Table 3.
Risk Factors of the mph(A) Gene in Commensal Escherichia coli Isolated From Fecal Samples of the Participating Children
| No. (%)a | Model 1: Univariable Analysis | Model 2: Multivariable Analysis | ||||||
|---|---|---|---|---|---|---|---|---|
| mph(A)+ (n = 109) | mph(A)– (n = 129) | PR | 95% CI | P Value | Adjusted PRb | 95% CI | P Value | |
| Location of the facility | … | … | … | |||||
| Kisii | 64 (59) | 80 (62) | 1 [Ref] | |||||
| Homa Bay | 45 (41) | 49 (38) | 1.08 | .81–1.42 | .602 | 1.09 | .82- 1.44 | .560 |
| Child characteristics | ||||||||
| Age, mo | … | … | … | |||||
| 0–5 | 14 (13) | 13 (10) | 1 [Ref] | |||||
| 6–11 | 21 (19) | 24 (19) | 0.90 | .56–1.45 | .667 | 0.92 | .57- 1.48 | .719 |
| 12–23 | 28 (26) | 45 (35) | 0.74 | .46–1.18 | .205 | 0.74 | .46- 1.18 | .207 |
| 24–59 | 46 (42) | 47 (36) | 0.95 | .63–1.45 | .825 | 0.94 | .62- 1.43 | .777 |
| Sex | … | … | … | |||||
| Male | 61 (56) | 87 (67) | 1 [Ref] | |||||
| Female | 48 (44) | 42 (33) | 1.29 | .98–1.70 | .065 | 1.28 | .98- 1.69 | .075 |
| Breastfeedingc | ||||||||
| Exclusively breastfed | 53 (49) | 51 (40) | 1 [Ref] | 1 [Ref] | ||||
| Partially breastfed | 49 (45) | 68 (53) | 0.82 | .62–1.09 | .178 | 0.82 | .61–1.10 | .177 |
| Unknown | 7 (6) | 10 (8) | 0.81 | .44–1.47 | .486 | 0.82 | .44–1.54 | .540 |
| Child HIV statusd | ||||||||
| HIV unexposed | 95 (88) | 104 (84) | 1 [Ref] | 1 [Ref] | ||||
| HIV positive or exposed | 13 (12) | 20 (16) | 0.83 | .53–1.29 | .401 | 0.80 | .51–1.26 | .343 |
| Underweight (WAZ <−2) | ||||||||
| WAZ ≥−2 | 99 (91) | 111 (86) | 1 [Ref] | 1 [Ref] | ||||
| WAZ <−2 | 10 (9) | 18 (14) | 0.76 | .45–1.27 | .294 | 0.82 | .48–1.38 | .451 |
| Stunting (HAZ/LAZ <−2) | ||||||||
| HAZ/LAZ ≥−2 | 79 (73) | 94 (73) | 1 [Ref] | 1 [Ref] | ||||
| HAZ/LAZ <−2 | 29 (27) | 34 (27) | 1.01 | .74–1.38 | .960 | 1.08 | .79–1.48 | .622 |
| Acute malnutrition | ||||||||
| None | 96 (88) | 115 (89) | 1 [Ref] | 1 [Ref] | ||||
| MAM | 8 (7) | 7 (5) | 1.17 | .71–1.93 | .531 | 1.16 | .70–1.90 | .569 |
| SAM | 5 (5) | 7 (5) | 0.92 | .46–1.82 | .802 | 0.89 | .44–1.82 | .753 |
| Vaccination status | ||||||||
| Pneumococcal vaccinatione | ||||||||
| No | 8 (7) | 10 (8) | 1 [Ref] | 1 [Ref] | ||||
| Yes | 101 (93) | 119 (92) | 1.03 | .60–1.77 | .906 | 1.03 | .59–1.78 | .926 |
| Rotavirus vaccinationf | ||||||||
| No | 25 (23) | 30 (23) | 1 [Ref] | 1 [Ref] | ||||
| Yes | 84 (77) | 99 (77) | 1.01 | .73–1.40 | .954 | 1.06 | .75–1.50 | .725 |
| DPT vaccinationg | ||||||||
| No | 6 (6) | 10 (8) | 1 [Ref] | 1 [Ref] | ||||
| Yes | 103 (94) | 119 (92) | 1.24 | .65–2.37 | .521 | 1.30 | .69–2.47 | .421 |
| Measles vaccinationh | ||||||||
| No | 50 (46) | 42 (33) | 1 [Ref] | |||||
| Yes | 59 (54) | 87 (67) | 0.74 | .57–.98 | .033 | 0.70 | .52–.95 | .022 |
| Completed all essential vaccinesi | ||||||||
| No | 74 (68) | 68 (53) | 1 [Ref] | 1 [Ref] | ||||
| Yes | 35 (32) | 61 (47) | 0.70 | .51–.95 | .023 | 0.68 | .49–.93 | .017 |
| Hospitalization information | ||||||||
| Length of hospital stay | ||||||||
| ≤3 d | 47 (44) | 78 (60) | 1 [Ref] | 1 [Ref] | ||||
| >3 d | 60 (56) | 51 (40) | 1.44 | 1.08–1.91 | .012 | 1.47 | 1.10–1.98 | .009 |
| Antibiotic use during admission | ||||||||
| No | 10 (9) | 26 (20) | 1 [Ref] | 1 [Ref] | ||||
| Yes | 99 (91) | 103 (80) | 1.76 | 1.02–3.05 | .042 | 1.83 | 1.06–3.18 | .031 |
| Ceftriaxone use during admissionj | ||||||||
| No | 59 (60) | 64 (62) | 1 [Ref] | 1 [Ref] | ||||
