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Shigella flexneri Sepsis in an Infant
Ju-Bei Yen,Kuei-Wen Chang,Tsu-Lan Wu,An-Jin Kuo
Chang Gung Medical Journal , 2003,
Abstract: Shigellosis continues to be an important public health problem in developed countries,since communication in the world village has become more frequent. In addition, this diseaseis difficult to be prevented because only a small number of bacteria are required tocause infection, and it has exhibited steady trends towards multiple drug resistance. Thisreport describes a 7-month-old female infant with Shigella flexneri sepsis presenting initiallywith a high fever, watery diarrhea, and dehydration. She was successfully treated with ceftriaxonefor 7 days. This case illustrates that Shigella should be included in the differentialdiagnosis of sepsis associated with diarrhea particularly in young infants traveling to or livingin an endemic area. The choice of antimicrobial therapy and the optimal duration fortreatment should be carefully evaluated because of the emergence of multidrug-resistantShigella.
Proinflammatory signal transduction pathway induced by Shigella flexneri porins in caco-2 cells
Elena, Grimaldi;Giovanna, Donnarumma;Brunella, Perfetto;Anna, De Filippis;Alessandro, Melito;Antonietta, Tufano Maria;
Brazilian Journal of Microbiology , 2009, DOI: 10.1590/S1517-83822009000300036
Abstract: the recognition of bacterial components on the intestinal epithelial cells occurs through the toll-like receptors and is followed by the induction of an effective innate immune response. we analyzed receptor expression and signaling pathways involved in activation of human colon adenocarcinoma cells after stimulation with porins and lps of shigella flexneri. we also analyzed the expression and production of some cytokines, of intercellular adhesion molecule-1, of antimicrobial peptides human 2-defensins, and of the inducible form of nitric oxide synthase. our data demonstrate that tlr2 is involved in porin recognition, whereas tlr4 with md2, is required for lps recognition.
Molecular epidemiology of Shigella spp strains isolated in two different metropolitam areas of southeast Brazil
Angelini, Michelle;Stehling, Eliana Guedes;Moretti, Maria Luiza;Silveira, Wanderley Dias da;
Brazilian Journal of Microbiology , 2009, DOI: 10.1590/S1517-83822009000300034
Abstract: shigella spp., the human pathogen responsible for shigellosis, is highly infectious even at low levels. the incidence rate of shigellosis varies with geographical distribution, location human development index, and age groups, being higher among children aged under 5 years. in brazil, a few works indicate that shigellosis cases are underestimated, with s. flexneri and s. sonnei strains being the major agents responsible for the shigellosis cases. the present study used pulsed field gel electrophoresis (pfge) to investigate the molecular epidemiology of 119 strains of s. sonnei and s. flexneri isolated from shigellosis cases that occurred in the metropolitan areas of ribeir?o preto and campinas cities, s?o paulo sate, southeast brazil. the results indicated (i) the existence of just a few strain clusters for both species, but with genotype variability with either a high speed of genetic change or constant introduction of several genotypes, considering the intense migration to these two metropolitan areas, and (ii) the prevalence of specific genotypes in each geographical area, which suggests the successful adaptation of some genotypes to the local environmental conditions. our results indicate the need of more efficacious sanitary barriers to prevent shigella spp. outbreaks and epidemics.
Two Cases of Vulvovaginitis Caused by Shigella flexneri and Shigella sonnei: a Case Report
Gül?in Bayramo?lu,Faruk Ayd?n,Gülay Karagüzel,Mustafa ?mamo?lu
Balkan Medical Journal , 2012,
Abstract: Vulvovaginitis caused by Shigella species (Shigella spp.) has rarely been reported. This paper describes two cases of prepubertal vulvovaginitis, presenting with a bloody and purulent vaginal discharge, separately caused by ampicillin-resistant Shigella flexneri and trimethoprim-sulfomethoxazole-resistant Shigella sonnei. Our conclusions are that Shigella spp. is the potential cause of vulvovaginitis in prepubertal girls in developing countries where these pathogens are endemic, and identification of the bacteria and making antibiotic susceptibility testing in these cases should not be overlooked.
