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Severe shigellosis in childhood
C Sirivichayakul1, U Thisyakorn
1Department of Tropical Pediatrics, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
Summary
Severe shigellosis in children often presents with dehydration and convulsions, with Shigella B being the most common type. Antibiotic resistance is notable, though trimethoprim-sulfamethoxazole (TMP-SMX) and ceftriaxone showed effectiveness in certain pediatric cases.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Severe shigellosis is a significant pediatric health concern, particularly in developing regions.
- Understanding the clinical presentation and antimicrobial resistance patterns is crucial for effective management.
Purpose of the Study:
- To investigate the clinical characteristics, causative pathogens, and treatment outcomes of severe shigellosis in pediatric patients.
- To assess the prevalence of antibiotic resistance in Shigella isolates.
Main Methods:
- Prospective study of 20 bacteriologically confirmed pediatric shigellosis cases.
- Clinical data collection including symptoms, laboratory findings, and treatment regimens.
- Antimicrobial susceptibility testing of isolated Shigella strains.
Main Results:
- Shigella B (85%) and Shigella D (15%) were the predominant serogroups.
- Common admissions reasons included convulsions and dehydration; malnutrition was prevalent (42.1%).
- High resistance rates were observed for ampicillin and trimethoprim-sulfamethoxazole (TMP-SMX), yet TMP-SMX led to good recovery in immunocompetent patients. Ceftriaxone was effective in malignancy cases.
Conclusions:
- Severe pediatric shigellosis requires prompt management, considering common complications like convulsions and dehydration.
- Antimicrobial resistance is a challenge, necessitating careful antibiotic selection.
- TMP-SMX and ceftriaxone demonstrate therapeutic potential in specific pediatric shigellosis scenarios.