RESUMEN
The Streptococcus bovis/Streptococcus equinus complex (SBSEC) and possibly Streptococcus infantarius subsp. infantarius (Sii) are associated with human and animal diseases. Sii predominate in spontaneously fermented milk products with unknown public health effects. Sii/SBSEC prevalence data from West Africa in correlation with milk transformation practices are limited. Northern Côte d'Ivoire served as study area due to its importance in milk production and consumption and to link a wider Sudano-Sahelian pastoral zone of cross-border trade. We aimed to describe the cow milk value chain and determine Sii/SBSEC prevalence with a cross-sectional study. Dairy production practices were described as non-compliant with basic hygiene standards. The system is influenced by secular sociocultural practices and environmental conditions affecting product properties. Phenotypic and molecular analyses identified SBSEC in 27/43 (62.8%) fermented and 26/67 (38.8%) unfermented milk samples. Stratified by collection stage, fermented milk at producer and vendor levels featured highest SBSEC prevalence of 71.4% and 63.6%, respectively. Sii with 62.8% and 38.8% as well as Streptococcus gallolyticus subsp. macedonicus with 7.0% and 7.5% were the predominant SBSEC species identified among fermented and unfermented milk samples, respectively. The population structure of Sii/SBSEC isolates seems to reflect evolving novel dairy-adapted, non-adapted and potentially pathogenic lineages. Northern Côte d'Ivoire was confirmed as area with high Sii presence in dairy products. The observed production practices and the high diversity of Sii/SBSEC supports in-depth investigations on Sii ecology niche, product safety and related technology in the dairy value chain potentially affecting large population groups across sub-Saharan Africa.
Asunto(s)
Productos Lácteos Cultivados/microbiología , Leche/microbiología , Streptococcus bovis/aislamiento & purificación , Animales , Bovinos , Côte d'Ivoire , Estudios Transversales , Femenino , Microbiología de Alimentos , Humanos , Filogenia , Streptococcus/genética , Streptococcus/aislamiento & purificación , Streptococcus bovis/genética , Streptococcus gallolyticus/genética , Streptococcus gallolyticus/aislamiento & purificaciónRESUMEN
Streptococcus spp. cause a wide range of diseases in animals and humans. A Streptococcus strain (FMD1) was isolated from forest musk deer lung. To identify the bacterium at the species level and investigate its pathogenicity, whole genome sequencing and experimental infections of mice were performed. The genome had 97.63% average nucleotide identity with the S. equinus strain. Through virulence gene analysis, a beta-hemolysin/cytolysin genome island was found in the FMD1 genome, which contained 12 beta-hemolysin/cytolysin-related genes. Hemolytic reaction and histopathological analysis established the strain's pathogenicity in mice. This is the first report of a beta-hemolytic S. equinus strain in forest musk deer identified based on phenotypic and genotypic analyzes; this strategy could be useful for analyzing pathogens affecting rare animals.
Asunto(s)
Ciervos/microbiología , Infecciones Estreptocócicas/veterinaria , Streptococcus bovis/clasificación , Streptococcus bovis/patogenicidad , Animales , Proteínas Bacterianas/genética , Genoma Bacteriano , Proteínas Hemolisinas/genética , Enfermedades Pulmonares/microbiología , Enfermedades Pulmonares/veterinaria , Ratones Endogámicos BALB C , Infecciones Estreptocócicas/microbiología , Infecciones Estreptocócicas/patología , Streptococcus bovis/genética , Streptococcus bovis/aislamiento & purificación , VirulenciaAsunto(s)
Neoplasias del Colon/complicaciones , Leucemia Mieloide Aguda/complicaciones , Infecciones Estreptocócicas/microbiología , Streptococcus bovis/aislamiento & purificación , Úlcera/microbiología , Anciano , Biopsia , Neoplasias del Colon/patología , Colonoscopía , Humanos , Inmunohistoquímica , Leucemia Mieloide Aguda/patología , Masculino , Infecciones Estreptocócicas/complicaciones , Infecciones Estreptocócicas/diagnóstico , Úlcera/patologíaAsunto(s)
Humanos , Masculino , Adolescente , Endocarditis Bacteriana/cirugía , Endocarditis Bacteriana/complicaciones , Endocarditis Bacteriana/diagnóstico , Endocarditis Bacteriana/diagnóstico por imagen , Astenia/diagnóstico , Pérdida de Peso , Streptococcus bovis/aislamiento & purificación , Diagnóstico Diferencial , Fiebre de Origen Desconocido/diagnósticoRESUMEN
Streptococcus bovis/Streptococcus equinus complex (SBSEC), a non-enterococcal group D Streptococcus spp. complex, has been described as commensal bacteria in humans and animals, with a fecal carriage rate in humans varying from 5% to over 60%. Among streptococci, SBSEC isolates represent the most antibiotic-resistant species-with variable resistance rates reported for clindamycin, erythromycin, tetracycline, and levofloxacin-and might act as a reservoir of multiple acquired genes. Moreover, reduced susceptibility to penicillin and vancomycin associated with mobile genetic elements have also been detected, although rarely. Since the association of SBSEC bacteremia and colon lesions, infective endocarditis and hepatobiliary diseases has been established, particularly in elderly individuals, an accurate identification of SBSEC isolates to the species and subspecies level, as well as the evaluation of antibiotic resistance, are needed. In this paper, we reviewed the major methods used to identify SBSEC isolates and the antimicrobial resistance rates reported in the scientific literature among SBSEC species.