Brote de shigellosis con 146 casos relacionado con una feria
Castell Monsalve,Juan; Gutiérrez ávila,Gonzalo; Rodolfo Saavedra,Remedios; Santos Azorín,Antonia;
Gaceta Sanitaria , 2008,
Abstract: background: on september 3, 2005, the ciudad real public health service (spain) received a report of 20 cases of gastroenteritis in the municipality of daimiel. we conducted an investigation to determine the cause or causes of the outbreak and to implement control measures. most of the cases involved young people who visited the municipality's fair. methods: we carried out a descriptive study and an analytic case-control study. in the descriptive study, all variables of interest available in the medical records were included. in the case-control study, each case was matched with a control by age (plus or minus 5 years), gender, and attendance at the fair. sixty-five cases and 65 controls were finally included in the study. samples of foods and stools from food handlers were taken. results: we found 196 cases, 146 of which were confirmed. the epidemic curve suggested a common source of infection with a short period of activity. the case-control study showed an association between infection and eating potatoes with a sauce at any of the fair's five food stalls (or = 20.56; 95%ci, 6.15-75.93; p < 0.0001). logistic regression analysis showed an association with eating potatoes in food stall number 2 (or = 6.38; 95%ci, 1.70-23.90; p < 0.0059). neither samples of foods nor stools from food handlers yielded any positive results. however, shigella sonnei was isolated from stool samples from 20 cases. conclusions: the epidemiological study suggested that the most probable cause of the outbreak was a sauce, handmade with garlic, milk, and oil and served with the potatoes.
Frequency and antimicrobial susceptibility of Shigella species isolated in Children Medical Center Hospital, Tehran, Iran, 2001-2006
Pourakbari, Babak;Mamishi, Setareh;Mashoori, Negar;Mahboobi, Nastaran;Ashtiani, Mohammad H;Afsharpaiman, Shahla;Abedini, Masomeh;
Brazilian Journal of Infectious Diseases , 2010, DOI: 10.1590/S1413-86702010000200007
Abstract: appropriate antimicrobial treatment of shigellosis depends on identifying its changing resistance pattern over time. we evaluated 15,255 stool culture submitted from july 2001 to june 2006 to the laboratory of children medical center hospital. specimen culture, bacterial identification, and disk diffusion susceptibility testing were performed according to national committee for clinical laboratory standards guidelines. from 15,255 stool samples, 682 (4.5%) were positive for shigella species. the most common species of shigella were s. flexneri (48%) and s. sonnei (45%); other results were s. dysenteriae (5%) and s. boydii (2%). the rate of sensitivity to ceftriaxone (95%), ceftizoxime (94%), and nalidixic acid (84%) were among our isolates. resistance to co-trimoxazole and ampicillin was 87% and 86%, respectively. s. flexneri was more multiresistant than other species (47.9%). our isolates are overall most sensitive to ceftriaxone, ceftazidime, and nalidixic acid (> 84%). they were most resistant to co-trimoxazole and ampicillin (> 86%). because resistance varies according to specific location, continuous local monitoring of resistance patterns is necessary for the appropriate selection of empirical antimicrobial therapy.
Bacterial pathogens associated with bloody diarrhea in Uruguayan children
Mota,M. I.; Gadea,M. P.; González,S.; González,G.; Pardo,L.; Sirok,A.; Rivas,M.; Algorta,G.; Schelotto,F.; Varela,G.;
Revista argentina de microbiolog?-a , 2010,
Abstract: diarrheal disease continues to be a serious health problem, especially in developing countries. bloody diarrhea represents approximately 20-30% of all cases and has higher morbidity and mortality. treatment with antibiotics is beneficial in cases of shigella, campylobacter, yersinia and salmonella infection, principally in those children with a higher risk of invasive disease. the aims of this study were to detect the bacterial agents associated with bloody diarrhea in children and to determine their antimicrobial susceptibility patterns. between june 2001 and january 2008, 249 children with bloody diarrhea were studied. shigella and shiga toxin-producing escherichia coli (stec) were recovered from 48 (19.3%) and 3 (1.2%) of the total of cases, respectively. in 49 out of 249 children, in whom other enteropathogens were investigated, we recovered campylobacter jejuni from 7 children (14.3%), salmonella spp. from 2 (4.1%) and aeromonas spp. from 1 (2%) in addition to shigella from 7 children (14.3%). thirty-four (70%) shigella isolates showed resistance to ampicillin and 13 (27%) to trimethoprim-sulfamethoxazole. all shigella isolates were susceptible to nalidixic acid, ciprofloxacin and ceftriaxone. salmonella and stec isolates were susceptible to all antibiotics assayed. thus, the use of trimethoprim-sulfamethoxazole or ampicillin would not be appropriate for the empirical treatment of shigella - associated diarrhea.
