مقاله انگلیسی رایگان در مورد عفونت های شایع دستگاه گوارش – الزویر 2018

Gastrointestinal infections account for a large burden of acute and chronic disease worldwide. Diarrhea is defined as 3 or more stools in 24 hours and is the most common manifestation. It is defined as acute if lasting less than 7 days, prolonged if lasting 7 to 13 days, persistent if lasting 14 to 29 days, and chronic if lasting 30 days or longer.1 Common bacterial, viral, and parasitic pathogens are spread via food, via contaminated water, or from person to person. According to the World Health Organization, diarrhea is the cause of 4% of deaths globally and kills approximately 2.2 million people each year.2 Those in developing countries, and particularly children, are most affected. In the United States, not all cases are actively reported, but it is approximated that 179 million cases of acute diarrhea in adults occur each year, resulting in 500,000 hospitalizations and more than 5000 deaths.3 Nationally, children less than 5 years old account for the largest portion of infections, but those older than 65 years old account for greatest number of hospitalizations and deaths.4 Despite modern advances in food preparation and delivery, gastrointestinal infections in the United States are commonly caused by food-borne pathogens. In 2011, it was found that norovirus (58%) caused the most food-borne infections followed by nontyphoidal Salmonella spp (11%), Clostridium perfringens (10%), and Campylobacter spp (9%). Nontyphoidal Salmonella spp (35%) was the leading cause of hospitalization followed by norovirus (26%), Campylobacter spp (15%), and Toxoplasma gondii (8%). Nontyphoidal Salmonella spp (28%) also caused the most deaths followed by T gondii (24%), Listeria monocytogenes (19%), and norovirus (11%).3 Diarrhea also accounts for the largest number of travel-related illness in the United States, with acute diarrhea accounting for 22% of travel-related diagnoses in US residents.5 Areas with the highest risk of acquiring traveler’s diarrhea include Africa, South Asia, Latin America, and the Middle East. Risk is increased for those taking medications that lower gastric acid.6 Traveler’s diarrhea (Table 1) is more likely bacterial in contrast to infectious diarrhea acquired in the United States, which is most commonly viral. Protozoa are less common causes of traveler’s diarrhea but may result in longer duration or persistence of symptoms upon return to the United States.