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True Advances in defining etiology and new therapeutic approaches in acute diarrhoea. J Infect. 2007 Nov;55(5):385-93. Epub 2007 Sep 7. Marcos LA, DuPont HL. Defining aetiology of acute diarrhoea is critical to disease therapy and prevention. In this review we look at recent developments in etiologic agents of acute diarrhoea and advances in therapy and prevention of the illness. Newly appreciated agents include enterotoxigenic Bacteroides fragilis, Klebsiella oxytoca and Laribacter hongkongensis. Atypical enteropathogenic E. coli (EPEC) strains lacking the gene for epithelial attachment appear to be more important as causes of diarrhoea than traditional EPEC strains. Enterotoxigenic E. coli and enteroaggregative E. coli diarrhoea known to be important abroad, have recently been shown to occur in the United States. Non-O157:H7 strains of Shiga toxin-producing E. coli are increasing and infrequently are being sought. There is currently a serious epidemic of nosocomial diarrhoea due to a fluoroquinolone-resistant and more virulent and difficult to treat strain of C. difficile. Rotavirus vaccine development should lead to reduction of infant gastroenteritis mortality in infants living in developing regions. Noroviruses produce outbreaks of water- and food-borne disease but show broad genetic diversity. Reduced osmolarity oral rehydration treatment (ORT) and recombinant human lactoferrin/lysozyme plus rice-based ORT effectively treat acute diarrhoea. Probiotics were shown to be effective in preventing antibiotic associated- and C. difficile-diarrhoea. Rifaximin prevents and azithromycin effectively treats travellers' diarrhoea. Read about Laribacter
Laribacter A novel type of bacterium first isolated in Hong Kong in 2001 from the blood and empyema (pus in the chest) of a man with alcoholic cirrhosis. Laribacter hongkongensis has been associated with (but not yet proven to cause) community-acquired gastroenteritis and traveller's diarrhoea. Risk factors for infection include consumption of fish and minced freshwater fish meat. Laribacter hongkongensis has now been recorded in countries in Asia (China and Japan), Europe (Switzerland), Africa (Tunisia), and Central America (Cuba), suggesting that the bacterium is of worldwide importance. has now been recorded in countries in Asia (China and Japan), Europe (Switzerland), Africa (Tunisia), and Central America (Cuba), suggesting that the bacterium is of worldwide importance. In technical terms, Laribacter hongkongensisis a facultative anaerobic, motile, nonsporulating, non-fermentative, urease-positive, gram-negative, S-shaped bacillus, and belongs to the Neisseriaceae family of the ß-subclass of Proteobacteria.
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