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TropicalMed
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Diarrheagenic Pathogens and Gastrointestinal Infections
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Diarrheagenic Pathogens and Gastrointestinal Infections

A special issue of Tropical Medicine and Infectious Disease (ISSN 2414-6366). This special issue belongs to the section "Infectious Diseases".

Deadline for manuscript submissions: closed (31 December 2021) | Viewed by 30103

Special Issue Editor

Prof. Dr. Sören Becker

E-Mail Website
Guest Editor
Institute of Medical Microbiology and Hygiene, Saarland University Medical Center, Homburg, Germany
Interests: clinical microbiology; diagnostic techniques; diarrheagenic bacteria; infectious diseases; intestinal protozoa; soil-transmitted helminths; tropical medicine
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Gastrointestinal infections caused by bacteria, parasites (helminths and intestinal protozoa) and viruses account for significant morbidity and mortality worldwide, with the highest burden still concentrated in the resource-constrained settings of tropical and subtropical countries.
While new molecular diagnostic techniques have revealed the importance of multiple co-infections in both symptomatic and asymptomatic individuals, a causal association between specific pathogens and subsequent clinical disease is often difficult to infer. Additionally, there is considerable setting-specificity with regard to the most prevalent pathogens so that tailored approaches are needed to improve diagnostic algorithms and clinical management.
Indeed, the wide range of potential pathogens calls for a combination of different diagnostic techniques, which is often difficult to implement in low-income countries. Hence, new rapid diagnostic tests and point-of-care assays hold promise to improve the diagnostic accuracy and cost-effectiveness of syndromic approaches in different clinical settings.
This Special Issue aims to address new developments in the epidemiology, clinical features, diagnostic techniques (including comparative diagnostic studies), treatment, prevention, and control of acute, persistent, and chronic infectious disorders of the gastrointestinal tract in individuals living in or returning from the tropics. Basic research on the pathogenesis of specific intestinal infections will be considered, as well as clinical, diagnostic, epidemiological, and cost-effectiveness studies assessing enteric pathogens in a variety of settings. Manuscripts addressing specific treatment and control interventions, including therapeutic trials and vaccine studies, are also of high interest.

You may choose our Joint Special Issue in Life.

Prof. Dr. Sören Becker
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Tropical Medicine and Infectious Disease is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2700 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Acute, persistent and chronic diarrhea
  • Clinical features and diagnostic techniques
  • Digestive disorders
  • Enteric pathogens (bacteria, helminths, intestinal protozoa, viruses)
  • Epidemiology and spatial mapping
  • Gastrointestinal infections
  • Neglected tropical diseases
  • Treatment, prevention, and control

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Related Special Issue

Published Papers (5 papers)

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Research

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11 pages, 1359 KiB  
Article
Burden, Antibiotic Resistance, and Clonality of Shigella spp. Implicated in Community-Acquired Acute Diarrhoea in Lilongwe, Malawi
by Abel F.N.D. Phiri, Akebe Luther King Abia, Daniel Gyamfi Amoako, Rajab Mkakosya, Arnfinn Sundsfjord, Sabiha Y. Essack and Gunnar Skov Simonsen
Trop. Med. Infect. Dis. 2021, 6(2), 63; https://doi.org/10.3390/tropicalmed6020063 - 28 Apr 2021
Cited by 16 | Viewed by 4643
Abstract
Although numerous studies have investigated diarrhoea aetiology in many sub-Saharan African countries, recent data on Shigella species’ involvement in community-acquired acute diarrhoea (CA-AD) in Malawi are scarce. This study investigated the incidence, antibiotic susceptibility profile, genotypic characteristics, and clonal relationships of Shigella flexneri [...] Read more.
Although numerous studies have investigated diarrhoea aetiology in many sub-Saharan African countries, recent data on Shigella species’ involvement in community-acquired acute diarrhoea (CA-AD) in Malawi are scarce. This study investigated the incidence, antibiotic susceptibility profile, genotypic characteristics, and clonal relationships of Shigella flexneri among 243 patients presenting with acute diarrhoea at a District Hospital in Lilongwe, Malawi. Shigella spp. were isolated and identified using standard microbiological and serological methods and confirmed by identifying the ipaH gene using real-time polymerase chain reaction. The isolates’ antibiotic susceptibility to 20 antibiotics was determined using the VITEK 2 system according to EUCAST guidelines. Genes conferring resistance to sulfamethoxazole (sul1, sul2 and sul3), trimethoprim (dfrA1, dfrA12 and dfrA17) and ampicillin (oxa-1 and oxa-2), and virulence genes (ipaBCD, sat, ial, virA, sen, set1A and set1B) were detected by real-time PCR. Clonal relatedness was assessed using ERIC-PCR. Thirty-four Shigella flexneri isolates were isolated (an overall incidence of 14.0%). All the isolates were fully resistant to sulfamethoxazole/trimethoprim (100%) and ampicillin (100%) but susceptible to the other antibiotics tested. The sul1 (79%), sul2 (79%), sul3 (47%), dfrA12 (71%) and dfrA17 (56%) sulfonamide and trimethoprim resistance genes were identified; Oxa-1, oxa-2 and dfrA1 were not detected. The virulence genes ipaBCD (85%), sat (85%), ial (82%), virA (76%), sen (71%), stx (71%), set1A (26%) and set1B (18%) were detected. ERIC-PCR profiling revealed that the Shigella isolates were genetically distinct and clonally unrelated, indicating the potential involvement of genetically distinct S. flexneri in CA-AD in Malawi. The high percentage resistance to ampicillin and sulfamethoxazole/trimethoprim and the presence of several virulence determinants in these isolates emphasises a need for continuous molecular surveillance studies to inform preventive measures and management of Shigella-associated diarrhoeal infections in Malawi. Full article
(This article belongs to the Special Issue Diarrheagenic Pathogens and Gastrointestinal Infections)
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Review

