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Abstract
Background
The incidence of infectious diarrheal disease in Korea has decreased over the past decade, but traveler's diarrhea (TD) is increasing in frequency. We therefore investigated the distribution of the causative agents of TD.
Methods
A total of 132 rectal swab specimens were acquired from TD patients who entered the country via Gimhae International Airport. The specimens were screened for 12 bacterial pathogens by realtime PCR, and target pathogens were isolated from the PCR positive specimens using conventional microbiological isolation methods.
Results
A total of 93 specimens (70.5%) showed positive PCR screening results, and of these specimens, nine species and 50 isolates (37.9%), including Vibrio parahaemolyticus (18 isolates) and ETEC (17 isolates), were isolated. No specimens were PCR positive for Listeria monocytogenes or Campylobacter jejuni, and no pathogenic Bacillus cereus were isolated.
Conclusion
Even though viruses and EAEC were not included as target pathogens, the high isolation rate of these pathogens in this study provides indirect evidence that most cases of pathogen-negative TD are caused by undetected bacterial agents. Furthermore, our study results confirm the effectiveness of realtime PCR-based screening methods. This study is the first report in Korea to demonstrate that ETEC and V. parahaemolyticus are the major causative pathogens of TD, and this knowledge can be used to help treat and prevent TD.
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Table 1.
Real time PCR kit used in this study
| Kit | Pathogens | Target gene |
|---|---|---|
| PowerChekTM V. cholerae Real-time PCR Kit | V. cholerae | hlyA |
| PowerChekTM V. parahaemolyticus Real-time PCR Kit | V. parahaemolyticus | toxR |
| PowerChekTM ETEC Real-time PCR Kit∗ | ETEC | LT ST |
| PowerChekTM EHEC Real-time PCR Kit∗ | EHEC | stx1 stx2 |
| PowerChekTM Salmonella PCR Kit | Salmonella spp. | invE |
| PowerChekTM Shigella spp. PCR Kit | Shigella spp. | ipaH |
| PowerChekTM Staphylococcus aureus PCR Kit | S. aureus | femA |
| PowerChekTM Yersinia enterocolitica PCR Kit | Y. enterocolitica | 16s rRNA |
| PowerChekTM Listeria monocytogenes PCR Kit | L. monocytogens | iap |
| PowerChekTM Bacillus cereus PCR Kit | B. cereus | groEL |
| PowerChekTM Campylobacter jejuni PCR Kit | C. jejuni | hip |
| PowerChekTM Clostridium perfringens PCR Kit∗ | C. perfringens | cpa, cpe |
Table 2.
PCR positive rate and isolation rate of pathogenic bacteria
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