Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0740441 (acute diarrhea)
 2,275 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In April 1994, Vibrio metschnikovii was isolated from five infants with watery diarrhoea in Arequipa, Peru, as part of a passive cholera surveillance system. The children ranged in age from 11 to 20 months and had acute diarrhoea, with two cases showing moderate dehydration. Two children also had traces of blood in liquid stool. The children were seen at two different hospitals, and no evidence of a common source of infection was found. No additional V. metschnikovii isolates were identified in the remaining surveillance period that covered the rest of 1994 and 1995. However, stool samples were not screened for enteric pathogens other than vibrios. V. metschnikovii strains isolated from stool samples produced opaque and translucent colonies on agar plates, suggesting capsular material. All isolates were resistant to ampicillin, erythromycin and streptomycin. Plasmid analysis revealed a common 200-kb plasmid in isolates from all cases and an additional 2.7-kb plasmid in three of the isolates. Ribotyping of each isolate after restriction with BglI and HindIII endonucleases demonstrated identical ribotyping patterns. The cases reported suggest that V. metschnikovii may be associated with diarrhoea in man by mechanisms so far unknown.
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PMID:Clinical manifestations and molecular epidemiology of five cases of diarrhoea in children associated with Vibrio metschnikovii in Arequipa, Peru. 895 56

Twenty horses, ponies, and foals referred with acute diarrhoea were divided at random into two treatment groups. One group was treated intravenously with trimethoprim/ sulfadiazine and the other group with ampicillin/gentamicin. Both groups were given the same standardized symptomatic therapy. All animals were evaluated clinically and 5 variables (general impression, heart rate, rectal temperature, appetite, and consistency of the faeces) were estimated on a five point scale (0-4). Jugular blood samples were taken at admittance and at regular intervals for routine screening. Three blood variables (packed cell volume, white blood cell count, and base excess) were also classified in a 5-point scale. The 'diarrhoea prognosis index' was the total sum of the eight variables scaled. Faecal samples were cultured aerobically and examined for worm eggs and larvae. A definite diagnosis was only reached in 11 horses (55%). Salmonellosis and parasitic infections were the most common causes of the diarrhoea. Seven horses (35%), three from the ampicillin/gentamicin group and four from the trimethoprim/sulfadiazine group, died or were euthanized because of a poor prognosis. Only the packed cell volume differed significantly between horses that died and horses that survived. No single clinical or haematological/biochemical variable did forecast the prognosis for the individual patient reliably, nor did the 'diarrhoea prognosis index'. The only reliable indication for the outcome of an individual horse appeared to be the clinical response to treatment within 4 days. The clinical outcome of both treatment groups did not differ significantly. In conclusion, it was difficult to reach a specific diagnosis in these horses with diarrhoea. It was not possible to forecast the prognosis of an individual patient by a single variable or by a combination of variables. No significant differences were found between the two antibiotic treatment groups.
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PMID:A survey of horses with acute diarrhoea: diagnosis, assessment of the prognosis, and comparison of two antibiotic therapies. 897 65

A total of 691 children below five years of age, who were suffering from acute diarrhoea, were investigated. Conventional bacterial pathogens were isolated in 133 (19.2%) cases. Shigella sp. was the most common isolate being positive in 72 (10.4%) faecal specimens. No isolation of Shigella sp. was observed in paediatric patients less than 6 months of age while the maximum isolations were observed among 7-12 month old children. All isolates were sensitive to ciprofloxacin, norfloxacin, gentamycin and nalidixic acid and resistant to ampicillin. Multiple drug resistant isolates were observed during the study also. In all, 7 antibiograms were observed.
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PMID:Existing status of shigellosis in Andaman & Nicobar islands. 906 37

