Harb Ali, O'Dea Mark, Abraham Sam, Habib Ihab
College of Science, Health, Education and Engineering, Murdoch University, Perth 6150, Australia.
Thi-Qar Public Health Division, Ministry of Health, Thi-Qar 64007, Iraq.
Pathogens. 2019 May 6;8(2):60. doi: 10.3390/pathogens8020060.
Diarrhoeal disease is still one of the most challenging issues for health in many countries across the Eastern Mediterranean region (EMR), with infectious diarrhoea being an important cause of morbidity and mortality, especially in children under five years of age. However, the understanding of the aetiological spectrum and the burden of enteric pathogens involved in diarrhoeal disease in the EMR is incomplete. Non-typhoidal (NTS), the focus of this review, is one of the most frequently reported bacterial aetiologies in diarrhoeal disease in the EMR. Strains of NTS with resistance to antimicrobial drugs are increasingly reported in both developed and developing countries. In the EMR, it is now widely accepted that many such resistant strains are zoonotic in origin and acquire their resistance in the food-animal host before onward transmission to humans through the food chain. Here, we review epidemiological and microbiological aspects of diarrhoeal diseases among children in the EMR, with emphasis on the implication and burden of NTS. We collate evidence from studies across the EMR on the zoonotic exposure and antimicrobial resistance in NTS at the interface between human and foods of animal origin. This review adds to our understanding of the global epidemiology of with emphasis on the current situation in the EMR.
腹泻病仍然是东地中海区域（EMR）许多国家卫生领域最具挑战性的问题之一，感染性腹泻是发病和死亡的重要原因，尤其是在五岁以下儿童中。然而，对EMR腹泻病的病因谱以及肠道病原体负担的了解并不完整。非伤寒型（NTS）是本综述的重点，是EMR腹泻病中最常报告的细菌病因之一。在发达国家和发展中国家，对抗菌药物耐药的NTS菌株报告越来越多。在EMR，现在人们普遍认为，许多此类耐药菌株源自动物，在通过食物链传播给人类之前，在食用动物宿主中获得耐药性。在此，我们综述了EMR儿童腹泻病的流行病学和微生物学方面，重点是NTS的影响和负担。我们整理了来自EMR各地关于人与动物源性食品界面处NTS的人畜共患病暴露和抗菌药物耐药性的研究证据。本综述增进了我们对全球流行病学的理解，重点是EMR的现状。
