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15 April 2005

Volume 191, Number 8
The Journal of Infectious Diseases 2005;191:1245–1252
© 2005 by the Infectious Diseases Society of America. All rights reserved.
0022-1899/2005/19108-0008$15.00
DOI: 10.1086/428947
MAJOR ARTICLE

Enterotoxigenic Bacteroides fragilis–Associated Diarrhea in Children 0–2 Years of Age in Rural Bangladesh

Preeti Pathela,1

K. Zahid Hasan,3

Eliza Roy,3

Korshed Alam,3

Fazlul Huq,3

A. Kasem Siddique,3 and

R. Bradley Sack2

Departments of 1Epidemiology and 2International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; 3International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh

The burden of enterotoxigenic Bacteroides fragilis (ETBF)–related diarrhea was determined in a birth cohort of 252 children in rural Bangladesh. Isolation rates of ETBF in stool and risk factors for acquisition of ETBF and disease were established. Of 382 B. fragilis–positive specimens, 14.4% of the strains found in them produced enterotoxin, as determined by a tissue‐culture assay. The overall isolation rate of ETBF was 2.3% (40/1750) from diarrheal specimens and 0.3% (15/5679) from nondiarrheal specimens collected throughout the 2 years of the study ( ). ETBF was isolated from 20.3% (40/197) of the B. fragilis–positive diarrheal specimens and from 8.1% (15/185) of the B. fragilis–positive nondiarrheal specimens ( ) and was significantly associated with acute diarrheal disease in children 1 year of age ( ). The diarrheal illness was mild in nature. In conditional multivariate analyses that examined environmental and host risk factors, the presence of livestock in the household area was linked to the acquisition of ETBF (chickens, ; cows, ). ETBF was found to be a small but significant contributor to diarrheal disease in this rural community. Improved management of livestock may be useful for the prevention of ETBF infection.

Received 12 July 2004; accepted 19 November 2004; electronically published 14 March 2005.

Reprints or correspondence: Dr. R. Bradley Sack, Dept. of International Health, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Rm. 5035, Baltimore, MD 21205 ().

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Online publication date: 15-Sep-2008.
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Shervin Rabizadeh, Ki-Jong Rhee, Shaoguang Wu, David Huso, Christine M. Gan, Jonathan E. Golub, XinQun Wu, Ming Zhang, Cynthia L. Sears. (2008) EnterotoxigenicBacteroides fragilis: A potential instigator of colitis. Inflammatory Bowel Diseases 13:12, 1475-1483
Online publication date: 1-Jan-2008.
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  • Presented in part: The analysis and manuscript were completed as a part of a doctoral thesis project (P.P.).

    Financial support: US Agency for International Development (grant HRN‐A‐00‐96‐90005‐02).

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