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==Overview==
==Overview==
The risk factors of acute diarrhea may be assessed based on the [[epidemiologic]] associations and the patient exposure histories. Risk factors may be classified based on travel history, [[Epidemic|epidemics]], [[Outbreak|outbreaks]], food history, animal contact, [[Hospital|hospitalization]] and [[immunosupression]]. The 2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea lists the risk factors of diarrhea along with their causative [[Pathogen|pathogens]].
The [[risk factors]] of acute diarrhea may be assessed based on the [[epidemiologic]] associations and the patient exposure histories. [[Risk factors]] may be classified based on travel history, [[Epidemic|epidemics]], [[Outbreak|outbreaks]], food history, animal contact, [[Hospital|hospitalization]] and [[immunosupression]]. The 2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea lists the [[risk factors]] of diarrhea along with their causative [[Pathogen|pathogens]].


==Risk factors==  
==Risk factors==  
According to the '''2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea''', conditions associated with causative [[Pathogen|pathogens]] of diarrhea include the following:<ref name="pmid29083755">{{cite journal |vauthors=Dunn N, Gossman WG |title= |journal= |volume= |issue= |pages= |year= |pmid=29083755 |doi= |url=}}</ref>
According to the '''2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea''', common [[risk factors]] along with causative [[Pathogen|pathogens]] of diarrhea include the following:<ref name="pmid29083755">{{cite journal |vauthors=Dunn N, Gossman WG |title= |journal= |volume= |issue= |pages= |year= |pmid=29083755 |doi= |url=}}</ref>
{{Family tree/start}}
{{Family tree/start}}
{{Family tree | | | | | | B01 | | | |B01='''Contamination''': <br> •Foodborne <br> •Waterborne <br> •Animal exposure}}
{{familytree |boxstyle=text-align: left; | | | | | | B01 | | | |B01='''Contamination''': <br> •Foodborne outbreaks in hotels, cruise ships, resorts, restaurants, catered events  <br> •Consumption of unpasteurized milk or dairy products <br> •Waterborne <br> •Animal exposure <br> •Consumption of raw or undercooked meat or poultry}}
{{Family tree | | | | | | |!| | | | | }}
{{Family tree | | | | | | |!| | | | | }}
{{Family tree | | | | | | |!| | | | | }}
{{Family tree | | | | | | |!| | | | | }}
{{familytree |boxstyle=text-align: left; | A01 |-|-| A02 |-|-|-| A03 | |A01= '''Exposure''': <br> •Child care facilities <br>•Long term care facilities <br>•Hospitalisation <br>•International travel| A02= '''RISK FACTORS FOR ACUTE DIARRHEA'''| A03='''Host factors''': <br>• Immunocompromised hosts <br>• Certain sexual practices}}
{{familytree |boxstyle=text-align: left; | A01 |-|-| A02 |-|-|-| A03 | |A01= '''Exposure''': <br> •Child care facilities <br>•Long term care facilities <br>•[[Hospitalisation]] <br>•International travel| A02= '''RISK FACTORS FOR ACUTE DIARRHEA'''| A03='''Host factors''': <br>•[[Immunocompromised]] hosts <br>•Certain sexual practices <br>•Age group <br>•[[Hemochromatosis]] or [[hemoglobinopathy]]}}
 


