Walter Reed Army Institute of Research, Armed Forces Research Institute of Medical Sciences-Bangkok
|Swierczewski, Brett Edward
Travelers’ Diarrhea (TD) is the most common illness reported in international travelers from industrialized nations to low-income, developing nations. Additionally, traveler’s diarrhea is a major cause of morbidity among US military personnel deployed to austere environments where the sanitary conditions are poor. TD can be caused by multiple etiologic agents to include enteric bacteria (diarrheagenic Escherichia coli, Shigella spp., Campylobacter spp.), viruses (noroviruses, adenoviruses, astroviruses) and parasites (Giardia lamblia, Entamoeba histolytica, Cryptosporidium parvum). Enterotoxigenic E. coli (ETEC) is one of the most common bacterial pathogens responsible for TD infections in Southeast Asia and has typically been treated with antibiotic administration. However, the widespread emergence of antimicrobial resistant ETEC pathogens, in particular extended spectrum beta lactamase (ESBL) producing strains and carbapenem resistant strains, greatly limits available treatment options. Despite the widespread emergence of ETEC multidrug resistant strains, ETEC remains largely uncharacterized in terms of the acquisition of antibiotic resistance mechanisms and antibiotic resistant genes. Understanding of these mechanisms will contribute to a broader understanding of the spread of multidrug resistant ETEC causing traveler’s diarrhea in Southeast Asia and the common resistance mechanisms and genes in this population.
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