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Graham A, Hawkins L, Balasegaram S, Narasimhan S, Wain J, Clarke J, Manuel R. A decade of Campylobacter and Campylobacter bacteraemias in a district general hospital and the surrounding London and South East region, England. J Infect 2024; 88:15-20. [PMID: 37995801 DOI: 10.1016/j.jinf.2023.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 11/07/2023] [Accepted: 11/14/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND Campylobacter bacteraemia is a rare complication of the most common bacterial gastrointestinal infection but is associated with significant morbidity and mortality. There is limited data describing current trends in surveillance and antimicrobial resistance for the Campylobacter strains involved. At the Epsom and St Helier's University Hospital (ESTH), we noted a marked increase in Campylobacter bacteraemia infections in 2021. METHODS We extracted Campylobacter reports using the UK Health Security Agency's (UKHSA) Second Generation Surveillance System (laboratory reporting system) between 1st January 2012 and 31st December 2021. We reviewed patient records of patients with Campylobacter bacteraemia for details including presentation, past medical history, duration of hospital stay, and antibiotic use. RESULTS Between 2012 and 2021, ESTH reported a total of 34 cases of Campylobacter bacteraemia. In 2021, the estimated incidence was 6.8 cases per 100,000 population and in the surrounding area, the incidence was 0.4 per 100,000 population. The incidence rate of Campylobacter bacteraemia in London and the South East region was significantly lower than ESTH (RR = 0.17, p < 0.0001). Campylobacter bacteraemia cases at ESTH reported a high number of co-morbidities (average number of comorbidities = 2.3) and had a duration of stay in hospital of a median of 7 days (IQR = 4-10 days). Campylobacter jejuni was the most commonly reported species for stool and blood Campylobacter in ESTH, London, and South East England. CONCLUSION Campylobacter bacteraemia reports at ESTH were significantly (p < 0.001) higher than the surrounding London and South East region. While no common cause for the exceedance of Campylobacter bacteraemia has been identified, common risk factors for Campylobacter bacteraemia infection include underlying health conditions, being older, and male.
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Affiliation(s)
- Alice Graham
- Field Service London and South East, UK Health Security Agency, Nobel House, London, United Kingdom
| | - Lois Hawkins
- Department of Infection, Epsom and St Heliers' University Hospitals, Carshalton, United Kingdom
| | - Sooria Balasegaram
- Field Service London and South East, UK Health Security Agency, Nobel House, London, United Kingdom
| | - Subha Narasimhan
- Department of Infection, Epsom and St Heliers' University Hospitals, Carshalton, United Kingdom
| | - John Wain
- Quadram Institute Bioscience, Norwich Research Park, Norwich, United Kingdom; Norwich Medical School, University of East Anglia (UEA), Norwich, United Kingdom
| | - John Clarke
- Field Service London and South East, UK Health Security Agency, Nobel House, London, United Kingdom; Department of Infection, Epsom and St Heliers' University Hospitals, Carshalton, United Kingdom; Quadram Institute Bioscience, Norwich Research Park, Norwich, United Kingdom; Norwich Medical School, University of East Anglia (UEA), Norwich, United Kingdom
| | - Rohini Manuel
- Field Service London and South East, UK Health Security Agency, Nobel House, London, United Kingdom; Department of Infection, Epsom and St Heliers' University Hospitals, Carshalton, United Kingdom.
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Khattak I, Yen WL, Usman T, Nasreen N, Khan A, Ahmad S, Rehman G, Khan K, Said MB, Chen CC. Individual and Community-Level Risk Factors for Giardiasis in Children under Five Years of Age in Pakistan: A Prospective Multi-Regional Study. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1087. [PMID: 37371318 DOI: 10.3390/children10061087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 06/02/2023] [Accepted: 06/15/2023] [Indexed: 06/29/2023]
Abstract
OBJECTIVES This study aimed to estimate the prevalence of Giardia lamblia infection and identify associated risk factors at both individual and community levels in a pediatric population in different agroecological zones of Khyber Pakhtunkhwa, Pakistan. METHODS A community-based cross-sectional study was conducted from March to December 2022. Using stratified sampling, 1026 households were recruited from nine agroecological zones. Stool samples were collected from 1026 children up to the age of five years and processed for detection of Giardia using a commercial ELISA kit. Data on potential risk factors were collected using a pre-structured questionnaire. A multivariable logistic regression model was used to identify risk factors associated with giardiasis. RESULTS The study found that the prevalence of giardiasis in the study area was 3.31%. Children aged 13-24 months were found to be at higher risk for giardiasis. Illiterate mothers and fathers attending daycare institutions/kindergartens, mothers not practicing hand washing during critical times, households with companion animals, and homes where stray dogs/cats enter were identified as predictors of giardiasis at the individual level. Children living in sub-mountain valleys use un-piped water, inadequate domestic water storage vessels, drink un-boiled or unfiltered water, live near rubbish heaps or un-paved streets/pathways, and have unimproved latrine facilities were identified as risk factors of giardiasis at the community level. CONCLUSIONS The study highlights the need for integrated intervention approaches at both individual and community levels to reduce the incidence of giardiasis in Khyber Pakhtunkhwa, Pakistan. Interventions aimed at promoting behavioral change and providing safe and adequate water sources, combined with individual-level interventions such as hand washing and awareness of giardiasis prevention methods, would be critical to addressing this health concern. Inter-sectoral collaboration between the health sector and other sectors would also be necessary to achieve meaningful progress in reducing the incidence of giardiasis in resource-limited areas.