{{Family tree | | | | | | |!| | | | | }}
{{Family tree | | | | | | |!| | | | | }}
{{Family tree | | | | | | |!| | | | | }}
{{Family tree | | | | | | |!| | | | | }}
{{familytree |boxstyle=text-align: left; | | | | | | B01 | | | |B01= '''Side effects of pharmacotherapy''': <br>•Antimicrobial therapy}}
{{familytree |boxstyle=text-align: left; | | | | | | B01 | | | |B01= '''Side effects of pharmacotherapy''': <br>•[[Antimicrobial]] therapy <br>•Drug side effects}}
{{Family tree/end}}
{{Family tree/end}}
*Age group
**Birth- 3 months: [[Salmonella|Nontyphoidal Salmonella]]
**6–18 months: [[Rotavirus]]
**1–7 years: [[Shigella]]
**Young adults: [[Campylobacter]]
**Adults >50 years with a history of [[atherosclerosis]]: [[Salmonella|Nontyphoidal Salmonella]]
*[[Immunocompromised|Immunocompromised individuals]]
**[[Salmonella|Nontyphoidal Salmonella]], [[Yersinia]], [[Shigella]], [[Cryptosporidium]], [[Campylobacter]]
*[[Hemochromatosis]] or [[hemoglobinopathy]]
**[[Salmonella]], [[Yersinia Enterocolitica Infection|Y. enterocolitica]]
*[[HIV AIDS|AIDS]], [[Immunosuppression|immunosuppressive therapies]], [[homosexual men]], [[Transplant|transplant recipients]]
**[[Cytomegalovirus]], [[Mycobacterium avium intracellulare|Mycobacterium avium–intercellulare complex]], [[Cryptosporidium]], [[Cyclospora cayetanensis|Cyclospora]], [[Cystoisospora belli|Cystoisospora]], [[Microsporidia]], [[Human Immunodeficiency Virus (HIV)|HIV]]
*Drug side effects<ref name="pmid16319813">{{cite journal |vauthors= |title=Severe Clostridium difficile-associated disease in populations previously at low risk--four states, 2005 |journal=MMWR Morb. Mortal. Wkly. Rep. |volume=54 |issue=47 |pages=1201–5 |year=2005 |pmid=16319813 |doi= |url=}}</ref>
**[[Antibiotic|Broad spectrum antibiotics]], [[Immunosuppressive drug|Immunosuppressants]], [[Antifungal drug|Antifungals]]
*[[Anal]]-[[Sex organ|genital]], oral-anal, or digital-anal contact
**[[Shigella]], [[Giardia lamblia]], [[Campylobacter]], [[Entamoeba histolytica|E. histolytica]], [[Cryptosporidium]] and [[Sexually transmitted disease|sexually transmitted infections]], [[Salmonella]]


