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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
The epidemiology of travelers' diarrhea in Incirlik, Turkey: A region with a predominance of heat-stabile toxin producing enterotoxigenic Escherichia coli
Diagnostic Microbiology and Infectious Disease, Volume 66, No. 3, Year 2010
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Description
This study evaluated travelers' diarrhea among US military personnel on short-term deployment to Incirlik Air Base, Turkey, from June through September 2002. Upon reporting for care for travelers' diarrhea, subjects were enrolled into the study and completed a series of questionnaires and provided stool specimens for pathogen identification and antimicrobial susceptibility testing. Fifty-three percent of the 202 participating subjects had a pathogen isolated from their stool. Enterotoxigenic Escherichia coli (ETEC) was the predominant pathogen (41%), followed by Campylobacter spp. (12%). The most common ETEC phenotype recovered was stable toxin (ST) CS6 (47% of all ETEC). Most (91.1%) of the cases presented with water diarrhea regardless of isolated pathogen. However, there were some differences in nongastrointestinal symptoms among subjects with Campylobacter spp. All illnesses were well managed with antibiotics with or without loperamide with a median time to the last unformed stool of 9 h (interquartile range, 1-32 h). We found no food or environmental factors associated with a differential risk of infection with a specific pathogen. Travelers' diarrhea among a US military population in and around Incirlik, Turkey, can commonly be attributed to ETEC and Campylobacter spp. The high proportion of ST-only-producing CS6 ETEC in this region highlights the pathogen's worldwide diversity. Future studies of travelers' diarrhea in this population should adapt more novel microbiologic techniques such as polymerase chain reaction and enhanced culture methods to increase the likelihood of identifying pathogenic E. coli. © 2010.
Authors & Co-Authors
Porter, Chad K.
United States, Silver Spring
Naval Medical Research Center
Riddle, Mark S.
United States, Silver Spring
Naval Medical Research Center
Tribble, David R.
United States, Bethesda
Uniformed Services University of the Health Sciences
Putnam, Shannon D.
Indonesia, Jakarta
U.s. Naval Medical Research Unit No. 2, Jakarta
Rockabrand, David M.
Egypt, Cairo
U.s. Naval Medical Research Unit No. 3, Egypt
Frenck, Robert W.
Egypt, Cairo
U.s. Naval Medical Research Unit No. 3, Egypt
Rozmajzl, Patrick J.
Egypt, Cairo
U.s. Naval Medical Research Unit No. 3, Egypt
Kilbane, Edward
Egypt, Cairo
U.s. Naval Medical Research Unit No. 3, Egypt
Fox, Anne T.
United States
Oak Harbor Naval Hospital
Ruck, Richard
United States, Bethesda
Walter Reed National Military Medical Center
Lim, Matthew
United States, Bethesda
Walter Reed National Military Medical Center
Johnston, James
Egypt, Cairo
U.s. Naval Medical Research Unit No. 3, Egypt
Murphy, Emmett
United States, San Diego
Medical Center
Sanders, John Walton
Egypt, Cairo
U.s. Naval Medical Research Unit No. 3, Egypt
Statistics
Citations: 31
Authors: 14
Affiliations: 7
Identifiers
Doi:
10.1016/j.diagmicrobio.2009.10.002
ISSN:
07328893
Research Areas
Environmental
Food Security
Study Design
Cross Sectional Study