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Affiliation(s)
- Irfan Khattak
- College of Veterinary and Animal Husbandry, Abdul Wali Khan University, Mardan 23200, Pakistan
| | - Wen-Lan Yen
- Department of Pediatrics, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 60002, Taiwan
| | - Tahir Usman
- College of Veterinary and Animal Husbandry, Abdul Wali Khan University, Mardan 23200, Pakistan
| | - Nasreen Nasreen
- Department of Zoology, Abdul Wali Khan University, Mardan 23200, Pakistan
| | - Adil Khan
- Department of Zoology, Bacha Khan University, Charsadda 24540, Pakistan
- Department of Biology, Mount Allison University, Sackville, NB E4L1E4, Canada
| | - Saghir Ahmad
- Department of Microbiology, Abdul Wali Khan University, Mardan 23200, Pakistan
| | - Gauhar Rehman
- Department of Zoology, Abdul Wali Khan University, Mardan 23200, Pakistan
| | - Khurshaid Khan
- Department of Zoology, Abdul Wali Khan University, Mardan 23200, Pakistan
| | - Mourad Ben Said
- Laboratory of Microbiology, National School of Veterinary Medicine of Sidi Thabet, University of Manouba, Manouba 2010, Tunisia
- Department of Basic Sciences, Higher Institute of Biotechnology of Sidi Thabet, University of Manouba, Manouba 2010, Tunisia
| | - Chien-Chin Chen
- Department of Pathology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 60002, Taiwan
- Department of Cosmetic Science, Chia Nan University of Pharmacy and Science, Tainan 71710, Taiwan
- Ph.D. Program in Translational Medicine, Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung 40227, Taiwan
- Department of Biotechnology and Bioindustry Sciences, College of Bioscience and Biotechnology, National Cheng Kung University, Tainan 70101, Taiwan
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Naz A, Nawaz Z, Rasool MH, Zahoor MA. Cross-sectional epidemiological investigations of Giardia lamblia in children in Pakistan. SAO PAULO MED J 2018; 136:449-453. [PMID: 30570096 PMCID: PMC9907771 DOI: 10.1590/1516-3180.2018.0350060918] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 09/06/2018] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND The prevalence of Giardia lamblia in Pakistani children is currently unknown. The aim here was to evaluate the prevalence and risk factors of Giardia lamblia in children exhibiting diarrhea. DESIGN AND SETTING Cross-sectional study at different district healthcare hospitals in Pakistan. METHODS A total of 800 samples were collected from children aged 0-10 years. Information regarding personal data, demographic data and supposed risk factors was collected through a structured questionnaire. Giardia lamblia was detected through direct microscopy and antigens through the enzyme-linked immunosorbent assay (ELISA). RESULTS The prevalence of Giardia lamblia was 2.75% through direct microscopy and inflated to 9.5% through ELISA. The demographic factors positively associated with occurrences of giardiasis were age (P = 0.035; odds ratio, OR = 1.96; 95% confidence interval, CI = 1.094-3.533), mother's educational level (P = 0.031; OR = 2.67; 95% CI = 1.186-6.045) and father's educational level (P = 0.004; OR = 3.56; 95% CI = 1.612-7.899). Similarly, among the supposed risk factors, rural residency (P = 0.032; OR = 1.76; 95% CI = 1.098- 2.851), absence of proper sewerage system (P = 0.000; OR = 6.60; 95% CI = 4.029-10.841) and unavailability of safe drinking water (P = 0.000; OR = 4.08; 95% CI = 2.207-7.547) were the factors strongly connected with giardiasis. Abdominal discomfort was a prominent clinical sign with 46% frequency. CONCLUSION Various risk factors were associated with occurrences of Giardia, thus emphasizing the importance of parents' education, safe drinking water and proper sewerage systems for Pakistani children's health.
