{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T02:48:55Z","timestamp":1791600535557,"version":"4.3.4"},"reference-count":20,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T00:00:00Z","timestamp":1791417600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background\/Objectives: The COVID-19 public health emergency altered enteric infection surveillance, diagnostic testing, and antibiotic prescribing. We compared pathogen\/testing composition among post-infectious irritable bowel syndrome (PI-IBS) cases stratified by whether index gastroenteritis occurred before, during, or after the emergency. Methods: This single-centre retrospective case series included 138 adults with clinician-diagnosed PI-IBS classified as Rome IV-compatible by chart adjudication. Index gastroenteritis occurred from January 2019 to December 2024; existing clinical records were reviewed retrospectively. The primary comparison was a five-category pathogen\/testing profile. Results: The profile differed across pre-pandemic (n = 30), pandemic (n = 39), and post-emergency (n = 69) periods (\u03c72 = 35.56, p &lt; 0.001; Cram\u00e9r V = 0.36, 95% CI 0.30\u20130.48). Bacterial\/protozoal cases represented 63.3%, 7.7%, and 33.3%, respectively; SARS-CoV-2-associated cases represented 0%, 35.9%, and 13.0%. Antibiotic exposure was 56.7%, 12.8%, and 33.3%. In an exploratory adjusted model, confirmed enteric pathogens were associated with antibiotic exposure (OR 16.28, 95% CI 3.03\u201387.35), whereas period was not. Sensitivity analyses excluding SARS-CoV-2 cases and period-crossing diagnoses were concordant. Conclusions: Pathogen\/testing and antibiotic-exposure profiles differed across periods among diagnosed PI-IBS cases. These data describe case composition, not incidence or causal risk, and cannot separate infection ecology from diagnostic behaviour.<\/jats:p>","DOI":"10.3390\/jcm15197729","type":"journal-article","created":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T01:40:17Z","timestamp":1791596417000},"page":"7729","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pathogen and Testing Profiles in Post-Infectious Irritable Bowel Syndrome Across the COVID-19 Public Health Emergency: A Retrospective Case Series"],"prefix":"10.3390","volume":"15","author":[{"given":"Erhan","family":"Bozkurt","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar 03030, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0779-992X","authenticated-orcid":false,"given":"Osman","family":"Sa\u011flam","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Afyonkarahisar Health Sciences University, Afyonkarahisar 03030, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alper","family":"Sar\u0131","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar 03030, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7741-9067","authenticated-orcid":false,"given":"Murat","family":"Ay","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar 03030, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O\u011fuzhan","family":"K\u00f6se","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar 03030, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alper Emre","family":"Kurt","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar 03030, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali Arda","family":"Demir","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar 03030, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mesut","family":"\u00c7eliker","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar 03030, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,10,8]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1053\/j.gastro.2020.04.014","article-title":"Worldwide prevalence and burden of functional gastrointestinal disorders, results of Rome Foundation global study","volume":"160","author":"Sperber","year":"2021","journal-title":"Gastroenterology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1431","DOI":"10.1136\/gutjnl-2023-331835","article-title":"Prevalence of irritable bowel syndrome and functional dyspepsia after acute gastroenteritis: Systematic review and meta-analysis","volume":"73","author":"Porcari","year":"2024","journal-title":"Gut"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1053\/j.gastro.2018.07.011","article-title":"Rome Foundation working team report on post-infection irritable bowel syndrome","volume":"156","author":"Barbara","year":"2019","journal-title":"Gastroenterology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1042","DOI":"10.1053\/j.gastro.2016.12.039","article-title":"Prevalence, risk factors, and outcomes of irritable bowel syndrome after infectious enteritis: A systematic review and meta-analysis","volume":"152","author":"Klem","year":"2017","journal-title":"Gastroenterology"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1260","DOI":"10.15585\/mmwr.mm7140a2","article-title":"Preliminary incidence and trends of infections caused by pathogens transmitted commonly through food\u2014Foodborne Diseases Active Surveillance Network, 10 U.S. sites, 2016-2021","volume":"71","author":"Collins","year":"2022","journal-title":"MMWR Morb. 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