感染性腹泻病中的特殊类型-旅行者腹泻
聂青和,中国人民解放军第四军医大学唐都医院全军感染病诊疗中心 陕西省西安市 710038
通讯作者:聂青和,710038, 陕西省西安市新寺路1号,中国人民解放军第四军医大学唐都医院全军感染病诊疗中心. nieqinghe@hotmail.com
电话: 029-83377752-83377852 传真:029-83537377
收稿日期:2005-03-18 接受日期:2005-04-20
摘要感染性腹泻病(infectiousdiarrhea disease)为一组广泛存在并流行于世界各地的胃肠道传染病，也是当今全球性重要的公共卫生问题之一，其发病率仅次于上呼吸道感染.在我国感染性腹泻的发病率居所有传染病之首位.旅行者腹泻(diarrheain travelers，DT)为感染性腹泻病中的一种特殊类型，其定义系指在旅行期间或旅行后，每天有3次或3次以上未成形粪，或未成形粪次数不定但伴有发热、腹痛或呕吐.该定义的范围也可进一步扩大，包括更多较轻微的、但足以影响商务日程或旅游计划的肠道紊乱.目前认为DT并非由于气候、食物或水土等因素所致，可由多种微生物引起，多能自限.绝大多数DT具有传染性，其病原体有细菌、病毒、寄生虫、真菌等，偶见原虫和蠕虫感染.据统计DT发生率低(发病率<8%)的地区有美国、加拿大、欧洲、澳大利亚和新西兰等.DT发生率高(发病率20-60%)的国家有亚、非、拉的大多数发展中国家，处于上述两种类型之间的国家有地中海北部、加勒比海地区、日本和其他国家.旅行者腹泻现已成为感染性腹泻病研究中的热点之一.
, 百拇医药
聂青和.感染性腹泻病中的特殊类型-旅行者腹泻. 世界华人消化杂志 2005;13(10):1210-1215
Steffen R, Tornieporth N, Clemens SA, Chatterjee S, Cavalcanti AM, Collard F, De Clercq N, DuPont HL, von
Sonnenburg F. Epidemiology of travelers diarrhea: details of a global survey. J Travel Med 2004;11:231-237
3 聂青和. 感染性腹泻病的诊断与治疗. 世界华人消化杂志 2001;9:925-946
4 Reinthaler FF, Feierl G, Beubler E, Kollaritsch H, Ruckenbauer G, Klem G, Wendelin I, Marth E. Treatment of travelers'
, http://www.100md.com
diarrhea among Austrian tourists. J Travel Med 2004;11:66-68
5 Infante RM, Ericsson CD, Jiang ZD, Ke S, Steffen R, Riopel L, Sack DA, DuPont HL. Enteroaggregative Escherichia coli
diarrhea in travelers:response to rifaximin therapy. Clin Gastroenterol Hepatol 2004;2:135-138