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Affiliation(s)
- Aneeqa Naz
- BSc, MSc. Microbiologist and Doctoral Student, Department of Microbiology, Government College University Faisalabad, Faisalabad, Pakistan.
| | - Zeeshan Nawaz
- MSc, PhD. Microbiologist and Assistant Professor, Department of Microbiology, Government College University Faisalabad, Faisalabad, Pakistan.
| | - Muhammad Hidayat Rasool
- MSc, PhD. Microbiologist and Associate Professor, Department of Microbiology, Government College University Faisalabad, Faisalabad, Pakistan.
| | - Muhammad Asif Zahoor
- MSc, PhD. Microbiologist and Assistant Professor, Department of Microbiology, Government College University Faisalabad, Faisalabad, Pakistan.
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Siyadatpanah A, Sharif M, Daryani A, Sarvi S, Kohansal MH, Barzegari S, Pagheh AS, Gholami S. Spatial distribution of Giardia lamblia infection among general population in Mazandaran Province, north of Iran. J Parasit Dis 2018; 42:171-176. [PMID: 29844619 DOI: 10.1007/s12639-018-0976-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Accepted: 01/03/2018] [Indexed: 02/02/2023] Open
Abstract
Giardia lamblia is the most prevalent intestinal parasites of humans in Iran and other in the world although information on geographical distribution of giardiasis plays significant role in identifying communities at high risk, little attention has been paid to study human giardiasis using geographical information system. Therefore, the aim of the current study was to determine temporal and spatial patterns of human giardiasis distribution to identify possible high risk areas and seasons in northern Iran. A total of 4788 people referred to health centers in the Mazandaran Province of northern Iran were surveyed January to December 2015. From each person stool sample and questionnaire with socio-demographic data were collected. Giardia infection was diagnosed using direct wet mount, formalin ether concentration and trichrome staining. The results were analyzed using Moran Local Indicators of spatial association and geographically weighted regression. The overall prevalence of Giardia infection was 4.6% (222/4788), and was significantly higher among those aged 5-9 years compared to their older peers (P < 0.0001). Our data showed a significant dependency between the prevalence of G. lamblia and age, job, residence, season and height from the sea (P < 0.0001). The results of this study provided a precise and specific spatial and temporal pattern of human giardiasis distribution in the Mazandaran Province, Iran. These evidences should be considered for proper control of disease decisions and strategies.
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Affiliation(s)
- Abolghasem Siyadatpanah
- 1Student Research Committee, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.,2Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Mazandaran Iran
| | - Mehdi Sharif
- 2Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Mazandaran Iran.,Department of Parasitology, Medical School, Sari Branch, Islamic Azad University, Sari, Iran
| | - Ahmad Daryani
- 2Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Mazandaran Iran.,4Department of Parasitology and Mycology, School of Medicine, Mazandaran University of Medical Science, Sari, Iran
| | - Shahabeddin Sarvi
- 2Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Mazandaran Iran.,4Department of Parasitology and Mycology, School of Medicine, Mazandaran University of Medical Science, Sari, Iran
| | - Mohammad Hasan Kohansal
- 5Department of Parasitology and Mycology, School of Medicine, Zanjan University of Medical Science, Zanjan, Iran
| | - Saeed Barzegari
- 6Amol Faculty of Paramedical Sciences, Mazandaran University of Medical Sciences, Sari, Iran.,7Department of Health Information Technology, Amol Faculty of Paramedical Sciences, Mazandaran University of Medical Sciences, Sari, Iran
| | - Abdol Sattar Pagheh
- 1Student Research Committee, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.,2Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Mazandaran Iran
| | - Shirzad Gholami
- 2Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Mazandaran Iran.,4Department of Parasitology and Mycology, School of Medicine, Mazandaran University of Medical Science, Sari, Iran
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Gundacker ND, Rolfe RJ, Rodriguez JM. Infections associated with adventure travel: A systematic review. Travel Med Infect Dis 2017; 16:3-10. [PMID: 28351605 PMCID: PMC7185378 DOI: 10.1016/j.tmaid.2017.03.010] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 03/20/2017] [Accepted: 03/21/2017] [Indexed: 12/16/2022]
Abstract
AIM To review infections associated with adventure travel. METHODS The PubMed, Embase and Scopus databases were searched combining the words infection with the following keywords: rafting, whitewater, surfing, (surfer* or windsurf*), (caves or caving or spelunking), (triathlon or trekking) or (hiking or adventure race), bicycling, backpacking, (mountain climb* or bouldering), horseback riding, orienteering, trekking, and skiing. RESULTS Adventure travel is becoming much more common among travelers and it is associated with a subset of infectious diseases including: leptospirosis, schistosomiasis, viral hemorrhagic fevers, rickettsial diseases and endemic mycosis. Caving and whitewater rafting places individuals at particular risk of leptospirosis, schistosomiasis and endemic mycosis, while adventure races also place individuals at high risk of a variety of infections including campylobacter, norovirus and leptospirosis. CONCLUSION Travel practitioners need to be aware of the risks associated with adventure travel and should educate individuals about the risks associated with various activities. Doxycycline prophylaxis should be considered for travelers who are susceptible to leptospirosis due to participation in high-risk sports such as whitewater rafting, caving or adventure races.
