The etiology of diarrhea among American adults living in Peru.
During 1984-1989, 655 diarrheic and 287 nondiarrheic stool specimens from adult U.S. citizens living in Lima, Peru were tested for presence of bacterial enteropathogens. Frequencies of isolation among diarrheic specimens were: Shigella 9.8%; Campylobacter 6.1%; enterotoxigenic Escherichia coli (ETEC) 6.0%; Plesiomonas 2.0%; Salmonella 1.4%; and Vibrio 0.6%. Isolates recovered from non-diarrheic stools were: Shigella 4.5%; Campylobacter 2.1%; Salmonella 1.0%; ETEC 0.7%; Plesiomonas 0.7%; and Vibrio 0.3%. Aeromonas, an unproven cause of diarrhea, was isolated from 9.2% of cases and 3.5% of controls. Disease occurrence was strongly associated with isolation of Shigella, ETEC, Campylobacter, or Aeromonas (p less than or equal to 0.01). During the 6-year period of study, shifts in the dominant phenotypes of Shigella and Campylobacter occurred which may have important implications for vaccine development and intervention strategies.
Pazzaglia
G
G
U.S. Naval Medical Research Institute Detachment (Lima, Peru), A.P.O., Miami, FL 34031.
Escamilla
J
J
Batchelor
R
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D003967:Diarrhea / Q000382:microbiology*; D005243:Feces / Q000382:microbiology; D006801:Humans; D008875:Middle Aged; D010568:Peru; D014195:Travel; D014481:United States / Q000208:ethnology