Food borne disease outbreaks have increased in France, but outbreaks caused by Shigella are rare, accounting for only 73 cases (1.62%) in 1993. We report a food borne outbreak of Shigella flexneri strain 3 infection in a fire fighting unit in Paris between July 13th and 17th 1995. Forty of the 127 firemen suffered symptoms including acute diarrhea (80%), fever (50%) and blood and mucus in stools (1 case, 2.5%). Epidemiological investigation generated an unimodal epidemic curve suggesting a single source of contamination with no secondary cases. The median incubation period was between 43 hours 30 minutes and 51 hours 30 minutes. This is consistent with food borne Shigella infection. Statistical analysis of a case-control study implicated a mixed salad containing frozen shellfish from Asia (shrimps and mussels), served at lunch and dinner on July 13th 1995. Shigella was not detected in this salad by microbiological methods. However, inoculation with as little as 100 organisms can cause symptoms. There was low-level contamination with Escherichia coli (940 cfu/g) due to cross-contamination. Shigella flexneri strain 3 was isolated from 11 of 18 stool cultures, but was never isolated from cultures of stools provided by the cooks. All isolates had identical antibiotic resistance profiles. They were resistant to ampicillin and ticarcillin, moderately sensitive to amoxicillin-clavulanic acid, highly sensitive to aminosides, erythromycin and quinolones. This identical pattern in all isolates suggests a common source of contamination. Plasmid-based multiple resistance is common in this organism. Therefore, antibiotics should only be given to patients with evident clinical signs of infection. Treatment was symptom-based in all but 4 patients, who had acute diarrhea and were treated with ciprofloxacin. This antibiotic is well tolerated, has rapid bactericidal action and significantly reduces the duration of the symptoms and excretion of Shigella, thus preventing secondary contamination with this highly infectious bacterium. Thus, food borne outbreaks of Shigella can occur in countries with a high standard of living because of the increase in mass catering (e.g. fast food restaurants) and importation of foodstuffs from developing countries with endemic shigellosis. This is a public health problem because of the morbidity and absenteeism due to illness, particularly when the patients are firemen responsible for emergency management.
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PMID:[Toxic food infection caused by Shigella flexneri in a military unit]. 948 34

A study of the etiologies of diarrhea in adults in relation to their human immunodeficiency virus (HIV) serostatus and number of CD4+ cells was carried out in the Central African Republic. In cases and controls, multi-parasitism was observed. Salmonella spp. were identified mainly during acute diarrhea, with 50% of the S. enteritidis isolated during the study being responsible for septicemia and/or urinary tract infection in immunodeficient patients. Enteroaggregative Escherichia coli (EAggEC) were the most frequently identified agent in HIV+ patients with persistent diarrhea; 42.8% of the patients with EAggEC as sole pathogens had bloody diarrhea, and these strains were negative for the presence of a virulence plasmid. Coccidia were found in those with acute and persistent diarrhea. Blood was observed in 53.3% of infections involving coccidia as the sole pathogen. Microsporidium spp. and Blastocystis hominis were found only in HIV+ patients with persistent diarrhea. Shigella spp., Campylobacter spp., and Entamoeba histolytica were found in HIV+ and HIV- dysenteric patients; bacteria resembling spirochetes that could not be cultivated were identified only in HIV+ cases with dysentery. Shiga-like toxin-producing E. coli O157:H- was isolated from two cases with hemolytic-uremic syndrome. Fungi were identified as the sole pathogen in 6.4% of the HIV+ patients with persistent diarrhea. Most of enteropathogenic bacteria identified were resistant to ampicillin and trimethoprim-sulfamethoxazole, remained susceptible to ampicillin plus clavulanic acid, and were susceptible to amikacin, gentamicin, and ciprofloxacin.
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PMID:Etiologies of acute, persistent, and dysenteric diarrheas in adults in Bangui, Central African Republic, in relation to human immunodeficiency virus serostatus. 988 15

Klebsiella pneumoniae was isolated as the predominant growth from 12 of 100 children under 3 years of age suffering from acute diarrhea. Of the 12 isolates, SA1, SA2, SA4, SA5, SA6 produced a secretogenic response in the ligated rabbit ileal loop, and one isolate, SA3, induced a diarrheagenic response in suckling mice. Two isolates, SA7 and SA8, were diarrheagenic in both assays. Strains SA9, SA10, SA11, and SA12 were found to be non-enterotoxigenic. These isolates belonged to serotypes K6, 16, 25, 30, 39, 46, 49, 53, 66, and 81. All eight enterotoxigenic strains were resistant to ampicillin, streptomycin, ceftazidime, cefuroxime, and cotrimoxazole. Only quinolones such as ciprofloxacin and norfloxacin appear to be effective against enterotoxigenic K. pneumoniae.
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PMID:Enterotoxigenicity of Klebsiella pneumoniae associated with childhood gastroenteritis in Madras, India. 1080 54

