- Common Gastrointestinal Infections. [Review]
- PCPrim Care 2018; 45(3):519-532
- Gastrointestinal infections account for a large burden of acute and chronic disease, with diarrhea being the most common manifestation. Most cases are due to viruses, with norovirus being the most co...
Gastrointestinal infections account for a large burden of acute and chronic disease, with diarrhea being the most common manifestation. Most cases are due to viruses, with norovirus being the most common, whereas bacteria and parasites are also important contributors to acute and chronic gastrointestinal infections and their sequelae. Nontyphoidal Salmonella species cause the most hospitalizations and deaths in the United States. This article reviews an evidence-based approach to diarrhea evaluation with a focus on pathogen-specific testing and management for the most common viral, bacterial, and parasitic causes in the United States.
- Closing The Brief Case: A Rare Case of Invasive Amebiasis Requiring Emergency Subtotal Colectomy in an HIV-Positive Man. [Editorial]
- JCJ Clin Microbiol 2018; 56(8)
- The Brief Case: A Rare Case of Invasive Amebiasis Requiring Emergency Subtotal Colectomy in an HIV-Positive Man. [Editorial]
- JCJ Clin Microbiol 2018; 56(8)
- Extended-spectrum β-lactamase prevalence and virulence factor characterization of enterotoxigenic Escherichia coli responsible for acute diarrhea in Nepal from 2001 to 2016. [Journal Article]
- ARAntimicrob Resist Infect Control 2018; 7:87
- CONCLUSIONS: Over 30% of ETEC isolates collected post-2013 and evaluated in this study demonstrated ESBL resistance. Persistent surveillance and characterization of enteric ETEC isolates are vital for tracking the community presence of MDR bacterial species in order to recommend effective treatment strategies and help mitigate the spread of resistant pathogens.
- A deadly prescription: combination of methotrexate and trimethoprim-sulfamethoxazole. [Journal Article]
- JCJ Community Hosp Intern Med Perspect 2018; 8(3):149-151
- Methotrexate (MTX) is a chemotherapeutic synthetic(s) phase cell cycle inhibitor, and its role has evolved as an immunological agent in autoimmune diseases like rheumatoid arthritis, psoriasis, and s...
Methotrexate (MTX) is a chemotherapeutic synthetic(s) phase cell cycle inhibitor, and its role has evolved as an immunological agent in autoimmune diseases like rheumatoid arthritis, psoriasis, and systemic lupus erythematosus, etc. Trimethoprim-sulfamethoxazole (TS) is one of the most widely prescribed antibiotics commonly used for urinary tract infections, exacerbations of chronic bronchitis, traveler's diarrhea, and pneumocystis pneumonia. Both MTX and TS can have significantly overlapping side effects involving dermatologic, renal, and hematological systems, and the combination of these can be deadly. Our case is about the combination of MTX and TS that leads to mucocutaneous ulceration, leukopenia, and renal insufficiency. The purpose of this case is to increase awareness of potentially significant toxicity from the combination of MTX with TS. Abbreviations: MTX: methotrexate; TS: trimethoprim-sulfamethoxazole; ED: emergency department; IV: intravenous; GI: gastrointestinal; NSAIDs: nonsteroidal anti-inflammatory drugs.
- Anti-infectious properties of the probiotic Saccharomyces cerevisiae CNCM I-3856 on enterotoxigenic E. coli (ETEC) strain H10407. [Journal Article]
- AMAppl Microbiol Biotechnol 2018 May 25
- Enterotoxigenic Escherichia coli (ETEC) are major food-borne pathogens responsible for traveler's diarrhea. The production of adhesins and the secretion of enterotoxins constitute the major virulence...
Enterotoxigenic Escherichia coli (ETEC) are major food-borne pathogens responsible for traveler's diarrhea. The production of adhesins and the secretion of enterotoxins constitute the major virulence traits of the bacteria. Treatments are mainly symptomatic and can involve antibiotherapy. However, given the rise of antibiotic resistance worldwide, there is an urgent need for the development of new preventive strategies for the control of ETEC infections. Among them, a promising approach is the use of probiotics. The aim of this study was to investigate, using complementary in vitro and in vivo approaches, the inhibitory potential of the yeast Saccharomyces cerevisiae CNCM I-3856 against the human ETEC reference strain H10407. In conventional culture media, S. cerevisiae significantly reduced ETEC growth and toxin production. The yeast also inhibited bacterial adhesion to mucin-agar and intestinal Caco-2/TC7 cells in a dose-dependent manner. Lastly, pre-treatment with S. cerevisiae inhibited interleukin-8 production by ETEC-infected intestinal cells. In streptomycin-treated mice, the probiotic yeast decreased bacterial colonization, mainly in the ileum, the main site of ETEC pathogenesis. For the first time, this study shows that the probiotic yeast S. cerevisiae CNCM I-3856 can exert an anti-infectious activity against a human ETEC strain through a multi-targeted approach, including inhibition of bacterial growth and toxin production, reduction of bacterial adhesion to mucins and intestinal epithelial cells, and suppression of ETEC-induced inflammation. Interestingly, the highest activity was obtained with a prophylactic treatment. Further studies will aim to assess the effect of the yeast on ETEC survival and virulence under human simulated digestive conditions.
