Impact of asymptomatic enteroaggregative Escherichia coli infection and co-pathogen burden on intestinal barrier function, linear growth, and cognitive development in early childhood: Insights from a birth cohort study

Authors

• Aldo A M Lima, Federal University of Ceará
• Virginia L S C Urtiga, Federal University of Ceará
• Samilly A. Ribeiro, Federal University of Ceará
• José Q S Filho, Federal University of Ceará
• Bruna L L Maciel, Federal University of Rio Grande do Norte
• Ana E S Alves, Federal University of Ceará
• Luis F B Lino, Federal University of Ceará
• Francisco A P Rodrigues, Federal Institute of Education
• Ana K F Leit, Federal University of Ceará
• Alexandre Havt, Federal University of Ceará
• Gagandeep Kang, Christian Medical College, Vellore
• Margaret N. Kosek, niversity of Virginia School of Medicine
• Pascal O. Bessong, University of Venda
• Amidou Samie, University of Venda
• Rashidul Haque, International Centre for Diarrhoeal Disease Research, Bangladesh
• Estomih R. Mduma, Haydom Global Health Research Centre
• Jose P. Leite, Fundação Oswaldo Cruz
• Ladaporn Bodhidatta, Armed Forces Research Institute of Medical Sciences
• Najeeha Talat Iqbal, Aga Khan UniversityFollow
• Nicola Page, National Institute for Communicable Diseases
• Ireen Kiwelu, Kilimanjaro Clinical Research Institute
• Zulfiqar Ahmed Bhutta, Aga Khan UniversityFollow
• Tahmeed Ahmed, International Centre for Diarrhoeal Disease Research

Document Type

Article

Department

Paediatrics and Child Health; Office of the Provost

Abstract

Enteroaggregative Escherichia coli (EAEC) is a major enteric pathogen in low-resource settings. The aim for the present study is to reanalyze the effects of subclinical EAEC infection, alone or in combination with other pathogens, on intestinal function, growth, and cognition in children aged 0-6 months through molecular diagnosis. A total of 1,659 non-diarrheal stool samples from the Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development cohort were analyzed using quantitative polymerase chain reaction testing for 29 enteropathogens. Children were grouped by infection status: EAEC alone or with 1, 2, or ≥3 co-pathogens. Enteroaggregative Escherichia coli and a higher pathogen burden were associated with lower socioeconomic status and greater antibiotic use (P < 0.001). Enteroaggregative Escherichia coli with ≥3 co-pathogens was linked to elevated neopterin (β = 687.5; CI: 129.7-1,245.3), increased intestinal permeability (β = 0.41; CI: 0.058-0.77), and a lower length-for-age z-score (β = -0.44; CI: -0.76 to -0.12), and EAEC alone reduced cognitive scores at 15 and 24 months of age (β = -2.82 and -5.02, respectively; CI: -5.15 to -0.48 and -9.81 to -0.22, respectively). Subclinical EAEC infection is associated with inflammation, gut dysfunction, growth failure, and cognitive delay.

Comments

Volume, issue, and pagination are not provided by the author/publisher.

Publication (Name of Journal)

The American Journal of Tropical Medicine and Hygiene

DOI

10.4269/ajtmh.25-0499

Recommended Citation

Lima, A. A., Urtiga, V. L., Ribeiro, S. A., Filho, J. Q., Maciel, B. L., Alves, A. E., Lino, L. F., Rodrigues, F. A., Leit, A. K., Havt, A., Kang, G., Kosek, M. N., Bessong, P. O., Samie, A., Haque, R., Mduma, E. R., Leite, J. P., Bodhidatta, L., Iqbal, N. T., Page, N., Kiwelu, I., Bhutta, Z. A., Ahmed, T. (2026). Impact of asymptomatic enteroaggregative Escherichia coli infection and co-pathogen burden on intestinal barrier function, linear growth, and cognitive development in early childhood: Insights from a birth cohort study. The American Journal of Tropical Medicine and Hygiene.
Available at: https://ecommons.aku.edu/pakistan_fhs_mc_bbs/1116