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Infectious Diarrhoea
Published in Firza Alexander Gronthoud, Practical Clinical Microbiology and Infectious Diseases, 2020
Medically important Salmonella spp. causing diarrhoea are S. choleraesuis, S. typhimurium and S. enteritidis. Most infections are acquired by eating poultry, eggs or dairy products and are transmitted through the fecal-oral route. Shigella spp. cause dysentery, which is a clinical syndrome consisting of fever, bloody diarrhoea and abdominal pain. Shigellosis is primarily caused by S. dysenteriae, S. flexneri, S. boydii and S. sonnei. Shigella spp. are genetically very similar to E. coli and are now biogroups within the species E. coli. Humans are the only reservoir for Shigella spp., with more than half of all infections occurring in children younger than 10 years. Shigellosis is transmitted person-to-person by the fecal-oral route through contaminated hands and, less commonly, contaminated water or food. Yersinia enterocolitica can grow in cold temperature and can grow to high numbers in refrigerated food or blood products and is associated with transfusion-related sepsis. Enteric disease in children may manifest as enlarge mesenteric lymph nodes and mimic acute appendicitis. Yersinosis is a zoonotic infection, with humans as accidental hosts.
Chemical and Biological Threats to Public Safety
Published in Frank A. Barile, Barile’s Clinical Toxicology, 2019
Shigellosis is caused by infection with Shigella species, a Gram-negative bacillus. As with the other members of the Enterobacteria family, the organisms colonize the GI tracts of many species of animals. Several species of Shigella are further divided into 45 serogroups: Shigella sonnei (group D) accounts for over 65% of shigellosis in the United States; S. flexneri (group B) accounts for the rest (about 450,000 total unconfirmed cases in the United States each year). S. dysenteriae type 1 and S. boydii are rare, although they continue to be important causes of disease in the developing world. Over 150 million cases of shigellosis occur annually worldwide.* As with salmonella infections, fecal–oral transmission of contaminated food is the major route of transmission.
Shigella: Insights into the Clinical Features, Pathogenesis, Diagnosis, and Treatment Strategies
Published in Dongyou Liu, Handbook of Foodborne Diseases, 2018
Periyanaina Kesika, Bhagavathi Sundaram Sivamaruthi, Krishnaswamy Balamurugan
The primary method of transmission is by oral-fecal route. The infective dose of Shigella as low as 10–100 bacilli can cause severe infection and outbreaks.133 The incubation period of Shigella ranges from 1 day to 1 week. Shigella primarily infects the lower intestinal tract of humans. The clinical symptoms of shigellosis are high fever (30%–40%), abdominal cramps (70%–93%), and bloody (35%–55%) or mucoid diarrhea (70%–85%). S. dysenteriae and S. flexneri cause dysentery, whereas S. boydii and S. sonnei often cause watery diarrhea (30%–40%).75,134–136
A murine model of diarrhea, growth impairment and metabolic disturbances with Shigella flexneri infection and the role of zinc deficiency
Published in Gut Microbes, 2019
Pedro Henrique Q.S. Medeiros, Solanka E. Ledwaba, David T. Bolick, Natasa Giallourou, Lauren K. Yum, Deiziane V.S. Costa, Reinaldo B. Oriá, Eileen M. Barry, Jonathan R. Swann, Aldo Ângelo M. Lima, Hervé Agaisse, Richard L. Guerrant
Several efforts have been made to model shigellosis in vivo.8,12,17–20 However, unnatural inoculum administration routes and the absence of common disease outcomes are limitations of current models. In contrast, by using prior antibiotic treatment, we have been able to reproduce common human clinical effects through oral administration of S. flexneri inoculum, that are also affected by dietary zinc deficiency. Different antibiotic treatments lead to different susceptible conditions for the host;21 and association of selected bacterial species in germ-free mice leads to different interactions with Shigella.22 We have used a broad spectrum antibiotic cocktail to induce shigellosis susceptibility, in contrast to a study by Martino et al. who used only streptomycin.19 The use of antibiotics was crucial for enabling S. flexneri colonization in our mouse model. Indeed, S. flexneri inoculation in non-antibiotic treated house chow-fed mice did not provide robust colonization or outcomes. Other studies that used the same antibiotic cocktail have shown increased susceptibility to other experimental enteric infections.23–26
Guidelines for the treatment of dysentery (shigellosis): a systematic review of the evidence
Published in Paediatrics and International Child Health, 2018
Phoebe C. M. Williams, James A. Berkley
Because of overcrowding and poor sanitation, shigellosis occurs predominantly in LMIC. Infants, non-breast fed or malnourished children and adults >50 years have a more severe illness and a greater risk of death [4]. Acquired immunity to shigella is serotype-specific. While S. boydii and S. sonnei usually cause a relatively mild illness (watery or bloody diarrhoea only), S. flexneri and S. dysenteriae are chiefly responsible for endemic and epidemic shigellosis, respectively, in developing countries, with high transmission rates and significant case fatality. S. dysenteriae (Type 1, also known as Shiga bacillus) is capable of causing a more severe and prolonged illness owing to the production of a potent cytotoxin (Shiga) which is associated with the development of haemolytic-uraemic syndrome [5]. Other complications of shigellosis include sepsis, rectal prolapse, arthralgia, intestinal perforation, toxic megacolon, electrolyte imbalance, seizures and leukaemoid reactions [1,2].
Characterization of integrons, extended-spectrum β-lactamases, AmpC cephalosporinase, quinolone resistance, and molecular typing of Shigella spp. from Iran
Published in Infectious Diseases, 2018
Sajjad Zamanlou, Mohammad Ahangarzadeh Rezaee, Mohammad Aghazadeh, Reza Ghotaslou, Farhad Babaie, Younes Khalili
Shigella species are the major cause of community-acquired bacillary dysentery, and shigellosis is a public health concern in both developed and developing countries [1], such as Iran. Globally, it has been reported that shigellosis causes more than one million deaths per year among people of all ages, with two-thirds of the patients being children under 5 years of old [2]. Only in Asia, it has been estimated that the incidence and mortality rate of shigellosis are 91 million and 414 000 annually, respectively [3]. Beside these, it has been found that shigellosis is one of the main causes of morbidity with diarrheal diseases among the Iranian children [4].