- The Critical Role of Zinc in a New Murine Model of Enterotoxigenic E. coli (ETEC) Diarrhea. [Journal Article]
- IIInfect Immun 2018 Apr 16
- Enterotoxigenic E. coli are major causes of traveler's diarrhea as well as endemic diarrhea and stunting in children in developing areas. However a small mammal model has been badly needed to better ...
Enterotoxigenic E. coli are major causes of traveler's diarrhea as well as endemic diarrhea and stunting in children in developing areas. However a small mammal model has been badly needed to better understand and assess mechanisms, vaccines and interventions. We report a murine model of ETEC diarrhea, weight loss and enteropathy, and investigate the role of zinc on the outcomes. LT+ST producing enterotoxigenic E. coli (ETEC) given to weaned C57BL/6 mice after antibiotic disruption of normal microbiota cause growth impairment, watery diarrhea, heavy stool shedding and mild to moderate intestinal inflammation, the latter worse with zinc deficiency. Zinc treatment promoted growth in zinc deficient infected mice, and subinhibitory zinc reduced expression of ETEC virulence genes cfa1, cexE, sta2 and degP, but not eltA in vitro. Zinc supplementation increased shedding and ileal burden of WT ETEC, but decreased shedding and tissue burden of LTKO ETEC. LTKO ETEC infected mice had delayed disease onset and also had less inflammation by fecal MPO assessment These findings provide a new murine model of ETEC infection that can help elucidate mechanisms of growth, diarrhea and inflammatory responses as well as potential vaccines and interventions.
- Ancylostoma ceylanicum , novel etiological agent for traveler's diarrhea-report of four Japanese patients who returned from Southeast Asia and Papua New Guinea. [Journal Article]
- TMTrop Med Health 2018; 46:6
- CONCLUSIONS: A .ceylanicumshould be recognized as an important etiologic pathogen of hookworm diseases in travelers to countries in the Southeast Asia and West Pacific Ocean regions.
- A Role for Salivary Peptides in the Innate Defense Against Enterotoxigenic Escherichia coli. [Journal Article]
- JIJ Infect Dis 2018 Apr 11; 217(9):1435-1441
- CONCLUSIONS: Our data represent the first report of a salivary component exerting specific antimicrobial activity against an enteric pathogen and suggest that histatin-5 and related peptides might be exploited for prophylactic and/or therapeutic uses. Numerous viruses, bacteria, and fungi traverse the oropharynx to cause disease, so there is considerable opportunity for various salivary components to neutralize these pathogens prior to arrival at their target organ. Identification of additional salivary components with unexpectedly broad antimicrobial spectra should be a priority.
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- Antibiotic treatment of acute gastroenteritis in children. [Review]
- FF1000Res 2018; 7:193
- Antibiotic therapy is not necessary for acute diarrhea in children, as rehydration is the key treatment and symptoms resolve generally without specific therapy. Searching for the etiology of gastroen...
Antibiotic therapy is not necessary for acute diarrhea in children, as rehydration is the key treatment and symptoms resolve generally without specific therapy. Searching for the etiology of gastroenteritis is not usually needed; however, it may be necessary if antimicrobial treatment is considered. The latter is left to the physician evaluation in the absence of clear indications. Antimicrobial treatment should be considered in severely sick children, in those who have chronic conditions or specific risk factors or in specific settings. Traveler's diarrhea, prolonged diarrhea, and antibiotic-associated diarrhea may also require antibiotic therapy. Depending on the severity of symptoms or based on risk of spreading, empiric therapy may be started while awaiting the results of microbiological investigations. The choice of antibiotic depends on suspected agents, host conditions, and local epidemiology. In most cases, empiric therapy should be started while awaiting such results. Empiric therapy may be started with oral co-trimoxazole or metronidazole, but in severe cases parenteral treatment with ceftriaxone or ciprofloxacin might be considered.