Acute diarrhea risk factors: Difference between revisions
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==Overview== | ==Overview== | ||
The risk factors of | 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 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''', 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> | ||
==== Exposure or condition ==== | ==== Exposure or condition ==== | ||
*Age group | *Age group | ||
**Birth- 3 months: Nontyphoidal Salmonella | **Birth- 3 months: [[Salmonella|Nontyphoidal Salmonella]] | ||
**6–18 months: Rotavirus | **6–18 months: [[Rotavirus]] | ||
**1–7 years: Shigella | **1–7 years: [[Shigella]] | ||
**Young adults: Campylobacter | **Young adults: [[Campylobacter]] | ||
**Adults >50 years with a history of atherosclerosis: Nontyphoidal Salmonella | **Adults >50 years with a history of [[atherosclerosis]]: [[Salmonella|Nontyphoidal Salmonella]] | ||
*Immunocompromised individuals | *[[Immunocompromised|Immunocompromised individuals]] | ||
**Nontyphoidal Salmonella, Yersinia, | **[[Salmonella|Nontyphoidal Salmonella]], [[Yersinia]], [[Shigella]], [[Cryptosporidium]], [[Campylobacter]] | ||
*Hemochromatosis or hemoglobinopathy | *[[Hemochromatosis]] or [[hemoglobinopathy]] | ||
**Salmonella, Y. enterocolitica | **[[Salmonella]], [[Yersinia Enterocolitica Infection|Y. enterocolitica]] | ||
*AIDS, immunosuppressive therapies, homosexual men, transplant recipients | *[[HIV AIDS|AIDS]], [[Immunosuppression|immunosuppressive therapies]], [[homosexual men]], [[Transplant|transplant recipients]] | ||
**Cytomegalovirus, Mycobacterium avium–intercellulare complex, Cryptosporidium, Cyclospora, Cystoisospora, Microsporidia, HIV | **[[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> | *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> | ||
**Broad spectrum antibiotics, | **[[Antibiotic|Broad spectrum antibiotics]], [[Immunosuppressive drug|Immunosuppressants]], [[Antifungal drug|Antifungals]] | ||
*Anal-genital, oral-anal, or digital-anal contact | *[[Anal]]-[[Sex organ|genital]], oral-anal, or digital-anal contact | ||
**Shigella, Giardia lamblia, Campylobacter, E. histolytica, Cryptosporidium and sexually transmitted infections, Salmonella | **[[Shigella]], [[Giardia lamblia]], [[Campylobacter]], [[Entamoeba histolytica|E. histolytica]], [[Cryptosporidium]] and [[Sexually transmitted disease|sexually transmitted infections]], [[Salmonella]] | ||
==== Foodborne ==== | ==== Foodborne ==== | ||
*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, nontyphoidal Salmonella, Clostridium perfringens,Campylobacter | **[[Shigella]], [[Vibrio cholerae]], [[Bacillus cereus]], [[Staphylococcus aureus]], [[Salmonella|nontyphoidal Salmonella]], [[Clostridium perfringens]], [[Campylobacter]], [[ETEC]], [[Listeria monocytogenes|Listeria]], [[Norovirus]], [[Rotavirus]], [[Cryptosporidium]], [[Cyclospora cayetanensis]] | ||
*Consumption of unpasteurized milk or dairy products<ref name="pmid23804024">{{cite journal |vauthors=Gould LH, Walsh KA, Vieira AR, Herman K, Williams IT, Hall AJ, Cole D |title=Surveillance for foodborne disease outbreaks - United States, 1998-2008 |journal=MMWR Surveill Summ |volume=62 |issue=2 |pages=1–34 |year=2013 |pmid=23804024 |doi= |url=}}</ref> | *Consumption of unpasteurized milk or dairy products<ref name="pmid23804024">{{cite journal |vauthors=Gould LH, Walsh KA, Vieira AR, Herman K, Williams IT, Hall AJ, Cole D |title=Surveillance for foodborne disease outbreaks - United States, 1998-2008 |journal=MMWR Surveill Summ |volume=62 |issue=2 |pages=1–34 |year=2013 |pmid=23804024 |doi= |url=}}</ref> | ||
