Epidemiological trends of traveler's diarrhea in Japan: An analysis of imported infectious disease registry data from 2017–2022
Traveler's diarrhea (TD) is a global problem, and identifying the causative organisms of TD is important for adequate treatment. Therefore, this study retrospectively analyzed TD cases in patients who returned to Japan after traveling abroad to determine the causative organisms by travel region...
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| Published in | Global Health & Medicine Vol. 5; no. 6; pp. 372 - 376 |
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National Center for Global Health and Medicine
31.12.2023
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| Abstract | Traveler's diarrhea (TD) is a global problem, and identifying the causative organisms of TD is important for adequate treatment. Therefore, this study retrospectively analyzed TD cases in patients who returned to Japan after traveling abroad to determine the causative organisms by travel region. We included patients with a final diagnosis of TD registered in the Japan Registry for Infectious Diseases from Abroad database from September 25, 2017, to September 1, 2022, from 14 medical institutions. A total of 919 patients were analyzed; the causative TD pathogen was identified in 188 cases (20%), of which 154 were caused by diarrheagenic bacteria, the most common being Campylobacter spp. (64%). A 2.2 mg/dL C-reactive protein concentration cutoff value had some predictive ability for bacterial TD (negative predictive value, 89%). Therefore, the C-reactive protein level may help rule out bacterial diarrhea and prevent unnecessary antimicrobial administration when patients cannot provide a stool specimen. |
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| AbstractList | Traveler's diarrhea (TD) is a global problem, and identifying the causative organisms of TD is important for adequate treatment. Therefore, this study retrospectively analyzed TD cases in patients who returned to Japan after traveling abroad to determine the causative organisms by travel region. We included patients with a final diagnosis of TD registered in the Japan Registry for Infectious Diseases from Abroad database from September 25, 2017, to September 1, 2022, from 14 medical institutions. A total of 919 patients were analyzed; the causative TD pathogen was identified in 188 cases (20%), of which 154 were caused by diarrheagenic bacteria, the most common being Campylobacter spp. (64%). A 2.2 mg/dL C-reactive protein concentration cutoff value had some predictive ability for bacterial TD (negative predictive value, 89%). Therefore, the C-reactive protein level may help rule out bacterial diarrhea and prevent unnecessary antimicrobial administration when patients cannot provide a stool specimen. Traveler's diarrhea (TD) is a global problem, and identifying the causative organisms of TD is important for adequate treatment. Therefore, this study retrospectively analyzed TD cases in patients who returned to Japan after traveling abroad to determine the causative organisms by travel region. We included patients with a final diagnosis of TD registered in the Japan Registry for Infectious Diseases from Abroad database from September 25, 2017, to September 1, 2022, from 14 medical institutions. A total of 919 patients were analyzed; the causative TD pathogen was identified in 188 cases (20%), of which 154 were caused by diarrheagenic bacteria, the most common being spp. (64%). A 2.2 mg/dL C-reactive protein concentration cutoff value had some predictive ability for bacterial TD (negative predictive value, 89%). Therefore, the C-reactive protein level may help rule out bacterial diarrhea and prevent unnecessary antimicrobial administration when patients cannot provide a stool specimen. Traveler's diarrhea (TD) is a global problem, and identifying the causative organisms of TD is important for adequate treatment. Therefore, this study retrospectively analyzed TD cases in patients who returned to Japan after traveling abroad to determine the causative organisms by travel region. We included patients with a final diagnosis of TD registered in the Japan Registry for Infectious Diseases from Abroad database from September 25, 2017, to September 1, 2022, from 14 medical institutions. A total of 919 patients were analyzed; the causative TD pathogen was identified in 188 cases (20%), of which 154 were caused by diarrheagenic bacteria, the most common being Campylobacter spp. (64%). A 2.2 mg/dL C-reactive protein concentration cutoff value had some predictive ability for bacterial TD (negative predictive value, 89%). Therefore, the C-reactive protein level may help rule out bacterial diarrhea and prevent unnecessary antimicrobial administration when patients cannot provide a stool specimen.Traveler's diarrhea (TD) is a global