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Volume 21, Number 2—February 2015
Research

Microbiota That Affect Risk for Shigellosis in Children in Low-Income Countries

Brianna LindsayComments to Author , Joe Oundo, M. Anowar Hossain, Martin Antonio, Boubou Tamboura, Alan W. Walker, Joseph N. Paulson, Julian Parkhill, Richard Omore, Abu S.G. Faruque, Suman Kumar Das, Usman N. Ikumapayi, Mitchell Adeyemi, Doh Sanogo, Debasish Saha, Samba Sow, Tamer H. Farag, Dilruba Nasrin, Shan Li, Sandra Panchalingam, Myron M. Levine, Karen Kotloff, Laurence S. Magder, Laura Hungerford, Halvor Sommerfelt, Mihai Pop, James P. Nataro, and O. Colin Stine
Author affiliations: University of Maryland School of Medicine, Baltimore, Maryland, USA (B. Lindsay, T.H. Farag, D. Nasrin, S. Li, S. Panchalingam, M.M. Levine, K. Kotloff, L.S. Magder, L. Hungerford, O.C. Stine); Centers for Disease Control and Prevention/Kenya Medical Research Institute Research Station, Kisumu, Kenya (J. Oundo, R. Omore); International Center for Diarrheal Disease Research, Mirzapur, Bangladesh (M.A. Hossain, A.S.G. Faruque, S.K. Das); Medical Research Council, Basse, The Gambia (M. Antonio, U.N. Ikumapayi, M. Adeyemi, D. Saha); Centre pour le Developpement des Vaccins du Mali, Bamako, Mali (B. Tamboura, D. Sanogo, S. Sow); Wellcome Trust Sanger Institute, Hinxton, UK (A.W. Walker, J. Parkhill); University of Maryland, College Park, Maryland, USA (J.N. Paulson, M. Pop); University of Queensland, Brisbane, Queensland, Australia (S.K. Das); University of Bergen, Bergen, Norway (H. Sommerfelt); Norwegian Institute of Public Health, Bergen (H. Sommerfelt); University of Virginia School of Medicine, Charlottesville, Virginia, USA (J.P. Nataro)

Main Article

Table 3

Measures of additive and multiplicative interactions of co-occurrence of Shigella spp. and another pathogen or Lactobacillus spp. in children in low-income countries*

Pathogen or organism OR10† (95% CI) OR01‡ (95% CI) OR11§ (95% CI) RERI (95% CI) Additive
p value Multiplicative
p value
C. jejuni 3.84 (2.98–4.95) 1.97 (1.62–2.40) 5.55 (3.67–9.15) 0.79 (−2.15 to 3.73) 0.62 0.29
ETEC 3.77 (2.97–4.80) 1.69 (1.32–2.18) 4.65 (2.32–9.30) 0.15 (−3.20 to 3.52) 0.92 0.41
tEPEC 3.69 (2.91–4.69) 1.36 (1.02–1.83) 4.09 (2.01–8.33) 0.03 (−2.99 to 3.06) 0.99 0.61
Cryptosporidium spp. 3.79 (2.99–4.81) 2.40 (1.78–3.24) 4.95 (2.28–10.75) −0.27 (−4.27 to 3.73) 0.91 0.16
Rotavirus 4.01 (3.18–5.05) 7.56 (5.29–10.80) 28.85 (3.77–220) 18.29 (−40.32 to 76.91) 0.54 0.96
Norovirus genogroups GI or GII 3.65 (2.87–4.64) 1.14 (0.86–1.51) 4.00 (2.08–7.71) 0.21 (−2.56 to.98) 0.88 0.91
EAEC 3.59 (2.78–4.63) 0.87 (0.71–1.07) 3.29 (2.06–5.26) −0.17 (−1.92 to 1.58) 0.85 0.86
Giardia lamblia
 3.65 (2.84–4.69)
 0.83 (0.68–1.02)
 2.70 (1.63–4.49)
 −0.78 (−2.83 to 0.83)
 0.35
 0.70
Lactobacillus taxon
KLDS 1.0718 4.10 (3.19–5.26) 1.25 (1.01–1.55) 2.42 (1.41–4.13) −1.93 (−3.56 to 0.29) 0.02 0.02
L. salivarius 4.12 (3.20–5.31) 1.77 (1.45–2.16) 3.88 (2.35–6.38) −1.02 (−3.18 to 1.14) 0.36 0.03
L. ruminis 4.30 (3.19–5.79) 0.82 (0.69–0.96) 2.20 (1.55–3.13) −1.92 (−3.36 to 0.47) 0.01 0.05
DJF RP24 4.59 (3.41–6.16) 0.85 (0.72–0.99) 1.99 (1.39–2.85) −2.44 (−3.93 to 0.95) 0.001 0.01
TSK G32–2 3.89 (3.08–4.92) 1.40 (1.07–1.85) 1.60 (0.59–4.30) −2.69 (−4.55 to 0.84) 0.004 0.02

*OR, odds ratio; RERI, relative excess risk caused by the interaction; ETEC, enterotoxigenic Escherichia coli; tEPEC, typical enteropathogenic E. coli; EAEC, enteroaggregative E. coli. Boldface indicates significance (p≤0.05). Under an additive interaction, OR11 – OR10 – OR01 + 1 = 0. Under a multiplicative interaction, OR11 = OR10OR01.
†OR caused by having a high level of the ipaH gene alone (in the absence of the other pathogen or Lactobacillus taxon).
‡OR caused by having the other pathogen or Lactobacillus taxon alone (in the absence of a high level of the ipaH gene).
§OR caused by having a high level of the ipaH gene and another pathogen or Lactobacillus taxon (relative to having neither).

Main Article

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