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We studied changes in species distribution and antimicrobial resistance patterns of Shigella during 1980-2008, using the Diarrhoeal Diseases Surveillance system of Dhaka Hospital of ICDDR,B. In hospitalized patients Shigella prevalence decreased steadily from 8-12% in the 1980s to 3% in 2008. Endemic S. flexneri was the most commonly isolated species (54%). Epidemic S. dysenteriae type 1 had two peaks in 1984 and 1993, but was not found after 2000, except for one case in 2004. The therapeutic options are now limited: in 2008 a total of 33% of S. flexneri were resistant to ciprofloxacin and 57% to mecillinam. In the <5 years age group, severely underweight, wasted and stunted children were more at risk of shigellosis compared to well-nourished children (P<0·001). Although hospitalization for Shigella diarrhoea is decreasing, the high levels of antimicrobial resistance and increased susceptibility of malnourished children continue to pose an ongoing risk.

Original publication

DOI

10.1017/s0950268810001093

Type

Journal article

Journal

Epidemiology and infection

Publication Date

03/2011

Volume

139

Pages

446 - 452

Addresses

International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh. kfatema@icddrb.org

Keywords

Humans, Shigella dysenteriae, Shigella flexneri, Dysentery, Bacillary, Child Nutrition Disorders, Anti-Bacterial Agents, Hospitalization, Microbial Sensitivity Tests, Prevalence, Risk Factors, Drug Resistance, Bacterial, Adolescent, Child, Child, Preschool, Infant, Infant, Newborn, Bangladesh, Female, Male, Young Adult