Network analysis of patterns and relevance of enteric pathogen co-infections among infants in a diarrhea-endemic setting

Despite significant progress in recent decades toward ameliorating the excess burden of diarrheal disease globally, childhood diarrhea remains a leading cause of morbidity and mortality in low-and-middle-income countries (LMICs). Recent large-scale studies of diarrhea etiology in these populations h...

Full description

Saved in:
Bibliographic Details
Published in:PLoS computational biology 2023-11, Vol.19 (11), p.e1011624-e1011624
Main Authors: Colgate, E Ross, Klopfer, Connor, Dickson, Dorothy M, Lee, Benjamin, Wargo, Matthew J, Alam, Ashraful, Kirkpatrick, Beth D, Hébert-Dufresne, Laurent
Format: Article
Language:English
Subjects:
Analysis
Asymptomatic
Bacteria
Bangladesh
Binomial distribution
Child
Children
Children & youth
Childrens health
Coinfection - epidemiology
Diarrhea
Diarrhea - epidemiology
Diarrhea - microbiology
Diseases
E coli
Escherichia coli
Escherichia coli Infections - epidemiology
Escherichia coli Infections - microbiology
Feces - microbiology
Humans
Hypotheses
Identification and classification
Infant
Infants
Infection
Infections
Morbidity
Mortality
Network analysis
Pathogens
Prevalence studies (Epidemiology)
Surveillance
Vaccines
Citations: Items that this one cites
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Despite significant progress in recent decades toward ameliorating the excess burden of diarrheal disease globally, childhood diarrhea remains a leading cause of morbidity and mortality in low-and-middle-income countries (LMICs). Recent large-scale studies of diarrhea etiology in these populations have revealed widespread co-infection with multiple enteric pathogens, in both acute and asymptomatic stool specimens. We applied methods from network science and ecology to better understand the underlying structure of enteric co-infection among infants in two large longitudinal birth cohorts in Bangladesh. We used a configuration model to establish distributions of expected random co-occurrence, based on individual pathogen prevalence alone, for every pathogen pair among 30 enteropathogens detected by qRT-PCR in both diarrheal and asymptomatic stool specimens. We found two pairs, Enterotoxigenic E. coli (ETEC) with Enteropathogenic E. coli (EPEC), and ETEC with Campylobacter spp., co-infected significantly more than expected at random (both pairs co-occurring almost 4 standard deviations above what one could expect due to chance alone). Furthermore, we found a general pattern that bacteria-bacteria pairs appear together more frequently than expected at random, while virus-bacteria pairs tend to appear less frequently than expected based on model predictions. Finally, infants co-infected with leading bacteria-bacteria pairs had more days of diarrhea in the first year of life compared to infants without co-infection (p-value
ISSN:1553-7358
1553-734X
1553-7358
DOI:10.1371/journal.pcbi.1011624