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Affiliation(s)
- Nathan D Gundacker
- University of Alabama at Birmingham, 1900 University Blvd, THT 229, Birmingham, AL 35294, United States.
| | - Robert J Rolfe
- University of Alabama at Birmingham, 1900 University Blvd, THT 229, Birmingham, AL 35294, United States.
| | - J Martin Rodriguez
- University of Alabama at Birmingham, 1900 University Blvd, THT 229, Birmingham, AL 35294, United States.
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Lee MF, Auer H, Lindo JF, Walochnik J. Multilocus sequence analysis of Giardia spp. isolated from patients with diarrhea in Austria. Parasitol Res 2016; 116:477-481. [PMID: 27885465 DOI: 10.1007/s00436-016-5306-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Accepted: 10/20/2016] [Indexed: 11/30/2022]
Abstract
Giardia duodenalis is a protozoan parasite causing intestinal infections in a wide range of mammals. Two distinct assemblages, A and B, infect humans predominantly; however, both are believed to be generally zoonotic. Giardia strains associated with infections in Austria have not been investigated at the molecular level. In this study, 65 human stool samples microscopically positive for Giardia spp. were subjected to DNA isolation and nested PCR targeting fragments of the glutamate dehydrogenase (gdh), triose phosphate isomerase (tpi), and beta-gardin (bg) genes. A total of 52 samples were successfully analyzed using PCR and DNA sequencing. Assemblage B was detected most frequently and accounted for 65.4% (34/52) of infections, while Assemblage A accounted for 34.6% (18/52). There was a high level of genetic diversity among the isolates with 46.2% designated as sub-assemblage BIV (24/52), 25% sub-assemblage AII (13/52), 19.2% sub-assemblage BIII (10/52), and 9.6% sub-assemblage AI (5/52). No mixed infections were detected. The results suggest that the majority of infections were imported and that endemic anthroponotic transmission plays a minor role in Austria.
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Affiliation(s)
- Mellesia F Lee
- Institute of Specific Prophylaxis and Tropical Medicine, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria.,Department of Microbiology, The University of the West Indies, Kingston 7, Mona, Jamaica
| | - Herbert Auer
- Institute of Specific Prophylaxis and Tropical Medicine, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
| | - John F Lindo
- Department of Microbiology, The University of the West Indies, Kingston 7, Mona, Jamaica.
| | - Julia Walochnik
- Institute of Specific Prophylaxis and Tropical Medicine, Center of Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
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Kist M. Impact and management of Campylobacter in human medicine--European perspective. Int J Infect Dis 2013; 6 Suppl 3:3S44-7; discussion 3S47-8, 3S53-8. [PMID: 23570173 DOI: 10.1016/s1201-9712(02)90183-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
In 2001 in Germany, Campylobacter was second to Salmonella as the most frequent foodborne pathogen isolated from humans. This is also true for the major part of the European population with incidence data available, namely Germany, Hungary, Belgium, Denmark, Austria and Spain, with a total population of 154.5 million, and incidence rates for Salmonella and Campylobacter of 81.8/100 000 and 49.0/100 000 respectively. Countries where Campylobacter is predominant are the UK, Switzerland, Sweden, Finland, Norway, and The Netherlands, with a total population of 94.2 million, and incidence rates for Campylobacter and Salmonella of 79.6/100 000 and 33.3/100 000, respectively. Shigella is rarely isolated in Europe (1.9-4.5/100 000). Epidemiologic risk factors for human campylobacteriosis are poultry, untreated milk, and surface water. Travel plays an important role, especially in Scandinavia and the UK. Isolates acquired outside these countries are much more often resistant to fluoroquinolones than are domestic strains. Fluoroquinolone resistance in human Campylobacter isolates is lowest in the UK and Denmark, at 12%. Resistance quotes of around 20-40% are found in Finland, The Netherlands, Norway, Sweden, Austria, and Germany, and peaks in Spain reaching 70-80%. Usually, uncomplicated Campylobacter enteritis is symptomatically treated. If, in severe cases, antimicrobials are indicated, in all European countries except Switzerland, macrolides are used as first-line drugs, followed by fluoroquinolones or doxycycline.