6 聂青和. 感染性腹泻研究进展. 王宇明, 顾长海. 感染病学新进展. 第一版. 北京: 人民卫生出版社, 2001:1200-1233
7 DuPont HL. Treatment of travelers' diarrhea. J Travel Med 2001;8(Suppl 2):S31-33
, http://www.100md.com
8 Goodyer L, Gibbs J. Medical supplies for travelers to developing countries. J Travel Med 2004;11:208-211
9 Suh KN, Mileno MD. Challenging scenarios in a travel clinic:advising the complex traveler.
Infect Dis Clin North Am 2005;19:15-47
10 聂青和. 感染性腹泻研究现状. 中国实用内科杂志 2003;23:631-633
11 Maloney SA, Weinberg M. Prevention of infectious diseases among international pediatric travelers:considerations
, 百拇医药
for clinicians. Semin Pediatr Infect Dis 2004;15:137-149
12 Chapin AR, Carpenter CM, Dudley WC, Gibson LC, Pratdesaba R, Torres O, Sanchez D, Belkind-Gerson J, Nyquist I,Karnell A, Gustafsson B, Halpern JL, Bourgeois AL, Schwab KJ. Prevalence of norovirus among visitors from the united
states to mexico and guatemala who experience traveler's diarrhea. J Clin Microbiol 2005;43:1112-1117
13 Sullivan A, Nord CE. Probiotics and gastrointestinal diseases. J Intern Med 2005;257:78-92
, 百拇医药
14 聂青和. 感染性腹泻. 梅长林, 李兆申. 内科学教程. 第一版. 北京: 人民卫生出版社, 2003:1356-1366
15 Kansouzidou A, Charitidou C, Varnis T, Vavatsi N, Kamaria F. Cyclospora cayetanensis in a patient with travelers'
diarrhea:case report and review. J Travel Med 2004;11:61-63
16 Caumes E, Menegaux F, Hoang C, Duhem C, Bricaire F, Chigot JP. From travelers' diarrhea to abdominal surgery:
, http://www.100md.com report of three cases. J Travel Med 2004;11:117-119
17 聂青和. 感染性腹泻病原及诊断程序. 世界华人消化杂志 2001;9:925-926
18 Yang JH, Kobayashi N, Wang YH, Zhou X, Li Y, Zhou DJ, Hu ZH, Ishino M, Alam MM, Naik TN, Ahmed MU. Phylogenetic
analysis of a human group B rotavirus WH-1 detected in China in 2002. J Med Virol 2004;74:662-667
19 郭顺明, 聂青和. 急性致病性新弧菌腹泻的临床及实验观察. 中华内科杂志 1999;38:838-839
, 百拇医药
20 聂青和. 感染性腹泻. 周永兴, 陈勇. 感染病学. 第一版. 北京: 高等教育出版社, 2001:199-207
21 程勇前, 聂青和. 感染性腹泻的微生态疗法. 世界华人消化杂志 2001;9:932-934
22 Pakyz AL. Rifaximin: a new treatment for travelers' diarrhea. Ann Pharmacother 2005;39:284-289
23 Ropers G, Krause G, Tiemann F, van Beest Holle Mdu R, Stark K. Nationwide survey of the role of travel medicine in
primary care in Germany. J Travel Med 2004;11:287-294
, 百拇医药
24 聂青和. 感染性腹泻新病原体研究动态. 临床内科杂志 2003;20:567-570
25 Roy SL, DeLong SM, Stenzel SA, Shiferaw B, Roberts JM, Khalakdina A, Marcus R, Segler SD, Shah DD, Thomas S,Vugia DJ, Zansky SM, Dietz V, Beach MJ;Emerging Infections Program FoodNet Working Group. Risk factors for
