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We previously showed that coinfection with Gram negative (G[\u2212]) enteric Bacilli and<jats:italic>Plasmodium falciparum<\/jats:italic>(<jats:italic>Pf<\/jats:italic>[+]) was associated with reduced high-density parasitemia (HDP, &gt;10,000 parasites\/<jats:italic>\u03bc<\/jats:italic>L), enhanced respiratory distress, and severe anemia. Since inflammatory mediators are largely unexplored in such coinfections, circulating cytokines were determined in four groups of children (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\"><mml:mi>n<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn mathvariant=\"normal\">206<\/mml:mn><\/mml:math>, aged &lt;3\u2009yrs): healthy;<jats:italic>Pf<\/jats:italic>[+] alone; G[\u2212] coinfected; and G[+] coinfected.<jats:italic>Staphylococcus aureus<\/jats:italic>and non-Typhi<jats:italic>Salmonella<\/jats:italic>were the most frequently isolated G[+] and G[\u2212] organisms, respectively. Coinfected children, particularly those with G[\u2212] pathogens, had lower parasite burden (peripheral and geometric mean parasitemia and HDP). In addition, both coinfected groups had increased IL-4, IL-5, IL-7, IL-12, IL-15, IL-17, IFN-<jats:italic>\u03b3<\/jats:italic>, and IFN-<jats:italic>\u03b1<\/jats:italic>and decreased TNF-<jats:italic>\u03b1<\/jats:italic>relative to malaria alone. Children with G[\u2212] coinfection had higher IL-1<jats:italic>\u03b2<\/jats:italic>and IL-1Ra and lower IL-10 than the<jats:italic>Pf<\/jats:italic>[+] group and higher IFN-<jats:italic>\u03b3<\/jats:italic>than the G[+] group. To determine how the immune response to malaria regulates parasitemia, cytokine production was investigated with a multiple mediation model. Cytokines with the greatest mediational impact on parasitemia were IL-4, IL-10, IL-12, and IFN-<jats:italic>\u03b3<\/jats:italic>. Results here suggest that enhanced immune activation, especially in G[\u2212] coinfected children, acts to reduce malaria parasite burden.<\/jats:p>","DOI":"10.1155\/2016\/4286576","type":"journal-article","created":{"date-parts":[[2016,6,24]],"date-time":"2016-06-24T02:07:48Z","timestamp":1466734068000},"page":"1-14","source":"Crossref","is-referenced-by-count":21,"title":["Reduced Parasite Burden in Children with Falciparum Malaria and Bacteremia Coinfections: Role of Mediators of Inflammation"],"prefix":"10.1155","volume":"2016","author":[{"given":"Gregory C.","family":"Davenport","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA"},{"name":"Center for Global Health, Department of Internal Medicine, Division of Infectious Diseases, School of Medicine, University of New Mexico, Albuquerque, NM 87131, 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