title: Shigella: A Highly Virulent and Elusive Pathogen.
abstract: Despite a significant decrease inShigella-related mortality, shigellosis continues to carry a significant burden of disease worldwide, particularly in Asia and Africa.Shigellais a highly virulent pathogen comprised of four major species with numerous subtypes.Shigella dysenteriaeandShigella flexneriinfections are predominant in resource-limited settings. Clinical presentations range from mild watery diarrhea to severe dysentery with systemic complications such as electrolyte imbalance, seizures and hemolytic uremic syndrome.S. dysenteriaesubtype 1, the producer of Shiga toxin, causes the most severe illness and highest mortality. Susceptible strains ofShigellamay be effectively treated with inexpensive oral antibiotics such as ampicillin or trimethoprim-sulfamethoxazole. Unfortunately, multidrug resistant strains have emerged that have rendered most antibiotics, including fluoroquinolones and extended-spectrum cephalosporins, ineffective. Management and prevention of shigellosis represents a major public health challenge. The development of an effective vaccine is urgently needed to decrease its global impact.
authors.affiliation: Microbiology Research Laboratory, Hospital General O'Horan, Av. Itzaes x Jacinto Canek, C.P. 97000 Mérida, Mexico. Phone and fax: +52-(999) 923-8673, mbzaidi@prodigy.net.mx ; Infectious Diseases Research Unit, Hospital Regional de Alta Especialidad de la Península de Yucatán, Km. 8.5 Carr. Merida-Cholul S/N, Col. Maya, C.P. 97134, Merida, Mexico.
authors.forename: Mussaret Bano
authors.initials: MB
authors.lastname: Zaidi
authors.affiliation: Department of Molecular Biomedicine, CINVESTAV-IPN, Av. Instituto Politecnico Nacional 2508, San Pedro Zacatenco, C.P. 07360, Mexico City, Mexico. , testrada@cinvestav.mx.
authors.forename: Teresa
authors.initials: T
authors.lastname: Estrada-García
keywords: Ipa; Shigella; Type III secretion system; antimicrobial resistance; bacterial; developing countries; epidemiology; extended-spectrum cephalosporins; fluoroquinolones; immune evasion; industrialized countries; morbidity; mortality; serotype switching; socioeconomic conditions; tropical medicine; vaccine; virulence factors
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