Dysenteric Diarrhea Research Articles

Patrones de sensibilidad in vitro y comportamiento clínico de Shigella

Shigella is an important cause of diarrhea in children, with an increasing prevalence of antibiotic resistance during the past years making the choice of an empiric therapy in dysentery difficult. Between 1997 and 1999, 163 isolated Shigella strains were studied in vitro for susceptibility to antibiotics. S. sonnei represented 63% of the isolated strains. Antimicrobial resistance patterns have increased, specially for commonly used antimicrobials. The strains studied were 95% resistant to ampicillin, 84% to chloramphenicol, 43.6% to cotrimoxazole and 3.7% to furazolidone. There was no resistance to ciprofloxacin. Fifty seven children with shigellosis were admited into the hospital, 82.5% of them were older than two years. All the patients were feverish, 56% had dysentery and 8.8% had seizures. Six patient with a torpid evolution and therapeutic failure received ciprofloxacin with eventual clinical success. Ciprofloxacin represents an effective alternative empiric therapy in children with dysenteric diarrhea, which should be evaluated. The need of surveying the local prevalence of antimicrobial resistance to guide therapy in shigellosis is emphasized

Primer aislamiento de Escherichia coli O157:H7 Enterohemorrágica en el Perú

In February 2001, as a part of the «Cross-sectional study of the etiology agents of acute diarrea» in the South Macro region of the country, the Reference Laboratory of Tacna isolated a strain from a stool sample of a eleven months breast feeding infant who suffered an episode of dysenteric diarrhoea, identifying the strain as Escherichia coli O157. The strain was confirmed and characterized in the National Institute of Health as E. coli O157:H7 which carried a shiga like type II toxin, being the first report of an isolation of enterohemorragic Escherichia coli in Peru.

Effect of terdecamycin on experimentally induced swine dysentery in pigs.

The authors evaluated the effect of terdecamycin, a novel antibiotic, on experimentally induced Serpulina (S.) hyodysenteriae infection in pigs. In a prophylactic test, feed containing terdecamycin was fed to pigs for 7 days before inoculation and 21 days after inoculation. Dysenteric diarrhea, development of lesions in the large intestinal mucosa and colonization of S. hyodysenteriae in colonic mucosa were completely inhibited by treatment with 5 ppm or 10 ppm terdecamycin. In the therapeutic test, an unmedicated feed was fed to pigs inoculated with S. hyodysenteriae, until the typical mucohemorrhagic diarrhea appeared after inoculation, and was then changed to the medicated feed for 10 days. By treating with 20 ppm terdecamycin, the clinical signs in the pigs were improved and S. hyodysenteriae was completely eradicated.

Oral Rehydration Therapy for Invasive Diarrhea

Current guidelines for the management of diarrheal diseases focus on the use of oral rehydration therapy (ORT). Clinically evident dehydration of a moderate degree is not uncommon with invasive diarrhea, and when it occurs, the response to ORT is satisfactory. Studies from hospitals and the community each document the effectiveness of ORT for rehydration of patients with invasive diarrhea. This has been confirmed in a clinical trial of oral rehydration solution (ORS) for the treatment of diarrheal diseases in children less than 5 years of age. Children with moderate dehydration benefited most from ORS, especially those who had culture-proven invasive diarrhea. Significant early weight gain was observed for this group of patients alone after rehydration with ORS. In developing countries, there is no reason to withhold ORT at the first signs of watery or dysenteric diarrhea regardless of the cause and independent of the decision to treat the patient with antimicrobial agents.

Peculiar acute toxic colitis after ingestion of colocynth: a clinicopathological study of three cases.

We report three examples of toxic acute colitis which occurred after ingestion of colocynth (Citrullus colocynthis) for ritual purposes. The prominent clinical feature was dysenteric diarrhoea; colonoscopic changes included congestion and hyperaemia of the mucosa with abundant exudates but no ulceration or pseudopolyp formation. A causal relationship between colonic injury and the intake of colocynth was supported by the following features: (1) the pharmacology of the colocynth extract ingested; (2) the temporal relationship between colocynth intake and clinical onset (eight to 12 h); (3) the rapid recovery within three to six days, with normal endoscopy at day 14; (4) the absence of other possible causes for the observed patterns, except in one case, in which a concomitant intestinal infection with Clostridium perfringens Type A was discovered; (5) the specific pathological features. Colonic biopsies taken 27, 44, and 72 h after colocynth intake showed: erosions with fibrino-purulent exudate, early fibrosis of the lamina propria, hyaline thickening of the superficial epithelial basal membrane. These pathological features completely disappeared within 14 days in all three cases.

Notes on an Epidemic of Colitis at the Derby County Asylum

During the year from May, 1898, to May, 1899, 26 male and 28 female patients in the Derby County Asylum were attacked with the disease variously known as dysentery, dysenteric diarrhoea, or colitis, and characterised clinically by bloody stools and rise of temperature, and in advanced cases showing in post-mortem examination extensive thickening and ulceration of the lower end of the large intestine, with numerous microscopic hæmorrhages into the submucous layer. Of the 54 attacked, 23 died, in 13 the colitis being apparently the direct cause of death, in 10 a contributory cause. Some brief notes of our attempt to ascertain the cause of the outbreak may be of interest, though the results obtained were mostly negative or inconclusive.