Contributors: Unité de Bactériologie Expérimentale Antananarivo, Madagascar (IPM); Institut Pasteur de Madagascar; Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP); Unité d’Épidémiologie et de Recherche clinique Antananarivo, Madagascar; Bactéries pathogènes entériques (BPE); Institut Pasteur Paris (IP); Pathogénie microbienne moléculaire; Institut Pasteur Paris (IP)-Institut National de la Santé et de la Recherche Médicale (INSERM); Hub Bioinformatique et Biostatistique - Bioinformatics and Biostatistics; This project was funded by the Total and Petram Foundations and by Institut Pasteur. LA, PA and RR wages were supported by the Total Foundation and MR wage by the Petram Foundation. PV was supported by an Early Postdoctoral Fellowship (P2EZP3_152159), an Advanced Postdoctoral Fellowship (P300PA_177876) as well as a Return Grant (P3P3PA_17877) from the Swiss National Science Foundation, a Roux-Cantarini Fellowship (2016), a L'Oréal-UNESCO for Women in Science France Fellowship (2017) and an Excellence Scholarship from the University of Basel (Forschungsfonds, 2019).; We wish to thank all participating families, the AFRIBIOTA Consortium, the participating hospitals in Antananarivo, as well as the Institut Pasteur, the Institut Pasteur de Madagascar, and members of the scientific advisory board for their continuous support; Prof. Jean-Louis Demarquez for training sessions to teach the local health professionals the methods used for duodenal aspirations; Aurélie Etienne for precious help with the clinical procedures and first aspirations performed; the field workers Tseheno Harisoa and Rado Andrianantenaina, as well as all implicated community health workers, for countless hours spent in the field; the Centre de Recherche Translationelle and the Direction Internationale of the Institut Pasteur, and especially Paméla Palvadeau, Jane Lynda Deuve, Marc Rovatiana Ranarijesy, Kanto Liantsoa Razanakolona, Cécile Artaud, Nathalie Jolly, Sophie Jarrijon, Mamy Ratsialonina, Jean-François Damaras, Marie-Noelle Ungeheuer, and Laurence Arowas for precious help in setting up and steering the AFRIBIOTA project and managing the funds and the biobank. We would like to thank the staff of the “Plateforme de Microbiologie Mutualisée (P2M)” at Institut Pasteur Paris where the whole genome sequencing was performed, Sophie Lefevre from the Centre National de Référence des Escherichia coli, Shigella et Salmonella in Paris, France for Shigella serotyping, and Claude Parsot and Alexandre Grassart for the interesting discussions on Shigella.
نبذة مختصرة : International audience ; Environmental Enteric Dysfunction (EED) refers to an incompletely defined syndrome of inflammation, reduced absorptive capacity, and reduced barrier function in the small intestine. It is widespread among children and adults in low- and middle-income countries and is also associated with poor sanitation and certain gut infections possibly resulting in an abnormal gut microbiota, small intestinal bacterial overgrowth (SIBO) and stunting. We investigated bacterial pathogen exposure in stunted and non-stunted children in Antananarivo, Madagascar by collecting fecal samples from 464 children (96 severely stunted, 104 moderately stunted and 264 non-stunted) and the prevalence of SIBO in 109 duodenal aspirates from stunted children (61 from severely stunted and 48 from moderately stunted children). SIBO assessed by both aerobic and anaerobic plating techniques was very high: 85.3% when selecting a threshold of ≥10 5 CFU/ml of bacteria in the upper intestinal aspirates. Moreover, 58.7% of the children showed more than 10 6 bacteria/ml in these aspirates. The most prevalent cultivated genera recovered were Streptococcus , Neisseria , Staphylococcus , Rothia , Haemophilus , Pantoea and Branhamella . Feces screening by qPCR showed a high prevalence of bacterial enteropathogens, especially those categorized as being enteroinvasive or causing mucosal disruption, such as Shigella spp., enterotoxigenic Escherichia coli , enteropathogenic E . coli and enteroaggregative E . coli . These pathogens were detected at a similar rate in stunted children and controls, all showing no sign of severe diarrhea the day of inclusion but both living in a highly contaminated environment (slum-dwelling). Interestingly Shigella spp. was the most prevalent enteropathogen found in this study (83.3%) without overrepresentation in stunted children.
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