problem, and identifying the causative organisms of TD is important for adequate treatment. Therefore, this study retrospectively analyzed TD cases in patients who returned to Japan after traveling abroad to determine the causative organisms by travel region. We included patients with a final diagnosis of TD registered in the Japan Registry for Infectious Diseases from Abroad database from September 25, 2017, to September 1, 2022, from 14 medical institutions. A total of 919 patients were analyzed; the causative TD pathogen was identified in 188 cases (20%), of which 154 were caused by diarrheagenic bacteria, the most common being Campylobacter spp. (64%). A 2.2 mg/dL C-reactive protein concentration cutoff value had some predictive ability for bacterial TD (negative predictive value, 89%). Therefore, the C-reactive protein level may help rule out bacterial diarrhea and prevent unnecessary antimicrobial administration when patients cannot provide a stool specimen. Traveler's diarrhea (TD) is a global problem, and identifying the causative organisms of TD is important for adequate treatment. Therefore, this study retrospectively analyzed TD cases in patients who returned to Japan after traveling abroad to determine the causative organisms by travel region. We included patients with a final diagnosis of TD registered in the Japan Registry for Infectious Diseases from Abroad database from September 25, 2017, to September 1, 2022, from 14 medical institutions. A total of 919 patients were analyzed; the causative TD pathogen was identified in 188 cases (20%), of which 154 were caused by diarrheagenic bacteria, the most common being Campylobacter spp. (64%). A 2.2 mg/dL C-reactive protein concentration cutoff value had some predictive ability for bacterial TD (negative predictive value, 89%). Therefore, the C-reactive protein level may help rule out bacterial diarrhea and prevent unnecessary antimicrobial administration when patients cannot provide a stool specimen. |
| ArticleNumber | 2023.01079 |
| Author | Sahara, Toshinori Ohmagari, Norio Kutsuna, Satoshi Sakamoto, Naoya Yamamoto, Kei Shinohara, Koh Kodama, Fumihiro Yamamoto, Yoshihiro Hase, Ryota Maruki, Taketomo Shirano, Michinori Yokota, Kyoko Yoshimi, Yusuke Yamato, Masaya Imakita, Natsuko Hasegawa, Chihiro Yoshimura, Yukihiro |
| Author_xml | – sequence: 1 fullname: Maruki, Taketomo organization: Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan – sequence: 2 fullname: Yamamoto, Kei organization: Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan – sequence: 3 fullname: Yamato, Masaya organization: Rinku General Medical Center, Osaka, Japan – sequence: 4 fullname: Sahara, Toshinori organization: Tokyo Metropolitan Ebara Hospital, Tokyo, Japan – sequence: 5 fullname: Shirano, Michinori organization: Osaka City General Hospital, Osaka, Japan – sequence: 6 fullname: Sakamoto, Naoya organization: Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan – sequence: 7 fullname: Hase, Ryota organization: Japanese Red Cross Narita Hospital, Chiba, Japan – sequence: 8 fullname: Shinohara, Koh organization: Kyoto City Hospital, Kyoto, Japan – sequence: 9 fullname: Yoshimura, Yukihiro organization: Yokohama Municipal Citizen's Hospital, Kanagawa, Japan – sequence: 10 fullname: Imakita, Natsuko organization: Nara Medical University Hospital, Nara, Japan – sequence: 11 fullname: Kodama, Fumihiro organization: Sapporo City General Hospital, Hokkaido, Japan – sequence: 12 fullname: Yamamoto, Yoshihiro organization: Toyama University Hospital, Toyama, Japan – sequence: 13 fullname: Yokota, Kyoko organization: Kagawa Prefectural Central Hospital, Kagawa, Japan – sequence: 14 fullname: Yoshimi, Yusuke organization: Japanese Red Cross Nagoya Daini Hospital, Aichi, Japan – sequence: 15 fullname: Hasegawa, Chihiro organization: Nagoya City University East Medical Center, Aichi, Japan – sequence: 16 fullname: Kutsuna, Satoshi organization: Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan – sequence: 17 fullname: Ohmagari, Norio organization: Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan |
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| Cites_doi | 10.4269/ajtmh.15-0157 10.1016/j.tmaid.2022.102293 10.1186/s12879-021-06223-3 10.1016/j.jiac.2020.11.028 10.1186/s40794-018-0077-1 10.1016/j.jiac.2020.08.009 10.1111/j.1708-8305.2008.00198.x 10.1093/jtm/tax026 10.1001/jama.2014.17006 |
