Diarrhea among expatriate residents in Thailand: Correlation between reduced campylobacter prevalence and longer duration of stay

Abstract

Background: The etiology of diarrhea among expatriates in Thailand was investigated. Methods: One hundred and five stool specimens were collected from Americans and Europeans who had developed diarrhea while residing in Thailand. These stools were analyzed for bacterial enteric pathogens. Results: Enterotoxigenic Escherichia coli was isolated from 18 (17%) persons and Campylobacter from 10 (10%). Shigella and Salmonella were each isolated from 8 (8%) persons. Vibrio sp., enteroinvasive Escherichia coli, and enteropathogenic Escherichia coli were found in rare cases. Conclusions: Bacterial pathogens, particularly Campylobacter, were isolated significantly less often in patients who had lived in Thailand for more than 1 year, compared with those who had lived there less than 1 year (relative risk: 0.62, 95% confidence interval: 0.40-0.97, p=.03).