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travelers' diarrhea

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https://www.readbyqxmd.com/read/29145631/rifaximin-fails-to-prevent-campylobacteriosis-in-the-human-challenge-model-a-randomized-double-blind-placebo-controlled-trial
#1
Joanna E Rimmer, Clayton Harro, David A Sack, Kawsar R Talaat, Ramiro L Gutierrez, Barbara DeNearing, Jessica Brubaker, Renee M Laird, Frédéric Poly, Alexander C Maue, Kayla Jaep, Ashley Alcala, Yelizaveta Mochalova, Christina L Gariepy, Subhra Chakraborty, Patricia Guerry, David R Tribble, Chad K Porter, Mark S Riddle
Background: Campylobacter species are a leading cause of diarrheal disease globally with significant morbidity. Primary prevention efforts have yielded limited results. Rifaximin chemoprophylaxis decreases travelers' diarrhea rates and may be suitable for high risk persons. We assessed the efficacy of rifaximin in the controlled human infection model (CHIM) for Campylobacter jejuni. Methods: Twenty-eight subjects were admitted to an inpatient facility and randomized to a twice daily dose of 550 mg rifaximin or placebo...
November 14, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29079628/neutralizing-anti-sta-antibodies-derived-from-enterotoxigenic-escherichia-coli-etec-toxoid-fusions-with-heat-stable-toxin-sta-mutant-stan12s-stal9a-n12s-or-stan12s-a14t-show-little-cross-reactivity-with-guanylin-or-uroguanylin
#2
Qiangde Duan, Jiachen Huang, Nan Xiao, Hyesuk Seo, Weiping Zhang
Heat-stable toxin (STa)-producing enterotoxigenic Escherichia coli (ETEC) strains are a top cause of moderate-to-severe diarrhea in children from developing countries and a common cause of travelers' diarrhea. Recent progress in using STa toxoids and toxoid fusions to induce neutralizing anti-STa antibodies accelerates ETEC vaccine development. However, concern remains whether the derived anti-STa antibodies cross-react with STa-like guanylin and uroguanylin, two GC-C ligands regulating the fluid and electrolyte transportation in human intestinal and renal epithelial cells...
October 27, 2017: Applied and Environmental Microbiology
https://www.readbyqxmd.com/read/29079318/transitions-in-care-from-pediatric-to-adult-general-surgery-evaluating-an-unmet-need-for-patients-with-anorectal-malformation-and-hirschsprung-disease
#3
Sarah B Cairo, Priscilla P L Chiu, Roshni Dasgupta, Karen A Diefenbach, Allan M Goldstein, Nicholas A Hamilton, Andrea Lo, Michael D Rollins, David H Rothstein
BACKGROUND: The provision of timely and comprehensive transition of care from pediatric to adult surgical providers for patients who have undergone childhood operations remains a challenge. Understanding the barriers to transition from a patient and family perspective may improve this process. METHODS: A cross-sectional survey was conducted of patients with a history of anorectal malformation (ARM) or Hirschsprung Disease (HD) and their families. The web-based survey was administered through two support groups dedicated to the needs of individuals born with these congenital abnormalities...
October 7, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29055284/multiple-sampling-and-saf-fixative-triple-faeces-testing-for-dysbiosis-and-pathogenic-infections-of-the-gastrointestinal-tract-case-report
#4
Johanna Mauss, Michelle Retz, Roger Dilts, Jeffrey Langland
The classic presentation of acute gastrointestinal (GI) parasitic infection including fever, diarrhea, nausea, and/or abdominal pain is not always a reliable measure. In these cases, parasitic infections require sensitive stool testing to be identified and treated effectively. The standard practice for stool analysis typically requires 3 separate stool specimens to be collected on 3 separate days to overcome the possibility of misdiagnosis due to intermittent shedding. Nonetheless, this practice is not often utilized due to very short periods of sample viability, which often leads to patient misdiagnosis...
