Cargando…

Reactive arthritis and other musculoskeletal symptoms associated with acquisition of diarrhoeagenic Escherichia coli (DEC)

OBJECTIVES: Using a prospective research design, we evaluated the association between acquisition of diarrhoeagenic Escherichia coli (DEC) and development of reactive arthritis (ReA) and other reactive musculoskeletal (MSK) symptoms among international travellers. METHODS: A total of 526 study parti...

Descripción completa

Detalles Bibliográficos
Autores principales: Tuompo, Riitta, Lääveri, Tinja, Hannu, Timo, Pakkanen, Sari H, Kirveskari, Juha, Leirisalo-Repo, Marjatta, Kantele, Anu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7213310/
https://www.ncbi.nlm.nih.gov/pubmed/32179576
http://dx.doi.org/10.1136/annrheumdis-2019-216736
_version_ 1783531776846594048
author Tuompo, Riitta
Lääveri, Tinja
Hannu, Timo
Pakkanen, Sari H
Kirveskari, Juha
Leirisalo-Repo, Marjatta
Kantele, Anu
author_facet Tuompo, Riitta
Lääveri, Tinja
Hannu, Timo
Pakkanen, Sari H
Kirveskari, Juha
Leirisalo-Repo, Marjatta
Kantele, Anu
author_sort Tuompo, Riitta
collection PubMed
description OBJECTIVES: Using a prospective research design, we evaluated the association between acquisition of diarrhoeagenic Escherichia coli (DEC) and development of reactive arthritis (ReA) and other reactive musculoskeletal (MSK) symptoms among international travellers. METHODS: A total of 526 study participants were asked to provide pretravel and post-travel stool samples and fill in questionnaires (pretravel, post-travel and 3-week follow-up). A multiplex quantitative PCR assay was deployed to detect five DEC comprising enteroaggregative E. coli, enteropathogenic E. coli, enterotoxigenic E. coli, enterohaemorrhagic E. coli and enteroinvasive E. coli and Salmonella, Shigella, Campylobacter, Yersinia, and Vibrio cholerae. Multivariate analysis was employed to identify factors predisposing to MSK symptoms. New post-travel MSK symptoms reported by participants with DEC were assessed by phone interviews and, if needed, clinically confirmed. RESULTS: From among the total of 224 volunteers who returned all questionnaires and stool specimens, 38 (17.0%) reported MSK symptoms. Multivariate analysis revealed that acquisition of DEC was associated with MSK symptoms (OR 3.9; 95% CI 1.2 to 13.3). Of the 151 with only-DEC, four (2.6%) had ReA, two (1.3%) reactive tendinitis and three (2.0%) reactive arthralgia. ReA was mostly mild, and all patients with ReA were negative for human leucocyte antigen B27. Antibiotic treatment of travellers’ diarrhoea did not prevent development of MSK symptoms. CONCLUSION: A total of 17% of volunteers reported post-travel MSK symptoms. DEC acquisition was associated with an increased risk of developing them, yet the ReA incidence remained low and the clinical picture mild. Antibiotic treatment did not protect against development of MSK symptoms.
format Online
Article
Text
id pubmed-7213310
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher BMJ Publishing Group
record_format MEDLINE/PubMed
spelling pubmed-72133102020-05-14 Reactive arthritis and other musculoskeletal symptoms associated with acquisition of diarrhoeagenic Escherichia coli (DEC) Tuompo, Riitta Lääveri, Tinja Hannu, Timo Pakkanen, Sari H Kirveskari, Juha Leirisalo-Repo, Marjatta Kantele, Anu Ann Rheum Dis Spondyloarthritis OBJECTIVES: Using a prospective research design, we evaluated the association between acquisition of diarrhoeagenic Escherichia coli (DEC) and development of reactive arthritis (ReA) and other reactive musculoskeletal (MSK) symptoms among international travellers. METHODS: A total of 526 study participants were asked to provide pretravel and post-travel stool samples and fill in