Ann Rheum Dis: Reactive arthritis and other musculoskeletal symptoms associated with infection with e. coli (DEC)

The study used a forward-looking design to assess the association between infection with ecoli (DEC) and reactive arthritis (ReA) and other reactive musculoskeletal (MSK) symptoms in international travelers526 study participants were asked to provide pre- and post-travel stool samples and fill out questionnaires (pre-travel, post-travel and 3-week follow-up)Multiple quantitative PCR assays were performed to detect 5 types of DEC, including ecoli, E.Coli, ecoli, ecoli, ecoli, ecoli and entero-invasive Ecoli, as well as salmonella, Shiga, Campylobacter, Jersen and Vibrio choleraeMulti-factor analysis is used to determine the factors that induce MSK symptomsAssess new MSK symptoms after travel reporting by dec participants by telephone interview and make clinical diagnosis if necessaryOf the 224 volunteersreturned all questionnaires and stool samples, 38 (17.0%) reported MSK symptomsMulti-factor analysis showed that infection of DEC was associated with MSK symptoms (OR 3.9; 95% CI 1.2-13.3)Of the 151 patients with only DEC, 4 (2.6%) had ReA, 2 (1.3%) had reactive tendinitis and 3 (2.0%) had reactive joint pain ReA is mostly mild, and all ReA patients with human leukocyte antigen B27 are negative Antibiotic treatment for traveler's diarrhea does not prevent the progression of MSK symptoms 17 percent of volunteers reported post-travel MSK symptoms INFECTION OF DEC IS ASSOCIATED WITH AN INCREASED RISK OF DEVELOPING SYMPTOMS, BUT THE INCIDENCE OF REA REMAINS LOW AND CLINICAL SYMPTOMS ARE MILD Antibiotic treatment does not prevent the onset of MSK symptoms