October 21, 2017: Alternative Therapies in Health and Medicine
https://www.readbyqxmd.com/read/29029033/trial-evaluating-ambulatory-therapy-of-travelers-diarrhea-treat-td-study-a-randomized-controlled-trial-comparing-3-single-dose-antibiotic-regimens-with-loperamide
#5
Mark S Riddle, Patrick Connor, Jamie Fraser, Chad K Porter, Brett Swierczewski, Emma J Hutley, Brook Danboise, Mark P Simons, Christine Hulseberg, Tahaniyat Lalani, Ramiro L Gutierrez, David R Tribble
Background: Recommended treatment for travelers' diarrhea includes the combination of an antibiotic, usually a fluoroquinolone or azithromycin, and loperamide for rapid resolution of symptoms. However, adverse events, postdose nausea with high-dose azithromycin, effectiveness of single-dose rifaximin, and emerging resistance to front-line agents are evidence gaps underlying current recommendations. Methods: A randomized, double-blind trial was conducted in 4 countries (Afghanistan, Djibouti, Kenya, and Honduras) between September 2012 and July 2015...
September 23, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29018300/vaxchora-the-first-fda-approved-cholera-vaccination-in-the-united-states
#6
Juan F Mosley, Lillian L Smith, Patricia Brantley, Dustin Locke, Madison Como
Vaxchora is the first vaccine approved by the Food and Drug Administration for the prophylaxis of cholera infection. Cholera, a potentially life-threatening bacterial infection that occurs in the intestines and causes severe diarrhea and dehydration, has a low incidence in the U.S., but a high incidence in Africa, Southeast Asia, and other locations around the world. These areas draw travelers from the U.S., so cholera can present in patients who return from visits to these regions. Previous means of prophylaxis included the use of doxycycline for the prevention of traveler's diarrhea, but doxycycline is not specific for cholera...
October 2017: P & T: a Peer-reviewed Journal for Formulary Management
https://www.readbyqxmd.com/read/29016296/strategies-to-improve-management-of-acute-watery-diarrhea-during-a-military-deployment-a-cost-effectiveness-analysis
#7
Andrew J Schrader, David R Tribble, Mark S Riddle
To inform policy and decision makers, a cost-effectiveness model was developed to predict the cost-effectiveness of implementing two hypothetical management strategies separately and concurrently on the mitigation of deployment-associated travelers' diarrhea (TD) burden. The first management strategy aimed to increase the likelihood that a deployed service member with TD will seek medical care earlier in the disease course compared with current patterns; the second strategy aimed to optimize provider treatment practices through the implementation of a Department of Defense Clinical Practice Guideline...
September 25, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28988952/uncommon-and-fatal-case-of-cystoisosporiasis-in-a-non-hiv-immunosuppressed-patient-from-a-non-endemic-country
#8
Lucie Post, Cécile Garnaud, Danièle Maubon, Hervé Pelloux, Catherine Mansard, Annick Bosseray, Céline Dard
Cystoisospora belli (previously known as Isospora belli) is a tropical coccidian parasite sometimes leading to severe diarrhea in immunocompromised patients. Here we describe a fatal case of cystoisosporiasis in a non HIV-immunocompromised 71-year-old female with no recent travel history. Infection was either latent or potentially caused by the consumption of contaminated imported food from Asia. Diagnosis was made by microscopical detection of numerous C. belli oocysts in stools without specific staining. Treatment with TMP-SMZ slightly improved diarrhea within 3days, but dehydration subsequently led to acute decompensated heart failure and a fatal evolution...
October 6, 2017: Parasitology International
https://www.readbyqxmd.com/read/28971107/food-finds-its-way-to-a-woman-s-heart-campylobacter-jejuni-associated-myopericarditis
#9
Manivannan Veerasamy, Craig T Alguire
Campylobacter jejuni-associated myopericarditis (CAM) has been reported infrequently in the literature. We describe a case of immunocompetent young woman presenting with chest pain, with history of recent travel and diarrhea. Evaluation led to diagnosis of myopericarditis associated with this infection. The patient improved with conservative management. The pathogenesis of CAM remains unknown. Patients present with chest pain, heart failure, pulmonary edema and arrhythmias. Diagnostic evaluation includes EKG, cardiac enzymes, echocardiogram, cardiac MRI and stool culture...