Asunto(s)
Infecciones Estreptocócicas/microbiología , Streptococcus bovis/clasificación , Streptococcus bovis/aislamiento & purificación , Streptococcus/clasificación , Streptococcus/aislamiento & purificación , Animales , Antibacterianos/farmacología , Farmacorresistencia Microbiana , Regulación Bacteriana de la Expresión Génica/efectos de los fármacos , Humanos , Pruebas de Sensibilidad Microbiana , Infecciones Estreptocócicas/diagnóstico , Infecciones Estreptocócicas/epidemiología , Streptococcus/efectos de los fármacos , Streptococcus bovis/efectos de los fármacos , Streptococcus bovis/genéticaRESUMEN
Infective endocarditis (IE) is an uncommon, life-threatening systemic disorder with significant morbidity and persistently high mortality. The age of the peak incidence of IE has shifted from 45 years in the 1950s to 70 years at the present time, and elderly people have a five-fold higher risk of IE than the general adult population. Elderly IE patients demonstrate a higher prevalence of coagulase-negative staphylococci, enterococci and Streptococcus bovis, and lower rates of infection by viridans group streptococci. Methicillin resistance is more prevalent in elderly patients as a consequence of increased nosocomial acquisition. The elderly are a vulnerable group in whom diagnosis is often difficult on account of non-specific presenting features and where higher prevalence of comorbidities contributes to adverse outcomes. Treatment of older patients with IE presents specific challenges associated with prolonged antibiotic therapy, and access to surgery may be denied on account of advanced age and attendant comorbidities. This practical review covers all aspects of elderly IE, including clinical and microbiological diagnosis and appropriate diagnostic procedures, initial antibiotic selection, antibiotic prophylaxis, considerations about antibiotic therapy and surgery.
Asunto(s)
Endocarditis Bacteriana/diagnóstico , Endocarditis Bacteriana/terapia , Factores de Edad , Antibacterianos/uso terapéutico , Profilaxis Antibiótica , Endocarditis Bacteriana/microbiología , Enterococcus/aislamiento & purificación , Humanos , Staphylococcus/aislamiento & purificación , Streptococcus bovis/aislamiento & purificaciónRESUMEN
Streptococcus bovis is an uncommon cause of biliary tract infection, being acute cholecystitis including this microorganism extremely rare. This entity is more frequent in older patients with cardiovascular disease, diabetes, hepatitis, or neoplasms as colon cancer.