sporadic cryptosporidiosis among immunocompetent persons in the United States from 1999 to 2001.
JClin Microbiol 2004;42:2944-2951
, 百拇医药
26 Shlim DR. Update in traveler's diarrhea. Infect Dis Clin North Am 2005;19:137-149
27 Teitelbaum JE. Probiotics and the treatment of infectious diarrhea. Pediatr Infect Dis J 2005;24:267-268
28 Rendi-Wagner P, Kollaritsch H. Drug prophylaxis for travelers' diarrhea. Clin Infect Dis 2002;34:628-633
29 聂青和. 基因疫苗的基础研究及应用现状. 世界华人消化杂志 2003;11:125-129
, 百拇医药 30 Wecker J. Costs of a rotavirus vaccine. Science 2005;307:517-519
31 Boedeker EC. Vaccines for enterotoxigenic Escherichia coli:current status. Curr Opin Gastroenterol 2005;21:15-19
32 罗红, 聂青和. 感染性腹泻研究进展. 寄生虫病与感染性疾病 2003;1:37-40
33 Huerta M, Schwaber MJ, Davidovitch N, Balicer RD, Zelikovitch Y, Cohen D, Grotto I. Trends in Shigella outbreaks in
the Israeli military over 15 years. Eur J Clin Microbiol Infect Dis 2005;24:71-73
34 Pereg D, Kimhi O, Tirosh A, Orr N, Kayouf R, Lishner M. The effect of fermented yogurt on the prevention of diarrhea in
a healthy adult population. Am J Infect Control 2005;33:122-125
编辑 张海宁, 百拇医药
通讯作者:聂青和,710038, 陕西省西安市新寺路1号,中国人民解放军第四军医大学唐都医院全军感染病诊疗中心. nieqinghe@hotmail.com
电话: 029-83377752-83377852 传真:029-83537377
收稿日期:2005-03-18 接受日期:2005-04-20
摘要感染性腹泻病(infectiousdiarrhea disease)为一组广泛存在并流行于世界各地的胃肠道传染病，也是当今全球性重要的公共卫生问题之一，其发病率仅次于上呼吸道感染.在我国感染性腹泻的发病率居所有传染病之首位.旅行者腹泻(diarrheain travelers，DT)为感染性腹泻病中的一种特殊类型，其定义系指在旅行期间或旅行后，每天有3次或3次以上未成形粪，或未成形粪次数不定但伴有发热、腹痛或呕吐.该定义的范围也可进一步扩大，包括更多较轻微的、但足以影响商务日程或旅游计划的肠道紊乱.目前认为DT并非由于气候、食物或水土等因素所致，可由多种微生物引起，多能自限.绝大多数DT具有传染性，其病原体有细菌、病毒、寄生虫、真菌等，偶见原虫和蠕虫感染.据统计DT发生率低(发病率<8%)的地区有美国、加拿大、欧洲、澳大利亚和新西兰等.DT发生率高(发病率20-60%)的国家有亚、非、拉的大多数发展中国家，处于上述两种类型之间的国家有地中海北部、加勒比海地区、日本和其他国家.旅行者腹泻现已成为感染性腹泻病研究中的热点之一.
, 百拇医药
聂青和.感染性腹泻病中的特殊类型-旅行者腹泻. 世界华人消化杂志 2005;13(10):1210-1215
Steffen R, Tornieporth N, Clemens SA, Chatterjee S, Cavalcanti AM, Collard F, De Clercq N, DuPont HL, von
Sonnenburg F. Epidemiology of travelers diarrhea: details of a global survey. J Travel Med 2004;11:231-237
3 聂青和. 感染性腹泻病的诊断与治疗. 世界华人消化杂志 2001;9:925-946
4 Reinthaler FF, Feierl G, Beubler E, Kollaritsch H, Ruckenbauer G, Klem G, Wendelin I, Marth E. Treatment of travelers'
, http://www.100md.com
diarrhea among Austrian tourists. J Travel Med 2004;11:66-68
5 Infante RM, Ericsson CD, Jiang ZD, Ke S, Steffen R, Riopel L, Sack DA, DuPont HL. Enteroaggregative Escherichia coli
diarrhea in travelers:response to rifaximin therapy. Clin Gastroenterol Hepatol 2004;2:135-138
