title: A school outbreak of Shigella sonnei infection in China: clinical features, antibiotic susceptibility and molecular epidemiology.
abstract: OBJECTIVE
  To describe the clinical features of infection, and the antibiotic susceptibility of epidemic strains, and investigate plasmid maps and integrons of the isolates from an outbreak of Shigella sonnei infection at an elementary school in southwest China.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  An elementary school and five hospitals in Chengdu in southwest China.
  
  
  RESULTS
  There were 1,134 students in the school. 937 (82.6%) students had signs and symptoms. Of the 568 (60.6%, 568/937) hospitalized students, 93.3% 86.8%, 72.4%, and 28.9% of the hospitalized patients had diarrhea, fever, abdominal pain, and vomiting, respectively. S. sonnei strains were isolated from the stool samples of 36.0% (337/937) students. All of the outbreak isolates had the same high-level antimicrobial resistance and plasmid profiles, which were different from that of sporadic strains. All the outbreak S. sonnei isolates were positive for the integrin gene and contained class 2 integron; however, two outbreak isolates contained class 1 and class 2 integrons.
  
  
  CONCLUSIONS
  Diarrhea, fever, and abdominal pain were the three most common clinical manifestations observed in patients infected with S. sonnei. High-level antibiotic resistance was observed among Shigella species.
authors: Department of Pediatrics, West China Second Hospital, Sichuan University, Chengdu, Sichuan Province, PR China.
authors: G G
authors: GG
authors: Xiao
authors: J
authors: J
authors: Fan
authors: J J
authors: JJ
authors: Deng
authors: C H
authors: CH
authors: Chen
authors: W
authors: W
authors: Zhou
authors: X H
authors: XH
authors: Li
authors: Y W
authors: YW
authors: He
authors: H
authors: H
authors: Li
authors: B
authors: B
authors: Hu
authors: Y
authors: Y
authors: Qiao
authors: G H
authors: GH
authors: Chen
authors: C M
authors: CM
authors: Wan
mesh_terms: D000293:Adolescent; D000818:Animals; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004196:Disease Outbreaks / Q000706:statistics & numerical data*; D024881:Drug Resistance, Bacterial; D004405:Dysentery, Bacillary / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D005517:Foodborne Diseases / Q000188:drug therapy / Q000453:epidemiology / Q000235:genetics; D006801:Humans; D008297:Male; D008460:Meat / Q000382:microbiology; D008826:Microbial Sensitivity Tests; D017720:Molecular Epidemiology; D012574:Schools / Q000706:statistics & numerical data; D012764:Shigella sonnei / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D013552:Swine
chemical_list: D000900:Anti-Bacterial Agents