T Lääveri1, K Vilkman2, S H Pakkanen3, J Kirveskari4, A Kantele5. 1. Inflammation Center, Division of Infectious Diseases, Helsinki University Hospital, Finland and University of Helsinki, Finland. 2. Inflammation Center, Division of Infectious Diseases, Helsinki University Hospital, Finland and University of Helsinki, Finland; Aava Travel Clinic, Medical Centre Aava, Helsinki, Finland. 3. Department of Bacteriology and Immunology, University of Helsinki, Finland. 4. Department of Bacteriology, Helsinki University Hospital Laboratory (HUSLAB), Finland. 5. Inflammation Center, Division of Infectious Diseases, Helsinki University Hospital, Finland and University of Helsinki, Finland; Aava Travel Clinic, Medical Centre Aava, Helsinki, Finland; Clinicum, University of Helsinki, Finland; Unit of Infectious Diseases, Department of Medicine/Solna, Karolinska Institutet, Stockholm, Sweden. Electronic address: anu.kantele@hus.fi.
Abstract
OBJECTIVES: Eighty million travellers visiting (sub)tropical regions contract travellers' diarrhoea (TD) each year, yet prospective data comparing the prevalence of TD pathogens in various geographical regions are scarce. Our recent study using modern molecular methods found enteropathogenic (EPEC) and enteroaggregative (EAEC) Escherichia coli to be the most frequent pathogens, followed by enterotoxigenic E. coli (ETEC) and Campylobacter. We revisited our data to compare the findings by geographical region. METHODS: A total of 459 prospectively recruited travellers provided stool samples and completed questionnaires before and after visiting destinations in various geographical regions. A multiplex quantitative real-time PCR assay was used to analyse Salmonella, Yersinia, Campylobacter jejuni/Campylobacter coli, Shigella, Vibrio cholerae, EPEC, EAEC, ETEC, enterohaemorrhagic E. coli and enteroinvasive E. coli. RESULTS: TD was contracted by 69% (316/459) of the subjects; EPEC and EAEC outnumbered ETEC and Campylobacter in all regions. Multiple pathogens were detected in 42% (133/316) of the samples. The proportions of all pathogens varied by region. The greatest differences were seen for Campylobacter: while relatively frequent in South Asia (n = 11; 20% of the 55 with TD during travel) and Southeast Asia (15/84, 15%), it was less common in East and West Africa (5/71, 7% and 1/57, 2%) and absent in South America and the Caribbean (0/40). CONCLUSIONS: EPEC and EAEC outnumbered ETEC and Campylobacter everywhere, yet the proportions of pathogen findings varied by region, with ETEC and Campylobacter rates showing the greatest differences. The high frequency of multibacterial findings in many regions indicates a need for further investigation of the clinical role of each pathogen.
OBJECTIVES: Eighty million travellers visiting (sub)tropical regions contract travellers' diarrhoea (TD) each year, yet prospective data comparing the prevalence of TD pathogens in various geographical regions are scarce. Our recent study using modern molecular methods found enteropathogenic (EPEC) and enteroaggregative (EAEC) Escherichia coli to be the most frequent pathogens, followed by enterotoxigenic E. coli (ETEC) and Campylobacter. We revisited our data to compare the findings by geographical region. METHODS: A total of 459 prospectively recruited travellers provided stool samples and completed questionnaires before and after visiting destinations in various geographical regions. A multiplex quantitative real-time PCR assay was used to analyse Salmonella, Yersinia, Campylobacter jejuni/Campylobacter coli, Shigella, Vibrio cholerae, EPEC, EAEC, ETEC, enterohaemorrhagic E. coli and enteroinvasive E. coli. RESULTS: TD was contracted by 69% (316/459) of the subjects; EPEC and EAEC outnumbered ETEC and Campylobacter in all regions. Multiple pathogens were detected in 42% (133/316) of the samples. The proportions of all pathogens varied by region. The greatest differences were seen for Campylobacter: while relatively frequent in South Asia (n = 11; 20% of the 55 with TD during travel) and Southeast Asia (15/84, 15%), it was less common in East and West Africa (5/71, 7% and 1/57, 2%) and absent in South America and the Caribbean (0/40). CONCLUSIONS: EPEC and EAEC outnumbered ETEC and Campylobacter everywhere, yet the proportions of pathogen findings varied by region, with ETEC and Campylobacter rates showing the greatest differences. The high frequency of multibacterial findings in many regions indicates a need for further investigation of the clinical role of each pathogen.
Authors: Shanon M Smith; Lorena Montero; Maritza Paez; Estefania Ortega; Eric Hall; Kate Bohnert; Xavier Sanchez; Edison Puebla; Pablo Endara; William Cevallos; Gabriel Trueba; Karen Levy Journal: Trop Med Int Health Date: 2018-12-06 Impact factor: 2.622
Authors: Thi Loi Dao; Van Thuan Hoang; Tran Duc Anh Ly; Amal Magmoun; Naomie Canard; Tassadit Drali; Florence Fenollar; Laetitia Ninove; Didier Raoult; Philippe Parola; Johan Courjon; Philippe Gautret Journal: Travel Med Infect Dis Date: 2019-12-21 Impact factor: 6.211
Authors: Julian E Grass; Sunkyung Kim; Jennifer Y Huang; Stephanie M Morrison; Andre E McCullough; Christy Bennett; Cindy R Friedman; Anna Bowen Journal: PLoS One Date: 2019-12-04 Impact factor: 3.240
Authors: Aditya R Gandhi; Sowmya R Rao; Lin H Chen; Michael D Nelson; Edward T Ryan; Regina C LaRocque; Emily P Hyle Journal: Open Forum Infect Dis Date: 2020-08-26 Impact factor: 3.835
Authors: Riitta Tuompo; Tinja Lääveri; Timo Hannu; Sari H Pakkanen; Juha Kirveskari; Marjatta Leirisalo-Repo; Anu Kantele Journal: Ann Rheum Dis Date: 2020-03-16 Impact factor: 19.103
Authors: Kristian Riesbeck; Johan Tham; Oskar Ljungquist; Angela Camporeale; Shoeib Nematzadeh; Christian G Giske; Fredrik Resman Journal: Antimicrob Agents Chemother Date: 2020-11-17 Impact factor: 5.191
Authors: Hayley R Ashbaugh; June M Early; Myles E Johnson; Mark P Simons; Paul C F Graf; Mark S Riddle; Brett E Swierczewski Journal: Am J Trop Med Hyg Date: 2020-11 Impact factor: 2.345