Der Gastroenterologe

, Volume 9, Issue 4, pp 366–371 | Cite as

Reisediarrhö

Schwerpunkt

Zusammenfassung

Die Reisediarrhö ist die häufigste Krankheit des Fernreisenden und kommt bei 10–50 % dieser Zielgruppe vor. Bei gut 90 % der Diarrhöepisoden klingen die Beschwerden innerhalb von 3 bis 5 Tagen ohne Komplikationen ab. Es ist jedoch wichtig, komplikationsträchtige Verläufe zu erfassen und rasch zu therapieren. Enterotoxinbildende E.-coli-Stämme (ETEC) sind die wichtigsten Erreger der Reisediarrhö mit einer Häufigkeit von 30–40 %. Zur Therapie sind Rehydratationsmaßnahmen obligat; Motilitätshemmer und Antibiotika können die Erkrankungsdauer verkürzen. Die Möglichkeiten einer Prophylaxe sind limitiert, dennoch sollte über Nahrungsmittelhygiene beraten werden. Der prophylaktische Einsatz von Antibiotika oder einer Immunisierung kommt nur für gezielte Risikogruppen infrage.

Schlüsselwörter

Gastrointestinale Infektion Escherichia-coli-Infektionen Protozoen Toxine Rehydration 

Traveler‘s diarrhea

Abstract

Traveler’s diarrhea is the most frequent health problem for travelers to the tropics and occurs in 10–50 % of this target group. In about 90 % of cases diarrheal symptoms stop within 3–5 days without complications, but it is important to detect severe courses and treat them immediately. Enterotoxigenic Escherichia coli strains (ETEC) are the most frequent pathogens causing traveler’s diarrhea with a frequency of 30–40 %. Rehydration measures are the basis of therapy and anti-motility agents and antibiotics may shorten the duration of the disease. Prophylactic measures are limited in efficacy, but advice on food hygiene rules should be given. The prophylactic use of antibiotics or immunization is only warranted in special risk groups.

Keywords

Gastrointestinal infection Escherichia coli infections Protozoa Toxins Rehydration 

Weiterführende Literatur

  1. 1.
    Apelt N, Hartberger C, Campe H, Löscher T (2010) The prevalence of norovirus in returning international travelers with diarrhea. BMC Infect Dis 10:131. DOI 10.1186/1471-2334-10-131PubMedCentralPubMedCrossRefGoogle Scholar
  2. 2.
    Behrens RH, Cramer JP, Jelinek T et al (2014) Efficacy and safety of a patch vaccine containing heat-labile toxin from Escherichia coli against travellers‘ diarrhoea: a phase 3, randomised, double-blind, placebo-controlled field trial in travellers from Europe to Mexico and Guatemala. Lancet Infect Dis 14:197–204PubMedCrossRefGoogle Scholar
  3. 3.
    Burchard GD, Hentschke M, Weinke T et al (2013) Reisediarrhoe. Dtsch Med Wochenschr 138:1673–1678PubMedCrossRefGoogle Scholar
  4. 4.
    DuPont HL (2012) Approach to the patient with infectious colitis. Curr Opin Gastroenterol 28:39–46PubMedCrossRefGoogle Scholar
  5. 5.
    DuPont HL, Ericsson CD, Farthing MJ et al (2009) Expert review of the evidence base for self-therapy of travelers‘ diarrhea. J Travel Med 16:161–171PubMedCrossRefGoogle Scholar
  6. 6.
    Ericsson CD (2003) Travellers‘ diarrhoea. Int J Antimicrob Agents 21:116–124PubMedCrossRefGoogle Scholar
  7. 7.
    Irving PM, Gibson PR (2008) Infections and IBD. Nat Clin Pract Gastroenterol Hepatol 5:18–27PubMedCrossRefGoogle Scholar
  8. 8.
    Jiang ZD, Dupont HL, Brown EL et al (2010) Microbial etiology of travelers‘ diarrhea in Mexico, Guatemala, and India: importance of enterotoxigenic Bacteroides fragilis and Arcobacter species. J Clin Microbiol 48:1417–1419PubMedCentralPubMedCrossRefGoogle Scholar
  9. 9.
    Lundkvist J, Steffen R, Jonsson B (2009) Cost-benefit of WC/rBS oral cholera vaccine for vaccination against ETEC-caused travelers‘ diarrhea. J Travel Med 16:28–34PubMedCrossRefGoogle Scholar
  10. 10.
    Murphy H, Pandey P (2012) Pathogens for travelers‘ diarrhea in Nepal and resistance patterns. Curr Infect Dis Rep 14:238–245PubMedCrossRefGoogle Scholar
  11. 11.
    Okhuysen PC (2005) Current concepts in travelers‘ diarrhea: epidemiology, antimicrobial resistance and treatment. Curr Opin Infect Dis 18:522–526PubMedCrossRefGoogle Scholar
  12. 12.
    Pitzurra R, Fried M, Rogler G et al (2011) Irritable bowel syndrome among a cohort of European travelers to resource-limited destinations J Travel Med 18:250–256Google Scholar
  13. 13.
    Rendi-Wagner P, Kollaritsch H (2002) Drug prophylaxis for travelers‘ diarrhea. Clin Inf Dis 34:628–633CrossRefGoogle Scholar
  14. 14.
    Shah N, Du Pont HL, Ramsey DJ (2009) Global etiology of travelers‘ diarrhea: systematic review from 1973 to the present. Am J Trop Med Hyg 80:609–614PubMedGoogle Scholar
  15. 15.
    Steffen R, Acar J, Walker E, Zuckerman J (2003) Cholera: assessing the risk to travellers and identifying methods of protection. Trav Med Inf Dis 1:80–88CrossRefGoogle Scholar
  16. 16.
    Swaminathan A, Torresi J, Schlagenhauf P et al (2009) A global study of pathogens and host risk factors associated with infectious gastrointestinal disease in returned international travellers. J Infect 59:19–27PubMedCrossRefGoogle Scholar
  17. 17.
    Taylor DN, Bourgeois AL, Ericsson CD et al (2006) A randomized, double-blind, multicenter study of rifaximin compared with placebo and with ciprofloxacin in the treatment of travelers‘ diarrhea. Am J Trop Med Hyg 74:1060–1066PubMedGoogle Scholar
  18. 18.
    Von Sonnenburg F, Tornieporth N, Waiyaki P et al (2000) Risk and aetiology of diarrhoea at various tourist destinations. Lancet 356:133–134CrossRefGoogle Scholar
  19. 19.
    Weinke T, Liebold I, Burchard GD et al (2008) Prophylactic immunisation against traveller’s diarrhoea caused by enterotoxin-forming strains of Escherichia coli and against cholera: does it make sense and for whom? Travel Med Infect Dis 6:362–367PubMedCrossRefGoogle Scholar
  20. 20.
    Weinke T, Liebold I (2013) Intestinale Protozoeninfektionen. Dtsch Med Wochenschr 138:709–711PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  1. 1.Zentrum für Innere Medizin, Klinik für Gastroenterologie und InfektiologieKlinikum Ernst von BergmannPotsdamDeutschland

Personalised recommendations