Infectious etiology of intussusception in Indian children less than 2 years old: a matched case-control analysis.

IF 4.3 3区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY Gut Pathogens Pub Date : 2024-10-23 DOI:10.1186/s13099-024-00659-z

Ira Praharaj, Samarasimha Nusi Reddy, Nayana Prabhakaran Nair, Jacqueline Elizabeth Tate, Sidhartha Giri, Varunkumar Thiyagarajan, Venkata Raghava Mohan, Rajendiran Revathi, Kalaivanan Maheshwari, Priya Hemavathy, Nirmal Kumar, Mohan Digambar Gupte, Rashmi Arora, Sowmiya Senthamizh, Suhasini Mekala, Krishna Babu Goru, Padmalatha Pamu, Manohar Badur, Subal Pradhan, Mrutunjay Dash, Nirmal Kumar Mohakud, Rajib Kumar Ray, Geetha Gathwala, Madhu Gupta, Ravi Kanojia, Rajkumar Gupta, Suresh Goyal, Pramod Sharma, Mannancheril Abraham Mathew, Tarun John Kochukaleekal Jacob, Balasubramanian Sundaram, Chethrapilly Purusothaman Girish Kumar, Priyadarshini Dorairaj, Ramasubramaniam Pitchumani, Raghul Maniam, Sambandan Kumaravel, Hemant Jain, Jayanta Kumar Goswami, Ashish Wakhlu, Vineeta Gupta, Jie Liu, Eric R Houpt, Umesh D Parashar, Gagandeep Kang

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Abstract

Background: Enteric infections are hypothesized to be associated with intussusception in children. A small increase in intussusception following rotavirus vaccination has been seen in some settings. We conducted post-marketing surveillance for intussusception following rotavirus vaccine, Rotavac introduction in India and evaluated association of intussusception with enteric pathogens.

Methods: In a case-control study nested within a large sentinel hospital-based surveillance program in India, stool samples from 272 children aged less than 2 years admitted for intussusception and 272 age-, gender- and location-matched controls were evaluated with Taqman array card based molecular assays to detect enteric viruses, bacterial enteropathogens and parasites. Matched case-control analysis with conditional logistic regression evaluated association of enteropathogens with intussusception. Population attributable fractions (PAF) were calculated for enteropathogens significantly associated with intussusception.

Results: The most prevalent enteropathogens in cases and controls were enteroaggregative Escherichia coli, adenovirus 40/41, adenovirus C serotypes and enteroviruses. Children with intussusception were more likely to harbor adenovirus C serotypes (adjusted odds-ratio (aOR) = 1.74; 95% confidence interval (CI) 1.06-2.87) and enteroviruses (aOR = 1.77; 95% CI 1.05-2.97) than controls. Rotavirus was not associated with increased intussusception risk. Adenovirus C (PAF = 16.9%; 95% CI 4.7% - 27.6%) and enteroviruses (PAF = 14.7%; 95% CI 4.2% - 24.1%) had the highest population attributable fraction for intussusception.

Conclusion: Adenovirus C serotypes and enteroviruses were significantly associated with intussusception in Indian children. Rotavirus was not associated with risk of intussusception.

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两岁以下印度儿童肠套叠的感染病因：匹配病例对照分析。

背景：肠道感染被认为与儿童肠套叠有关。在某些情况下，接种轮状病毒疫苗后肠梗阻的发病率略有上升。我们在印度开展了轮状病毒疫苗（Rotavac）上市后肠套叠监测，并评估了肠套叠与肠道病原体的相关性：方法：在印度一项基于医院的大型定点监测计划中开展了一项病例对照研究，使用基于 Taqman 阵列卡的分子检测方法对 272 名因肠套叠入院的 2 岁以下儿童和 272 名年龄、性别和地点匹配的对照组儿童的粪便样本进行了评估，以检测肠道病毒、细菌性肠道病原体和寄生虫。利用条件逻辑回归进行的匹配病例对照分析评估了肠道病原体与肠套叠的相关性。计算了与肠套叠显著相关的肠道病原体的人群归因分数（PAF）：结果：病例和对照组中最常见的肠道病原体是肠道聚集性大肠杆菌、腺病毒 40/41、腺病毒 C 血清型和肠道病毒。与对照组相比，肠套叠患儿更有可能携带腺病毒 C 血清型（调整后赔率 (aOR) = 1.74；95% 置信区间 (CI) 1.06-2.87）和肠道病毒（aOR = 1.77；95% CI 1.05-2.97）。轮状病毒与肠套叠风险增加无关。腺病毒 C（PAF = 16.9%; 95% CI 4.7% - 27.6%）和肠道病毒（PAF = 14.7%; 95% CI 4.2% - 24.1%）的肠套叠人群归因率最高：结论：腺病毒C血清型和肠道病毒与印度儿童肠套叠密切相关。轮状病毒与肠套叠风险无关。

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来源期刊

Gut Pathogens GASTROENTEROLOGY & HEPATOLOGY-MICROBIOLOGY

CiteScore

7.70

自引率

2.40%

发文量

期刊介绍： Gut Pathogens is a fast publishing, inclusive and prominent international journal which recognizes the need for a publishing platform uniquely tailored to reflect the full breadth of research in the biology and medicine of pathogens, commensals and functional microbiota of the gut. The journal publishes basic, clinical and cutting-edge research on all aspects of the above mentioned organisms including probiotic bacteria and yeasts and their products. The scope also covers the related ecology, molecular genetics, physiology and epidemiology of these microbes. The journal actively invites timely reports on the novel aspects of genomics, metagenomics, microbiota profiling and systems biology. Gut Pathogens will also consider, at the discretion of the editors, descriptive studies identifying a new genome sequence of a gut microbe or a series of related microbes (such as those obtained from new hosts, niches, settings, outbreaks and epidemics) and those obtained from single or multiple hosts at one or different time points (chronological evolution).