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Affiliation(s)
- Manfred Kist
- Consiliary Laboratory for Campylobacter/Aeromonas, Department of Microbiology and Hygiene, University Hospital Freiburg, Freiburg, Germany.
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8
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The risk of transfer of foodborne bacterial hazards in Turkey through the consumption of meat; risk ranking of muscle foods with the potential to transfer Campylobacter spp. Food Secur 2013. [DOI: 10.1007/s12571-012-0230-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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9
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Demographic/socio-economic factors and dietary habits determining consumer exposure to foodborne bacterial hazards in Turkey through the consumption of meat. Food Secur 2013. [DOI: 10.1007/s12571-012-0231-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Affiliation(s)
- Kristina N Feja
- Division of Allergy, Immunology and Infectious Diseases, The Children's Hospital at Saint Peter's University Hospital, 254 Easton Avenue, New Brunswick, NJ 08901, USA
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Mosli M, Gregor J, Chande N, Lannigan R. Nonutility of routine testing of stool for ova and parasites in a tertiary care Canadian centre. Can J Microbiol 2012; 58:653-659. [DOI: 10.1139/w2012-039] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Abstract
Background In many clinical situations, stool examinations for ova and parasites (O&P) are routine in the work-up of patients with acute or chronic diarrhea. Frequently, these tests are found to be negative for pathogens. The purpose of this study was to examine the diagnostic yield of routine stool testing for O&P in a Canadian tertiary care centre and to estimate the potential clinical benefit of a positive result. Patients and Methods All stool samples sent to the central microbiology laboratory at London Health Sciences Centre were reviewed over a 5-year period ending January 2010. Initial screening was done by direct antigen testing using an enzyme immunoassay (EIA) technique followed by direct microscopy for negative results where there was a high index of suspicion and for positive results to rule out any concurrent parasites not included in the EIA kit. Pathogens identified were categorized and their potential susceptibility to metronidazole was estimated. No clinical data were available, as this was purely a utilization study. Results A total of 5812 stool tests were ordered. Of these, 5681 (97.7%) were completed. The most common reasons for an incomplete test were sample leakage (n = 38) and use of the incorrect collection kit (n = 32). Direct microscopy identified white blood cells in 17% of patients with positive testing. The most common pathogen was Giardia lamblia , which was detected in 45/83 (54%) of positive specimens. Entamoeba histolytica / Entamoeba dispar was identified in 16/83 (19%) and Cryptosporidium spp. in 10/83 (12%) of positive specimens. Microorganisms not thought to be pathogenic were identified in 7/83 (8%). Direct laboratory costs independent of labor were estimated at $1836 per clinically significant organism identified. Of the 77 specimens positive for pathogenic organisms, 62 (81%) were likely to be sensitive to treatment with metronidazole. Conclusion In a tertiary care centre, the diagnostic yield of routine testing of stool for O&P during the evaluation of patients with acute or chronic diarrhea is low. Most clinically significant positive results should be responsive to metronidazole, but empirical treatment is not encouraged. Strategies to identify patients with a higher likelihood of harboring pathogenic parasites and consideration of empiric metronidazole therapy for patients at highest risk merit further research.
