Stool samples were evaluated for hipO (C. jejuni), ask (C. coli), and cdtABC (C. jejuni's cytolethal distending toxin) genes. The nutritional status from these children was assessed by anthropometric measures and z-scores. C. jejuni and C. coli were detected in 9.6% (8/83) and 6.0% (5/83) in the diarrhea group and in 7.2% (6/83) and 1.2% (1/83) of the nondiarrhea group, respectively. Children with positive molecular detection of C. jejuni showed significantly lower z-scores than children without C. jejuni. The cdtABC operon was found in 57% of hipO(+) samples. C. jejuni/coli prevalence was similar in diarrhea and nondiarrhea groups. There was a significant association of C. jejuni infection with lower nutritional status.
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Affiliation(s)
- Josiane da Silva Quetz
- Institute of Biomedicine for Brazilian Semi-Arid and Clinical Research Unit/Center for Global Health, Federal University of Ceara, Fortaleza, Brazil.
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Chimalizeni Y, Kawaza K, Molyneux E. The epidemiology and management of non typhoidal salmonella infections. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2010; 659:33-46. [PMID: 20204753 DOI: 10.1007/978-1-4419-0981-7_3] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Fernández H, Vera F, Villanueva MP, García A. Occurrence of campylobacter species in healthy well-nourished and malnourished children. Braz J Microbiol 2008; 39:56-8. [PMID: 24031178 PMCID: PMC3768365 DOI: 10.1590/s1517-838220080001000013] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2007] [Revised: 10/31/2007] [Accepted: 11/16/2007] [Indexed: 11/21/2022] Open
Abstract
The occurrence of Campylobacter species in healthy, well-nourished and healthy, malnourished children of low socioeconomic level in Southern Chile was determined. Campylobacter carriers were significantly most frequent among malnourished (31.4%) than among well-nourished (9.9%) children. Six species were isolated from malnourished children whereas four were found among well-nourished children. C. upsaliensis was the most frequent (13.3%) species isolated from malnourished children, followed by C. lari (7.6%) and C. fetus ssp. fetus (1.9%).
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Affiliation(s)
- Heriberto Fernández
- Institute of Clinical Microbiology, Universidad Austral de Chile , Valdivia , Chile
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Graham SM, Molyneux EM, Walsh AL, Cheesbrough JS, Molyneux ME, Hart CA. Nontyphoidal Salmonella infections of children in tropical Africa. Pediatr Infect Dis J 2000; 19:1189-96. [PMID: 11144383 DOI: 10.1097/00006454-200012000-00016] [Citation(s) in RCA: 114] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- S M Graham
- Department of Paediatrics, College of Medicine, University of Malawi, Blantyre
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Brewster DR, Greenwood BM. Seasonal variation of paediatric diseases in The Gambia, west Africa. ANNALS OF TROPICAL PAEDIATRICS 1993; 13:133-46. [PMID: 7687109 DOI: 10.1080/02724936.1993.11747637] [Citation(s) in RCA: 100] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
In a 3-year prospective study of 9584 consecutive paediatric admissions to the Royal Victoria Hospital in Banjul, The Gambia, we examined the impact of seasonal variations in childhood diseases. The four principal diseases (falciparum malaria, pneumonia, gastro-enteritis and malnutrition) all peaked in September to October following the rainy season. The mortality rate was also higher in the rainy season than in the dry season. Of the 1525 children with cerebral malaria, 83% were admitted during the extended rainy season from July to December. With the emergence of chloroquine-resistant malaria over the 3 years, there was a 27% annual increase in severe anaemia owing to malaria. The median age of malarial anaemia (23 months) was significantly younger than that of cerebral malaria (42 months). Malnutrition peaked immediately following the annual rainy season epidemics of bacterial gastro-enteritis but was not associated with the cool dry season rotavirus outbreaks. Rainy season diarrhoea was also associated with more persistent diarrhoea, an older mean age and a higher mortality. Meningitis was caused by either pneumococcus or Haemophilus influenzae in 64% of cases, of whom 19% were 0-2 months of age. Causes of death in hospital showed good agreement with Gambian community studies. We conclude that analysis of hospital data in a developing country can give accurate information on childhood morbidity and mortality patterns which can be used to set priorities for health care interventions. Seasonal variation is a cardinal feature of paediatric diseases in this part of Africa, and accentuates the vulnerability of children in poor families.
