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Thompson CN, Phan MVT, Hoang NVM, Minh PV, Vinh NT, Thuy CT, Nga TTT, Rabaa MA, Duy PT, Dung TTN, Phat VV, Nga TVT, Tu LTP, Tuyen HT, Yoshihara K, Jenkins C, Duong VT, Phuc HL, Tuyet PTN, Ngoc NM, Vinh H, Chinh NT, Thuong TC, Tuan HM, Hien TT, Campbell JI, Chau NVV, Thwaites G, Baker S. A prospective multi-center observational study of children hospitalized with diarrhea in Ho Chi Minh City, Vietnam. Am J Trop Med Hyg 2015; 92:1045-52. [PMID: 25802437 PMCID: PMC4426562 DOI: 10.4269/ajtmh.14-0655] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2014] [Accepted: 01/28/2015] [Indexed: 12/15/2022] Open
Abstract
We performed a prospective multicenter study to address the lack of data on the etiology, clinical and demographic features of hospitalized pediatric diarrhea in Ho Chi Minh City (HCMC), Vietnam. Over 2,000 (1,419 symptomatic and 609 non-diarrheal control) children were enrolled in three hospitals over a 1-year period in 2009–2010. Aiming to detect a panel of pathogens, we identified a known diarrheal pathogen in stool samples from 1,067/1,419 (75.2%) children with diarrhea and from 81/609 (13.3%) children without diarrhea. Rotavirus predominated in the symptomatic children (664/1,419; 46.8%), followed by norovirus (293/1,419; 20.6%). The bacterial pathogens Salmonella, Campylobacter, and Shigella were cumulatively isolated from 204/1,419 (14.4%) diarrheal children and exhibited extensive antimicrobial resistance, most notably to fluoroquinolones and third-generation cephalosporins. We suggest renewed efforts in generation and implementation of policies to control the sale and prescription of antimicrobials to curb bacterial resistance and advise consideration of a subsidized rotavirus vaccination policy to limit the morbidity due to diarrheal disease in Vietnam.
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Affiliation(s)
- Corinne N Thompson
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - My V T Phan
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Nguyen Van Minh Hoang
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Pham Van Minh
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Nguyen Thanh Vinh
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Cao Thu Thuy
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Tran Thi Thu Nga
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Maia A Rabaa
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Pham Thanh Duy
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Tran Thi Ngoc Dung
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Voong Vinh Phat
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Tran Vu Thieu Nga
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Le Thi Phuong Tu
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Ha Thanh Tuyen
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Keisuke Yoshihara
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Claire Jenkins
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Vu Thuy Duong
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Hoang Le Phuc
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Pham Thi Ngoc Tuyet
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Nguyen Minh Ngoc
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Ha Vinh
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Nguyen Tran Chinh
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Tang Chi Thuong
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Ha Manh Tuan
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Tran Tinh Hien
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - James I Campbell
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Nguyen Van Vinh Chau
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Guy Thwaites
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
| | - Stephen Baker
- The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam; Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, United Kingdom; The London School of Hygiene and Tropical Medicine, London, United Kingdom; The Wellcome Trust Sanger Institute, Hinxton, Cambridge, United Kingdom; Centre for Immunity, Infection and Evolution, University of Edinburgh, Edinburgh, United Kingdom; The Institute of Tropical Medicine, Nagasaki University, Nagasaki, Japan; Gastrointestinal Bacteria Reference Unit, Public Health England, London, United Kingdom; Children's Hospital 1, Ho Chi Minh City, Vietnam; Children's Hospital 2, Ho Chi Minh City, Vietnam; Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam
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