Asunto(s)
Colecistitis Enfisematosa/microbiología , Infecciones Estreptocócicas , Streptococcus bovis/aislamiento & purificación , Anciano de 80 o más Años , Colecistectomía , Colecistitis Enfisematosa/diagnóstico por imagen , Femenino , Humanos , Evaluación de SíntomasAsunto(s)
Arteritis/diagnóstico , Endocarditis Bacteriana/diagnóstico , Infecciones Estreptocócicas/diagnóstico , Streptococcus bovis/aislamiento & purificación , Anciano , Arteritis/microbiología , Arteritis/patología , Endocarditis Bacteriana/microbiología , Endocarditis Bacteriana/cirugía , Pie , Implantación de Prótesis de Válvulas Cardíacas , Humanos , Masculino , Piel/irrigación sanguínea , Piel/patología , Infecciones Estreptocócicas/microbiología , Infecciones Estreptocócicas/patología , Infecciones Estreptocócicas/cirugía , Resultado del TratamientoRESUMEN
Anchoring bias is one of the most common diagnostic biases that may lead to closed-minded thinking and could result in unnecessary tests, inappropriate patient management and even misdiagnosis. A 4-year-old boy was brought to the emergency department because of shaking chills. On the basis of bilateral swollen preauricular areas, high level of serum amylase and the prevalence of mumps, he initially received a diagnosis of mumps in spite of the shaking chills. However, blood culture turned out to be positive for two different kinds of bacteria. The patient finally received a diagnosis of polymicrobial bacteraemia resulting from suppurative appendicitis. We must consider and rule out bacteraemia in the differential diagnosis for patients who present with shaking chills, even in the presence of symptoms or information consistent with a more common viral infection such as mumps. In addition, intra-abdominal infection should be ruled out in the presence of polymicrobial enterobacteriaceae bacteraemia.
Asunto(s)
Apendicitis/diagnóstico , Bacteriemia/diagnóstico , Antibacterianos/uso terapéutico , Apendicectomía , Apendicitis/complicaciones , Apendicitis/diagnóstico por imagen , Apendicitis/terapia , Bacteriemia/sangre , Bacteriemia/complicaciones , Bacteriemia/tratamiento farmacológico , Preescolar , Escalofríos/etiología , Diagnóstico Diferencial , Escherichia coli/aislamiento & purificación , Humanos , Masculino , Paperas/diagnóstico , Streptococcus bovis/aislamiento & purificación , Tomografía Computarizada por Rayos XRESUMEN
OBJECTIVE: To describe the presentation, diagnosis, treatment, and outcome of a case of emphysematous gastritis (EG) in a cat. CASE SERIES SUMMARY: A 15-year-old female neutered domestic short-hair cat presented for a 4-month history of weight loss and intermittent vomiting. Clinicopathologic and imaging findings suggested an underlying primary gastrointestinal (GI) disease, as well as possible hepatobiliary disease. Two days following exploratory laparotomy to obtain GI and liver biopsies, the patient became septic and intracellular bacteria were present on cytology of peritoneal effusion. On radiographs, the stomach was markedly distended with fluid and contained a thin gas opacity surrounding the stomach wall. The patient was taken back to surgery to identify a source of sepsis. At surgery, the patient's stomach was firm and emphysematous on palpation but grossly appeared normal. There were no signs of dehiscence of the previous biopsy sites. Stomach biopsy confirmed the presence of intralesional Gram-positive rods, consistent with microbial EG, and a light growth of a Clostridium sp. was cultured from abdominal fluid, consistent with clostridial peritonitis. During a third surgery for suspected septic peritonitis, a jejunostomy tube was placed for postgastric enteral feeding. The patient ultimately survived to discharge and is clinically stable 10 months later. NEW/UNIQUE INFORMATION PROVIDED: EG is a rare but potentially fatal clinical entity in the human and veterinary literature with only 1 other case reported in cats. Though clostridial organisms have been reported in EG in people, this is the first implication of EG secondary to a Clostridium sp. in the cat. This is also the first report to document the use of a jejunostomy tube for postgastric enteral nutrition to treat EG in the veterinary literature.
Asunto(s)
Enfermedades de los Gatos/diagnóstico , Enfisema/veterinaria , Gastritis/veterinaria , Sepsis/veterinaria , Animales , Antibacterianos/uso terapéutico , Enfermedades de los Gatos/diagnóstico por imagen , Enfermedades de los Gatos/tratamiento farmacológico , Gatos , Diagnóstico Diferencial , Enfisema/complicaciones , Enfisema/diagnóstico , Femenino , Gastritis/complicaciones , Gastritis/diagnóstico , Radiografía/veterinaria , Sepsis/complicaciones , Sepsis/diagnóstico , Streptococcus bovis/aislamiento & purificación , Vómitos/etiología , Vómitos/veterinariaRESUMEN
BACKGROUND: Common etiological agents of neonatal meningitis include group B Streptococcus, Escherichia coli, and Staphylococcus aureus. Here we report a rare pathogen - Streptococcus bovis - causing meningitis in a premature neonate with Down syndrome. CASE PRESENTATION: A 26-day-old Asian male neonate with Down syndrome presented with a history of high-grade fever, poor sucking, poor cry, and reduced activity. On admission, he was febrile and had features of circulatory collapse. A cerebrospinal fluid examination confirmed bacterial meningitis and blood culture isolated the causative organism: group D Streptococcus, which was verified as Streptococcus bovis biotype 2. An echocardiogram did not show evidence of infective endocarditis. CONCLUSIONS: This is probably the first report of neonatal meningitis due to Streptococcus bovis in a child with Down syndrome. Although our patient did not show features of overt immunodeficiency, subtle abnormalities in his immune system would have predisposed him to infection with this unusual organism. This case highlights the need for considering unusual pathogens when managing serious infections in children with Down syndrome.
