Clinical and nutritional correlates of bacterial diarrhoea aetiology in young children: a secondary cross-sectional analysis of the ABCD trial.
BMJ Paediatr Open
; 8(1)2024 Apr 11.
Article
in En
| MEDLINE
| ID: mdl-38604769
ABSTRACT
OBJECTIVE:
The objective was to assess the association between nutritional and clinical characteristics and quantitative PCR (qPCR)-diagnosis of bacterial diarrhoea in a multicentre cohort of children under 2 years of age with moderate to severe diarrhoea (MSD).DESIGN:
A secondary cross-sectional analysis of baseline data collected from the AntiBiotics for Children with Diarrhoea trial (NCT03130114). PATIENTS Children with MSD (defined as >3 loose stools within 24 hours and presenting with at least one of the following some/severe dehydration, moderate acute malnutrition (MAM) or severe stunting) enrolled in the ABCD trial and collected stool sample. STUDY PERIOD June 2017-July 2019.INTERVENTIONS:
None. MAIN OUTCOMEMEASURES:
Likely bacterial aetiology of diarrhoea. Secondary outcomes included specific diarrhoea aetiology.RESULTS:
A total of 6692 children with MSD had qPCR results available and 28% had likely bacterial diarrhoea aetiology. Compared with children with severe stunting, children with MAM (adjusted OR (aOR) (95% CI) 1.56 (1.18 to 2.08)), some/severe dehydration (aOR (95% CI) 1.66 (1.25 to 2.22)) or both (aOR (95% CI) 2.21 (1.61 to 3.06)), had higher odds of having likely bacterial diarrhoea aetiology. Similar trends were noted for stable toxin-enterotoxigenic Escherichia coli aetiology. Clinical correlates including fever and prolonged duration of diarrhoea were not associated with likely bacterial aetiology; children with more than six stools in the previous 24 hours had higher odds of likely bacterial diarrhoea (aOR (95% CI) 1.20 (1.05 to 1.36)) compared with those with fewer stools.CONCLUSION:
The presence of MAM, dehydration or high stool frequency may be helpful in identifying children with MSD who might benefit from antibiotics.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Bacterial Infections
/
Dysentery
Limits:
Child, preschool
/
Humans
/
Infant
/
Newborn
Language:
En
Journal:
BMJ Paediatr Open
Year:
2024
Document type:
Article
Affiliation country:
Finland
Country of publication:
United kingdom