Effect of Small Bowel Bacterial Overgrowth on the Immunogenicity of Single-Dose Live Oral Cholera Vaccine CVD 103-HgR

Several live oral vaccines (polio, bovine rotavirus, CVD 103-HgR cholera) are less immunogenic in developing than in industrialized countries. It was hypothesized that proximal small bowel bacterial overgrowth (common in children in less developed countries but rare in industrialized settings) dimin...

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Bibliographic Details
Published in:The Journal of infectious diseases 1999-11, Vol.180 (5), p.1709-1712
Main Authors: Lagos, Rosanna, Fasano, Alessio, Wasserman, Steven S., Prado, Valeria, Martin, Oriana San, Abrego, Paulina, Losonsky, Genevieve A., Alegria, Silvia, Levine, Myron M.
Format: Article
Language:English
Subjects:
Administration, Oral
Antibodies
Antibodies, Bacterial - blood
Bacteriology
Biological and medical sciences
Blood groups
Breath Tests
Child
Child, Preschool
Cholera vaccine
Cholera Vaccines - administration & dosage
Cholera Vaccines - immunology
Correspondence
Developing countries
Excretion
Female
Fundamental and applied biological sciences. Psychology
Humans
Hydrogen - analysis
Immune response
Ingestion
Intestine, Small - microbiology
Lactulose - metabolism
Male
Microbiology
Small intestine
Socioeconomics
Tropical medicine
Vaccination
Vaccines, antisera, therapeutical immunoglobulins and monoclonal antibodies
Vibrio cholerae
Vibrio cholerae - immunology
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Summary:Several live oral vaccines (polio, bovine rotavirus, CVD 103-HgR cholera) are less immunogenic in developing than in industrialized countries. It was hypothesized that proximal small bowel bacterial overgrowth (common in children in less developed countries but rare in industrialized settings) diminishes the vibriocidal antibody response to CVD 103-HgR. In total, 202 fasting Santiago schoolchildren aged 5–9 years had lactulose breath H2 tests to detect proximal small bowel bacteria 1 day before ingesting CVD 103-HgR. Florid small bowel overgrowth was observed in 10 (5.6%) of 178 analyzable children. In children with florid overgrowth, vibriocidal seroconversion differed little from other children (60% vs. 67%), but the geometric mean titer was lower (160 vs. 368; P = .25). By logistic regression, increased peak breath H2 at small bowel time points was associated with diminished seroconversion (P = .04), as was the interaction of H2 value and weight (children >25 kg had lower seroconversion rates among subjects with heaviest overgrowth).
ISSN:0022-1899
1537-6613
DOI:10.1086/315051