Aeromonas-Associated Diarrhea in Children under 5 Years: The GEMS Experience

作者：Qamar Farah Naz^*; Nisar Muhammad Imran; Quadri Farheen; Shakoor Sadia; Sow Samba O; Nasrin Dilruba; Blackwelder William C; Wu Yukun; Farag Tamer; Panchalingham Sandra; Sur Dipika; Qureshi Shahida; Faruque Abu S G; Saha Debasish; Alonso Pedro L; Breiman Robert F; Bassat Quique; Tamboura Boubou; Ramamurthy Thandavarayan; Kanungo Suman; Ahmed Shahnawaz; Hossain Anowar; Das Sumon K; Antonio Martin; Hossain M Jahangir; Mandomando Inacio; Tennant Sharon M

来源：The American Journal of Tropical Medicine and Hygiene, 2016, 95(4): 774-780.

DOI：10.4269/ajtmh.16-0321

We report the clinical findings, epidemiology, and risk factors for moderate-to-severe diarrhea (MSD) associated with Aeromonas species in children 0-59 months of age, from the Global Enteric Multicenter Study, conducted at three sites in south Asia and four sites in sub-Saharan Africa. Children with MSD were enrolled along with controls matched for age, gender, and neighborhood. Pooled, age-stratified conditional logistic regression models were applied to evaluate the association of Aeromonas infection controlling for coinfecting pathogens and socio-demographic variables. A pooled, age-stratified, multivariate logistic regression analysis was done to identify risk factors associated with Aeromonas positivity in MSD cases. A total of 12,110 cases and 17,291 matched controls were enrolled over a period of 48 months. Aeromonas was identified as a significant pathogen in 736 cases of MSD in Pakistan and Bangladesh (22.2%). Aeromonas remained a significant pathogen even after adjustment for the presence of other pathogens and sociodemographic factors. Odds ratio (OR) for Aeromonas were higher in the presence of Shigella (matched OR: 6.2, 95% confidence interval [CI]: 1.9-20.2). Cases of Aeromonas were likely to present with dysentery, particularly in the 0-11 months (OR: 1.4, 95% CI 1.0-2.0) and 12-23 months (OR: 1.8, 95% CI: 1.3-2.5) age group. The odds of Aeromonas increased with increasing degree of stunting, being highest for severe stunting (OR: 10.1, 95% CI: 3.6-28.9). Aeromonas is a significant pathogen for MSD in Pakistan and Bangladesh. Presence of dysentery and co-occurrence with other pathogens, notably Shigella spp. are significant features of Aeromonas-associated diarrhea.

• 出版日期2016-10