Shigellosis update: advancing antibiotic resistance, investment empowered vaccine development, and green bananas.
OBJECTIVE
Shigella is the principal cause of clinical dysentery and an important cause of morbidity and mortality among children in impoverished regions. The purpose of this review is to present key findings in the areas of epidemiology, disease control, and treatment of shigellosis.


RESULTS
Recent research activity has advanced the understanding of the epidemiology and host-pathogen interactions. Increased investment and activity in the area of vaccine development have lead to a diversification of candidates and ongoing technical advances yet continue to yield disappointing results in clinical trials in endemic populations and among the most relevant age groups (children under 2 years of age). The description of the rapid spread of quinolone resistance requires monitoring to ensure appropriate case management, particularly in south-east Asia. The evaluation of adjunctive nutritional therapy in endemic areas has supported the use of green bananas in shortening the duration of Shigella dysentery and persistent diarrhea due to Shigella, as well as improving weight gain in early convalescence.


CONCLUSIONS
Despite a great level of activity in basic sciences, there continues to be a large gap in the ability to translate these findings into disease control measures or therapeutic options for individuals living in areas in which shigellosis is endemic.
Kosek
Margaret
M
Department of International Health, Johns Hopkins School of Public Health, Baltimore, Maryland, USA. mkosek@jhsph.edu
Yori
Pablo Peñataro
PP
Olortegui
Maribel Paredes
MP
D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D004032:Diet; D024881:Drug Resistance, Bacterial; D004405:Dysentery, Bacillary / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D006801:Humans; D028521:Musa; D012760:Shigella / Q000187:drug effects*; D022281:Shigella Vaccines / Q000276:immunology*
D000900:Anti-Bacterial Agents; D022281:Shigella Vaccines