Zaidi Deenaz, Wine Eytan
Division of Pediatric Gastroenterology and Nutrition, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada.
Curr Opin Gastroenterol. 2015 Jan;31(1):7-13. doi: 10.1097/MOG.0000000000000133.
Travelers' diarrhea, affecting millions of travelers every year globally, continues to be a leading cause of morbidity despite advances in vaccination, prevention, and treatment. Complications of travelers' diarrhea often present to gastroenterologists and some patients followed by gastroenterologists are at higher risk of developing travelers' diarrhea. This review will provide an update on recent progress made in the epidemiology, pathogenesis, diagnosis, prevention, and treatment of travelers' diarrhea.
Most causes of travelers' diarrhea remain bacterial, but newly recognized pathogens are emerging. Patient-related and travel-related factors affect disease development risk and should guide prophylaxis and treatment. Although specific vaccines are being developed, they have not yet had a major impact on travelers' diarrhea, and understanding their roles and limitations is especially important. Prophylaxis and treatment of populations at risk (children, chronically ill patients, and those on immunosuppressive medications) remain challenging and require a tailored approach.
Travelers' diarrhea will continue to challenge patients and physicians despite the use of sanitation advice, prophylactic vaccines, and treatment with antibiotics. Effects may extend beyond the time of travel, such as postinfectious complications and exacerbation of preexisting disease. Future research should focus on novel strategies for reducing exposure to pathogens, vaccine development, early detection, and targeted treatments.
旅行者腹泻每年在全球影响数百万旅行者，尽管在疫苗接种、预防和治疗方面取得了进展，但它仍然是发病的主要原因。旅行者腹泻的并发症常常需要胃肠病学家处理，一些由胃肠病学家随访的患者发生旅行者腹泻的风险更高。本综述将介绍旅行者腹泻在流行病学、发病机制、诊断、预防和治疗方面的最新进展。
旅行者腹泻的大多数病因仍然是细菌性的，但新发现的病原体不断出现。与患者相关和与旅行相关的因素会影响疾病发生风险，应指导预防和治疗。虽然正在研发特定疫苗，但它们尚未对旅行者腹泻产生重大影响，了解其作用和局限性尤为重要。对高危人群（儿童、慢性病患者和服用免疫抑制药物者）的预防和治疗仍然具有挑战性，需要采取量身定制的方法。
尽管采用了卫生建议、预防性疫苗和抗生素治疗，但旅行者腹泻仍将继续给患者和医生带来挑战。其影响可能会超出旅行期间，例如感染后并发症和原有疾病的加重。未来的研究应侧重于减少接触病原体的新策略、疫苗研发、早期检测和靶向治疗。
