title: Defining causality in emerging agents of acute bacterial diarrheas: a step beyond the Koch's postulates.
abstract: Diarrheal illnesses account for significant morbidity and mortality worldwide. Most cases of diarrhea are caused by bacteria, viruses or parasites. Advances in molecular biology and epidemiology have allowed the identification of emerging pathogens that may cause or, at least, may be associated with diarrhea. However, the same advances have also revealed the complexity of the gut microbiome, suggesting that a potential agent of diarrhea may also been found in healthy individuals. In addition, most of the newly identified emerging agents of diarrhea are ubiquitous and have not yet fulfilled Koch's postulates. Research investigations should address appropriate matched controls and integrate findings from medical microbiology, epidemiology and molecular biology. This integrative approach should provide insights to our knowledge regarding exposition to common source or risk factors. Here, we aim to review some of these emerging bacterial agents of diarrheas and propose guidelines or prescriptions that may help in defining causality.
authors.affiliation: Unité de Recherche sur les Maladies Infectieuses et Tropicales Émergentes, Centre National de la Recherche Scientifique, UMR 6236, Faculté de Médecine de la Timone, 27 boulevard Jean Moulin, 13385 Marseille Cedex 5, France. benoit.desnues@univmed.fr
authors.forename: Benoit
authors.initials: B
authors.lastname: Desnues
authors.forename: Khatoun
authors.initials: K
authors.lastname: Al Moussawi
authors.forename: Didier
authors.initials: D
authors.lastname: Raoult
mesh_terms: D000208:Acute Disease; D001424:Bacterial Infections / Q000150:complications* / Q000382:microbiology*; D003967:Diarrhea / Q000209:etiology* / Q000382:microbiology; D004198:Disease Susceptibility; D006801:Humans; D007422:Intestines / Q000382:microbiology; D054892:Metagenome / Q000502:physiology