PMID- 32846225
OWN - NLM
STAT- MEDLINE
DCOM- 20210701
LR  - 20211216
IS  - 1873-0442 (Electronic)
IS  - 1477-8939 (Linking)
VI  - 38
DP  - 2020 Nov-Dec
TI  - Clinical aspects of heat-labile and heat-stable toxin-producing enterotoxigenic 
      Escherichia coli: A prospective study among Finnish travellers.
PG  - 101855
LID - S1477-8939(20)30351-3 [pii]
LID - 10.1016/j.tmaid.2020.101855 [doi]
AB  - BACKGROUND: Enterotoxigenic Escherichia coli (ETEC) is a major pathogen causing 
      travellers' diarrhoea (TD) among visitors to low- and middle-income countries 
      (LMIC). Scant data are available on rates of travel-acquired ETEC producing 
      heat-labile (LT) and/or heat-stable (ST) toxin or its subtypes, STh (human) and 
      STp (porcine) in various geographic regions, and on clinical pictures associated 
      with each toxin. METHODS: Using qPCR, we analysed LT, STh, and STp in stools 
      positive for ETEC in a prospective study among 103 Finnish travellers visiting 
      LMIC. They filled in questionnaires and provided stool samples before and after 
      travel. We scrutinized geographic distribution of LT, STh, and STp ETEC findings, 
      and association between these different ETEC subtypes and moderate/severe TD. 
      RESULTS: Among the 103 stool samples positive for ETEC toxins, the rate for LT 
      was 76%, for STh 26%, and STp 41%. The rate for LT-only was 44%, for STh-only 6%, 
      STp-only 16%, LT + STh 10%, LT + STp 15%, STh + STp 3%, and LT + STh + STp 8%. 
      Findings varied by destination; the rates of LT, STh, and STp were 79%, 21%, and 
      57%, respectively, in Southern Asia (n = 14); 85%, 10%, and 20% in South-eastern 
      Asia (n = 20); 84%, 13%, and 29% in Eastern Africa (n = 31); and 56%, 50%, and 
      63% in Western Africa (n = 32), respectively. Of travellers positive for LT, STh, 
      and STp, 83%, 100%, and 88%, encountered TD; 35%, 55%, and 41% reported 
      moderate/severe TD. STh was associated with moderate/severe TD. CONCLUSIONS: 
      Toxin findings varied by destination; multiple toxins were commonly detected. 
      Moderate/severe TD was reported most frequently by subjects with STh-ETEC.
CI  - Copyright (c) 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.
FAU - Turunen, Katri
AU  - Turunen K
AD  - Department of Bacteriology and Immunology, University of Helsinki, P.O. Box 21, 
      FI-00014, University of Helsinki, Finland; Inflammation Center, Division of 
      Infectious Diseases, University of Helsinki and Helsinki University Hospital, 
      P.O. Box 348, FI-00029, HUS, Finland. Electronic address: 
      katri.a.turunen@helsinki.fi.
FAU - Antikainen, Jenni
AU  - Antikainen J
AD  - HUS Diagnostic Center (HUSLAB), Bacteriology, Helsinki, Finland. Electronic 
      address: jenni.antikainen@hus.fi.
FAU - Laaveri, Tinja
AU  - Laaveri T
AD  - Inflammation Center, Division of Infectious Diseases, University of Helsinki and 
      Helsinki University Hospital, P.O. Box 348, FI-00029, HUS, Finland. Electronic 
      address: tinja.laaveri@hus.fi.
FAU - Kirveskari, Juha
AU  - Kirveskari J
AD  - HUS Diagnostic Center (HUSLAB), Bacteriology, Helsinki, Finland; Mobidiag Ltd, 
      Helsinki, Finland. Electronic address: juha.kirveskari@mobidiag.com.
FAU - Svennerholm, Ann-Mari
AU  - Svennerholm AM
AD  - University of Gothenburg, Gothenburg, Sweden. Electronic address: 
      ann-mari.svennerholm@microbio.gu.se.
FAU - Kantele, Anu
AU  - Kantele A
AD  - Inflammation Center, Division of Infectious Diseases, University of Helsinki and 
      Helsinki University Hospital, P.O. Box 348, FI-00029, HUS, Finland; Travel 
      Clinic, Aava Medical Center, Annankatu 32, FI-00100, Helsinki, Finland. 
      Electronic address: anu.kantele@hus.fi.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20200823
PL  - Netherlands
TA  - Travel Med Infect Dis
JT  - Travel medicine and infectious disease
JID - 101230758
RN  - 0 (Bacterial Toxins)
RN  - 0 (DNA, Bacterial)
RN  - 0 (Enterotoxins)
RN  - 0 (Escherichia coli Proteins)
RN  - 0 (heat stable toxin (E coli))
RN  - D9K3SN2LNY (heat-labile enterotoxin, E coli)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Africa, Eastern
MH  - Africa, Western
MH  - Aged
MH  - Asia
MH  - Bacterial Toxins/*genetics
MH  - Child
MH  - Child, Preschool
MH  - DNA, Bacterial
MH  - Diarrhea/*microbiology
MH  - Enterotoxigenic Escherichia coli/*genetics/isolation & purification
MH  - Enterotoxins/*genetics
MH  - Escherichia coli Infections/*epidemiology
MH  - Escherichia coli Proteins/*genetics
MH  - Feces/microbiology
MH  - Finland
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - Middle Aged
MH  - Prospective Studies
MH  - Real-Time Polymerase Chain Reaction
MH  - Travel
MH  - Travel-Related Illness
MH  - Young Adult
OTO - NOTNLM
OT  - ETEC
OT  - LT
OT  - ST
OT  - STh
OT  - STp
OT  - Travellers' diarrhoea
EDAT- 2020/08/28 06:00
MHDA- 2021/07/02 06:00
CRDT- 2020/08/27 06:00
PHST- 2020/02/05 00:00 [received]
PHST- 2020/07/28 00:00 [revised]
PHST- 2020/08/19 00:00 [accepted]
PHST- 2020/08/28 06:00 [pubmed]
PHST- 2021/07/02 06:00 [medline]
PHST- 2020/08/27 06:00 [entrez]
AID - S1477-8939(20)30351-3 [pii]
AID - 10.1016/j.tmaid.2020.101855 [doi]
PST - ppublish
SO  - Travel Med Infect Dis. 2020 Nov-Dec;38:101855. doi: 10.1016/j.tmaid.2020.101855. 
      Epub 2020 Aug 23.