Project Details

Quantifying the role of zoonotic transmission of E. coli in pediatric sepsis in Nigeria

Daniel Park, PhD, MSPH

Summary

BACKGROUND: Sepsis is a leading cause of morbidity and mortality among neonates and children under 5-years of age, with extraintestinal pathogenic Escherichia coli (ExPEC) strains being among the most common causes. The proportion of ExPEC infections from zoonotic sources is unknown but may represent a substantial fraction, particularly in settings with suboptimal water, sanitation, and hygiene conditions and increased human exposure to food animals. GAP: ExPEC infections may frequently be caused by zoonotic transmission, particularly in LMICs; however, there is a dearth of well-characterized bloodstream infection isolates that have been sequenced from LMICs, precluding quantification of zoonotic transmission rates. HYPOTHESIS: We hypothesize that around 30% of neonatal ExPEC infections are from zoonotic sources in Nigeria. We aim to quantify the fraction of neonatal and pediatric infections caused by zoonotic ExPEC strains and identify their primary animal reservoirs. METHODS: We will collect 60 food animal E. coli isolates from abattoirs (slaughterhouses) in Nigeria, along with 70 retrospectively collected neonatal and pediatric ExPEC isolates from tertiary care facilities in Abuja and surrounding regions. The sequenced isolates will be evaluated using our existing Bayesian latent class model which uses mobile genetic elements in the accessory genome to assign a probability of isolate origin. RESULTS: Pending. IMPACT: Quantifying the proportion of ExPEC infections attributable to zoonotic transmission would identify targets for interventions along an unexplored but potentially significant causal pathway. Simple interventions such as physical restrictions to reduce in food-animal exposures (e.g. fences), vaccination against E. coli strains in food-animals, and awareness of food-animals as vectors of bacterial transmission to bolster of water, sanitation, and hygiene practices may substantially reduce pediatric sepsis rates in LMICs.