Department of Surgery, Central Manchester NHS Foundation Trust, Oxford Road, Manchester, UK
Department of Microbiology Research, School of Healthcare Sciences, Manchester Metropolitan University, Manchester, UK.
J Travel Med. 2017 Jan 11;24(1). doi: 10.1093/jtm/taw077. Print 2017 Jan.
To ascertain any predictors of potential food poisoning pathogens and development of post-infective irritable bowel syndrome (IBS) in UK travellers. An analysis was undertaken on prospectively collected data on 527 patients reporting symptoms of suspected food poisoning between June 2012 and June 2015.
Positive stool sample indicative of food poisoning pathogens and diagnosis of post-infective IBS.
Data on 527 patients were examined. The large majority of patients did not provide a stool sample on return from holiday (n = 430, 81.6%) as few visited a Doctor locally or in the UK. Only 18 patients (18.6%, 95% confidence interval [CI] 11.4-27.7) who provided a stool sample were positive for microbiological food poisoning pathogens. Univariate analysis indicated a significant relationship between a positive stool sample and whether the individual sought any medical assistance at the resort (odds ratio [OR] 0.24, 95% CI 0.08-0.70) and whether they took any treatment (including self-medicated), (OR 0.21, 95% CI 0.06-0.67). Of the 527 patients only 30 (5.7%, 95% CI 3.9-8.1) experienced post-infective IBS. Univariate regression indicated a significant relationship between experiencing Per Rectal (PR) bleeding and a diagnosis of post-infective IBS (OR 3.64, 95% CI 1.00-10.49). Univariate regression also indicated an increase in the risk of developing post-infective IBS with increasing duration of symptoms (OR 1.04, 95% CI 1.02-1.05). No significant relationship was found between a positive stool sample and developing post-infective IBS (P = 0.307).
Very few patients provide a stool sample after experiencing holiday sickness abroad. Of those that do, only a small proportion have a positive stool sample indicative of a food poisoning microorganism. Around 6% of individuals were diagnosed with post-infective IBS. Those individuals with PR bleeding and symptoms persisting for longer durations were significantly more at risk of developing post-infective IBS, whilst medical aid and treatment abroad was found to reduce the odds of a positive stool sample.
确定英国旅行者中潜在食源性病原体和感染后肠易激综合征（IBS）发展的预测因素。对 2012 年 6 月至 2015 年 6 月期间报告疑似食物中毒症状的 527 例患者的前瞻性收集数据进行了分析。
粪便样本中存在食源性病原体阳性和感染后 IBS 的诊断。
对 527 例患者的数据进行了检查。大多数患者（n=430，81.6%）在度假后未提供粪便样本，因为很少有患者在当地或英国就医。只有 18 例（18.6%，95%置信区间[CI]11.4-27.7）提供粪便样本的患者微生物食源性病原体阳性。单因素分析表明，粪便样本阳性与个体在度假地是否寻求任何医疗援助（比值比[OR]0.24，95%CI0.08-0.70）以及是否接受任何治疗（包括自我用药）（OR0.21，95%CI0.06-0.67）之间存在显著关系。在 527 例患者中，仅有 30 例（5.7%，95%CI3.9-8.1）发生感染后 IBS。单因素回归分析表明，经直肠（PR）出血与感染后 IBS 诊断之间存在显著关系（OR3.64，95%CI1.00-10.49）。单因素回归分析还表明，随着症状持续时间的增加，发生感染后 IBS 的风险增加（OR1.04，95%CI1.02-1.05）。粪便样本阳性与感染后 IBS 的发生之间未发现显著关系（P=0.307）。
在经历了国外度假疾病后，很少有患者提供粪便样本。在那些提供粪便样本的人中，只有一小部分粪便样本中存在指示食源性病原体的阳性样本。大约 6%的个体被诊断为感染后 IBS。那些有 PR 出血和症状持续时间较长的个体发生感染后 IBS 的风险显著增加，而在国外获得医疗帮助和治疗被发现降低了粪便样本阳性的几率。