6 聂青和. 感染性腹泻研究进展. 王宇明, 顾长海. 感染病学新进展. 第一版. 北京: 人民卫生出版社, 2001:1200-1233
7 DuPont HL. Treatment of travelers' diarrhea. J Travel Med 2001;8(Suppl 2):S31-33
, http://www.100md.com
8 Goodyer L, Gibbs J. Medical supplies for travelers to developing countries. J Travel Med 2004;11:208-211
9 Suh KN, Mileno MD. Challenging scenarios in a travel clinic:advising the complex traveler.
Infect Dis Clin North Am 2005;19:15-47
10 聂青和. 感染性腹泻研究现状. 中国实用内科杂志 2003;23:631-633
11 Maloney SA, Weinberg M. Prevention of infectious diseases among international pediatric travelers:considerations
, 百拇医药
for clinicians. Semin Pediatr Infect Dis 2004;15:137-149
12 Chapin AR, Carpenter CM, Dudley WC, Gibson LC, Pratdesaba R, Torres O, Sanchez D, Belkind-Gerson J, Nyquist I,Karnell A, Gustafsson B, Halpern JL, Bourgeois AL, Schwab KJ. Prevalence of norovirus among visitors from the united
states to mexico and guatemala who experience traveler's diarrhea. J Clin Microbiol 2005;43:1112-1117
13 Sullivan A, Nord CE. Probiotics and gastrointestinal diseases. J Intern Med 2005;257:78-92
, 百拇医药
14 聂青和. 感染性腹泻. 梅长林, 李兆申. 内科学教程. 第一版. 北京: 人民卫生出版社, 2003:1356-1366
15 Kansouzidou A, Charitidou C, Varnis T, Vavatsi N, Kamaria F. Cyclospora cayetanensis in a patient with travelers'
diarrhea:case report and review. J Travel Med 2004;11:61-63
16 Caumes E, Menegaux F, Hoang C, Duhem C, Bricaire F, Chigot JP. From travelers' diarrhea to abdominal surgery:
, http://www.100md.com report of three cases. J Travel Med 2004;11:117-119
17 聂青和. 感染性腹泻病原及诊断程序. 世界华人消化杂志 2001;9:925-926
18 Yang JH, Kobayashi N, Wang YH, Zhou X, Li Y, Zhou DJ, Hu ZH, Ishino M, Alam MM, Naik TN, Ahmed MU. Phylogenetic
analysis of a human group B rotavirus WH-1 detected in China in 2002. J Med Virol 2004;74:662-667
19 郭顺明, 聂青和. 急性致病性新弧菌腹泻的临床及实验观察. 中华内科杂志 1999;38:838-839
, 百拇医药
20 聂青和. 感染性腹泻. 周永兴, 陈勇. 感染病学. 第一版. 北京: 高等教育出版社, 2001:199-207
21 程勇前, 聂青和. 感染性腹泻的微生态疗法. 世界华人消化杂志 2001;9:932-934
22 Pakyz AL. Rifaximin: a new treatment for travelers' diarrhea. Ann Pharmacother 2005;39:284-289
23 Ropers G, Krause G, Tiemann F, van Beest Holle Mdu R, Stark K. Nationwide survey of the role of travel medicine in
primary care in Germany. J Travel Med 2004;11:287-294
, 百拇医药
24 聂青和. 感染性腹泻新病原体研究动态. 临床内科杂志 2003;20:567-570
25 Roy SL, DeLong SM, Stenzel SA, Shiferaw B, Roberts JM, Khalakdina A, Marcus R, Segler SD, Shah DD, Thomas S,Vugia DJ, Zansky SM, Dietz V, Beach MJ;Emerging Infections Program FoodNet Working Group. Risk factors for
sporadic cryptosporidiosis among immunocompetent persons in the United States from 1999 to 2001.
JClin Microbiol 2004;42:2944-2951
, 百拇医药
26 Shlim DR. Update in traveler's diarrhea. Infect Dis Clin North Am 2005;19:137-149
27 Teitelbaum JE. Probiotics and the treatment of infectious diarrhea. Pediatr Infect Dis J 2005;24:267-268
28 Rendi-Wagner P, Kollaritsch H. Drug prophylaxis for travelers' diarrhea. Clin Infect Dis 2002;34:628-633
29 聂青和. 基因疫苗的基础研究及应用现状. 世界华人消化杂志 2003;11:125-129
, 百拇医药 30 Wecker J. Costs of a rotavirus vaccine. Science 2005;307:517-519
31 Boedeker EC. Vaccines for enterotoxigenic Escherichia coli:current status. Curr Opin Gastroenterol 2005;21:15-19
32 罗红, 聂青和. 感染性腹泻研究进展. 寄生虫病与感染性疾病 2003;1:37-40
33 Huerta M, Schwaber MJ, Davidovitch N, Balicer RD, Zelikovitch Y, Cohen D, Grotto I. Trends in Shigella outbreaks in
the Israeli military over 15 years. Eur J Clin Microbiol Infect Dis 2005;24:71-73
34 Pereg D, Kimhi O, Tirosh A, Orr N, Kayouf R, Lishner M. The effect of fermented yogurt on the prevention of diarrhea in
a healthy adult population. Am J Infect Control 2005;33:122-125
编辑 张海宁, 百拇医药
