Table 2.

Summary of common bacterial enteropathogens associated with acute gastroenteritis syndromes

pathogen(s)	exposures	clinical presentation	diagnostic tests		references
			culture	CIDT
Campylobacter spp	poultry; unpasteurized dairy products, travel abroad, puppies, reptiles, contaminated water	abdominal pain, fever, nausea, vomiting, diarrhea (often bloody), rarely bacteremia	yes	yes	25,161–164
nontyphoidal Salmonella spp	eggs, chicken, multiple foods, backyard flocks, broad range of pets including amphibians and reptiles	abdominal pain, fever, nausea, vomiting, diarrhea, bacteremia more frequent with some serotypes*	yes	yes	40,165
STEC	numerous foodborne outbreaks with multiple vehicles of transmission including beef (particularly ground), sprouts, salad greens, cookie dough; petting zoos, childcare centers	diarrhea abdominal pain vomiting >bloody diarrhea (90%)->HUS (15%)	yes	yes	49,166,167
Shigella spp.	foodborne, travel abroad, homeless, easily transmitted person>person, daycares, MSMa	1–2 day incubation period; serotype sonnei causes most disease in US. typically milder illness. watery/bloody/mucoid stool; fever, abdominal pain, nausea	yes	yes	56–58,62,168–170
Yersinia enterocolitica	pork, pork intestines (chitlins); unpasteurized milk/dairy	abdominal pain (may mimic appendicitis) diarrhea/bloody persistent diarrhea; bacteremia, particularly with iron overload states; metastatic infections	yes	yes	171,172
non-cholera Vibrio spp	raw or undercooked shellfish		yes	yes	173–175
ETECb	international travel, domestic foodborne outbreaks.	abdominal pain, watery diarrhea occasionally profuse & cholera-like, occasionally prolonged duration of illness (median up to 7days) fever, vomiting infrequent.	no	yes	53,74,78
other DECc	international travel, domestic foodborne(?); EAECd has been associated with protracted diarrhea in HIV+ patients; EPECe previously identified as a cause of infant diarrhea in U.S.	typically, watery diarrhea; borborygmi, low grade fever, nausea.	no	yes	176–178
pre-formed enterotoxin syndromes
Clostridium perfringens	beef, poultry, catered, pre-warmed foods; restaurants	diarrhea and cramps within 6–24 (median 11) hours of ingestion. fever and /or vomiting are very infrequent.	no	no**	87
Bacillus cereus	rice/fried rice; meat; restaurants	2–12 (median 5) hours, vomiting, diarrhea	no	no**	87
Staphylococcus aureus	diverse vehicles; restaurants	sudden onset nausea, vomiting, abdominal pain, diarrhea within 30 minutes to 8 hours (median 4 hours) of ingestion. self- limited.	no	no**	87,89

^*Dublin>Cholerasuis>Schwarzengrund>Heidelberg>Enteriditis~Typhimurium

^**preformed toxin detection by reference/public health laboratory

^amen who have sex with men

^bETEC enterotoxigenic E. coli;

^cDEC diarrheagenic E. coli,

^dEAEC enteroaggregative E. coli,

^eEPEC enteropathogenic E. coli