Diarrhea enterotoxigenic

Empiric antibiotic therapy is an appropriate approach to traveler s diarrhea. Eradication of the causal microbe depends on the etiologic agent and its antibiotic sensitivity. Most cases of traveler s diarrhea and other community-acquired infections result from enterotoxigenic (ETEC) or enteropathogenic (EPEC) Escherichia coli. Routine stool cultures do not identify these strains primary empiric antibiotic choices include fluoroquinolones such as ciprofloxacin or levofloxacin. Azithromycin may be a feasible option when fluoroquinolone resistance is encountered. 

The mechanism of diarrhea has not been clearly elucidated, but theories include a reduction in the absorptive surface along with impaired absorption owing to cellular damage, enterotoxigenic effects of a rotavirus protein, and stimulation of the enteric nervous system.43... 

Two of the most widely spread and well-studied enterotoxigenic forms of bacterial diarrhea are ETEC and Vibrio cholerae. The toxins they produce, labile toxin (LT) and cholera toxin (CT) respectively, are very similar in primary sequence, structure, and mechanism of action [72]. They are homologous multi-subunit proteins in which the non-toxic B subunit mediates GMj ganglioside binding, and thus are candidates for vaccines that can neutralize toxin activity. 

Escherichia coli GI disease may be caused by enterotoxigenic E. coli (ETEC), enteroinvasive E. coli, enteropathogenic E. coli, enteroadhesive E. coli, and enterohemorrhagic E. coli. ETEC is now incriminated as being the most common cause of traveler s diarrhea. 

Rabbani GH, Butler T, Knight J, Sanyal SC, Alam K. (1987) Randomized controlled trial of berberine sulfate therapy for diarrhea due to enterotoxigenic Escherichia coli and Vibrio cholerae. J Infect Dis 155 979-984. 

Travelers diarrhea in adults - Travelers diarrhea in adults caused by susceptible strains of enterotoxigenic E. coli. 

Has been used for diverticular disease and hepatic encephalopathy, but not FDA approved. Not effective for traveler s diarrhea due to bacteria other than enterotoxigenic Escherichia coli... 

Holland R E, Sriranganathan N, DuPont L 1989 Isolation of enterotoxigenic Escherichia coli from a foal with diarrhea. Journal of the American Veterinary Medical Association 194 389-391... 

Colitis in the rectosigmoid mucosa, with concomitant malabsorption, results in the characteristic sign of bacillary dysentery diarrhea tinged with blood and mucus. Shigellosis can be correctly diagnosed in most patients on the basis of fresh blood in the stool however, watery, mucoid diarrhea may be the only symptom of many Shigella infections. This disease differs from profuse watery diarrhea, as is commonly seen in choleraic diarrhea or in enterotoxigenic... 

The most common pathogens for traveler s diarrhea include enterotoxigenic Escherichia coli, Shigella, Campylobacter, Salmonella, and viruses. 

Enterotoxigenic Escherichia coli, vibrio and Shigella Acute diarrhea Detect multiple pathogens F4, K8, 01, VI... 

Recently, the U.S. Food and Drug Administration (U.S. FDA) has approved the release of rifaximin, a rifamycin antibiotic, for the treatment of travelers diarrhea (TD) caused by enterotoxigenic Escherichia coli. Although the drug is not intended for the treatment of TD, there are indications that the drug may be effective as a prophylactic agent. 

Escherichia coll "enterotoxigenic" 12-72h D>V. Toxin produced in gut. "Traveler s diarrhea." Water, various foods direct contact (eg, food handlers). 

Heo, J.M., J.C. Kim, C.R Hansen, B.P Mullan, D.J. Hampson and J.R. Pluske, 2009 Feeding a diet with decreased protein content reduces indices of protein fermentation and the incidence of postweaning diarrhea in weaned pigs challenged with an enterotoxigenic strain of Escherichia coli. J. Anim. Sci. 87, 2833-2843. 

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