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旅行者腹泻的诊断、治疗和预防的新概念。

Emerging concepts in the diagnosis, treatment, and prevention of travelers' diarrhea.

机构信息

McGill University Health Centre, Montreal, Quebec, Canada.

Christian Medical College, Vellore, India.

出版信息

Curr Opin Infect Dis. 2019 Oct;32(5):468-474. doi: 10.1097/QCO.0000000000000581.

Abstract

PURPOSE OF REVIEW

Traveller's diarrhea, though not life-threatening. is often a vexing problem, which impacts overall function of the traveller while on holiday. Increasing data is available regarding molecular diagnostic techniques, which may help obtain an early etiologic diagnosis. Use of antibiotics for traveller's diarrhea is controversial in this era of multidrug resistance and microbiome disruption.

RECENT FINDINGS

Travel to the tropics promotes gut colonization with drug-resistant bacteria and this risk increases after treatment with antibiotics, leading to potential ecological impacts in the country of residence.

SUMMARY

Traveller's diarrhea is common and can impact a traveller's itinerary leading to significant inconvenience, and occasional longer term sequelae. Though bacterial causes predominate, recommended treatment is conservative in mild-to-moderate cases. Molecular techniques for early diagnosis of traveller's diarrhea may help with appropriate management. Treatment with antibiotics is sometimes required but is associated with gut colonization by multidrug-resistant bacteria.

摘要

目的综述

旅行者腹泻虽然不会危及生命,但往往令人困扰,严重影响旅行者度假时的正常活动。目前已有越来越多的关于分子诊断技术的数据,这些技术可能有助于尽早确定病因诊断。在当前多药耐药和微生物组破坏的时代,旅行者腹泻使用抗生素存在争议。

最新发现

前往热带地区会促进肠道中耐药菌的定植,而抗生素治疗后这种风险会增加,从而对居住国产生潜在的生态影响。

总结

旅行者腹泻很常见,会影响旅行者的行程,导致严重的不便,偶尔还会产生长期的后果。尽管细菌性腹泻占主导地位,但推荐在轻度至中度病例中采取保守治疗。旅行者腹泻的早期分子诊断技术可能有助于进行适当的管理。有时需要使用抗生素治疗,但会导致肠道定植多种耐药菌。

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