{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T23:24:59Z","timestamp":1790810699521,"version":"4.1.0"},"reference-count":68,"publisher":"Wiley","license":[{"start":{"date-parts":[[2015,1,1]],"date-time":"2015-01-01T00:00:00Z","timestamp":1420070400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BioMed Research International"],"published-print":{"date-parts":[[2015]]},"abstract":"<jats:p><jats:italic>Introduction<\/jats:italic>. Since 2013, European soldiers have been deployed on the European Union Training Mission (EUTM) in Mali. From the beginning, diarrhea has been among the most \u201curgent\u201d concerns. Diarrhea surveillance based on deployable real-time PCR equipment was conducted between December 2013 and August 2014.<jats:italic>Material and Methods<\/jats:italic>. In total, 53 stool samples were obtained from 51 soldiers with acute diarrhea. Multiplex PCR panels comprised enteroinvasive bacteria, diarrhea-associated<jats:italic>Escherichia coli<\/jats:italic>(EPEC, ETEC, EAEC, and EIEC), enteropathogenic viruses, and protozoa. Noroviruses were characterized by sequencing. Cultural screening for Enterobacteriaceae with extended-spectrum beta-lactamases (ESBL) with subsequent repetitive sequence-based PCR (rep-PCR) typing was performed. Clinical information was assessed.<jats:italic>Results<\/jats:italic>. Positive PCR results for diarrhea-associated pathogens were detected in 43\/53 samples, comprising EPEC (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\"><mml:mi>n<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>21<\/mml:mn><\/mml:math>), ETEC (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\"><mml:mi>n<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>19<\/mml:mn><\/mml:math>), EAEC (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\"><mml:mi>n<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>15<\/mml:mn><\/mml:math>), Norovirus (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\"><mml:mi>n<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>10<\/mml:mn><\/mml:math>),<jats:italic>Shigella<\/jats:italic>spp.\/EIEC (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M5\"><mml:mi>n<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>6<\/mml:mn><\/mml:math>),<jats:italic>Cryptosporidium parvum<\/jats:italic>(<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M6\"><mml:mi>n<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>3<\/mml:mn><\/mml:math>),<jats:italic>Giardia duodenalis<\/jats:italic>(<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M7\"><mml:mi>n<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>2<\/mml:mn><\/mml:math>),<jats:italic>Salmonella<\/jats:italic>spp. (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M8\"><mml:mi>n<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>1<\/mml:mn><\/mml:math>), Astrovirus (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M9\"><mml:mi>n<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>1<\/mml:mn><\/mml:math>), Rotavirus (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M10\"><mml:mi>n<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>1<\/mml:mn><\/mml:math>), and Sapovirus (<mml:math xmlns:mml=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M11\"><mml:mi>n<\/mml:mi><mml:mo>=<\/mml:mo><mml:mn>1<\/mml:mn><\/mml:math>). ESBL-positive Enterobacteriaceae were grown from 13 out of 48 samples. Simultaneous infections with several enteropathogenic agents were observed in 23 instances. Symptoms were mild to moderate. There were hints of autochthonous transmission.<jats:italic>Conclusions<\/jats:italic>. Multiplex real-time PCR proved to be suitable for diarrhea surveillance on deployment. Etiological attribution is challenging in cases of detection of multiple pathogens.<\/jats:p>","DOI":"10.1155\/2015\/573904","type":"journal-article","created":{"date-parts":[[2015,10,12]],"date-time":"2015-10-12T23:15:18Z","timestamp":1444691718000},"page":"1-15","source":"Crossref","is-referenced-by-count":27,"title":["Surveillance of Food- and Smear-Transmitted Pathogens in European Soldiers with Diarrhea on Deployment in the Tropics: Experience from the European Union Training Mission (EUTM) Mali"],"prefix":"10.1155","volume":"2015","author":[{"given":"Hagen","family":"Frickmann","sequence":"first","affiliation":[{"name":"Department of Tropical Medicine at the Bernhard Nocht Institute, German Armed Forces Hospital of Hamburg, 20359 Hamburg, Germany"},{"name":"Institute for Medical Microbiology, Virology and Hygiene, University Medicine Rostock, 18057 Rostock, 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