Prospective study of pathogens in asymptomatic travellers and those with diarrhoea : aetiological agents revisited

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Lääveri , T , Antikainen , J , Pakkanen , S H , Kirveskari , J & Kantele , A 2016 , ' Prospective study of pathogens in asymptomatic travellers and those with diarrhoea : aetiological agents revisited ' , Clinical Microbiology and Infection , vol. 22 , no. 6 , pp. 535-541 . https://doi.org/10.1016/j.cmi.2016.02.011

Title: Prospective study of pathogens in asymptomatic travellers and those with diarrhoea : aetiological agents revisited
Author: Lääveri, T.; Antikainen, J.; Pakkanen, S. H.; Kirveskari, J.; Kantele, Anu
Contributor: University of Helsinki, Department of Medicine
University of Helsinki, Department of Bacteriology and Immunology
University of Helsinki, Clinicum
University of Helsinki, Clinicum
Date: 2016-06
Language: eng
Number of pages: 7
Belongs to series: Clinical Microbiology and Infection
ISSN: 1198-743X
URI: http://hdl.handle.net/10138/165210
Abstract: Travellers' diarrhoea (TD) remains the most frequent health problem encountered by visitors to the (sub) tropics. Traditional stool culture identifies the pathogen in only 15% of cases. Exploiting PCR-based methods, we investigated TD pathogens with a focus on asymptomatic travellers and severity of symptoms. Pre- and post-travel stools of 382 travellers with no history of antibiotic use during travel were analysed with a multiplex quantitative PCR for Salmonella, Yersinia, Campylobacter, Shigella, Vibrio cholerae and five diarrhoeagenic Escherichia coli: enteroaggregative (EAEC), enteropathogenic (EPEC), enterotoxigenic (ETEC), enterohaemorrhagic (EHEC) and enteroinvasive (EIEC). The participants were categorized by presence/absence of TD during travel and on return, and by severity of symptoms. A pathogen was indentified in 61% of the asymptomatic travellers, 83% of those with resolved TD, and 83% of those with ongoing TD; 25%, 43% and 53% had multiple pathogens, respectively. EPEC, EAEC, ETEC and Campylobacter associated especially with ongoing TD symptoms. EAEC and EPEC proved more common than ETEC. To conclude, modern methodology challenges our perception of stool pathogens: all pathogens were common both in asymptomatic and symptomatic travellers. TD has a multibacterial nature, but diarrhoeal symptoms mostly associate with EAEC, EPEC, ETEC and Campylobacter. (C) 2016 The Authors. Published by Elsevier Ltd on behalf of European Society of Clinical Microbiology and Infectious Diseases.
Subject: Aetiology
Campylobacter
diarrhoea
enteroaggregative Escherichia coli
enteropathogenic E. coli
enterotoxigenic Escherichia coli
quantitative RT-PCR
travel
ENTEROAGGREGATIVE ESCHERICHIA-COLI
HUMAN GASTROINTESTINAL-TRACT
DEVELOPING-COUNTRIES
UNITED-STATES
MEXICO
COLONIZATION
EPIDEMIOLOGY
MULTICENTER
PREVALENCE
SURVIVAL
3121 Internal medicine
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