{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T16:55:05Z","timestamp":1782924905730,"version":"3.54.5"},"reference-count":28,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,7,1]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n                  <jats:p>\n                    Enteroaggregative\n                    <jats:italic>Escherichia coli<\/jats:italic>\n                    (EAEC) is a major enteric pathogen in low-resource settings. The aim for the present study is to reanalyze the effects of subclinical EAEC infection, alone or in combination with other pathogens, on intestinal function, growth, and cognition in children aged 0\u20136 months through molecular diagnosis. A total of 1,659 non-diarrheal stool samples from the Etiology, Risk Factors and Interactions of Enteric Infections and Malnutrition and the Consequences for Child Health and Development cohort were analyzed using quantitative polymerase chain reaction testing for 29 enteropathogens. Children were grouped by infection status: EAEC alone or with 1, 2, or \u22653 co-pathogens. Enteroaggregative\n                    <jats:italic>Escherichia coli<\/jats:italic>\n                    and a higher pathogen burden were associated with lower socioeconomic status and greater antibiotic use (\n                    <jats:italic>P<\/jats:italic>\n                    &lt;0.001). Enteroaggregative\n                    <jats:italic>Escherichia coli<\/jats:italic>\n                    with \u22653 co-pathogens was linked to elevated neopterin (\u03b2 = 687.5; CI: 129.7\u20131,245.3), increased intestinal permeability (\u03b2 = 0.41; CI: 0.058\u20130.77), and a lower length-for-age\n                    <jats:italic>z<\/jats:italic>\n                    -score (\u03b2 = \u20130.44; CI: \u20130.76 to \u20130.12), and EAEC alone reduced cognitive scores at 15 and 24 months of age (\u03b2 = \u20132.82 and \u20135.02, respectively; CI: \u20135.15 to \u20130.48 and \u20139.81 to \u20130.22, respectively). Subclinical EAEC infection is associated with inflammation, gut dysfunction, growth failure, and cognitive delay.\n                  <\/jats:p>","DOI":"10.4269\/ajtmh.25-0499","type":"journal-article","created":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T16:27:16Z","timestamp":1779380836000},"page":"30-35","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Asymptomatic Enteroaggregative Escherichia coli Infection and Co-Pathogen Burden on Intestinal Barrier Function, Linear Growth, and Cognitive Development in Early Childhood: Insights from a Birth Cohort Study"],"prefix":"10.4269","volume":"115","author":[{"given":"Aldo A.M.","family":"Lima","sequence":"first","affiliation":[{"name":"Center of Biomedicine and Department of Physiology and Pharmacology, Faculty of Medicine, Federal University of Cear\u00e1, Fortaleza, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia L.S.C.","family":"Urtiga","sequence":"additional","affiliation":[{"name":"Center of Biomedicine and Department of Physiology and Pharmacology, Faculty of Medicine, Federal University of Cear\u00e1, Fortaleza, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samilly A.","family":"Ribeiro","sequence":"additional","affiliation":[{"name":"Center of Biomedicine and Department of Physiology and Pharmacology, Faculty of Medicine, Federal University of Cear\u00e1, Fortaleza, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 Q.S.","family":"Filho","sequence":"additional","affiliation":[{"name":"Center of Biomedicine and Department of Physiology and Pharmacology, Faculty of Medicine, Federal University of Cear\u00e1, Fortaleza, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruna L.L.","family":"Maciel","sequence":"additional","affiliation":[{"name":"Department of Nutrition, Federal University of Rio Grande do Norte, Natal, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana E.S.","family":"Alves","sequence":"additional","affiliation":[{"name":"Postgraduate Program in Medical Microbiology, Department of Pathology and Legal Medicine, Faculty of Medicine, Federal University of Cear\u00e1, Fortaleza, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis F.B.","family":"Lino","sequence":"additional","affiliation":[{"name":"Postgraduate Program in Medical Microbiology, Department of Pathology and Legal Medicine, Faculty of Medicine, Federal University of Cear\u00e1, Fortaleza, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco A.P.","family":"Rodrigues","sequence":"additional","affiliation":[{"name":"Department of Physical Education and Sport, Federal Institute of Education, Science and Technology of Cear\u00e1, Fortaleza, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana K.F.","family":"Leite","sequence":"additional","affiliation":[{"name":"Department of Food Engineering, Federal University of Cear\u00e1, Fortaleza, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandre","family":"Havt","sequence":"additional","affiliation":[{"name":"Center of Biomedicine and Department of Physiology and Pharmacology, Faculty of Medicine, Federal University of Cear\u00e1, Fortaleza, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gagandeep","family":"Kang","sequence":"additional","affiliation":[{"name":"Christian Medical College, Vellore, India;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret N.","family":"Kosek","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and International Health, University of Virginia School of Medicine, Charlottesville, Virginia, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascal O.","family":"Bessong","sequence":"additional","affiliation":[{"name":"SAMRC-UNIVEN Antimicrobial Resistance and Global Health Research Unit, Institute for Pathogen and Global Health Research, University of Venda, South Africa;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amidou","family":"Samie","sequence":"additional","affiliation":[{"name":"SAMRC-UNIVEN Antimicrobial Resistance and Global Health Research Unit, Institute for Pathogen and Global Health Research, University of Venda, South Africa;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rashidul","family":"Haque","sequence":"additional","affiliation":[{"name":"International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Estomih R.","family":"Mduma","sequence":"additional","affiliation":[{"name":"Haydom Global Health Research Centre, Haydom, Tanzania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose P.","family":"Leite","sequence":"additional","affiliation":[{"name":"Funda\u00e7\u00e3o Oswaldo Cruz, Rio de Janeiro, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ladaporn","family":"Bodhidatta","sequence":"additional","affiliation":[{"name":"Armed Forces Research Institute of Medical Sciences, Bangkok, Thailand;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Najeeha T.","family":"Iqbal","sequence":"additional","affiliation":[{"name":"Aga Khan University, Karachi, Pakistan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Page","sequence":"additional","affiliation":[{"name":"National Institute for Communicable Diseases, Johannesburg, South Africa;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ireen","family":"Kiwelu","sequence":"additional","affiliation":[{"name":"Kilimanjaro Clinical Research Institute, Moshi, Tanzania."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zulfiqar A.","family":"Bhutta","sequence":"additional","affiliation":[{"name":"Aga Khan University, Karachi, Pakistan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tahmeed","family":"Ahmed","sequence":"additional","affiliation":[{"name":"International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deiziane V.S.","family":"Costa","sequence":"additional","affiliation":[{"name":"Center of Biomedicine and Department of Physiology and Pharmacology, Faculty of Medicine, Federal University of Cear\u00e1, Fortaleza, Brazil;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard L.","family":"Guerrant","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and International Health, University of Virginia School of Medicine, Charlottesville, Virginia, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric R.","family":"Houpt","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases and International Health, University of Virginia School of Medicine, Charlottesville, Virginia, USA;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"issue":"5","key":"b1","series-title":"J Infect Dis","first-page":"1643","article-title":"Persistent diarrhea signals a critical period of increased diarrhea burdens and nutritional shortfalls: A prospective cohort study among children in northeastern Brazil","volume":"181","author":"Lima","year":"2000"},{"issue":"7","key":"b2","series-title":"PLoS Negl Trop Dis","first-page":"e0005798","article-title":"Epidemiology of enteroaggregative Escherichia coli infections and associated outcomes in the MAL-ED birth cohort","volume":"11","author":"Rogawski","year":"2017"},{"key":"b3","series-title":"Front Cell Infect 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