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Affiliation(s)
- Mahmoud Mosli
- London Health Sciences Centre, Department of Medicine, London, ON N6A 5W9, Canada
| | - Jamie Gregor
- London Health Sciences Centre, Department of Medicine, London, ON N6A 5W9, Canada
| | - Nilesh Chande
- London Health Sciences Centre, Department of Medicine, London, ON N6A 5W9, Canada
| | - Robert Lannigan
- London Health Sciences Centre, Department of Medicine, London, ON N6A 5W9, Canada
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Louwen R, van Baarlen P, van Vliet AHM, van Belkum A, Hays JP, Endtz HP. Campylobacter bacteremia: a rare and under-reported event? Eur J Microbiol Immunol (Bp) 2012; 2:76-87. [PMID: 24611124 DOI: 10.1556/eujmi.2.2012.1.11] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2012] [Accepted: 01/18/2012] [Indexed: 12/12/2022] Open
Abstract
Bacteria belonging to the species Campylobacter are the most common cause of bacterial diarrhoea in humans. The clinical phenotype associated with Campylobacter infections ranges from asymptomatic conditions to severe colitis and bacteremia. In susceptible patients, Campylobacter infections are associated with significant morbidity and mortality, with both host factors and bacterial factors being involved in the pathogenesis of bacteremia. In the host, age, gender and immune-compromising conditions may predispose for Campylobacter infections, whilst the most important bacterial determinants mentioned in the literature are cytotoxin production and flagellar motility. The role of sialylated lipo-oligosaccharide (LOS) and serum resistance in bacteremia is inconclusive at this time, and the clinical significance of Campylobacter bacteremia is not yet fully understood. More emphasis on the detection of Campylobacter species from blood cultures in susceptible patients at risk for Campylobacter infections will increase our understanding of the pathogenesis and the relevance of Campylobacter bacteremia.
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Júlio C, Vilares A, Oleastro M, Ferreira I, Gomes S, Monteiro L, Nunes B, Tenreiro R, Angelo H. Prevalence and risk factors for Giardia duodenalis infection among children: a case study in Portugal. Parasit Vectors 2012; 5:22. [PMID: 22284337 PMCID: PMC3275531 DOI: 10.1186/1756-3305-5-22] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2011] [Accepted: 01/27/2012] [Indexed: 01/28/2023] Open
Abstract
Background Giardia duodenalis is a widespread parasite of mammalian species, including humans. The prevalence of this parasite in children residing in Portugal is currently unknown. This study intended to estimate G. duodenalis infection prevalence and identify possible associated risk factors in a healthy paediatric population living in the District of the Portuguese capital, Lisbon. Methods Between February 2002 and October 2008, 844 children were randomly selected at healthcare centres while attending the national vaccination program. A stool sample and a questionnaire with socio-demographic data were collected from each child. Giardia infection was diagnosed by direct examination of stools and antigen detection by ELISA. Results The population studied revealed a gender distribution of 52.8% male and 47.2% female. Age distribution was 47.4% between 0-5 years and 52.6% between 6-15 years. The prevalence of Giardia infection was 1.9% (16/844) when estimated by direct examination and increased to 6.8% (57/844) when ELISA results were added. The prevalence was higher among children aged 0-5 years (7.8%), than among older children (5.8%), and was similar among genders (6.9% in boys and 6.5% in girls). The following population-variables were shown to be associated risk factors for G. duodenalis infection: mother's educational level (odds ratio (OR)= 4.49; confidence interval (CI): 1.20-16.84), father's educational level (OR = 12.26; CI: 4.08-36.82), presence of Helicobacter pylori infection (OR = 1.82; CI: 1.05-3.15), living in houses with own drainage system (OR = 0.10; CI: 0.02-0.64) and reported household pet contact, especially with dogs (OR = 0.53; CI: 0.31-0.93). Conclusion The prevalence of giardiasis in asymptomatic children residing in the region of Lisbon is high. Several risk factors were associated with Giardia prevalence and highlight the importance of parents' education and sanitation conditions in the children's well being. The association between G. duodenalis and H. pylori seems an important issue deserving further investigation in order to promote prevention or treatment strategies.
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Affiliation(s)
- Cláudia Júlio
- National Institute of Health Dr. Ricardo Jorge, Department of Infectious Diseases, National Reference Laboratory for Gastrointestinal Infections, Av. Padre Cruz, Lisbon, Portugal.