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12 pages, 269 KiB  
Review
Diagnostic Methods of Common Intestinal Protozoa: Current and Future Immunological and Molecular Methods
by Loeki Enggar Fitri, Didi Candradikusuma, Yulia Dwi Setia, Purwa Adrianta Wibawa, Agustin Iskandar, Nuning Winaris and Aulia Rahmi Pawestri
Trop. Med. Infect. Dis. 2022, 7(10), 253; https://doi.org/10.3390/tropicalmed7100253 - 21 Sep 2022
Cited by 9 | Viewed by 7692
Abstract
Intestinal protozoan infection is a persisting public health problem affecting the populations of developing countries in the tropical and subtropical regions. The diagnosis of intestinal protozoa remains a challenge especially in developing countries due to a shortage of laboratory facilities, limited health funding, [...] Read more.
Intestinal protozoan infection is a persisting public health problem affecting the populations of developing countries in the tropical and subtropical regions. The diagnosis of intestinal protozoa remains a challenge especially in developing countries due to a shortage of laboratory facilities, limited health funding, and the remoteness of communities. Despite still being widely used, conventional diagnoses using microscopy and staining methods pose important limitations, particularly due to their low sensitivities and specificities. The selection of diagnostic methods needs to be carefully considered based on the objective of examination, availability of resources, and the expected parasite to be found. In this review, we describe various immunodiagnosis and molecular diagnostic methods for intestinal protozoa infection, including their advantages, disadvantages, and suitability for different settings, with a focus on Entamoeba histolytica, Giardia duodenalis, and Cryptosporidium spp. Full article
(This article belongs to the Special Issue Diarrheagenic Pathogens and Gastrointestinal Infections)
11 pages, 264 KiB  
Review
Acute Viral Gastrointestinal (GI) Infections in the Tropics—A Role for Cartridge-Based Multiplex PCR Panels?
by Stefanie Kramme, Theo Dähne, Alexey Fomenko and Marcus Panning
Trop. Med. Infect. Dis. 2022, 7(5), 80; https://doi.org/10.3390/tropicalmed7050080 - 19 May 2022
Cited by 3 | Viewed by 3016
Abstract
Acute gastroenteritis (AGE) contributes to increased morbidity and mortality worldwide. In particular, children in resource-poor settings suffer from frequent episodes of diarrhea. A variety of pathogens, including bacteria, viruses, fungi, and protozoa, can cause AGE. Common viruses associated with AGE are norovirus, rotavirus, [...] Read more.
Acute gastroenteritis (AGE) contributes to increased morbidity and mortality worldwide. In particular, children in resource-poor settings suffer from frequent episodes of diarrhea. A variety of pathogens, including bacteria, viruses, fungi, and protozoa, can cause AGE. Common viruses associated with AGE are norovirus, rotavirus, astrovirus, adenovirus, and sapovirus. Due to their similar clinical presentation, AGE pathogens cannot be distinguished on clinical grounds rendering the etiological diagnosis challenging. However, reliable diagnosis is essential for individual and public health reasons, e.g., to limit transmission, for appropriate antibiotic use, prognostic appreciation, and vaccination programs. Therefore, high-quality data derived by accurate diagnostics are important to improve global health. In Western industrialized countries, diagnosis relies on microbiological testing, including culture methods, microscopy, immunochromatography, and single-target molecular methods. Recently, multiplex PCR or syndromic panels have been introduced, which simultaneously analyze for multiple pathogens in a very short time. A further technological advancement is cartridge-based syndromic panels, which allow for near patient/point-of-care testing independently from a laboratory. In resource-poor tropical regions, however, laboratory diagnosis is rarely established, and there are little routine laboratory data on the epidemiology of viral AGE pathogens. Limiting factors for the implementation of syndromic panels are high costs, sophisticated equipment, and the need for trained personnel. In addition, pilot studies have shown a large number of viral (co-)detections among healthy controls, thus further challenging their clinical utilization. Hence, there are little evidence-based data on the impact of multiplex syndromic panels from resource-limited regions. Here, we aim to provide a brief overview of what is known about the use of syndromic panels for virus-associated AGE in tropical regions and to address future challenges. Full article
(This article belongs to the Special Issue Diarrheagenic Pathogens and Gastrointestinal Infections)
10 pages, 733 KiB  
Review