**Salmonella, Campylobacter, Brucella (goat milk cheese), Coxiella burnetii, Yersinia enterocolitica, S. aureus toxin, Cryptosporidium, Listeria, Mycobacterium bovis | **[[Salmonella]], [[Campylobacter]], [[Brucella]] (goat milk cheese), [[Coxiella burnetii]], [[Yersinia enterocolitica]], [[Staphylococcus aureus infections|S. aureus toxin]], [[Cryptosporidium]], [[Listeria monocytogenes|Listeria]], [[Mycobacterium bovis]] | ||
*Consumption of raw or undercooked meat or poultry<ref name="pmid29379258">{{cite journal |vauthors=Somboonwit C, Menezes LJ, Holt DA, Sinnott JT, Shapshak P |title=Current views and challenges on clinical cholera |journal=Bioinformation |volume=13 |issue=12 |pages=405–409 |year=2017 |pmid=29379258 |pmc=5767916 |doi=10.6026/97320630013405 |url=}}</ref> | *Consumption of raw or undercooked meat or poultry<ref name="pmid29379258">{{cite journal |vauthors=Somboonwit C, Menezes LJ, Holt DA, Sinnott JT, Shapshak P |title=Current views and challenges on clinical cholera |journal=Bioinformation |volume=13 |issue=12 |pages=405–409 |year=2017 |pmid=29379258 |pmc=5767916 |doi=10.6026/97320630013405 |url=}}</ref> | ||
**C. perfringens (beef, poultry), EHEC (ground beef), Salmonella (poultry), Calcivirus (oysters), Campylobacter (poultry), Vibrio (oysters),Yersinia (pork, chitterlings), S. aureus (poultry), and Trichinella | **[[Clostridium perfringens|C. perfringens]] (beef, poultry), [[EHEC]] (ground beef), [[Salmonella]] (poultry), Calcivirus (oysters), [[Campylobacter]] (poultry), [[Vibrio]] (oysters),[[Yersinia]] (pork, chitterlings), [[Staphylococcus aureus|S. aureus]] (poultry), and [[Trichinella]] (pork, wild game meat) | ||
*Consumption of fruits or unpasteurized fruit juices, vegetables, leafy greens, and sprouts | *Consumption of fruits or unpasteurized fruit juices, vegetables, leafy greens, and sprouts | ||
**Hepatitis A, Listeria monocytogenes, Nontyphoidal Salmonella, Cyclospora, Cryptosporidium, Norovirus | **[[Hepatitis A]], [[Listeria monocytogenes]], [[Salmonella|Nontyphoidal Salmonella]], [[Cyclospora cayetanensis|Cyclospora]], [[Cryptosporidium]], [[Norovirus]] | ||
*Consumption of undercooked eggs | *Consumption of undercooked eggs | ||
**Salmonella, Shigella (egg salad) | **[[Salmonella]], [[Shigella]] (egg salad) | ||
*Consumption of raw shellfish | *Consumption of raw shellfish | ||
**Hepatitis A, Vibrio species, Plesiomonas | **[[Hepatitis A]], [[Vibrio]] species, [[Plesiomonas shigelloides|Plesiomonas]], [[Norovirus]] | ||
==== Contact or exposure ==== | ==== Contact or exposure ==== | ||
*Swimming in or drinking untreated fresh water<ref name="pmid26111239">{{cite journal |vauthors=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 |title=Waterborne outbreaks in the Nordic countries, 1998 to 2012 |journal=Euro Surveill. |volume=20 |issue=24 |pages= |year=2015 |pmid=26111239 |doi= |url=}}</ref> | *Swimming in or drinking untreated fresh water<ref name="pmid26111239">{{cite journal |vauthors=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 |title=Waterborne outbreaks in the Nordic countries, 1998 to 2012 |journal=Euro Surveill. |volume=20 |issue=24 |pages= |year=2015 |pmid=26111239 |doi= |url=}}</ref> | ||
**Giardia, Campylobacter, Cryptosporidium, Salmonella, Shigella, Plesiomonas shigelloides, Aeromonas | **[[Giardia lamblia|Giardia]], [[Campylobacter]], [[Cryptosporidium]], [[Salmonella]], [[Shigella]], [[Plesiomonas shigelloides]], [[Aeromonas]] | ||
*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 | *Healthcare, long-term care, prison exposure, or employment | ||
**Norovirus, Clostridium difficile, Shigella, Cryptosporidium, Giardia, Rotavirus | **[[Norovirus]], [[Clostridium difficile]], [[Shigella]], [[Cryptosporidium]], [[Giardia lamblia|Giardia]], [[Rotavirus]] | ||
*Day care | *Day care | ||
**Rotavirus, Cryptosporidium, Giardia, Shigella, | **[[Rotavirus]], [[Cryptosporidium]], [[Giardia lamblia|Giardia]], [[Shigella]], [[Norovirus]], Calcivirus, [[Campylobacter]] | ||
*Recent antimicrobial therapy and hospitalization<ref name="pmid16319813" /> | *Recent [[Antimicrobial|antimicrobial therapy]] and [[Hospital|hospitalization]]<ref name="pmid16319813" /> | ||