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Osisanya JO, Daniel SO, Sehgal SC, Afigbo A, Iyanda A, Okoro FI, Mbelu N. Acute diarrhoeal disease in Nigeria: detection of enteropathogens in a rural sub-Saharan population. Trans R Soc Trop Med Hyg 1988; 82:773-7. [PMID: 3252601 DOI: 10.1016/0035-9203(88)90233-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
A retrospective study was carried out to obtain epidemiological data concerning the relative risk of Shigella, Salmonella, Campylobacter jejuni and Vibrio cholerae infection in several rural population groups. Faecal samples (rectal swab specimens) were cultured from 914 selected children with acute diarrhoeal disease and from a matched control group of 984 non-diarrhoeal children. Shigella were more frequently isolated than the other enteropathogens from both the diarrhoeal (12.7%) and control children (6.6%). S. flexneri was the predominant species; S. sonnei and V. cholerae were not detected. Salmonella was isolated from 19 diarrhoeal (2.1%) and 16 control children (1.6%). C. jejuni was obtained from 34 diarrhoeal (3.7%) and 6 control children (0.6%). Most Shigella isolates were obtained during the peak agricultural periods (March/April and August/September) and from diarrhoeal children 0-5 months and 3-5 years of age. The highest infection rates with Salmonella and C. jejuni were observed during February and August, in diarrhoeal children aged 0-5 months and 6-11 months of age respectively. Up to 6 months of age, infection rates with Shigella, Salmonella and C. jejuni were markedly higher in bottle-fed than in breast-fed infants.
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Affiliation(s)
- J O Osisanya
- University of Sokoto College of Health Sciences, Sokoto, Nigeria
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Mølbak K, Højlyng N, Gaarslev K. High prevalence of campylobacter excretors among Liberian children related to environmental conditions. Epidemiol Infect 1988; 100:227-37. [PMID: 3356221 PMCID: PMC2249218 DOI: 10.1017/s0950268800067364] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Campylobacter was the bacterial pathogen most prevalent in 859 children, aged 6-59 months, examined in a house-to-house diarrhoea survey in two Liberian communities. 44.9% of the children from an urban slum and 28.4% from a rural area were excretors. Since the prevalence of diarrhoea was very high and consequently many convalescent carriers were found, it was not possible to evaluate the pathogenic role of campylobacter. The excretor rate increased with age and was significantly correlated to the use of supplementary feeding, inversely correlated to the quality of the water supply, and also associated with helminthic infestation. Results from re-examination of 172 children suggested a high intensity of transmission. The findings all indicate the existence of a heavy environmental contamination with campylobacter, probably of both human and animal faecal origin.
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Affiliation(s)
- K Mølbak
- Malaria Research Laboratory, Statens Seruminstitut, Copenhagen S, Denmark
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Wanke CA, Lima AA, Guerrant RL. Infectious diarrhoea in tropical and subtropical regions. BAILLIERE'S CLINICAL GASTROENTEROLOGY 1987; 1:335-59. [PMID: 3311232 PMCID: PMC7135853 DOI: 10.1016/0950-3528(87)90008-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Diarrhoeal diseases are among the most important health problems in the world today. While they are generally mild, nuisance illnesses in the developed world, where clean water and sanitation are adequate, these diseases are the most common cause of death in young children in the developing world, where clean water is not available and sanitation is inadequate. In these areas, up to 25% of children may never reach their fifth birthday. In addition, although the impact on growth and nutritional status is difficult to quantify, the cumulative toll on overall child health is enormous. A wide variety of infectious agents are implicated in the aetiology of acute diarrhoeal illness, many of which were unknown 20 years ago. The epidemiology, pathogenic mechanisms and clinical presentation of the common bacterial and viral pathogens, as they are currently understood, will be discussed in this chapter.
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