Asunto(s)
Síndrome de Down , Meningitis Bacterianas/microbiología , Infecciones Estreptocócicas , Streptococcus bovis/aislamiento & purificación , Administración Intravenosa , Antibacterianos/administración & dosificación , Cefotaxima/administración & dosificación , Humanos , Recién Nacido , Recien Nacido Prematuro , Masculino , Meningitis Bacterianas/líquido cefalorraquídeo , Meningitis Bacterianas/tratamiento farmacológico , Penicilina G/administración & dosificación , Enfermedades Raras , Infecciones Estreptocócicas/líquido cefalorraquídeo , Infecciones Estreptocócicas/tratamiento farmacológico , Infecciones Estreptocócicas/microbiologíaAsunto(s)
Bacteriemia/microbiología , Osteomielitis/microbiología , Infecciones Estreptocócicas/diagnóstico , Infección de la Herida Quirúrgica/microbiología , Antibacterianos/uso terapéutico , Bacteriemia/diagnóstico , Bacteriemia/tratamiento farmacológico , Neoplasias del Colon/diagnóstico , Comorbilidad , Humanos , Masculino , Persona de Mediana Edad , Osteomielitis/complicaciones , Osteomielitis/tratamiento farmacológico , Columna Vertebral/cirugía , Infecciones Estreptocócicas/tratamiento farmacológico , Streptococcus bovis/aislamiento & purificación , Infección de la Herida Quirúrgica/tratamiento farmacológicoRESUMEN
Casos clínicos: Presentamos 2 casos clínicos de endoftalmitis endógena bacteriana. El primero causado por Streptococcus bovis tras la realización de una colonoscopia, con mala evolución que acabó en evisceración. El segundo debido a un Staphylococcus aureus meticilin resistente procedente de un absceso paraespinal que complicaba una artrodesis, con excelente recuperación visual. Discusión: La endoftalmitis endógena bacteriana es una enfermedad poco frecuente y grave en la que bacterias procedentes de un foco primario llegan por vía sanguínea hasta el ojo. El diagnóstico de sospecha ha de ser lo más precoz posible, basado en la clínica y los antecedentes del paciente. Un tratamiento adecuado y específico con antibióticos intravenosos e intravítreos puede evitar el mal pronóstico visual en algunos casos (AU)
Clinical cases: The cases are presented on 2 patients with bacterial endogenous endophthalmitis. The first one was caused by Streptococcus bovis, developed after colonoscopy, which had a poor outcome and resulted in evisceration. The second case was caused by a methicillin resistant Staphylococcus aureus from an arthrodesis complicated with a para-spinal abscess. It had an excellent visual outcome. Discussion: Bacterial endogenous endophthalmitis is a rare, but serious ocular disease that occurs when bacteria reach the eye via the bloodstream. It requires a very early diagnosis based on the clinical symptoms and patient history. A suitable and specific treatment with intravenous and intravitreal antibiotics may prevent a bad visual prognosis in some cases (AU)
Asunto(s)
Humanos , Masculino , Femenino , Anciano , Endoftalmitis/microbiología , Streptococcus bovis/aislamiento & purificación , Staphylococcus aureus/aislamiento & purificación , Infecciones Bacterianas del Ojo/microbiología , Factores de Riesgo , Antibacterianos/uso terapéutico , Resultado del TratamientoRESUMEN
A 75-year-old woman was admitted to our hospital with a 3-month history of fever. Of note, she had a bioprosthetic mitral valve replacement 1 year prior to admission. Streptococcus bovis was isolated from three sets of blood cultures. An echocardiogram showed a flickering mass attached to the bioprosthesis. Her blood culture became sterile by the fourth day of ceftriaxone therapy. In spite of the absence of gastrointestinal symptoms, screening colonoscopy revealed an invasive colonic adenocarcinoma. The association linking S. bovis endocarditis and colonic tumours is well recognised. However, despite early reports of this association by Klein et al in 1979, a large number of practising physicians remain unaware of this phenomenon. This lack of awareness results in lost opportunities for early diagnosis and, consequently, improved outcome in such patients. Our report emphasises this association in an area with a low incidence of S. bovis endocarditis.
