Update on the Diagnosis of Traveler’s Diarrhea: Current Strategies and Emerging Trends

  • Kennedy Winata Undergraduate Student of Faculty of Medicine and Health Sciences, Universitas Warmadewa
  • Kartika Cahyaningrum Undergraduate Student of Faculty of Medicine and Health Sciences, Universitas Warmadewa
  • Dayana Puspawarna Undergraduate Student of Faculty of Medicine and Health Sciences, Universitas Warmadewa
  • Ngakan Satria Wibawa Undergraduate Student of Faculty of Medicine and Health Sciences, Universitas Warmadewa
  • Agung Kesuma Putra Undergraduate Student of Faculty of Medicine and Health Sciences, Universitas Warmadewa
  • Bagas Aditya Kurnia Pratama Undergraduate Student of Faculty of Medicine and Health Sciences, Universitas Warmadewa
  • Eva Santhy Undergraduate Student of Faculty of Medicine and Health Sciences, Universitas Warmadewa
  • Adi Arya Undergraduate Student of Faculty of Medicine and Health Sciences, Universitas Warmadewa
  • Miracle Lie Undergraduate Student of Faculty of Medicine and Health Sciences, Universitas Warmadewa
  • Herliana Yuliartha Undergraduate Student of Faculty of Medicine and Health Sciences, Universitas Warmadewa
  • Arnelia Tasau Undergraduate Student of Faculty of Medicine and Health Sciences, Universitas Warmadewa
  • Arya Giri Prebawa Department of Internal Medicine Faculty of Medicine and Health Sciences, Universitas Warmadewa, Bali, Indonesia
  • Saraswati Laksmi Dewi RS Bros, Denpasar-Bali, Indonesia
Keywords: traveler’s diarrhea, diagnosis, molecular techniques, pcr, stool culture, multiplex assays, metagenomic sequencing

Abstract

Traveler’s diarrhea (TD) remains a prevalent condition affecting individuals traveling to regions with varying sanitation standards. The diagnosis of TD has evolved with advancements in diagnostic tools and a better understanding of its etiology. Traditionally diagnosed based on clinical presentation and exposure history, current approaches increasingly incorporate molecular techniques to identify causative pathogens more accurately. Recent updates highlight the integration of polymerase chain reaction (PCR) and other molecular diagnostic methods that offer rapid, sensitive, and specific detection of bacterial, viral, and parasitic pathogens. These advances enable differentiation between infectious and non-infectious causes of diarrhea, which is crucial for effective management and treatment. Additionally, the role of stool cultures, although less commonly used in rapid diagnostics, remains important for comprehensive pathogen identification. Emerging research emphasizes the need for a tailored diagnostic approach considering geographic region, patient history, and symptom profile. The use of multiplex assays and metagenomic sequencing is showing promise in identifying a broad spectrum of pathogens and understanding the complex microbiological landscape of TD. This update underscores the importance of adopting a multifaceted diagnostic strategy to improve the accuracy of TD diagnosis, thereby enhancing patient care and contributing to the development of targeted treatment and preventive measures.

References

1. Leung, A.K.C. et al. (2019) ‘Travelers’ Diarrhea: A Clinical Review’, Recent Patents on Inflammation & Allergy Drug Discovery, 13(1), pp. 38–48. doi:10.2174/1872213x1366619051 4105054.
2. Bae JM. Prophylactic efficacy of probiotics on travelers' diarrhea: an adaptive meta-analysis of randomized controlled trials. Epidemiol Health. 2018;40:e2018043.
3. Ericsson CD, Riddle MS. Should travel medicine practitioners prescribe antibiotics for self- treatment of travelers' diarrhea? J Travel Med. 2018 Jan 01;25(1)
4. Connor BA: Travelers' Diarrhea. Yellow Book: Health Information for International Travel. 2020. CDC website. Last reviewed November 22, 2019. Accessed February 26, 2021.LaRocque, R., & Harris, J. B. Travelers' diarrhea: Epidemiology, microbiology, clinical manifestations, and diagnosis.
5. Thiagarajah, J., Donowitz, M. & Verkman, A. Secretory diarrhoea: mechanisms and emerging therapies. Nat Rev Gastroenterol Hepatol 12, 446–457 (2015). https://doi.org/10.1038/nrgastro.2015.111
6. Lindsay L, DuPont HL, Moe CL, Alberer M, Hatz C, Kirby AE, Wu HM, Verstraeten T, Steffen R. 2018.Estimating the incidence of norovirus acute gastroenteritis among US and European international travelers to areas of moderate to high risk of traveler's diarrhea: a prospective cohort study protocol. BMC Infect Dis. 18(1).
7. Riddle MS, Connor BA, Beeching NJ, DuPont HL, Hamer DH, Kozarsky P, Libman M, Steffen R, Taylor D, Tribble DR, Vila J, Zanger P, Ericsson CD. 2017. Guidelines for the prevention and treatment of travelers' diarrhea: a graded expert panel report. J Travel Med.
8. Shane AL, Mody RK, Crump JA, Tarr PI, Steiner TS, Kotloff K. 2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea. CID 2017;65:(12):e45–e80
9. Audrey V Adler, Hailee R Ciccotti, Spencer J H Trivitt, Roland C J Watson, Mark S Riddle, What’s new in travellers’ diarrhoea: updates on epidemiology, diagnostics, treatment and long-term consequences, Journal of Travel Medicine, Volume 29, Issue 1, January 2022, taab099, https://doi.org/10.1093/jtm/taab099
10. Jesser KJ, Levy K. Updates on defining and detecting diarrheagenic Escherichia coli pathotypes. Curr Opin Infect Dis. 2020 Oct;33(5):372-380. doi: 10.1097/QCO.0000000000000665. PMID: 32773499; PMCID: PMC7819864.
11. Takahashi, E., Motooka, D., Nakamura, S. et al. Metagenomic analysis of diarrheal stools in Kolkata, India, indicates the possibility of subclinical infection of Vibrio cholerae O1. Sci Rep 12, 19473 (2022). https://doi.org/10.1038/s41598-022-24167-9
12. Finkbeiner SR, Allred AF, Tarr PI, Klein EJ, Kirkwood CD, Wang D (2008) Metagenomic Analysis of Human Diarrhea: Viral Detection and Discovery. PLoS Pathog 4(2): e1000011. https://doi.org/10.1371/journal.ppat.1000011
13. Royer C, Patin NV, Jesser KJ, Peña- Gonzalez A, Hatt JK, Trueba G, Levy K, Konstantinidis KT. 2024. Comparison of metagenomic and traditional methods for diagnosis of E. coli enteric infections. mBio 15:e03422-23. https://doi.org/10.1128/mbio.03422-23
Published
2024-10-02
Section
Articles
Abstract viewed = 1 times
PDF downloaded = 1 times