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Shigellosis in Thai children: experience from a rural hospital 1985-1993
1Nakhon Nayok Hospital, Thailand.
Insights
Shigellosis outbreaks primarily affected young children, with Shigella flexneri being the most common strain. Antibiotic resistance to ampicillin and co-trimoxazole increased, though nalidixic acid remained effective.
Area of Science:
- Microbiology
- Epidemiology
- Infectious Diseases
Background:
- Shigellosis is a significant cause of diarrheal disease, particularly in children.
- Understanding local epidemiological and microbiological patterns is crucial for effective public health interventions.
Purpose of the Study:
- To investigate the epidemiologic and microbiological characteristics of shigellosis cases.
- To analyze trends in Shigella species and antibiotic resistance over time.
Main Methods:
- Retrospective analysis of 694 shigellosis cases.
- Microbiological identification of Shigella isolates.
- Antimicrobial susceptibility testing.
Main Results:
- Shigellosis predominantly affected children under 14, especially those under four.
- Shigella flexneri was the most common isolate (74.43%), while Shigella dysenteriae was rare (0.32%).
- High resistance rates to ampicillin and co-trimoxazole were observed by 1993, with 100% sensitivity to nalidixic acid.
Conclusions:
- Shigellosis remains a pediatric concern in the studied region.
- Increasing antibiotic resistance necessitates careful treatment strategies.
- The decline in recent cases may be linked to quinolone use for diarrhea treatment.
Abstract:
Six hundred and ninety-four cases of shigellosis in Nakhon Nayok Hospital from January 1985 to December 1993 were studied to determine epidemiologic and microbiological features. Forty-five percent of cases were children under the age of 14 years. The majority of cases were in children under the age of four. The organism was found throughout the year, with peak incidence in June and July. The most common type isolated was Shigella flexneri, about 74.43%. Only 0.32% of organisms were Shigella dysenteriae. Shigella isolates showed a high rate of resistance to ampicillin and co-trimoxazole, in 1993 only 16.67% and 22.22% were sensitive respectively to these 2 drugs, but 100% were still sensitive to nalidixic acid. Fewer cases of shigellosis were isolated in recent years possible due to widespread use of quinolones in the treatment of acute infective diarrhea in adults.