Diarreas asociadas a Shigella con un patrón de resistencia antimicrobiana alto en el cantón de Coto Brus, Costa Rica
Mora-Mora,Minar; Soto,Lisbeth; Salvador,Gonzalo;
Revista Costarricense de Ciencias Médicas , 2003,
Abstract: among 420 diarrheic simples from patients from the san vito hospital, puntarenas, costa rica, were essayed from 2001, january to 2002, january. the percentage of resistance of shigella sp; to eight of the first line antibiotics, was determined. the 65.1 % of the strains were isolated between october and december of 2001. one hundred and forty two of the strains isolated were shigella flexneri and six were shigella sonnei. the 70% of the strains shown resistance to trimethoprim / sulfametoxazole, tetracycline and ampicillin. aii of the strains were susceptibles to gentamicin, cefotaxime and ciprofloxacin. the case studies determined that most of the strains isolated, have an higher resistant rate to the most used antibiotics in treatment against diarrheic illness. for hence, it is important the continual monitoring of the resistance patterns for a subsequentt reatment.
Brote de Diarrea Asociado a Shigella Sonnei debido a Contaminación Hídrica, San José, Costa Rica, 2001
Barrantes,Kenia; Pardo,Vekoh; Achí,Rosario;
Revista Costarricense de Ciencias Médicas , 2004,
Abstract: during july of 2001, a diarrheal outbreak affected more than 7000 individuals in the urban area of san josé. even though the origen of the outbreak was not found, faecal pollution of the drinking water from the metropolitan aqueduct it is suspected. the objetive of the study was to determinate the presence of shigella spp., as a possible aetiological agent of the outbreak. samples were collected during two weeks (july 17th to 31st). sixteen shigella isolates were obtained out of 49 patients with diarrhoea (34,7%), 15 of the isolates were shigella sonnei and 1 corresponded to shigella flexneri. the most affected age groups were children under 10 and people older than 60. the antibiotic susceptibility pattern of the shigella isolates showed that they were resistant to eigth of the antibiotics: trimethoprim/sulfamethoxazole, tetracycline, ampicillin, eritromicine, chloramphenicol, cephalotin, amikacine and amoxicillin. they were sensitive to norfloxacin, ciprofloxacin and gentamicin. althought it was not possible to isolate shigella directly from water, the results highly suggest this pathogen to be the aetiological agent of the outbreak. this study demonstrates the import role of shigella spp. as cause of diarrhea affecting mainly small children and elderly people and its frequent association to outbreaks related to drinking water. this study also suggests that guidelines for treatment of shigellosis should include information on the antibiotic resistance pattern and further studies regarding the routes of transmission by water and food, will be required for strategies of prevention of such outbreaks
Shigella sp. aisladas en Ciudad Bolívar: Prevalencia y su sensibilidad a los antimicrobianos
Hernández de Cuesta,I.; Godoy,G. A.;
Revista de la Sociedad Venezolana de Microbiología , 2002,
Abstract: the isolation of 184 strains of shigella sp, during a 7 years period, showed that 63 (34.2%) were sh. flexnery, 62 (33.7%) sh. boydii, 28 (15.3%) sh. sonnei, and 20 (11%) sh. dysenteriae. the global susceptibility test against more than 16 different antimicrobial agents, indicated that 80% of them were resistant to ampicilin, 68% to trimethoprim/sulfamethoxazole, 57% to cloramphenicol, and 10% to imipenem and ciprofloxacin. strains of shigella collected at random in the area and identified under controlled laboratory condition, 15 out of 25 (60%) proved to be sh. flexneri, 25% sh. boydii, 8% sh. dysenteriae and 4% sh. sonnei being resistant to ampicillin/sulbactan, tetracycline, and to trimethoprim/sulfamethoxazole more tan 72% of them, but a 100% susceptible to ciprofloxacin and cefixime. the frequency of shigella species isolated at the hospital and those collected in the area, were different, as well as the susceptibility profile to antimicrobial agents tested. the demonstration of strains with moderate to height resistance level, seems to be an important fact on behalf of shigellosis epidemiological surveillance effort in the area, its prevalence and susceptibility to drugs used for treatment.
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