Detection of Campylobacter jejuni and other potential pathogens in travellers' diarrhoea in Bangladesh

To determine the distribution of pathogens associated with travellers' diarrhoea in Bangladesh, we have studied 269 expatriates who presented with diarrhoea to our clinic, over a one-year period. Patients were interviewed about their history of diarrhoea and a stool specimen examined for parasites and cultured for Campylobacter jejuni, Shigella sp., Salmonella sp., Vibrio and Aeromonas hydrophila and Plesiomonas shigelloides. C. jejuni and Shigella sp. were each isolated from 45 patients (17%) and P. shigelloides, A. hydrophila and V. cholerae non 01 from 7, 2 and 4 patients respectively. Patients with C. jejuni developed diarrhoea earlier after their arrival in Bangladesh than patients with Shigella. Fever and dysentery were significantly more common in patients with C. jejuni and Shigella. Infections with C. jejuni were less frequently associated with dysentery than infections with Shigella sp. Both C. jejuni and Shigella are commonly associated with travellers' diarrhoea in Bangladesh, and P. Shigelloides, A. hydrophila and V. cholerae non 01 may have an infrequent but potentially pathogenic role.