Asunto(s)
Adenocarcinoma/patología , Neoplasias del Colon/complicaciones , Endocarditis Bacteriana/complicaciones , Prótesis Valvulares Cardíacas/microbiología , Válvula Mitral/microbiología , Streptococcus bovis/aislamiento & purificación , Adenocarcinoma/cirugía , Cuidados Posteriores , Anciano , Bacteriemia , Neoplasias del Colon/diagnóstico , Neoplasias del Colon/patología , Colonoscopía/métodos , Ecocardiografía/métodos , Femenino , Humanos , Válvula Mitral/diagnóstico por imagen , Válvula Mitral/patología , Infecciones Estreptocócicas/complicaciones , Infecciones Estreptocócicas/diagnóstico , Infecciones Estreptocócicas/microbiología , Resultado del TratamientoRESUMEN
CLINICAL CASES: The cases are presented on 2patients with bacterial endogenous endophthalmitis. The first one was caused by Streptococcus bovis, developed after colonoscopy, which had a poor outcome and resulted in evisceration. The second case was caused by a methicillin resistant Staphylococcus aureus from an arthrodesis complicated with a para-spinal abscess. It had an excellent visual outcome. DISCUSSION: Bacterial endogenous endophthalmitis is a rare, but serious ocular disease that occurs when bacteria reach the eye via the bloodstream. It requires a very early diagnosis based on the clinical symptoms and patient history. A suitable and specific treatment with intravenous and intravitreal antibiotics may prevent a bad visual prognosis in some cases.
Asunto(s)
Endoftalmitis/microbiología , Infecciones Bacterianas del Ojo/microbiología , Staphylococcus aureus Resistente a Meticilina/aislamiento & purificación , Infecciones Estafilocócicas/microbiología , Infecciones Estreptocócicas/microbiología , Streptococcus bovis/aislamiento & purificación , Absceso/microbiología , Anciano , Bursitis/complicaciones , Bursitis/microbiología , Colonoscopía , Susceptibilidad a Enfermedades , Articulación del Codo/microbiología , Endoftalmitis/etiología , Endoftalmitis/cirugía , Evisceración del Ojo , Infecciones Bacterianas del Ojo/etiología , Infecciones Bacterianas del Ojo/cirugía , Femenino , Humanos , Masculino , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/microbiología , Complicaciones Posoperatorias/cirugía , Fusión Vertebral , Infecciones Estafilocócicas/tratamiento farmacológico , Infecciones Estafilocócicas/etiología , Infecciones Estreptocócicas/etiología , Infecciones Estreptocócicas/cirugíaRESUMEN
A 10-yr-old, male brown bear ( Ursus arctos ) from Bursa Zoo in Turkey died without any apparent signs. Severe purulent pericarditis and myocarditis with mild ascites, lung edema, and moderate liver congestion were observed during necropsy. Microscopically, there were severe neutrophilic infiltrations in the myocardium and thoracic lymph nodes. A member of the Streptococcus bovis - Streptococcus equinus complex (SBSEC) was isolated and identified phenotypically.
Asunto(s)
Endocarditis Bacteriana/veterinaria , Infecciones Estreptocócicas/veterinaria , Streptococcus bovis/aislamiento & purificación , Ursidae , Animales , Animales de Zoológico , Endocarditis Bacteriana/microbiología , Resultado Fatal , Masculino , Infecciones Estreptocócicas/microbiología , Infecciones Estreptocócicas/patologíaRESUMEN
This study compared two MALDI-TOF MS systems (Biotyper and VITEK MS) on clinical Streptococcus bovis group isolates (n=66). The VITEK MS gave fewer misidentifications and a higher rate of correct identifications than the Biotyper. Only the identification of S. lutetiensis by the VITEK MS was reliable. Additional optimization of the available system databases is needed.
