Abstract
Shigella species are a common cause of acute diarrheal disease in China. In this study, we characterized the changing trends and serotype distribution of Shigella species in Beijing from 1994 to 2010. A total of 5999 Shigella strains were isolated and serotyped from the 302nd Hospital in Beijing. The annual number of Shigella isolates reached a peak (n = 1192; 19.84%) in 1996 and then decreased annually, reaching the lowest point (n = 24; 0.41%) in 2010. S. flexneri 2a and S. sonnei were the most frequently isolated Shigella, with their respective isolates making up 53.3% and 27.6% of the total. Isolates of S. flexneri 4c, 4a, and x made up 3% respectively of the total isolates. Significant decreases in percentage of S. flexneri over time were observed. S. sonnei surpassed S. flexneri 2a as the predominant serotype in 2000. Most isolates were recovered from July to September; 13.6% of the isolates were recovered from children aged 0 to 5 years, and 16% were recovered from those aged 21 to 25 years. S. flexneri 2a and 5 were recovered mostly from males (33.41%, p < 0.001; and 0.46%, p < 0.001%; respectively), whereas S. flexneri 2b and 6, and S. sonnei were most often isolated from females. Continuous monitoring of Shigella showed that all 4 species and 27 serotypes were present in Beijing, China, during the study period. The emergence of S. sonnei and the overall decreasing isolation rate of Shigella in Beijing can potentially aid in the development of vaccine and control strategies for shigellosis in the city.
Highlights
Shigella species are a common cause of acute diarrheal disease worldwide, with an estimated 167 million cases per year and resulting in approximately 1.1 million deaths; 97.6% of the cases occur in developing countries [1]
The present study describes the trends in Shigella species and their serotypes isolated from patients with diarrhea in a national infectious disease hospital in Beijing, China, from 1994 to 2010
According to a multicenter shigellosis surveillance study that incorporated data from six Asian sites, including China, shigellosis incidence is approximately 100-fold higher in Asia than in industrialized countries [5]
Summary
Shigella species are a common cause of acute diarrheal disease worldwide, with an estimated 167 million cases per year and resulting in approximately 1.1 million deaths; 97.6% of the cases occur in developing countries [1]. Shigellosis is caused by four species, S. dysenteriae, S. flexneri, S. boydii, and S. sonnei. According to a previous multicenter study of Shigella diarrhea in six Asian countries, S. flexneri is the most common species in Bangladesh, China, Pakistan, Indonesia, and Vietnam; whereas S. sonnei is predominant in industrialized countries [14]. Two recent reports have indicated that S. flexneri 2a is the most frequently isolated Shigella organism in China [15,16]. These reports may not be generalizable for the whole China; the time period of these studies is short, and surveillance is performed only in less-developed areas of China
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