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| References | 8. Centers for Disease Control and Prevention, Traveler's health, Traveler's diarrhea. https://wwwnc.cdc.gov/travel/page/travelers-diarrhea (accessed March 2, 2023). 10. Kutsuna S, Hayakawa K, Mezaki K, Yamamoto K, Ohmagari N. Spectrum of enteropathogens in cases of traveler's diarrhea that were detected using the FilmArray GI panel: New epidemiology in Japan. J Infect Chemother. 2021; 27:49-54. 3. Lόpez-Vélez R, Lebens M, Bundy L, Barriga J, Steffen R. Bacterial travelers' diarrhea: A narrative review of literature published over the past 10 years. Travel Med Infect Dis. 2022; 47:102293. 2. Steffen R, Amitirigala I, Mutsch M. Health risks among travelers--need for regular updates. J Travel Med. 2008; 15:145-146. 1. Steffen R, Hill DR, DuPont HL. Traveler's diarrhea: A clinical review. JAMA. 2015; 313:71-80. 5. Kittitrakul C, Lawpoolsri S, Kusolsuk T, Olanwijitwong J, Tangkanakul W, Piyaphanee W. Traveler's diarrhea in foreign travelers in Southeast Asia: A cross-sectional survey study in Bangkok, Thailand. Am J Trop Med Hyg. 2015; 93:485-490. 6. Olson S, Hall A, Riddle MS, Porter CK. Travelers' diarrhea: Update on the incidence, etiology and risk in military and similar populations - 1990-2005 versus 2005-2015, does a decade make a difference? Trop Dis Travel Med Vaccines. 2019; 5:1. 4. Kutsuna S, Asai Y, Yamamoto K, et al. Epidemiological trends of imported infectious diseases in Japan: Analysis of imported 2-year infectious disease registry data. J Infect Chemother. 2021; 27:632-638. 11. Lever RA, Tapper L, Skarbek S, Chiodini PL, Armstrong M, Bailey RL. Predictors of aetiology and outcomes of acute gastrointestinal illness in returning travellers: A retrospective cohort analysis. BMC Infect Dis. 2021; 21:599. 7. Riddle MS, Connor BA, Beeching NJ, DuPont HL, Hamer DH, Kozarsky P, Libman M, Steffen R, Taylor D, Tribble DR, Vila J, Zanger P, Ericsson CD. Guidelines for the prevention and treatment of travelers' diarrhea: A graded expert panel report. J Travel Med. 2017; 24:S57-S74. 9. WHO statement regarding cluster of pneumonia cases in Wuhan, China. https://www.who.int/china/news/detail/09-01-2020-who-statement-regarding-cluster-of-pneumonia-cases-in-wuhan-china (accessed September 23, 2023). 11 1 2 3 4 5 6 7 8 9 10 |
| References_xml | – reference: 2. Steffen R, Amitirigala I, Mutsch M. Health risks among travelers--need for regular updates. J Travel Med. 2008; 15:145-146. – reference: 4. Kutsuna S, Asai Y, Yamamoto K, et al. Epidemiological trends of imported infectious diseases in Japan: Analysis of imported 2-year infectious disease registry data. J Infect Chemother. 2021; 27:632-638. – reference: 8. Centers for Disease Control and Prevention, Traveler's health, Traveler's diarrhea. https://wwwnc.cdc.gov/travel/page/travelers-diarrhea (accessed March 2, 2023). – reference: 11. Lever RA, Tapper L, Skarbek S, Chiodini PL, Armstrong M, Bailey RL. Predictors of aetiology and outcomes of acute gastrointestinal illness in returning travellers: A retrospective cohort analysis. BMC Infect Dis. 2021; 21:599. – reference: 1. Steffen R, Hill DR, DuPont HL. Traveler's diarrhea: A clinical review. JAMA. 2015; 313:71-80. – reference: 5. Kittitrakul C, Lawpoolsri S, Kusolsuk T, Olanwijitwong J, Tangkanakul W, Piyaphanee W. Traveler's diarrhea in foreign travelers in Southeast Asia: A cross-sectional survey study in Bangkok, Thailand. Am J Trop Med Hyg. 2015; 93:485-490. – reference: 10. Kutsuna S, Hayakawa K, Mezaki K, Yamamoto K, Ohmagari N. Spectrum of enteropathogens in cases of traveler's diarrhea that were detected using the FilmArray GI panel: New epidemiology in Japan. J Infect Chemother. 2021; 27:49-54. – reference: 9. WHO statement regarding cluster of pneumonia cases in Wuhan, China. https://www.who.int/china/news/detail/09-01-2020-who-statement-regarding-cluster-of-pneumonia-cases-in-wuhan-china (accessed September 23, 2023). – reference: 3. Lόpez-Vélez R, Lebens M, Bundy L, Barriga J, Steffen R. Bacterial travelers' diarrhea: A narrative review of literature published over the past 10 years. Travel Med Infect Dis. 2022; 47:102293. – reference: 7. Riddle MS, Connor BA, Beeching NJ, DuPont HL, Hamer DH, Kozarsky P, Libman M, Steffen R, Taylor D, Tribble DR, Vila J, Zanger P, Ericsson CD. Guidelines for the prevention and treatment of travelers' diarrhea: A graded expert panel report. J Travel Med. 2017; 24:S57-S74. – reference: 6. Olson S, Hall A, Riddle MS, Porter CK. Travelers' diarrhea: Update on the incidence, etiology and risk in military and similar populations - 1990-2005 versus 2005-2015, does a decade make a difference? Trop Dis Travel Med Vaccines. 2019; 5:1. – ident: 5 doi: 10.4269/ajtmh.15-0157 – ident: 3 doi: 10.1016/j.tmaid.2022.102293 – ident: 11 doi: 10.1186/s12879-021-06223-3 – ident: 4 doi: 10.1016/j.jiac.2020.11.028 – ident: 9 – ident: 8 – ident: 6 doi: 10.1186/s40794-018-0077-1 – ident: 10 doi: 10.1016/j.jiac.2020.08.009 – ident: 2 doi: 10.1111/j.1708-8305.2008.00198.x – ident: 7 doi: 10.1093/jtm/tax026 – ident: 1 doi: 10.1001/jama.2014.17006 |
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| Title | Epidemiological trends of traveler's diarrhea in Japan: An analysis of imported infectious disease registry data from 2017–2022 |
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