Abstract
Traveler’s diarrhea (TD) is a recurrent and significant issue for many travelers including the military. While many known enteric pathogens exist that are causative agents of diarrhea, our gut microbiome may also play a role in TD susceptibility. To this end, we conducted a pilot study of the microbiome of warfighters prior to- and after deployment overseas to identify marker taxa relevant to TD. This initial study utilized full-length 16S rRNA gene sequencing to provide additional taxonomic resolution toward identifying predictive taxa.16S rRNA analyses of pre- and post-deployment fecal samples identified multiple marker taxa as significantly differentially abundant in subjects that reported diarrhea, including Weissella, Butyrivibrio, Corynebacterium, uncultivated Erysipelotrichaceae, Jeotgallibaca, unclassified Ktedonobacteriaceae, Leptolinea, and uncultivated Ruminiococcaceae. The ability to identify TD risk prior to travel will inform prevention and mitigation strategies to influence diarrhea susceptibility while traveling.
Highlights
Traveler’s diarrhea (TD) is a recurrent and serious issue for many travelers abroad including the military
There is evidence that the gut microbiome plays a role in TD, whether that role is in the manifestation of diarrhea or in allowing for currently unknown pathogens to colonize and result in TD, and more broadly in that TD can change the gut community structure (David et al, 2014)
Timing of TD varied, with 42% reporting their first case of diarrhea on deployment within the first 2 weeks, 32% at 5 weeks or more while on deployment, and 26%
Summary
Traveler’s diarrhea (TD) is a recurrent and serious issue for many travelers abroad including the military. Deployed populations experience up to 36.3 cases of TD per 100 person-months, with the highest incidence rate during the first month of travel (Olson et al, 2019). TD is commonly ascribed to pathogenic bacteria such as Salmonella, Campylobacter jejuni, and Escherichia coli (including enterotoxigenic, enteroaggregative, and enteropathogenic strains); 40% of reported cases of TD have no known etiology (Olson et al, 2019). There is evidence that the gut microbiome plays a role in TD, whether that role is in the manifestation of diarrhea or in allowing for currently unknown pathogens to colonize and result in TD, and more broadly in that TD can change the gut community structure (David et al, 2014)
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