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Kowalewski MM, Salzer JS, Deutsch JC, Raño M, Kuhlenschmidt MS, Gillespie TR. Black and gold howler monkeys (Alouatta caraya) as sentinels of ecosystem health: patterns of zoonotic protozoa infection relative to degree of human-primate contact. Am J Primatol 2010; 73:75-83. [DOI: 10.1002/ajp.20803] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Gillespie TR, Morgan D, Deutsch JC, Kuhlenschmidt MS, Salzer JS, Cameron K, Reed T, Sanz C. A legacy of low-impact logging does not elevate prevalence of potentially pathogenic protozoa in free-ranging gorillas and chimpanzees in the Republic of Congo: logging and parasitism in African apes. ECOHEALTH 2009; 6:557-64. [PMID: 20238141 PMCID: PMC2921064 DOI: 10.1007/s10393-010-0283-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/20/2009] [Revised: 12/02/2009] [Accepted: 01/13/2010] [Indexed: 05/28/2023]
Abstract
Many studies have examined the long-term effects of selective logging on the abundance and diversity of free-ranging primates. Logging is known to reduce the abundance of some primate species through associated hunting and the loss of food trees for frugivores; however, the potential role of pathogens in such primate population declines is largely unexplored. Selective logging results in a suite of alterations in host ecology and forest structure that may alter pathogen dynamics in resident wildlife populations. In addition, environmental pollution with human fecal material may present a risk for wildlife infections with zoonotic protozoa, such as Cryptosporidium and Giardia. To better understand this interplay, we compared patterns of infection with these potentially pathogenic protozoa in sympatric western lowland gorillas (Gorilla gorilla gorilla) and chimpanzees (Pan troglodytes troglodytes) in the undisturbed Goualougo Triangle of Nouabalé-Ndoki National Park and the adjacent previously logged Kabo Concession in northern Republic of Congo. No Cryptosporidium infections were detected in any of the apes examined and prevalence of infection with Giardia was low (3.73% overall) and did not differ between logged and undisturbed forest for chimpanzees or gorillas. These results provide a baseline for prevalence of these protozoa in forest-dwelling African apes and suggest that low-intensity logging may not result in long-term elevated prevalence of potentially pathogenic protozoa.
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Affiliation(s)
- Thomas R Gillespie
- Department of Environmental Studies and Program in Population Biology, Ecology, and Evolution, Emory University, Atlanta, GA, USA.
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Onyango AO, Kenya EU, Mbithi JJN, Ng'ayo MO. Pathogenic Escherichia coli and food handlers in luxury hotels in Nairobi, Kenya. Travel Med Infect Dis 2009; 7:359-66. [PMID: 19945013 DOI: 10.1016/j.tmaid.2009.07.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2009] [Revised: 07/24/2009] [Accepted: 07/28/2009] [Indexed: 11/30/2022]
Abstract
BACKGROUND The epidemiology and virulence properties of pathogenic Escherichia coli among food handlers in tourist destination hotels in Kenya are largely uncharacterized. METHOD This cross-sectional study among consenting 885 food handlers working in nine luxurious tourist hotels in Nairobi, Kenya determined the epidemiology, virulence properties, antibiotics susceptibility profiles and conjugation abilities of pathogenic Escherichia coli. RESULT Pathogenic Escherichia coli was detected among 39 (4.4%) subjects, including 1.8% enteroaggregative Escherichia coli (EAEC) harboring aggR genes, 1.2% enterotoxigenic Escherichia coli (ETEC) expressing both LT and STp toxins, 1.1% enteropathogenic Escherichia coli (EPEC) and 0.2% Shiga-like Escherichia coli (EHEC) both harboring eaeA and stx2 genes respectively. All the pathotypes had increased surface hydrophobicity. Using multivariate analyses, food handlers with loose stools were more likely to be infected with pathogenic Escherichia coli. Majority 53.8% of the pathotypes were resistant to tetracycline with 40.2% being multi-drug resistant. About 85.7% pathotypes trans-conjugated with Escherichia coli K12 F(-) NA(r) LA. CONCLUSION The carriage of multi-drug resistant, toxin expressing pathogenic Escherichia coli by this population is of public health concern because exposure to low doses can result in infection. Screening food handlers and implementing public awareness programs is recommended as an intervention to control transmission of enteric pathogens.
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Affiliation(s)
- Abel O Onyango
- Department of Biochemistry and Biotechnology, Kenyatta University, P.O. Box 43844-00100, Nairobi, Kenya.
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17
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Abstract
Campylobacter species are among the most commonly identified causative agents of acute bacterial gastroenteritis in humans worldwide. In Austria, campylobacteriosis has been a notifiable disease since 1996 and its incidence has increased continuously over the past years. Improvement of notification has led to an important increase in knowledge of the epidemiology of this disease in Austria. In addition to existing programs monitoring food safety, implementation of a national surveillance program to monitor antimicrobial resistance and the prevalence of campylobacter in food animals allows continuous surveillance of trends in antimicrobial susceptibility patterns in humans, animals and food, as well as a more comprehensive evaluation of the occurrence of campylobacter in the relevant reservoirs of human infection. Such data make it possible to identify the most important areas for intervention and launch of control strategies. As in other countries around the world, antimicrobial resistance of campylobacter from human, animal and food origin, particularly resistance to fluoroquinolones, is of public health concern in Austria. The magnitude of global trade and foreign travel requires EU-wide and worldwide implementation of control strategies to fight campylobacteriosis.
