title: Shigella infections: A two year experience in cancer patients.
abstract: OBJECTIVE
  To identify clinical and microbiological characteristics of Shigella infections among cancer patients.
  
  
  METHODS
  The retrospective study was conducted at Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan, and comprised medical records from December 2011 to November 2013 which were reviewed to identify persons with laboratory-confirmed Shigella infections. Demographic information, clinical history, seasonal variation, microbiological details, treatment given, and outcomes in term of symptoms resolution and mortality at two weeks were noted.
  
  
  RESULTS
  Shigella infection was diagnosed in 45 cancer patients. The mean age of the patients was 36.02±19.30 years (range: 1-64 years), with 35(78%) patients being >18 years of age. Overall, 16(35.5%) patients had presented during winter months and 40(89%) presented as emergencies. Diarrhoea was present in 44(98%) patients and among them 20(45%) had dysentery whereas 28(64%) had fever and 21(47%) had abdominal pain. Of the total 45 cases, 41(91%) had isolates from stool. Besides, 39(87%) Shigella isolates were further speciated and Shigella flexneri was the most commonly isolated serotype in 25(64.1%). Overall, 42(93%) strains were sensitive to cefixime and ceftriaxone. Mean duration of symptoms resolution was 3.92±1.51 days (range: 1-10 days). No mortality was noted at 2 weeks.
  
  
  CONCLUSIONS
  Shigella flexneri was the most common serotype isolated. Majority of the isolates were sensitive to 3rd generation cephalosporins (cefixime/ceftriaxone).
authors.affiliation: Department of Internal Medicine, Shaukat Khanum Memorial Cancer Hospital & Research Center, Lahore, Pakistan.
authors.forename: Aun
authors.initials: A
authors.lastname: Raza
authors.affiliation: Department of Internal Medicine, Bacha Khan Medical Complex, Swabi, Pakistan.
authors.forename: Amjad
authors.initials: A
authors.lastname: Mahboob
authors.affiliation: Department of Pathology, Shaukat Khanum Memorial Cancer Hospital & Research Center, Lahore, Pakistan.
authors.forename: Summiya
authors.initials: S
authors.lastname: Nizammudin
authors.affiliation: Department of Internal Medicine, Shaukat Khanum Memorial Cancer Hospital & Research Center, Lahore, Pakistan.
authors.forename: Syed Hammad
authors.initials: SH
authors.lastname: Nazeer
authors.affiliation: Department of Internal Medicine, Shaukat Khanum Memorial Cancer Hospital & Research Center, Lahore, Pakistan.
authors.forename: Faisal
authors.initials: F
authors.lastname: Sultan
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D020682:Cefixime / Q000627:therapeutic use; D002443:Ceftriaxone / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D015897:Comorbidity; D024881:Drug Resistance, Bacterial / Q000502:physiology; D004405:Dysentery, Bacillary / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology*; D010154:Pakistan / Q000453:epidemiology; D012189:Retrospective Studies; D012763:Shigella flexneri / Q000302:isolation & purification / Q000502:physiology; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D002443:Ceftriaxone; D020682:Cefixime
keywords: Shigella, Cancer, Drug resistance, Pakistan.