Korean J Clin Microbiol.  2009 Dec;12(4):186-192.

Detection of the Causative Agents of Traveler's Diarrhea Using a Real-Time PCR Screening Method

Affiliations
  • 1Division of Enteric Bacterial Infections, National Institute of Health, Seoul, Korea. kkingsh@chol.com
  • 2Gimhae National Quarantine Station, Gimhae, Korea.

Abstract

BACKGROUND
The incidence of infectious diarrheal disease in Korea has decreased over the past decade, but traveler's diarrhea (TD) is increasing in frequency. We therefore investigated the distribution of the causative agents of TD.
METHODS
A total of 132 rectal swab specimens were acquired from TD patients who entered the country via Gimhae International Airport. The specimens were screened for 12 bacterial pathogens by real-time PCR, and target pathogens were isolated from the PCR positive specimens using conventional microbiological isolation methods.
RESULTS
A total of 93 specimens (70.5%) showed positive PCR screening results, and of these specimens, nine species and 50 isolates (37.9%), including Vibrio parahaemolyticus (18 isolates) and ETEC (17 isolates), were isolated. No specimens were PCR positive for Listeria monocytogenes or Campylobacter jejuni, and no pathogenic Bacillus cereus were isolated.
CONCLUSION
Even though viruses and EAEC were not included as target pathogens, the high isolation rate of these pathogens in this study provides indirect evidence that most cases of pathogen-negative TD are caused by undetected bacterial agents. Furthermore, our study results confirm the effectiveness of real-time PCR-based screening methods. This study is the first report in Korea to demonstrate that ETEC and V. parahaemolyticus are the major causative pathogens of TD, and this knowledge can be used to help treat and prevent TD.

Keyword

Traveler's diarrhea; PCR; ETEC

MeSH Terms

Airports
Bacillus cereus
Campylobacter jejuni
Diarrhea
Dysentery
Enterotoxigenic Escherichia coli
Humans
Incidence
Korea
Listeria monocytogenes
Mass Screening
Polymerase Chain Reaction
Real-Time Polymerase Chain Reaction
Vibrio parahaemolyticus

Figure

  • Fig. 1. Clustering of XbaI digested PFGE patterns of ETEC isolates.


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