Journal of travel medicine
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Randomized Controlled Trial
Development of a new travellers' diarrhoea clinical severity classification and its utility in confirming Rifamycin-SV efficacy.
travellers' diarrhoea (TD) is frequently reported with incidence up to 40% in high-risk destinations. Previous studies showed that the number of loose stools alone is inadequate to holistically predict the severity of TD. To improve the prediction of prognosis and to optimize treatments, a simple risk-based clinical severity classification has been developed. ⋯ this newly developed TD clinical severity classification demonstrated strong prognostic value and clinical utility by combining patients' multiple signs and symptoms of enteric infection and number of loose stools to provide a holistic assessment of TD. By expanding on the current classification by incorporating patient reported outcomes in addition to TLUS, a classification like the one developed, may help optimize patient selection for future clinical studies.
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Multicenter Study
Post-infectious irritable bowel syndrome after intercontinental travel: a prospective multicentre study.
By longitudinally following a large cohort of intercontinental travellers, this study highlights the importance of considering multiple risk factors to comprehend post-infectious irritable bowel syndrome (PI-IBS). Stomach cramps, antibiotic use and nausea during travel were amongst the variables that predicted PI-IBS development following an episode of traveller’s diarrhoea.
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Extended spectrum beta-lactamase producing Enterobacterales (ESBL-PE) present a risk to public health by limiting the efficacy of multiple classes of beta-lactam antibiotics against infection. International travellers may acquire these organisms and identifying individuals at high risk of acquisition could help inform clinical treatment or prevention strategies. ⋯ We demonstrate that by integrating traveller characteristics with destination-specific data, we could derive a CPR to identify those at highest risk of acquiring ESBL-PE during international travel.
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Highlights: Increased fluoroquinolone resistance in the two most common non-typhoidal Salmonella (NTS) serotypes among travellers returning to the Netherlands. Resistant Salmonella Enteritidis infections are most likely to be acquired abroad, specifically outside Europe. This study highlights the importance of travel history when patients with NTS infections require empiric antimicrobial treatment.