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Successful treatment of an institutional outbreak of shigellosis
Abstract:
An outbreak of shigellosis is described in an intermediate care hospital for children, where routine isolation procedures failed to halt the outbreak. Two weeks after the appearance of the first case, small numbers of patients became symptomatic with fever and diarrhea, but remained culture-negative. One week later, two patients with positive cultures were identified, with many other symptomatic patients having negative cultures. Twenty-five days after identification of the first case, there were fourteen cases identified with shigellosis and many more symptomatic patients. It was at that time that hospital-wide measures of infection control were instituted, and treatment of all patients, infected and uninfected, was initiated with trimethoprim-sulfamethoxazole (TMP-SMX). No new cases of shigellosis were diagnosed after initiation of treatment, and symptoms abated within 72 hours.
Insights
Routine isolation failed during a pediatric hospital shigellosis outbreak. Hospital-wide infection control and trimethoprim-sulfamethoxazole (TMP-SMX) treatment stopped new cases and resolved symptoms.
Area of Science:
- Pediatric Infectious Diseases
- Hospital Epidemiology
- Antimicrobial Therapy
Background:
- A shigellosis outbreak occurred in a pediatric intermediate care hospital.
- Initial isolation procedures were ineffective in controlling the spread.
Purpose of the Study:
- To describe the shigellosis outbreak and the effectiveness of intervention strategies.
Main Methods:
- Case identification based on symptoms and Shigella cultures.
- Implementation of hospital-wide infection control measures.
- Initiation of trimethoprim-sulfamethoxazole (TMP-SMX) treatment for all patients.
Main Results:
- The outbreak involved 14 confirmed cases and numerous symptomatic patients.
- Delayed implementation of comprehensive control measures.
- TMP-SMX treatment led to the cessation of new diagnoses and symptom resolution within 72 hours.
Conclusions:
- Shigellosis outbreaks in pediatric settings require prompt and comprehensive infection control.
- Hospital-wide TMP-SMX treatment can effectively manage shigellosis outbreaks.
- Early detection and intervention are crucial for preventing widespread transmission.