The increasing levels of resistance of enteropathogenic bacteria against antimicrobial agents present geographic variations. We have analysed the antimicrobial susceptibility of isolates obtained from 4,364 children under 5 years of age with acute diarrhea, in 7 cities of Argentina. Diarrheagenic E. coli exhibited 74.5% of resistance against ampicillin, 64.2% against sulfametoxazole-trimethoprim, and Shigella spp., 62% and 75.6% respectively. Salmonella sp. showed 35%, 14%, 41.8%, 65.4%, 14.5%, and 13.6% of resistance against ampicillin, chloranfenicol, sulfametoxazole-trimetoprim, sulfadiazin, gentamycin, and fosfomycin respectively. These values are higher than the ones observed in developed countries. Aeromonas showed significantly lower resistance percentage. Important differences in our country were observed, consequently, local trials should be carried out in order to apply corrective measures.
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PMID:[Antimicrobial resistance among species of Salmonella, Shigella, Escherichia, and aeromonas isolated from children with diarrhea in 7 Argentinian centers]. 1093 58

We report an outbreak of acute diarrhoea due to Aeromonas sobria in Benghazi which occurred during a 1-month period in 1997. Of 69 patients admitted with acute gastroenteritis, 28 were positive for A. sobria based on the production of gas from glucose, the production of acetoin, hydrogen sulfide and lysine decarboxylase and on aesculin hydrolysis and fermentation of arabinose and salicin. The strains were sensitive to chloramphenicol, co-trimoxazole, tetracycline and gentamicin but resistant to ampicillin and carbenicillin. We were unable to trace the source of the infection.
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PMID:An outbreak of acute gastroenteritis due to Aeromonas sobria in Benghazi, Libyan Arab Jamahiriya. 1155 43

Detection of diarrheagenic Aeromonas specific aerolysin toxin (Aer) gene by PCR based assay and isolation, identification of diarrhea causing Aeromonas from faeces by culture methods were carried out in the Division of Active Surveillance, National Institute of Cholera and Enteric Diseases (NICED), Kolkata, India for a period of 12 months. Out of 602 faecal samples collected from patients with acute diarrhea admitted in Infectious Diseases (ID) Hospital, Kolkata, 68 (11.29%) samples were found to be possessing Aer gene by PCR technique. The conventional culture methods using selective media yielded only 64 (10.6%) Aeromonas strains from the same faecal samples. The different Aeromonas species possessing Aer gene identified by PCR based technique include A. hydrophila (55.8%), A. caviae (17.6%), A. veronii (10.2%), A. schubertii (4.4%), A. jandaei (2.9%) and A. trota (8.8%). The isolation and identification of Aeromonas by routine culture did not detect enterotoxigenic A. trota present in four diarrheal faecal samples. The failure of the growth of enterotoxigenic A. trota on selective media may be attributed to the ampicillin susceptibility of those strains. The quality control studies revealed that PCR method for the direct detection of Aer gene from the faeces has the sensitivity of 100% and specificity of 98%.
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PMID:Direct detection of diarrheagenic Aeromonas from faeces by polymerase chain reaction (PCR) targeting aerolysin toxin gene. 1200 18

The author proposes general guidelines for the use of drugs in the treatment of diarrhea. It is stressed that antidiarrheal drugs should never be used for the routine management of acute diarrhea, especially in children under 5 years of age; rather, fluid and electrolyte replacement should be the primary treatment. Antibiotics are not indicated in patients with watery diarrhea unless cholera is suspected, in which case tetracycline or another antimicrobial agent should be used. In patients with dysentery, especially children who are febrile or appear seriously ill, antimicrobials such as ampicillin or co-trimoxazole should be given. The choice of antibiotic should be based on known antimicrobial sensitivity patterns of Shigella strains in the geographic area. Antimotility drugs may give some symptomatic relief in adults, but are contraindicated in children under 5 years of age because of the risk of depressed respiration and altered consciousness. The antisecretory drugs chlorpromazine and berberine have not yet proven practical for routine use.
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PMID:Diarrhoea management: drug treatment. 1234 65


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