Bacterial diarrhoea

Abstract

Purpose of reviewThis review describes recent findings about the burden of bacterial diarrhoea and its potential complications, newer diagnostics, the emerging threat of multidrug resistance, and the promise of vaccines in development.Recent findingsIntroduction of rotavirus vaccines in over 110 countries has changed the landscape of diarrheal pathogens. In upper middle and high-income countries, the incidence of rotavirus-specific and all-cause gastroenteritis has declined substantially, and norovirus has become the major pathogen in many settings. Bacterial pathogens cause approximately 10–15% of episodes, most often Shigella, nontyphoidal Salmonella (NTS) Campylobacter and Shiga toxin-producing Escherichia coli (STEC). In lower income countries, bacterial pathogens remain a major cause of medically attended diarrhoea with Shigella, Campylobacter and enterotoxigenic Escherichia coli (ETEC) predominating. Multidrug-resistant strains of Shigella, NTS and, Campylobacter have emerged globally requiring judicious use of antibiotics according to current guidance.SummaryManagement of bacterial diarrhoea includes standard fluid and electrolyte therapy, vigilance for potential complications, and use of antibiotics for children who have moderate-severe illness due to pathogens for which efficacy has been demonstrated, or for those at high risk for severe disease. The threat of multiply resistant strains provides impetus for preventive strategies such as development of vaccines.

Infectious Diseases Associated with Hydrometeorological Hazards in Europe: Disaster Risk Reduction in the Context of the Climate Crisis and the Ongoing COVID-19 Pandemic

“…STEC/VTEC causes a wide range of human gastrointestinal disorders, from watery and bloody diarrhea to hemorrhagic colitis. Infection can also result in the life-threatening hemolytic uremic syndrome (HUS), which is considered to be caused by Shiga toxins (Stx) [ 69 , 70 ]. It is demonstrated that heavy rainfall and high temperature are statistically significantly associated with the occurrence of waterborne VTEC outbreaks [ 71 ].…”

Bacterial outer membrane vesicles and their functionalization as vehicles for bioimaging, diagnosis and therapy

“…For example, Shigella disease, also known as bacillary dysentery, is caused by Shigella sonnei from food, which leads to bacterial spreading and invasion in the intestinal epithelia and results in diarrhea. 106 Considering that the S. sonnei O-antigen polysaccharide is effective in stimulating the production of protective antibodies, Tian et al have developed the O-antigen based OMV vaccine by expressing the O-antigen in recombinant Salmonella via the LPS synthesis pathway. 107 Inspired by this work, vaccines basing on polysaccharide antigen-loaded bacterial OMVs have received increasing attention.…”

Antibiotic Resistance of Diverse MLST Campylobacter from Pediatric Patients with Acute Diarrhea

“…An important issue of Campylobacter spp. of public health concern is the emerging of antibiotic resistant strains especially multidrug-resistant strains [11] that poses a challenge to the treatment of infections in humans. Infections caused by antibiotic-resistant strains of Campylobacter are more di cult to treat [12] particularly concerning those related to high levels of resistance to cipro oxacin and tetracycline [13][14][15].…”