Prevalence of Intestinal Parasitic Infections among Children in Europe over the Last Five Years
by Maria Kantzanou, Maria A. Karalexi, Georgia Vrioni and Athanasios Tsakris
Trop. Med. Infect. Dis. 2021, 6(3), 160; https://doi.org/10.3390/tropicalmed6030160 - 2 Sep 2021
Cited by 10 | Viewed by 6357
Abstract
While the prevalence of intestinal parasitic infections (IPI) has been most commonly studied in African and Asian populations, less is known about the prevalence rates of IPI in European children, as well as the potential risk factors that favor the spread of parasites. [...] Read more.
While the prevalence of intestinal parasitic infections (IPI) has been most commonly studied in African and Asian populations, less is known about the prevalence rates of IPI in European children, as well as the potential risk factors that favor the spread of parasites. We aimed to review published evidence on the prevalence rates of IPI in children residing in Europe, and to quantitatively synthesize the results of published studies. We searched Medline from 1 January 2015 to 1 April 2021 to address the most recently published prevalence patterns of IPI in European children. Random-effects meta-analyses were performed by type of IPI infection, age group and sex, depending on data availability. Of the 967 potentially relevant articles, eight eligible cross-sectional studies were included in this analysis, yielding a sample of 3376 children (0–19 years). The overall prevalence rate was 5.9% for any IPI in children residing in European countries. Blastocystis hominis was the most commonly detected parasite yielding a prevalence rate of 10.7%. Other parasites included Entamoeba coli, Endolimax nana, and Blastocystis hominis. Studies focusing on specific types of parasites showed prevalence rates ranging from 1.3% for Cryptosporidium to 68.3% for Dientamoeba fragilis. Despite the scarce literature, the present review showed relatively low prevalence rates of IPI in Europe. Future studies accounting for proper diagnostic methods used for the detection of parasites and including information on potential sociodemographic factors, such as travelling history and history of immigration, are needed to guide clinicians about which children to test, as well as when and how to test children for IPI. Full article
(This article belongs to the Special Issue Diarrheagenic Pathogens and Gastrointestinal Infections)
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15 pages, 340 KiB  
Review
New Developments in PCR-Based Diagnostics for Bacterial Pathogens Causing Gastrointestinal Infections—A Narrative Mini-Review on Challenges in the Tropics
by Ulrike Loderstädt, Ralf Matthias Hagen, Andreas Hahn and Hagen Frickmann
Trop. Med. Infect. Dis. 2021, 6(2), 96; https://doi.org/10.3390/tropicalmed6020096 - 2 Jun 2021
Cited by 17 | Viewed by 6682
Abstract
The application of modern PCR approaches for the diagnosis of bacterial gastrointestinal pathogens is on the rise due to their rapidly available results combined with high sensitivity. While multiple studies describe the ongoing implementation of this technique for routine diagnostic purposes in laboratories [...] Read more.
The application of modern PCR approaches for the diagnosis of bacterial gastrointestinal pathogens is on the rise due to their rapidly available results combined with high sensitivity. While multiple studies describe the ongoing implementation of this technique for routine diagnostic purposes in laboratories in Western industrialized countries, reports on successful and also sustainable respective approaches in resource-poor tropical settings are still scarce. In order to shed light on potential reasons for this marked discrepancy, this narrative review summarizes identified challenges for the application of diagnostic PCR targeting bacterial gastrointestinal pathogens from stool samples in the tropics. The identified and discussed issues comprise the lack of generally accepted definitions for (1) minimum standards regarding sample acquisition, storage and transport time for diagnostic PCR analyses in the tropics, (2) nucleic acid extraction standards allowing an optimum detection of all types of pathogens which may be responsible for gastroenteritis in the tropics, (3) validation standards to ensure comparable quality of applied diagnostic assays, and (4) cut-offs for a reliable discrimination of infection and mere colonization in areas where semi-immunity due to repeated exposition associated with poor hygiene conditions has to be expected. Further implementation research is needed to solve those issues. Full article
(This article belongs to the Special Issue Diarrheagenic Pathogens and Gastrointestinal Infections)
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