==== Contamination ====
*Foodborne outbreaks in hotels, cruise ships, resorts, restaurants, catered events<ref name="pmid9282385">{{cite journal |vauthors=Todd EC |title=Epidemiology of foodborne diseases: a worldwide review |journal=World Health Stat Q |volume=50 |issue=1-2 |pages=30–50 |year=1997 |pmid=9282385 |doi= |url=}}</ref>
*Foodborne outbreaks in hotels, cruise ships, resorts, restaurants, catered events<ref name="pmid9282385">{{cite journal |vauthors=Todd EC |title=Epidemiology of foodborne diseases: a worldwide review |journal=World Health Stat Q |volume=50 |issue=1-2 |pages=30–50 |year=1997 |pmid=9282385 |doi= |url=}}</ref>
**[[Shigella]], [[Vibrio cholerae]], [[Bacillus cereus]], [[Staphylococcus aureus]], [[Salmonella|nontyphoidal Salmonella]], [[Clostridium perfringens]], [[Campylobacter]], [[ETEC]], [[Listeria monocytogenes|Listeria]], [[Norovirus]], [[Rotavirus]], [[Cryptosporidium]], [[Cyclospora cayetanensis]]
**[[Shigella]], [[Vibrio cholerae]], [[Bacillus cereus]], [[Staphylococcus aureus]], [[Salmonella|nontyphoidal Salmonella]], [[Clostridium perfringens]], [[Campylobacter]], [[ETEC]], [[Listeria monocytogenes|Listeria]], [[Norovirus]], [[Rotavirus]], [[Cryptosporidium]], [[Cyclospora cayetanensis]]
Line 55: Line 37:
*Swimming in recreational water facility with treated water<ref name="pmid26111239" /><ref name="pmid28214721">{{cite journal |vauthors=Efstratiou A, Ongerth JE, Karanis P |title=Waterborne transmission of protozoan parasites: Review of worldwide outbreaks - An update 2011-2016 |journal=Water Res. |volume=114 |issue= |pages=14–22 |year=2017 |pmid=28214721 |doi=10.1016/j.watres.2017.01.036 |url=}}</ref>   
*Swimming in recreational water facility with treated water<ref name="pmid26111239" /><ref name="pmid28214721">{{cite journal |vauthors=Efstratiou A, Ongerth JE, Karanis P |title=Waterborne transmission of protozoan parasites: Review of worldwide outbreaks - An update 2011-2016 |journal=Water Res. |volume=114 |issue= |pages=14–22 |year=2017 |pmid=28214721 |doi=10.1016/j.watres.2017.01.036 |url=}}</ref>   
**[[Cryptosporidium]]  
**[[Cryptosporidium]]  
*Healthcare, long-term care, prison exposure, or employment
**[[Norovirus]], [[Clostridium difficile]], [[Shigella]], [[Cryptosporidium]], [[Giardia lamblia|Giardia]], [[Rotavirus]]
*Day care
**[[Rotavirus]], [[Cryptosporidium]], [[Giardia lamblia|Giardia]], [[Shigella]], [[Norovirus]], Calcivirus, [[Campylobacter]]
*Recent [[Antimicrobial|antimicrobial therapy]] and [[Hospital|hospitalization]]<ref name="pmid16319813" />
**[[Clostridium difficile infection|C. difficile]], multidrug-resistant [[Salmonella]], [[Rotavirus]]
*Travel to endemic areas, poor [[sanitation]] and crowding<ref name="pmid25928418">{{cite journal |vauthors=Heather CS |title=Travellers' diarrhoea |journal=BMJ Clin Evid |volume=2015 |issue= |pages= |year=2015 |pmid=25928418 |pmc=4415508 |doi= |url=}}</ref>
**[[Escherichia coli]] ([[EAEC|enteroaggregative]], [[Enterotoxigenic Escherichia coli|enterotoxigenic]], [[Enteroinvasive Escherichia coli infection|enteroinvasive]]), [[Shigella]], [[Salmonella|Typhi and nontyphoidal Salmonella]], [[Campylobacter]], [[Vibrio cholerae]], [[Aeromonas]], [[Plesiomonas shigelloides|Plesiomonas]], [[Rotavirus]], [[Norovirus]] (Cruise ship diarrhea), [[Adenoviridae|enteric Adenovirus]], [[Entamoeba histolytica]], [[Cryptosporidium]], [[Blastocystis]], [[Giardia lamblia|Giardia]], [[Cyclospora cayetanensis|Cyclospora]], [[Cystoisospora belli|Cystoisospora]]
*Exposure to house pets with diarrhea
*Exposure to house pets with diarrhea
**[[Campylobacter]], [[Yersinia]]
**[[Campylobacter]], [[Yersinia]]
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*Visiting a farm or petting zoo
*Visiting a farm or petting zoo
**[[Cryptosporidium]], [[Campylobacter]]
**[[Cryptosporidium]], [[Campylobacter]]
==== Host factors ====
*Age group
**Birth- 3 months: [[Salmonella|Nontyphoidal Salmonella]]
**6–18 months: [[Rotavirus]]
**1–7 years: [[Shigella]]
**Young adults: [[Campylobacter]]
**Adults >50 years with a history of [[atherosclerosis]]: [[Salmonella|Nontyphoidal Salmonella]]
*[[Immunocompromised|Immunocompromised individuals]]
**[[Salmonella|Nontyphoidal Salmonella]], [[Yersinia]], [[Shigella]], [[Cryptosporidium]], [[Campylobacter]]
*[[Hemochromatosis]] or [[hemoglobinopathy]]
**[[Salmonella]], [[Yersinia Enterocolitica Infection|Y. enterocolitica]]
*[[HIV AIDS|AIDS]], [[Immunosuppression|immunosuppressive therapies]], [[homosexual men]], [[Transplant|transplant recipients]]
**[[Cytomegalovirus]], [[Mycobacterium avium intracellulare|Mycobacterium avium–intercellulare complex]], [[Cryptosporidium]], [[Cyclospora cayetanensis|Cyclospora]], [[Cystoisospora belli|Cystoisospora]], [[Microsporidia]], [[Human Immunodeficiency Virus (HIV)|HIV]]
==== Side effects of pharmacotherapy ====
*Drug side effects<ref name="pmid16319813">{{cite journal |vauthors= |title=Severe Clostridium difficile-associated disease in populations previously at low risk--four states, 2005 |journal=MMWR Morb. Mortal. Wkly. Rep. |volume=54 |issue=47 |pages=1201–5 |year=2005 |pmid=16319813 |doi= |url=}}</ref>
**[[Antibiotic|Broad spectrum antibiotics]]
**[[Immunosuppressive drug|Immunosuppressants]]
**[[Antifungal drug|Antifungals]]
*Recent [[Antimicrobial|antimicrobial therapy]] and [[Hospital|hospitalization]]<ref name="pmid16319813" />
**[[Clostridium difficile infection|C. difficile]]
**Multidrug-resistant [[Salmonella]]
**[[Rotavirus]]
==== Exposure ====
*[[Anal]]-[[Sex organ|genital]], oral-anal, or digital-anal contact
**[[Shigella]], [[Giardia lamblia]], [[Campylobacter]], [[Entamoeba histolytica|E. histolytica]], [[Cryptosporidium]] and [[Sexually transmitted disease|sexually transmitted infections]], [[Salmonella]]
*Healthcare, long-term care, prison exposure, or employment
**[[Norovirus]], [[Clostridium difficile]], [[Shigella]], [[Cryptosporidium]], [[Giardia lamblia|Giardia]], [[Rotavirus]]
*Day care
**[[Rotavirus]], [[Cryptosporidium]], [[Giardia lamblia|Giardia]], [[Shigella]], [[Norovirus]], Calcivirus, [[Campylobacter]]
*Travel to endemic areas, poor [[sanitation]] and crowding<ref name="pmid25928418">{{cite journal |vauthors=Heather CS |title=Travellers' diarrhoea |journal=BMJ Clin Evid |volume=2015 |issue= |pages= |year=2015 |pmid=25928418 |pmc=4415508 |doi= |url=}}</ref>
**[[Escherichia coli]] ([[EAEC|enteroaggregative]], [[Enterotoxigenic Escherichia coli|enterotoxigenic]], [[Enteroinvasive Escherichia coli infection|enteroinvasive]]), [[Shigella]], [[Salmonella|Typhi and nontyphoidal Salmonella]], [[Campylobacter]], [[Vibrio cholerae]], [[Aeromonas]], [[Plesiomonas shigelloides|Plesiomonas]], [[Rotavirus]], [[Norovirus]] (Cruise ship diarrhea), [[Adenoviridae|enteric Adenovirus]], [[Entamoeba histolytica]], [[Cryptosporidium]], [[Blastocystis]], [[Giardia lamblia|Giardia]], [[Cyclospora cayetanensis|Cyclospora]], [[Cystoisospora belli|Cystoisospora]]


