Despite antibiotic treatment of travellers' diarrhoea pathogens are found in stools from half of travellers at return

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Lääveri , T , Vilkman , K , Pakkanen , S , Kirveskari , J & Kantele , A 2018 , ' Despite antibiotic treatment of travellers' diarrhoea pathogens are found in stools from half of travellers at return ' , Travel medicine and infectious disease , vol. 23 , pp. 49-55 . https://doi.org/10.1016/j.tmaid.2018.04.003

Title: Despite antibiotic treatment of travellers' diarrhoea pathogens are found in stools from half of travellers at return
Author: Lääveri, Tinja; Vilkman, Katri; Pakkanen, Sari; Kirveskari, Juha; Kantele, Anu
Contributor: University of Helsinki, Clinicum
University of Helsinki, Clinicum
University of Helsinki, Anu Kantele-Häkkinen Research Group
University of Helsinki, Clinicum
University of Helsinki, Clinicum
Date: 2018-04-24
Language: eng
Number of pages: 7
Belongs to series: Travel medicine and infectious disease
ISSN: 1477-8939
URI: http://hdl.handle.net/10138/301138
Abstract: Background: Among visitors to the (sub)tropics, 20-50% contract travellers' diarrhoea (TD) and 5-30% take antibiotics. While shortening the duration of illness, antimicrobials predispose to acquisition of multi-drug resistant bacteria. Therefore, liberal use is no longer advocated. Although antibiotics kill pathogens, no data support the view that they could prevent post-infectious sequelae. We investigated how antibiotic use for TD abroad impacts the pathogen findings at return. Materials and methods: We revisited 456 travellers' clinical data and stool pathogens examined by qPCR for Salmonella, Yersinia, Campylobacter, Shigella, Vibrio cholerae and enteroaggregative (EAEC), enteropathogenic (EPEC), enterotoxigenic (ETEC), enterohaemorrhagic (EHEC) and enteroinvasive (EIEC) Escherichia coli. Results: Among travellers with TD, antibiotic users had pathogen-positive samples less frequently than non-users (50% versus 83%). The difference was significant for EPEC (23% versus 47%) and EAEC (27% versus 54%), but not ETEC (17% versus 26%) or the other pathogens. Shigella/EIEC was found more often among antibiotic users than non-users (4% versus 1%). Conclusion: Despite antibiotic treatment of TD, half of the users still had stool pathogens at return, reflecting either antibiotic resistance of pathogens or recolonisation/reinfection while abroad. Treatment of TD with antibiotics during travel should not be interpreted to indicate eradication of pathogens.
Subject: 3111 Biomedicine
3142 Public health care science, environmental and occupational health
EPEC
EAEC
ETEC
CAMPYLOBACTER
DIARRHOEAGENIC ESCHERICHIA COLI
SHIGELLA
SALMONELLA INFECTIONS
ESCHERICHIA-COLI
SELF-TREATMENT
INTERNATIONAL TRAVELERS
DOUBLE-BLIND
LACTAMASE-PRODUCING ENTEROBACTERIACEAE
MULTIDRUG-RESISTANT ENTEROBACTERIACEAE
HUMAN GASTROINTESTINAL-TRACT
IRRITABLE-BOWEL-SYNDROME
DEVELOPING-COUNTRIES
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