Incidence of and in traveler's diarrhea cases and asymptomatic controls in Nepal and Thailand.
Oralak Serichantalergs, Sirigade Ruekit, Prativa Pandey, Sinn Anuras, Carl Mason, Ladaporn Bodhidatta, Brett Swierczewski
Author Information
Oralak Serichantalergs: Department of Enteric Diseases, Armed Forces Research Institute of Medical Sciences, 315/6 Rajvithi Road, Bangkok, 10400 Thailand.
Sirigade Ruekit: Department of Enteric Diseases, Armed Forces Research Institute of Medical Sciences, 315/6 Rajvithi Road, Bangkok, 10400 Thailand.
Prativa Pandey: CIWEC Clinic Travel Medicine Center, GPO Box 12895, Kapurdhara Marg, Kathmandu, 44600 Nepal.
Sinn Anuras: Bumrungrad International Hospital, 33 Soi Sukhumvit 3, Khwaeng Khlong Toei Nuea, Khet Watthana, Bangkok, 10110 Thailand.
Carl Mason: Department of Enteric Diseases, Armed Forces Research Institute of Medical Sciences, 315/6 Rajvithi Road, Bangkok, 10400 Thailand.
Ladaporn Bodhidatta: Department of Enteric Diseases, Armed Forces Research Institute of Medical Sciences, 315/6 Rajvithi Road, Bangkok, 10400 Thailand.
Brett Swierczewski: Department of Enteric Diseases, Armed Forces Research Institute of Medical Sciences, 315/6 Rajvithi Road, Bangkok, 10400 Thailand. ORCID
BACKGROUND: and have emerged in recent years as being associated with acute and prolonged gastroenteritis and implicated in the development of inflammatory bowel diseases. However, there are limited data on the prevalence of these microorganisms in Southeast Asia. In this study, 214 pathogen-negative stool samples after laboratory examination for common enteric pathogens to include and by culture from two case-control traveler's diarrhea (TD) studies conducted in Thailand (cases = 26; controls = 30) and Nepal (cases = 83; controls = 75) respectively were assayed by PCR for the detection of 16S and two specific heat shock protein genes specific for () and () respectively. RESULTS: 16S was detected in 28.5% (61/214) of the pathogen-negative TD stool samples (CIWEC Travel Medicine Clinic, Kathmandu, Nepal: cases = 36, control = 14; Bamrungrad International Hospital, Bangkok, Thailand: cases = 9, controls = 2). was identified significantly more often in TD cases in Nepal (28.9%; 24/83) as compared to controls (4%; 3/75) (OR = 9.76; 95% CI 2.80-34.02; = 0.0003) while was detected in only two cases (2/26; 7.7%) and none of the controls stool samples from Thailand. was detected in four cases (4.8%; 4/83) and four controls (5.3%; 4/75) and in one case (3.8%; 1/26) and one control (3.1%; 1/30) from Nepal and Thailand respectively. and were isolated in 18.3 and 3.4% of the cases and in 4.0 and 1.4% of the controls in stool samples from both Thailand and Nepal respectively while nor were not tested for in these samples. CONCLUSION: These findings suggest that potentially is a pathogen associated with TD in Nepal. To our knowledge, this is the first report of and detected from traveler's diarrhea cases from travelers to Nepal and Thailand.