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
[[Category:Medicine]]
[[Category:Gastroenterology]]
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Latest revision as of 20:16, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Chandrakala Yannam, MD [2] Sudarshana Datta, MD [3]

Overview

The risk factors of acute diarrhea may be assessed based on the epidemiologic associations and the patient exposure histories. Risk factors may be classified based on travel history, epidemics, outbreaks, food history, animal contact, hospitalization and immunosupression. The 2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea lists the risk factors of diarrhea along with their causative pathogens.

Risk factors

According to the 2017 Infectious Diseases Society of America Clinical Practice Guidelines for the Diagnosis and Management of Infectious Diarrhea, common risk factors along with causative pathogens of diarrhea include the following:[1]

 
 
 
 
 
Contamination:
•Foodborne outbreaks in hotels, cruise ships, resorts, restaurants, catered events
•Consumption of unpasteurized milk or dairy products
•Waterborne
•Animal exposure
•Consumption of raw or undercooked meat or poultry
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Exposure:
•Child care facilities
•Long term care facilities
•Hospitalisation
•International travel
 
 
RISK FACTORS FOR ACUTE DIARRHEA
 
 
 
Host factors:
•Immunocompromised hosts
•Certain sexual practices
•Age group
•Hemochromatosis or hemoglobinopathy
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
Side effects of pharmacotherapy:
•Antimicrobial therapy
•Drug side effects
 
 
 

Contamination

Host factors

Side effects of pharmacotherapy

Exposure

References

  1. ↑ Dunn N, Gossman WG. PMID 29083755. Missing or empty |title= (help)
  2. ↑ Todd EC (1997). "Epidemiology of foodborne diseases: a worldwide review". World Health Stat Q. 50 (1–2): 30–50. PMID 9282385.
  3. ↑ Gould LH, Walsh KA, Vieira AR, Herman K, Williams IT, Hall AJ, Cole D (2013). "Surveillance for foodborne disease outbreaks - United States, 1998-2008". MMWR Surveill Summ. 62 (2): 1–34. PMID 23804024.
  4. ↑ Somboonwit C, Menezes LJ, Holt DA, Sinnott JT, Shapshak P (2017). "Current views and challenges on clinical cholera". Bioinformation. 13 (12): 405–409. doi:10.6026/97320630013405. PMC 5767916. PMID 29379258.
  5. ↑ 5.0 5.1 Guzman-Herrador B, Carlander A, Ethelberg S, Freiesleben de Blasio B, Kuusi M, Lund V, Löfdahl M, MacDonald E, Nichols G, Schönning C, Sudre B, Trönnberg L, Vold L, Semenza JC, Nygård K (2015). "Waterborne outbreaks in the Nordic countries, 1998 to 2012". Euro Surveill. 20 (24). PMID 26111239.
  6. ↑ Efstratiou A, Ongerth JE, Karanis P (2017). "Waterborne transmission of protozoan parasites: Review of worldwide outbreaks - An update 2011-2016". Water Res. 114: 14–22. doi:10.1016/j.watres.2017.01.036. PMID 28214721.
  7. ↑ 7.0 7.1 "Severe Clostridium difficile-associated disease in populations previously at low risk--four states, 2005". MMWR Morb. Mortal. Wkly. Rep. 54 (47): 1201–5. 2005. PMID 16319813.
  8. ↑ Heather CS (2015). "Travellers' diarrhoea". BMJ Clin Evid. 2015. PMC 4415508. PMID 25928418.
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