title: Does Tropheryma whipplei contribute to travelers' diarrhea?: A PCR analysis of paired stool samples in French travelers to Senegal.
abstract: BACKGROUND
  Tropheryma whipplei was recently associated with acute infections as gastroenteritis in children. We hypothesize that T. whipplei may be a contributing microbe in traveler's diarrhea.
  
  
  METHODS
  The presence of T. whipplei was investigated by using a specific PCR on stool samples of travelers to Senegal before and after traveling, independently of the occurrence of diarrhea.
  
  
  RESULTS
  A total of 59 travelers returned both stool samples before and after travel and 16 (27%) experienced diarrhea during travel. Fifty-three patients (89.8%) were negative for T. whipplei before and after travel. Two patients (3.4%) were negative before and positive after travel. Two patients (3.4%) were positive before travel and negative after travel. Finally, two patients (3.4%) were positive before and after travel. There were no carriage differences of T. whipplei, visiting Senegal or staying in France. We found no significant association of T. whipplei carriage and travel-associated diarrhea but this may have been impacted by the use of doxycycline.
  
  
  CONCLUSIONS
  This is the first report of T. whipplei carriage acquired during travel to tropical area. Further study addressing this issue in larger cohorts of travelers to Senegal, including individuals visiting friends and relatives in their country of origin and the protective role of doxycycline malaria chemoprophylaxis may help to understand the potential contribution of T. whipplei to travelers' diarrhea.
authors.affiliation: Assistance Publique Hôpitaux de Marseille, CHU Nord, Pôle Infectieux, Institut Hospitalo-Universitaire Méditerranée Infection, 13015 Marseille, France; Aix Marseille Université, Unité de Recherche en Maladies Infectieuses et Tropicales Emergentes (URMITE), UM63, CNRS 7278, IRD 198, Inserm 1095, Faculté de Médecine, 27 Bd Jean Moulin, 13005 Marseille, France. Electronic address: philippe.gautret@club-internet.fr.
authors.forename: Philippe
authors.initials: P
authors.lastname: Gautret
authors.affiliation: Assistance Publique Hôpitaux de Marseille, CHU Nord, Pôle Infectieux, Institut Hospitalo-Universitaire Méditerranée Infection, 13015 Marseille, France; Aix Marseille Université, Unité de Recherche en Maladies Infectieuses et Tropicales Emergentes (URMITE), UM63, CNRS 7278, IRD 198, Inserm 1095, Faculté de Médecine, 27 Bd Jean Moulin, 13005 Marseille, France.
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Lagier
authors.affiliation: Aix Marseille Université, Unité de Recherche en Maladies Infectieuses et Tropicales Emergentes (URMITE), UM63, CNRS 7278, IRD 198, Inserm 1095, Faculté de Médecine, 27 Bd Jean Moulin, 13005 Marseille, France.
authors.forename: Samir
authors.initials: S
authors.lastname: Benkouiten
authors.affiliation: Assistance Publique Hôpitaux de Marseille, CHU Nord, Pôle Infectieux, Institut Hospitalo-Universitaire Méditerranée Infection, 13015 Marseille, France; Aix Marseille Université, Unité de Recherche en Maladies Infectieuses et Tropicales Emergentes (URMITE), UM63, CNRS 7278, IRD 198, Inserm 1095, Faculté de Médecine, 27 Bd Jean Moulin, 13005 Marseille, France.
authors.forename: Florence
authors.initials: F
authors.lastname: Fenollar
authors.affiliation: Assistance Publique Hôpitaux de Marseille, CHU Nord, Pôle Infectieux, Institut Hospitalo-Universitaire Méditerranée Infection, 13015 Marseille, France; Aix Marseille Université, Unité de Recherche en Maladies Infectieuses et Tropicales Emergentes (URMITE), UM63, CNRS 7278, IRD 198, Inserm 1095, Faculté de Médecine, 27 Bd Jean Moulin, 13005 Marseille, France.
authors.forename: Didier
authors.initials: D
authors.lastname: Raoult
authors.affiliation: Assistance Publique Hôpitaux de Marseille, CHU Nord, Pôle Infectieux, Institut Hospitalo-Universitaire Méditerranée Infection, 13015 Marseille, France; Aix Marseille Université, Unité de Recherche en Maladies Infectieuses et Tropicales Emergentes (URMITE), UM63, CNRS 7278, IRD 198, Inserm 1095, Faculté de Médecine, 27 Bd Jean Moulin, 13005 Marseille, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Brouqui
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003967:Diarrhea / Q000453:epidemiology* / Q000382:microbiology; D005243:Feces / Q000382:microbiology; D005260:Female; D005602:France / Q000453:epidemiology; D005759:Gastroenteritis / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012675:Senegal / Q000453:epidemiology; D013045:Species Specificity; D011795:Surveys and Questionnaires; D014195:Travel; D057236:Travel Medicine; D054851:Tropheryma / Q000235:genetics / Q000302:isolation & purification*; D008061:Whipple Disease / Q000453:epidemiology* / Q000382:microbiology; D055815:Young Adult
keywords: Diarrhea; Senegal; Traveler; Tropheryma whipplei