**C. difficile, multidrug-resistant Salmonella, Rotavirus | **[[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> | *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 (enteroaggregative, enterotoxigenic, enteroinvasive), Shigella, Typhi and nontyphoidal Salmonella, Campylobacter, Vibrio cholerae, Aeromonas, Plesiomonas, Rotavirus, | **[[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]] | ||
*Exposure to pig feces in certain parts of the world | *Exposure to pig feces in certain parts of the world | ||
**Balantidium coli | **[[Balantidium coli]] | ||
*Contact with young poultry or reptiles | *Contact with young poultry or reptiles | ||
**Nontyphoidal Salmonella | **[[Salmonella|Nontyphoidal Salmonella]] | ||
*Visiting a farm or petting zoo | *Visiting a farm or petting zoo | ||
**Cryptosporidium, Campylobacter | **[[Cryptosporidium]], [[Campylobacter]] | ||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Revision as of 16:10, 8 February 2018
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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, conditions associated with causative pathogens of diarrhea include the following:[1]
Exposure or condition
- Age group
- Birth- 3 months: Nontyphoidal Salmonella
- 6–18 months: Rotavirus
- 1–7 years: Shigella
- Young adults: Campylobacter
- Adults >50 years with a history of atherosclerosis: Nontyphoidal Salmonella
- Immunocompromised individuals
- Hemochromatosis or hemoglobinopathy
- AIDS, immunosuppressive therapies, homosexual men, transplant recipients
Foodborne
- Foodborne outbreaks in hotels, cruise ships, resorts, restaurants, catered events[3]
- Consumption of unpasteurized milk or dairy products[4]
- Salmonella, Campylobacter, Brucella (goat milk cheese), Coxiella burnetii, Yersinia enterocolitica, S. aureus toxin, Cryptosporidium, Listeria, Mycobacterium bovis
- Consumption of raw or undercooked meat or poultry[5]
- C. perfringens (beef, poultry), EHEC (ground beef), Salmonella (poultry), Calcivirus (oysters), Campylobacter (poultry), Vibrio (oysters),Yersinia (pork, chitterlings), S. aureus (poultry), and Trichinella (pork, wild game meat)
- Consumption of fruits or unpasteurized fruit juices, vegetables, leafy greens, and sprouts
- Consumption of undercooked eggs
- Salmonella, Shigella (egg salad)
- Consumption of raw shellfish
- Hepatitis A, Vibrio species, Plesiomonas, Norovirus
Contact or exposure
- Swimming in or drinking untreated fresh water[6]
- Swimming in recreational water facility with treated water[6][7]
- Healthcare, long-term care, prison exposure, or employment
- Day care
- Rotavirus, Cryptosporidium, Giardia, Shigella, Norovirus, Calcivirus, Campylobacter
- Recent antimicrobial therapy and hospitalization[2]
- C. difficile, multidrug-resistant Salmonella, Rotavirus
- Travel to endemic areas, poor sanitation and crowding[8]
- Escherichia coli (enteroaggregative, enterotoxigenic, enteroinvasive), Shigella, Typhi and nontyphoidal Salmonella, Campylobacter, Vibrio cholerae, Aeromonas, Plesiomonas, Rotavirus, Norovirus (Cruise ship diarrhea), enteric Adenovirus, Entamoeba histolytica, Cryptosporidium, Blastocystis, Giardia, Cyclospora, Cystoisospora
- Exposure to house pets with diarrhea
- Exposure to pig feces in certain parts of the world
- Contact with young poultry or reptiles
- Visiting a farm or petting zoo
References
- ↑ Dunn N, Gossman WG. PMID 29083755. Missing or empty
|title=(help) - ↑ 2.0 2.1 "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.
- ↑ Todd EC (1997). "Epidemiology of foodborne diseases: a worldwide review". World Health Stat Q. 50 (1–2): 30–50. PMID 9282385.
- ↑ 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.
- ↑ 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.
- ↑ 6.0 6.1 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.
- ↑ 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.
- ↑ Heather CS (2015). "Travellers' diarrhoea". BMJ Clin Evid. 2015. PMC 4415508. PMID 25928418.