Bacterial, viral and parasitic pathogens analysed by qPCR: Findings from a prospective study of travellers’ diarrhoea

Abstract Background The diagnostics of travellers’ diarrhoea (TD) has been revolutionised by multiplex qPCR assays. While mostly bacterial aetiology, viruses and parasites account for the disease among 10–20% travellers. Despite this, prospective studies applying assays remain scarce that cover not only bacteria, such as various diarrhoeagenic Escherichia coli (DEC), but also viral parasitic pathogens. Method We analysed pre- post-travel stool samples 146 Finnish travellers bacterial, pathogens: enteropathogenic (EPEC), enteroaggregative (EAEC), enterotoxigenic (ETEC), enterohaemorrhagic (EHEC), enteroinvasive (EIEC) E. coli; Shigella, Campylobacter, Salmonella, Yersinia Vibrio cholerae; norovirus G1 G2, rotavirus, enteroviruses, sapovirus; Giardia lamblia, Entamoeba histolytica, Cryptosporidium. Symptoms medication data during travel were collected questionnaires. Results detected pathogens in 102/146 (69.9%; EAEC, EPEC, ETEC most common), ones 13 (8.9%; one (0.7%; Giardia). Noroviruses associated with severe symptoms (23.5% versus non-severe 4.9%). In TD group, 41.7% (5/12) those (vs. 13.3%; 11/83 without) took antibiotics. Conclusion Viral pathogens, particularly noroviruses, prevail TD. are often lead to unwarranted use