title: Multiplex Polymerase Chain Reaction for Detection of Gastrointestinal Pathogens in Migrant Workers in Qatar.
abstract: The causes of infectious diarrhea among the migrant worker population in Qatar are not well understood. We conducted a prospective observational study to understand the demographic and clinical characteristics and infectious causes of diarrhea among migrant workers in Doha, Qatar. A total of 126 male workers presenting to the Qatar Red Crescent Worker's Health Center outpatient clinic or emergency department were studied over a 5-month period in 2015-2016. Epidemiologic surveys were administered to all subjects and the prevalence of 22 different stool pathogens was determined using multiplex polymerase chain reaction (PCR) (FilmArray®Gastrointestinal PCR). A target pathogen was identified in 62.7% of subjects. Enteropathogenic Escherichia coli was the most prevalent pathogen and was detected in 24.6% of subjects, followed by Salmonella (22.2%), enteroaggregative E. coli (15.1%), Giardia lamblia (9.5%), and enterotoxigenic E. coli (8.7%). Multiple pathogens were identified in 49.3% of positive stool samples. In a multivariable analysis, the presence of a heart rate ≥ 90 (adjusted odds ratio [OR] = 3.7, 95% confidence interval [CI] = 1.4-10.0) and > 5 fecal leukocytes/high-power field (adjusted OR = 2.8, 95% CI = 1.2-7.0) were significant predictors of detecting an acute inflammatory pathogen by PCR. Use of multiplex PCR enabled the detection of gastrointestinal pathogens in a high proportion of cases, illustrating the utility of this diagnostic tool in epidemiologic studies of infectious diarrhea.
authors.affiliation: Infectious Disease Epidemiology Group, Weill Cornell Medicine, Doha, Qatar.|Division of Infectious Diseases, Department of Medicine, Weill Cornell Medicine, New York, New York.
authors.forename: John M
authors.initials: JM
authors.lastname: Humphrey
authors.affiliation: Qatar Red Crescent Worker's Health Center, Doha, Qatar.
authors.forename: Sanjay
authors.initials: S
authors.lastname: Ranbhise
authors.affiliation: Hamad Medical Corporation, Doha, Qatar.
authors.forename: Emad
authors.initials: E
authors.lastname: Ibrahim
authors.affiliation: Communicable Diseases Department, Ministry of Public Health, Doha, Qatar.
authors.forename: Hamad E
authors.initials: HE
authors.lastname: Al-Romaihi
authors.affiliation: Communicable Diseases Department, Ministry of Public Health, Doha, Qatar.
authors.forename: Elmoubasher
authors.initials: E
authors.lastname: Farag
authors.affiliation: Department of Healthcare Policy and Research, Weill Cornell Medicine, Cornell University, New York, New York.|Infectious Disease Epidemiology Group, Weill Cornell Medicine, Doha, Qatar.
authors.forename: Laith J
authors.initials: LJ
authors.lastname: Abu-Raddad
authors.affiliation: Department of Healthcare Policy and Research, Weill Cornell Medicine, Cornell University, New York, New York.|Division of Infectious Diseases, Department of Medicine, Weill Cornell Medicine, New York, New York.
authors.forename: Marshall J
authors.initials: MJ
authors.lastname: Glesby
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D001424:Bacterial Infections / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology*; D060085:Coinfection; D005767:Gastrointestinal Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000382:microbiology* / Q000469:parasitology*; D006801:Humans; D008297:Male; D010272:Parasitic Diseases / Q000188:drug therapy / Q000453:epidemiology / Q000469:parasitology; D016133:Polymerase Chain Reaction / Q000379:methods*; D011780:Qatar / Q000453:epidemiology; D014171:Transients and Migrants; D014777:Virus Diseases / Q000453:epidemiology / Q000821:virology*
chemical_list: D000900:Anti-Bacterial Agents