Asunto(s)
Bacteriemia/diagnóstico , Técnicas Bacteriológicas/métodos , Cultivo de Sangre , Espectrometría de Masa por Láser de Matriz Asistida de Ionización Desorción/métodos , Infecciones Estreptocócicas/diagnóstico , Streptococcus bovis/química , Streptococcus bovis/aislamiento & purificación , Bacteriemia/microbiología , Humanos , Infecciones Estreptocócicas/microbiología , Streptococcus bovis/clasificaciónRESUMEN
Bacteremia with Streptococcus bovis/equinus complex strains is associated with hepatobiliary disease, colorectal lesions (CL), and infective endocarditis (IE). This study addressed the clinical significance of subspecies distinction of previously designated S. bovis blood culture isolates according to the updated nomenclature. During 2002-2013, all blood culture isolates previously designated as S. bovis were recultured and identified using 16S rRNA gene sequencing and MALDI-TOF (Bruker BioTyper and Vitek MS, bioMérieux). Clinical data of patients aged ≥18 years were reviewed. A review of four recent case series was performed as well. Forty blood isolates were identified using 16S rRNA sequencing. Twenty-six bacteremic patients had S. gallolyticus ssp. pasteurianus, six had S. gallolyticus ssp. gallolyticus, two had S. gallolyticus ssp. macedonicus, and six had S. infantarius bacteremia. Species diagnosis using Vitek and bioMérieux MALDI-TOF technology was applicable in 37 and 36 samples, respectively, and was successful in all samples (100 %). Subspecies identification was confirmed in 30 (83 %) samples (as compared with 16S rRNA sequencing detection). IE was diagnosed in 22 (59 %) patients and CL in 8 (20 %) patients. Both complications were associated with all subspecies. Combining our results with those of four recent series resulted in, overall, 320 bacteremic cases, of which 88 (28 %) had CL and 66 (21 %) had IE. All 'bovis/equinus' complex subspecies were associated with CL or IE. From a clinical point of view, species diagnosis using MALDI-TOF MS should suffice to warrant consideration of transesophageal echocardiography and colonoscopy.
Asunto(s)
Bacteriemia/microbiología , Streptococcus bovis/clasificación , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Sangre/microbiología , Colitis/microbiología , ADN Bacteriano/química , ADN Bacteriano/genética , ADN Ribosómico/química , ADN Ribosómico/genética , Endocarditis/microbiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , ARN Ribosómico 16S/genética , Análisis de Secuencia de ADN , Espectrometría de Masa por Láser de Matriz Asistida de Ionización Desorción , Infecciones Estreptocócicas/microbiología , Streptococcus bovis/química , Streptococcus bovis/genética , Streptococcus bovis/aislamiento & purificación , Adulto JovenRESUMEN
BACKGROUND: Rotavirus (RV) is the leading cause of diarrhea-related death in children worldwide and 95% of RV-associated deaths occur in Africa and Asia where RV vaccines (RVVs) have lower efficacy. We hypothesize that differences in intestinal microbiome composition correlate with the decreased RVV efficacy observed in poor settings. METHODS: We conducted a nested, case-control study comparing prevaccination, fecal microbiome compositions between 6-week old, matched RVV responders and nonresponders in rural Ghana. These infants' microbiomes were then compared with 154 age-matched, healthy Dutch infants' microbiomes, assumed to be RVV responders. Fecal microbiome analysis was performed in all groups using the Human Intestinal Tract Chip. RESULTS: We analyzed findings in 78 Ghanaian infants, including 39 RVV responder and nonresponder pairs. The overall microbiome composition was significantly different between RVV responders and nonresponders (FDR, 0.12), and Ghanaian responders were more similar to Dutch infants than nonresponders (P = .002). RVV response correlated with an increased abundance of Streptococcus bovis and a decreased abundance of the Bacteroidetes phylum in comparisons between both Ghanaian RVV responders and nonresponders (FDR, 0.008 vs 0.003) and Dutch infants and Ghanaian nonresponders (FDR, 0.002 vs 0.009). CONCLUSIONS: The intestinal microbiome composition correlates significantly with RVV immunogenicity and may contribute to the diminished RVV immunogenicity observed in developing countries.