questionnaires (pretravel, post-travel and 3-week follow-up). A multiplex quantitative PCR assay was deployed to detect five DEC comprising enteroaggregative E. coli, enteropathogenic E. coli, enterotoxigenic E. coli, enterohaemorrhagic E. coli and enteroinvasive E. coli and Salmonella, Shigella, Campylobacter, Yersinia, and Vibrio cholerae. Multivariate analysis was employed to identify factors predisposing to MSK symptoms. New post-travel MSK symptoms reported by participants with DEC were assessed by phone interviews and, if needed, clinically confirmed. RESULTS: From among the total of 224 volunteers who returned all questionnaires and stool specimens, 38 (17.0%) reported MSK symptoms. Multivariate analysis revealed that acquisition of DEC was associated with MSK symptoms (OR 3.9; 95% CI 1.2 to 13.3). Of the 151 with only-DEC, four (2.6%) had ReA, two (1.3%) reactive tendinitis and three (2.0%) reactive arthralgia. ReA was mostly mild, and all patients with ReA were negative for human leucocyte antigen B27. Antibiotic treatment of travellers’ diarrhoea did not prevent development of MSK symptoms. CONCLUSION: A total of 17% of volunteers reported post-travel MSK symptoms. DEC acquisition was associated with an increased risk of developing them, yet the ReA incidence remained low and the clinical picture mild. Antibiotic treatment did not protect against development of MSK symptoms. BMJ Publishing Group 2020-05 2020-03-16 /pmc/articles/PMC7213310/ /pubmed/32179576 http://dx.doi.org/10.1136/annrheumdis-2019-216736 Text en © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle Spondyloarthritis
Tuompo, Riitta
Lääveri, Tinja
Hannu, Timo
Pakkanen, Sari H
Kirveskari, Juha
Leirisalo-Repo, Marjatta
Kantele, Anu
Reactive arthritis and other musculoskeletal symptoms associated with acquisition of diarrhoeagenic Escherichia coli (DEC)
title Reactive arthritis and other musculoskeletal symptoms associated with acquisition of diarrhoeagenic Escherichia coli (DEC)
title_full Reactive arthritis and other musculoskeletal symptoms associated with acquisition of diarrhoeagenic Escherichia coli (DEC)
title_fullStr Reactive arthritis and other musculoskeletal symptoms associated with acquisition of diarrhoeagenic Escherichia coli (DEC)
title_full_unstemmed Reactive arthritis and other musculoskeletal symptoms associated with acquisition of diarrhoeagenic Escherichia coli (DEC)
title_short Reactive arthritis and other musculoskeletal symptoms associated with acquisition of diarrhoeagenic Escherichia coli (DEC)
title_sort reactive arthritis and other musculoskeletal symptoms associated with acquisition of diarrhoeagenic escherichia coli (dec)
topic Spondyloarthritis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7213310/
https://www.ncbi.nlm.nih.gov/pubmed/32179576
http://dx.doi.org/10.1136/annrheumdis-2019-216736
work_keys_str_mv AT tuomporiitta reactivearthritisandothermusculoskeletalsymptomsassociatedwithacquisitionofdiarrhoeagenicescherichiacolidec
AT laaveritinja reactivearthritisandothermusculoskeletalsymptomsassociatedwithacquisitionofdiarrhoeagenicescherichiacolidec
AT hannutimo reactivearthritisandothermusculoskeletalsymptomsassociatedwithacquisitionofdiarrhoeagenicescherichiacolidec
AT pakkanensarih reactivearthritisandothermusculoskeletalsymptomsassociatedwithacquisitionofdiarrhoeagenicescherichiacolidec
AT kirveskarijuha reactivearthritisandothermusculoskeletalsymptomsassociatedwithacquisitionofdiarrhoeagenicescherichiacolidec
AT leirisalorepomarjatta reactivearthritisandothermusculoskeletalsymptomsassociatedwithacquisitionofdiarrhoeagenicescherichiacolidec
AT kanteleanu reactivearthritisandothermusculoskeletalsymptomsassociatedwithacquisitionofdiarrhoeagenicescherichiacolidec