Childhood shigellosis at King Chulalongkorn Memorial Hospital, Bangkok, Thailand: a 5-year review (1996-2000).
The objective of this study was to evaluate the demographic data and clinical presentation of childhood shigellosis, and to study the microbiological data and antimicrobial susceptibilities of Shigella spp. Nine thousand nine hundred fourteen stool culture specimens from children aged 0-15 years who were treated at King Chulalongkorn Memorial Hospital, Bangkok, Thailand, between 1996 and 2000 were retrospectively reviewed. Data were collected from microbiological records and medical charts of childhood shigellosis in terms of demographic data, symptoms, signs, and complications of the patients, and the species and antimicrobial susceptibilities of the organisms. The data were analyzed in terms of means, ranges, and percentages. Of 1,523 children whose stool cultures were positive for pathogenic bacteria, 80 (5.3%) were infected with Shigella spp; 34 females and 46 males. The age distribution ranged from 1 day to 13 years with a mean age of 3.6 years. Common clinical presentations included diarrhea (96.6%), fever (77.6%) and vomiting (44.8%); seizures were the most common complication found (27.6%). Watery and mucous were the most common characteristics of stools. The major Shigella spp found was S. sonnei (62.8%), which was susceptible to co-trimoxazole, ampicillin, cefazolin and ciprofloxacin in 2.3, 84.1, 100 and 100%, respectively. A short course of quinolones or oral cephalosporins should be recommended for the treatment of childhood shigellosis in areas with low susceptibility rates to co-trimoxazole and ampicillin.
Hiranrattana
Ananya
A
Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Mekmullica
Jutarat
J
Chatsuwan
Tanittha
T
Pancharoen
Chitsanu
C
Thisyakorn
Usa
U
D000293:Adolescent; D017677:Age Distribution; D000667:Ampicillin / Q000494:pharmacology; D000890:Anti-Infective Agents / Q000494:pharmacology; D002437:Cefazolin / Q000494:pharmacology; D002648:Child; D002675:Child, Preschool; D002939:Ciprofloxacin / Q000494:pharmacology; D024881:Drug Resistance, Bacterial; D004405:Dysentery, Bacillary / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D005243:Feces / Q000382:microbiology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D012189:Retrospective Studies; D012760:Shigella / Q000145:classification / Q000187:drug effects / Q000302:isolation & purification*; D013785:Thailand / Q000453:epidemiology; D016896:Treatment Outcome; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000494:pharmacology
D000890:Anti-Infective Agents; D002939:Ciprofloxacin; D000667:Ampicillin; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D002437:Cefazolin