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Gastrointestinal Infections
Published in Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar, Handbook of Refugee Health, 2021
Dehydration is the leading cause of death in diarrhoeal illnesses followed by sepsis. In dehydration, water and electrolytes (sodium, chloride, potassium and bicarbonate) are lost. Other complications include bacteraemia, HUS, GBS and reactive arthritis. Severe complications with Shigella include severe sepsis, seizures, toxic megacolon and HUS.
Bacteria Causing Gastrointestinal Infections
Published in K. Balamurugan, U. Prithika, Pocket Guide to Bacterial Infections, 2019
B. Vinoth, M. Krishna Raja, B. Agieshkumar
The cardinal symptoms of Shigella infection are fever, abdominal pain, diarrhea (watery, mucoid or bloody), and vomiting. The incubation period is 1–7 days (average 3 days) (Hui 1994). The first to develop is usually fever (48 hours), followed by abdominal pain, diarrhea (72 hours), and dysentery (120–144 hours) (DuPont et al. 1969). Though the classical symptom is bloody diarrhea, it is seen only in 40%–60% of cases, and most often the diarrhea is mucoid (50%–99%) and sometimes watery (30%–60%) (Khan et al. 2013). Dysentery or bloody diarrhea is more common with S. dysentriae type 1 (80%) and is less common with S. sonnei (20%) and other species (Khan et al. 2013).
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
Shigella is one of the primary causative agents of pediatric diarrheal disease, and is implicated in 80–165 million incidences and about 1 million associated deaths per year worldwide. The Global Enteric Multicenter Study revealed that Shigella is one of the leading causes of diarrheal disease among the African (The Gambia, Mali, Mozambique, and Kenya) and Asian (India, Bangladesh, and Pakistan) countries.4Shigella infection and outbreaks are influenced by the economic status of the country, including the sanitary level and financial development. S. flexneri and S. sonnei are the primary causes of diarrheal disease in developing and developed regions of the world, respectively.61 Bangladesh and Southeast Asian countries are frequently recorded with S. boydii infections and outbreaks.16 African nations are severely affected with S. dysenteriae type 1. In Rwanda, approximately 180,000 bloody diarrheal cases were reported from 1993 to 1995 with a 6.3%–39.1% mortality rate.62
Antimicrobial resistance in enteric bacteria: current state and next-generation solutions
Published in Gut Microbes, 2020
M. J. Wallace, S. R. S. Fishbein, G. Dantas
Shigella bacteria are another major source of food poisoning and diarrheal disease.1,54 In 2016, shigellosis was the second leading cause of diarrheal death worldwide at over 200,000 deaths per year, ranking second only to rotavirus.51 The genus Shigella contains bacteria closely related to E. coli and is comprised of four major pathogenic species: S. dysenteriae, S. flexneri, S. boydii, and S. sonnei.21Shigella can be transmitted from person-to-person, or through contaminated food sources and water (Figure 1a), while some AMR Shigella outbreaks are associated with international travel and sexual transmission.57Shigella infections were once highly responsive to cheaper antibiotics such as β-lactams and antifolates, but rising resistance rates have shifted the treatments of choice toward macrolides or fluoroquinolones, with ceftriaxone as an alternative treatment option.50 MDR Shigella can arise through plasmid-borne or integron-mobilized elements encoding multiple types of resistance.21,54 A commonly observed MDR phenotype includes resistance to ampicillin, chloramphenicol, streptomycin, sulfonamides, and tetracyclines (ACSSuT).21,24,58 Epidemics driven by MDR Shigella have risen worldwide within the last decade and requires significant intervention efforts to prevent further disease.
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
The species distribution of shigella infection varies globally. While S. sonnei is the predominant species worldwide, S. flexneri is more prominent in low-income settings in Africa and Asia [1,4] while the less virulent S. sonnei predominates in higher-income settings [5,6]. Transmission occurs via a number of mechanisms – the faecal/oral route, person-to-person contact, household flies, infected water, or inanimate objects following exposure to as few as 10–100 organisms [3,6]. Once infected, all shigella species multiply and cause acute bloody diarrhoea by invading the colonic epithelium where pro-inflammatory cytokines are released, and the subsequent inflammatory reaction (recruiting a number of polymorphonuclear cells) destroys the epithelial cells which line the gut mucosa, allowing for further direct invasion by shigella.
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
In a prospective descriptive study, from May 2014 to May 2015, a total of 142 non-duplicate Shigella isolates were obtained from the stool cultures of different patients with diarrhea or dysentery at Tabriz, Urmia, Ardabil (northwest), and Kerman (southeast) cities, in Iran. All isolates were identified using standard Enterobacteriaceae differentiation biochemical tests such as triple sugar iron agar, motility, indole production, urea hydrolysis, methyl red/voges-Proskauer test, lysine decarboxylation, and citrate utilization. Furthermore, all isolates were serotyped by the slide agglutination test using the commercial specific polyvalent antisera (SIFIN, GmbH Berlin, Germany) [16]. The confirmed Shigella isolates were kept in a tryptic soy broth containing 20% of glycerol at –70 °C for further study.