TY - JOUR
T1 - Shigellosis in neonates and young infants
AU - Huskins, W. Charles
AU - Griffiths, Jeffrey K.
AU - Faruque, A. S.G.
AU - Bennish, Michael L.
N1 - Funding Information:
Supported by the Paul Schliesman Memorial Traveling Fellowship (Dr. Huskins), a grant from the Rockefeller Foundation (Dr. Griffiths), a grant from the Applied Diarrheal Disease Research Project of the U.S. Agency for International Development (Dr. Bennish), and the International Centre for Diarrhoeal Disease Research, Bangladesh, which is funded by governments and organizations that share its concern for the health problems of developing countries. Current donors include the governments of Australia, Bangladesh, Belgium, Canada, Denmark, France, Japan, The Netherlands, Norway, Sweden, Switzerland, the United Kingdom, and the United States of America; the United Nations Development Program and UNICEF; and the Ford and Sasakawa foundations.
PY - 1994
Y1 - 1994
N2 - To determine the clinical features and outcome of shigellosis in young infants, we reviewed the hospital records of 159 infants ≤ 3 months of age (including 30 neonates) and 159 children 1 to 10 years of age with shigellosis who were admitted to the Diarrhoea Treatment Centre in Dacca, Bangladesh. Infants more commonly had a history of nonbloody diarrhea (82.8% vs 42.7%; p <0.001), moderate or severe dehydration (59.9% vs 32.1%; p <0.001), or bacteremia (12.0% vs 5.0%; p = 0.027) and less commonly had fever (32.7% vs 58.6%; p <0.001), abdominal tenderness (1.9% vs 12.6%; p <0.001), or rectal prolapse (0% vs 8.3%; p = 0.001). Infections caused by Shigella boydii (20.8% vs 6.3%; p <0.001) and Shigella sonnei (7.5% vs 1.3%; p = 0.006) were more common, and Shigella dysenteriae type 1 (9.4% vs 31.4%; p <0.001) infections were less common in infants than in older children; the proportion of Shigella flexneri infections was equivalent in the two groups (59.1% vs 60.4%). Infants were twice as likely to die as older children (16.4% vs 8.2%; p = 0.026). Only 17 infants (14.3%) were being exclusively breast fed at the onset of their illness. In a multiple logistic regression analysis, independent predictors of death in infants were gram-negative bacteremia, ileus, decreased bowel sounds, hyponatremia, hypoproteinemia, and a lower number of erythrocytes detected on microscopic examination of stool specimens. Diarrhea management algorithms that rely only on clinical findings of dysentery to diagnose and treat shigellosis are likely to be unreliable in this high-risk age group. (J PEDIATR 1994;125:14-22)
AB - To determine the clinical features and outcome of shigellosis in young infants, we reviewed the hospital records of 159 infants ≤ 3 months of age (including 30 neonates) and 159 children 1 to 10 years of age with shigellosis who were admitted to the Diarrhoea Treatment Centre in Dacca, Bangladesh. Infants more commonly had a history of nonbloody diarrhea (82.8% vs 42.7%; p <0.001), moderate or severe dehydration (59.9% vs 32.1%; p <0.001), or bacteremia (12.0% vs 5.0%; p = 0.027) and less commonly had fever (32.7% vs 58.6%; p <0.001), abdominal tenderness (1.9% vs 12.6%; p <0.001), or rectal prolapse (0% vs 8.3%; p = 0.001). Infections caused by Shigella boydii (20.8% vs 6.3%; p <0.001) and Shigella sonnei (7.5% vs 1.3%; p = 0.006) were more common, and Shigella dysenteriae type 1 (9.4% vs 31.4%; p <0.001) infections were less common in infants than in older children; the proportion of Shigella flexneri infections was equivalent in the two groups (59.1% vs 60.4%). Infants were twice as likely to die as older children (16.4% vs 8.2%; p = 0.026). Only 17 infants (14.3%) were being exclusively breast fed at the onset of their illness. In a multiple logistic regression analysis, independent predictors of death in infants were gram-negative bacteremia, ileus, decreased bowel sounds, hyponatremia, hypoproteinemia, and a lower number of erythrocytes detected on microscopic examination of stool specimens. Diarrhea management algorithms that rely only on clinical findings of dysentery to diagnose and treat shigellosis are likely to be unreliable in this high-risk age group. (J PEDIATR 1994;125:14-22)
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U2 - 10.1016/S0022-3476(94)70115-6
DO - 10.1016/S0022-3476(94)70115-6
M3 - Article
C2 - 8021764
AN - SCOPUS:0028290037
SN - 0022-3476
VL - 125
SP - 14
EP - 22
JO - Journal of Pediatrics
JF - Journal of Pediatrics
IS - 1
ER -