title: Short report: High incidence of shigellosis among Peruvian soldiers deployed in the Amazon River basin.
abstract: We investigated the etiology of acute diarrhea among Peruvian military recruits undergoing three months of basic combat training near the Amazonian city of Iquitos. From January through September 2002, 307 of 967 recruits were seen at the Health Post for diarrhea (attack rate [AR] = 31.8%, incidence = 1.28 95% confidence interval [CI] = 1.14-1.43] episodes/person-year). Shigella spp. were the most common bacterial pathogen recovered from recruits experiencing diarrhea episodes. These bacteria were isolated from 89 (40%) of 225 diarrheal stools examined (AR = 7.6%, incidence = 0.30 [95% CI = 0.24-0.38] episodes/person-year). Most (83 of 90; 92%) of the Shigella isolates were S. flexneri, of which 57 (69%) were serotype 2a. Seventy-six percent of Shigella isolates were resistant to sulfamethoxazole/trimethoprim and all were sensitive to ciprofloxacin. Peruvian soldiers may be an excellent population in which to test the efficacy of S. flexneri vaccines in advanced development.
authors.affiliation: U.S. Naval Medical Research Center Detachment, American Embassy, Lima, Peru. jones@nmrcd.med.navy.mil
authors.forename: Franca R
authors.initials: FR
authors.lastname: Jones
authors.forename: Jose L
authors.initials: JL
authors.lastname: Sanchez
authors.forename: Rina
authors.initials: R
authors.lastname: Meza
authors.forename: Tanis M
authors.initials: TM
authors.lastname: Batsel
authors.forename: Rosa
authors.initials: R
authors.lastname: Burga
authors.forename: Enrique
authors.initials: E
authors.lastname: Canal
authors.forename: Karla
authors.initials: K
authors.lastname: Block
authors.forename: Juan
authors.initials: J
authors.lastname: Perez
authors.forename: Christian T
authors.initials: CT
authors.lastname: Bautista
authors.forename: Jorge
authors.initials: J
authors.lastname: Escobedo
authors.forename: Stephen E
authors.initials: SE
authors.lastname: Walz
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002939:Ciprofloxacin / Q000494:pharmacology; D003967:Diarrhea / Q000453:epidemiology* / Q000382:microbiology; D024881:Drug Resistance, Bacterial; D004405:Dysentery, Bacillary / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D015994:Incidence; D008297:Male; D008826:Microbial Sensitivity Tests; D008889:Military Personnel; D010568:Peru / Q000453:epidemiology; D012760:Shigella / Q000187:drug effects / Q000302:isolation & purification*; D012763:Shigella flexneri / Q000187:drug effects / Q000302:isolation & purification; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000494:pharmacology
chemical_list: D000900:Anti-Bacterial Agents; D002939:Ciprofloxacin; D015662:Trimethoprim, Sulfamethoxazole Drug Combination