Quick Search:

uzh logo
Browse by:

Zurich Open Repository and Archive

Maintenance: Tuesday, July the 26th 2016, 07:00-10:00

ZORA's new graphical user interface will be relaunched (For further infos watch out slideshow ZORA: Neues Look & Feel). There will be short interrupts on ZORA Service between 07:00am and 10:00 am. Please be patient.

Permanent URL to this publication: http://dx.doi.org/10.5167/uzh-10536

Meraz, I M; Jiang, Z D; Ericsson, C D; Bourgeois, A L; Steffen, R; Taylor, D N; Hernandez, N; DuPont, H L (2008). Enterotoxigenic Escherichia coli and Diffusely Adherent E coli as Likely Causes of a Proportion of Pathogen-Negative Travelers’ Diarrhea-A PCR-Based Study. Journal of Travel Medicine, 15(6):412-418.

[img] PDF - Registered users only
View at publisher


BACKGROUND: Enteropathogens cannot be identified in 40% to 50% of subjects with travelers' diarrhea (TD). METHODS: We used polymerase chain reaction (PCR) methods to look for the presence of two bacterial causes of diarrhea in a large group of international travelers after failing to detect a pathogen by conventional tests. DNA was isolated from the diarrheal stool and subjected to PCR from 162 subjects from whom we earlier failed to identify a pathogen in a previous study and included 54 from Antigua, Guatemala, 39 from Guadalajara, Mexico, 29 from Kolkata, India, and 40 from Goa, India. Gene products for enterotoxigenic Escherichia coli (ETEC)--LT (heat-labile enterotoxin) and ST (heat-stable enterotoxin)--and diffusely adherent E. coli (DAEC), afa/dr (Afa fimbrial and Dr nonfimbrial family of adhesins), were used. RESULTS: At least one gene product was identified in diarrhea stool samples of 47 of 162 (29%) subjects. ETEC virulence genes (LT, ST) were found in 34 (21%) samples studied, with rates of occurrence ranging from 8% in Goa to 39% for the samples from Guatemala (p = 0.0006). A large number of ST-only strains explained the high ETEC rate in Guatemala. DAEC afa/dr family of adhesions was identified in between 8 and 14% of the samples. CONCLUSIONS: ETEC and DAEC were implicated in nearly one-third of the subjects initially diagnosed as pathogen negative. Direct PCR results from stools are consistent with the previous assumption that most undiagnosed TD is bacterial in nature and also highlights the potential value that PCR can add to studies designed to evaluate treatment and preventive interventions for TD, including vaccines.


12 citations in Web of Science®
21 citations in Scopus®
Google Scholar™



1 download since deposited on 19 Jan 2009
0 downloads since 12 months

Detailed statistics

Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Epidemiology, Biostatistics and Prevention Institute (EBPI)
Dewey Decimal Classification:610 Medicine & health
Deposited On:19 Jan 2009 17:25
Last Modified:05 Apr 2016 12:50
Publisher DOI:10.1111/j.1708-8305.2008.00249.x
PubMed ID:19090795

Users (please log in): suggest update or correction for this item

Repository Staff Only: item control page