enteropathogens

Enteropathogens are microorganisms that infect the gastrointestinal tract and cause enteric disease, most commonly diarrhea. They include bacteria, viruses, protozoa, and occasionally intestinal parasites, and are transmitted chiefly by the fecal-oral route through contaminated food or water, person-to-person contact, or, less often, via vectors.

Pathogenesis varies by agent but generally involves disruption of the intestinal mucosa, toxin production, or invasion of enterocytes, leading to malabsorption and secretory or inflammatory diarrhea. Some pathogens cause illness primarily by enterotoxins, others by mucosal invasion and cytotoxic damage.

Bacterial enteropathogens include enterotoxigenic and enteropathogenic Escherichia coli, Salmonella, Shigella, Campylobacter, Vibrio cholerae, and Clostridioides difficile. Viral causes include norovirus and rotavirus; protozoa include Giardia lamblia, Entamoeba histolytica, Cryptosporidium, and Cyclospora.

Clinical features vary but commonly include acute or persistent diarrhea, abdominal cramps, nausea or vomiting, and sometimes fever or hematochezia with invasive pathogens. Diagnosis relies on stool testing—culture, PCR panels, antigen detection, and microscopy—alongside clinical history and exposure. Severe cases may require endoscopy.

Management emphasizes rehydration and electrolyte replacement; antibiotics are reserved for specific bacterial infections and emerging resistance issues, while antiparasitics treat selected parasites. C. difficile is treated with targeted antibiotics such as oral vancomycin or fidaxomicin.

Prevention focuses on safe water and food handling, sanitation, hygiene, and vaccination where available (e.g., rotavirus, cholera vaccines). Outbreak prevention includes infection control in healthcare and institutional settings.

Globally, diarrheal diseases caused by enteropathogens remain a leading cause of morbidity and mortality, especially among young children in low-income regions, highlighting the ongoing need for surveillance, vaccination, clean water, and sanitation.