March 31, 2017: Global Cardiology Science & Practice
https://www.readbyqxmd.com/read/28952896/gastrointestinal-prophylaxis-in-sports-medicine
#10
Akash R Patel, Daniel Oheb, Tracy L Zaslow
CONTEXT: Because sports participation at all levels often requires international travel, coaches, athletic trainers, and team physicians must effectively protect athletes from gastrointestinal infections. Traveler's diarrhea is the most common travel-related illness and can significantly interfere with training and performance. EVIDENCE ACQUISITION: A review of relevant publications was completed using PubMed and Google Scholar. STUDY DESIGN: Clinical review...
September 1, 2017: Sports Health
https://www.readbyqxmd.com/read/28944092/mefa-multiepitope-fusion-antigen-novel-technology-for-structural-vaccinology-proof-from-computational-and-empirical-immunogenicity-characterization-of-an-enterotoxigenic-escherichia-coli-etec-adhesin-mefa
#11
Qiangde Duan, Kuo Hao Lee, Rahul M Nandre, Carolina Garcia, Jianhan Chen, Weiping Zhang
Vaccine development often encounters the challenge of virulence heterogeneity. Enterotoxigenic Escherichia coli (ETEC) bacteria producing immunologically heterogeneous virulence factors are a leading cause of children's diarrhea and travelers' diarrhea. Currently, we do not have licensed vaccines against ETEC bacteria. While conventional methods continue to make progress but encounter challenge, new computational and structure-based approaches are explored to accelerate ETEC vaccine development. In this study, we applied a structural vaccinology concept to construct a structure-based multiepitope fusion antigen (MEFA) to carry representing epitopes of the seven most important ETEC adhesins [CFA/I, CFA/II (CS1-CS3), CFA/IV (CS4-CS6)], simulated antigenic structure of the CFA/I/II/IV MEFA with computational atomistic modeling and simulation, characterized immunogenicity in mouse immunization, and examined the potential of structure-informed vaccine design for ETEC vaccine development...
August 2017: Journal of Vaccines & Vaccination
https://www.readbyqxmd.com/read/28922822/comment-on-guidelines-for-the-prevention-of-and-treatment-of-travelers-diarrhea-a-graded-expert-panel-report-by-riddle-et-al
#12
COMMENT
Julie Richards
No abstract text is available yet for this article.
September 1, 2017: Journal of Travel Medicine
https://www.readbyqxmd.com/read/28912916/acute-liver-failure-in-a-patient-travelling-from-asia-the-other-face-of-the-coin-of-infectious-disease
#13
Balen Abdulrahman, Mohamed H Ahmed, John Ramage
We present a case of a 63-year-old male who had travelled from South India to United Kingdom (UK) visiting relatives. He had developed episodes of diarrhea, vomiting and fevers while travelling and on assessment in hospital, mild abdominal distension was noted with rapid deterioration to hypovolemic shock. Initial blood test showed a low platelet count with deranged liver function tests (LFTs). It was noted that during admission to intensive care unit (ICU), blood continued to ooze from a previous surgical laparoscopy wound, central and arterial line access sites...
August 2017: Gastroenterology Research
https://www.readbyqxmd.com/read/28906580/comparison-of-one-commercial-and-two-in-house-taqman-multiplex-real-time-pcr-assays-for-detection-of-enteropathogenic-enterotoxigenic-and-enteroaggregative-escherichia-coli
#14
COMPARATIVE STUDY
Andreas Hahn, Marc Luetgehetmann, Olfert Landt, Norbert Georg Schwarz, Hagen Frickmann
OBJECTIVE: Enteropathogenic, enterotoxigenic and enteroaggregative Escherichia coli (EPEC, ETEC, EAEC) are among the most frequent causes of diarrhoea during travel or on military deployments. Cost-efficient and reliable real-time multiplex PCR (mPCR) assays are desirable for surveillance or point prevalence studies in remote and resource-limited tropical settings. We compared one commercial PCR kit and two in-house assays without using a gold standard to estimate sensitivity and specificity of each assay...
November 2017: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/28887647/a-comparative-evaluation-study-of-growth-conditions-for-culturing-the-isolates-of-campylobacter-spp
#15
Ying-Hsin Hsieh, Steven Simpson, Khalil Kerdahi, Irshad M Sulaiman
Campylobacter is one of the leading causes of foodborne travelers' diarrhea worldwide. Although a large number cases of campylobacteriosis go undiagnosed or unreported, it is considered as the second most common foodborne illness in the USA affecting over 1.3 million individuals every year. Of various Campylobacter species, C. jejuni, C. coli, and C. lari have been accounted for causing more than 99% of human infections. Thus, there is a need to have efficient isolation method to protect public health on food safety and monitoring the burden of campylobacteriosis...