| Yes | 40 (40) | 39 (38) | 1.06 | .79–1.40 | .711 | 1.00 | .74–1.34 | .981 |
| Gentamicin use during admissionj | ||||||||
| No | 33 (33) | 43(42) | 1 [Ref] | 1 [Ref] | ||||
| Yes | 66 (67) | 60 (58) | 1.21 | .89–1.64 | .231 | 1.33 | .97–1.83 | .073 |
| Chloramphenicol use during admissionj | ||||||||
| No | 94 (95) | 97 (94) | 1 [Ref] | 1 [Ref] | ||||
| Yes | 5 (5) | 6 (6) | 0.92 | .48–1.80 | .815 | 1.04 | .53–2.01 | .916 |
| Penicillin use during admissionj | ||||||||
| No | 27 (27) | 36 (35) | 1 [Ref] | 1 [Ref] | ||||
| Yes | 72 (73) | 67 (65) | 1.21 | .87–1.68 | .257 | 1.36 | .97–1.89 | .071 |
| Household characteristics | ||||||||
| Caregiver-reported monthly income, Kenyan shilling | ||||||||
| ≥5000 | 33 (30) | 33 (26) | 1 [Ref] | 1 [Ref] | ||||
| <5000 | 73 (67) | 87 (67) | 0.91 | .68–1.23 | .543 | 0.89 | .65–1.20 | .438 |
| Unknown or refuse to answer | 3 (3) | 9 (7) | 0.50 | .18–1.37 | .179 | 0.42 | .15–1.22 | .110 |
| Crowding (>2 persons per room) | ||||||||
| No (≤2) | 53 (49) | 68 (53) | 1 [Ref] | 1 [Ref] | ||||
| Yes (>2) | 56 (51) | 61 (47) | 1.09 | .83–1.44 | .531 | 1.05 | .79–1.41 | .717 |
| Improved water source | ||||||||
| No | 19 (17) | 22 (17) | 1 [Ref] | 1 [Ref] | ||||
| Yes | 90 (83) | 107 (83) | 0.99 | .69–1.42 | .939 | 1.04 | .72–1.49 | .851 |
| Treated drinking water | ||||||||
| No | 49 (46) | 66 (52) | 1 [Ref] | 1 [Ref] | ||||
| Yes | 58 (54) | 62 (48) | 1.13 | 0.86–1.50 | .381 | 1.12 | .83–1.51 | .456 |
| Toilet | ||||||||
| Private, for household only | 46 (43) | 64 (50) | 1 [Ref] | 1 [Ref] | ||||
| Shared with ≥1 households | 53 (50) | 61 (47) | 1.11 | 0.83–1.50 | .483 | 1.15 | .85–1.56 | .368 |
| Open defecation | 8 (7) | 4 (3) | 1.59 | 1.01–2.52 | .046 | 1.58 | .95–2.62 | .076 |
Model 1 presents results from the univariable Poisson regression model with robust SE, and model 2 presents results of an adjusted multivariable Poisson regression model (adjusted for age, sex, and site) with robust SE. mph(A)+ and mph(A)– denote the presence and absence of the mph(A) gene in the isolated E coli from fecal samples.
Abbreviations: DPT, diphtheria, pertussis, and tetanus; HAZ, height for age; LAZ, length for age; MAM, moderate acute malnutrition; PR, prevalence ratio; Ref, reference; SAM, severe acute malnutrition; WAZ, weight for age.
aColumn percentages.
bAdjusted for sex, age, and site. Models including one of the three confounders were adjusted for the other two.
cWhether the child is currently breastfeeding (≤6 months old) or if the mother practiced breastfeeding when the child was ≤6 months old.
dSix children had exposure with an unknown infection status and were excluded.
ePneumococcal vaccination defined as vaccination completed for the 6-, 10-, and 14-week schedule or up to the age of the child allowing a 2-week margin.
fRotavirus vaccine defined as vaccination completed for the 6- and 10-week schedule or up to the age of the child allowing a 2-week margin.
gDPT vaccine defined as vaccination completed for the 6-, 10-, and 14-week schedule or up to the age of the child allowing a 2-week margin.
hMeasles vaccine defined as vaccination completed for the 9- and 18-month schedule or up to the age of the child allowing a 2-week margin.
iAll essential vaccination defined as having complete vaccination for pneumococcal, rotavirus, DPT, measles, and bacille Calmette-Guérin.
jAmong children who received at least 1 antibiotic during hospitalization (antibiotic of interest vs other antibiotics).