Short report: High incidence of shigellosis among Peruvian soldiers deployed in the Amazon River basin.
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.
Jones
Franca R
FR
U.S. Naval Medical Research Center Detachment, American Embassy, Lima, Peru. jones@nmrcd.med.navy.mil
Sanchez
Jose L
JL
Meza
Rina
R
Batsel
Tanis M
TM
Burga
Rosa
R
Canal
Enrique
E
Block
Karla
K
Perez
Juan
J
Bautista
Christian T
CT
Escobedo
Jorge
J
Walz
Stephen E
SE
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
D000900:Anti-Bacterial Agents; D002939:Ciprofloxacin; D015662:Trimethoprim, Sulfamethoxazole Drug Combination