September 8, 2017: Current Microbiology
https://www.readbyqxmd.com/read/28885922/management-of-acute-diarrheal-illness-during-deployment-a-deployment-health-guideline-and-expert-panel-report
#16
Mark S Riddle, Gregory J Martin, Clinton K Murray, Timothy H Burgess, Patrick Connor, James D Mancuso, Elizabeth R Schnaubelt, Timothy P Ballard, Jamie Fraser, David R Tribble
BACKGROUND: Acute diarrheal illness during deployment causes significant morbidity and loss of duty days. Effective and timely treatment is needed to reduce individual, unit, and health system performance impacts. METHODS: This critical appraisal of the literature, as part of the development of expert consensus guidelines, asked several key questions related to self-care and healthcare-seeking behavior, antibiotics for self-treatment of travelers' diarrhea, what antibiotics/regimens should be considered for treatment of acute watery diarrhea and febrile diarrhea and/or dysentery, and when and what laboratory diagnostics should be used to support management of deployment-related travelers' diarrhea...
September 2017: Military Medicine
https://www.readbyqxmd.com/read/28885921/acquisition-of-multidrug-resistant-gram-negative-organisms-during-travel
#17
Clinton K Murray, Dana M Blyth
The rate of multidrug resistance has continued to increase worldwide, presenting clinicians with further challenges related to patient care. In this article, we review information related to the acquisition of multidrug-resistant (MDR) Gram-negative organisms among travelers, including deployed personnel, as well as the potential impact on wound microbiology and travelers' diarrhea. Travel to Asia, experiencing travelers' diarrhea, and use of antibiotics, whereas abroad have been associated with an increased risk of acquiring MDR Enterobacteriaceae colonization...
September 2017: Military Medicine
https://www.readbyqxmd.com/read/28885920/antibiotic-therapy-for-acute-watery-diarrhea-and-dysentery
#18
David R Tribble
Diarrheal disease affects a large proportion of military personnel deployed to developing countries, resulting in decreased job performance and operational readiness. Travelers' diarrhea is self-limiting and generally resolves within 5 days; however, antibiotic treatment significantly reduces symptom severity and duration of illness. Presently, azithromycin is the preferred first-line antibiotic for the treatment of acute watery diarrhea (single dose 500 mg), as well as for febrile diarrhea and dysentery (single dose 1,000 mg)...
September 2017: Military Medicine
https://www.readbyqxmd.com/read/28885919/diagnostics-in-a-forward-deployed-setting
#19
Brett Swierczewski, Mark Simons
Current diagnostic methods for enteric pathogens include conventional/traditional microbiology, microscopy, enzyme immunoassay, automated identification platforms, and molecular methods. The choice of diagnostic test in the forward deployed military setting often depends on turnaround time, potential etiologic agents, costs, and laboratory capabilities. The military operational environment presents many challenges that impact the practicality and performance of even robust diagnostic platforms. With recent developments in diagnostic platforms and availability of high-performance multiplex molecular methods to pair with traditional culture and antibiotic susceptibility tests, there are more opportunities to gather information on the etiologic causes and clinical impacts of traveler's diarrhea, both in civilians and in deployed military populations...
September 2017: Military Medicine
https://www.readbyqxmd.com/read/28885918/travelers-diarrhea-an-update-on-the-incidence-etiology-and-risk-in-military-deployments-and-similar-travel-populations
#20
Chad K Porter, Scott Olson, Alexis Hall, Mark S Riddle
Travelers' diarrhea (TD) has historically been a common illness among visitors to developing nations. Although recent studies indicate decreasing incidence of TD among short-term travelers, a systematic review of illness among long-term travelers, including deployed military personnel, has not been conducted in more than 10 years. We conducted a literature search of studies published between 2005 and 2015 that evaluated TD in populations of deployed military personnel or similar long-term travelers (travel ≥1 month) to developing nations...
September 2017: Military Medicine
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