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Affiliation(s)
- Gebhard Feierl
- Institute of Hygiene, Microbiology and Environmental Medicine, Medical University of Graz, Austria
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18
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Affiliation(s)
- Mathyas Wang
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
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19
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Affiliation(s)
- Deepak Kamat
- Wayne State University, Institute of Medical Education, Carman and Ann Adams Department of Pediatrics, Children's Hospital of Michigan, Detroit 48201, USA.
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20
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Abstract
Of the millions who travel from the industrialized world to developing countries every year, between 20% and 50% will develop at least one episode of diarrhea, making it the most common medical ailment afflicting travelers. Although usually a mild illness, traveler's diarrhea can result in significant morbidity and hardship overseas. Precautions can be taken to minimize the risk of developing traveler's diarrhea, either through avoidance of potentially contaminated food or drink or through various prophylactic measures, including both nonpharmacological and antimicrobial strategies. If diarrhea does develop despite the precautions taken, effective treatment-usually a combination of an antibiotic and an antimotility agent-can be brought by the traveler and initiated as soon as symptoms develop. In the future, vaccines-several of which are in the advanced stages of clinical testing-may be added to the list of prophylactic measures.
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Affiliation(s)
- David J Diemert
- Human Hookworm Vaccine Initiative, Sabin Vaccine Institute, 1889 F St. NW, Suite 200S, Washington, DC 20006, USA.
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21
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Reinthaler FF, Feierl G, Beubler E, Kollaritsch H, Ruckenbauer G, Klem G, Wendelin I, Marth E. Treatment of travelers' diarrhea among Austrian tourists. J Travel Med 2004; 11:66-8. [PMID: 14769292 DOI: 10.2310/7060.2004.13527] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Altekruse SF, Tollefson LK. Human campylobacteriosis: a challenge for the veterinary profession. J Am Vet Med Assoc 2003; 223:445-52. [PMID: 12930081 DOI: 10.2460/javma.2003.223.445] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Sean F Altekruse
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6120 Executive Blvd MSC 7234, Rockville, MD 20852, USA
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23
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Abstract
Diarrhea is the most common medical problem affecting all travellers to developing countries. Younger children are at especially high risk of acquiring travellers' diarrhea and of suffering more severe consequences. Up to 50% of travellers from developed to developing countries can expect to have at least one episode of acute diarrhea during a two-week stay. Episodes of travellers' diarrhea usually begin abruptly, either during travel or soon after returning home, and are generally self-limited.
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24
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Abstract
Of the 50 million people who travel from the industrialized world to developing countries every year, between 20% and 50% will develop at least one episode of diarrhea, making it the most common ailment of travel. Although usually a mild illness, travelers' diarrhea can result in significant morbidity and hardship while overseas. Precautions can be taken to minimize the risk of developing diarrhea. If diarrhea does develop despite precautions, effective treatment, usually a combination of an antibiotic and an antimotility agent, can be taken along and started by the traveler at the onset of symptoms.
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Affiliation(s)
- David J Diemert
- Malaria Vaccine Development Unit, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Twinbrook I, Room 1123, 5640 Fishers Lane, Rockville, MD 20852, USA.
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25
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Abstract
Giardia lamblia is both the most common intestinal parasite in the United States and a frequent cause of diarrheal illness throughout the world. In spite of its recognition as an important human pathogen, there have been relatively few agents used in therapy. This paper discusses each class of drugs used in treatment, along with their mechanism of action, in vitro and clinical efficacy, and side effects and contraindications. Recommendations are made for the preferred treatment in different clinical situations. The greatest clinical experience is with the nitroimidazole drugs, i.e., metronidazole, tinidazole, and ornidazole, which are highly effective. A 5- to 7-day course of metronidazole can be expected to cure over 90% of individuals, and a single dose of tinidazole or ornidazole will cure a similar number. Quinacrine, which is no longer produced in the United States, has excellent efficacy but may be poorly tolerated, especially in children. Furazolidone is an effective alternative but must be administered four times a day for 7 to 10 days. Paromomycin may be used during early pregnancy, because it is not systematically absorbed, but it is not always effective. Patients who have resistant infection can usually be cured by a prolonged course of treatment with a combination of a nitroimidazole with quinacrine.
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Affiliation(s)
- T B Gardner
- Division of Infectious Diseases, University of Connecticut Health Center, Farmington, Connecticut 06030-3212, USA
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