Etiology of bloody diarrhea in Bolivian children: implications for empiric therapy. Bolivian Dysentery Study Group

The Journal of Infectious Diseases
J M TownesR V Tauxe

Abstract

In Bolivia, few data are available to guide empiric therapy for bloody diarrhea. A study was conducted between December 1994 and April 1995 to identify organisms causing bloody diarrhea in Bolivian children. Rectal swabs from children <5 years old with bloody diarrhea were examined for Salmonella, Shigella, and Campylobacter organisms; fecal specimens were examined for Entamoeba histolytica. A bacterial pathogen was identified in specimens from 55 patients (41%). Shigella organisms were found in 39 specimens (29%); 37 isolates (95%) were resistant to ampicillin, 35 (90%) to trimethoprim-sulfamethoxazole, and 24 (62%) to chloramphenicol, but all were susceptible to nalidixic acid. Only 1 of 133 stool specimens contained E. histolytica trophozoites. Multidrug-resistant Shigella species are a frequent cause of bloody diarrhea in Bolivian children; E. histolytica is uncommon. Clinical predictors described in this study may help identify patients most likely to have Shigella infection. Laboratory surveillance is essential to monitor antimicrobial resistance and guide empiric treatment.

Citations

Mar 18, 2000·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·M L ReplogleP R Cieslak
Feb 22, 2001·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·D TalanUNKNOWN EMERGEncy ID NET Study Group
Apr 21, 2004·Journal of Pediatric Gastroenterology and Nutrition·I-Fei HuangChristine C Chiou
Jul 3, 1999·The Pediatric Infectious Disease Journal·V PradoM M Levine
Mar 15, 2005·Scandinavian Journal of Infectious Diseases·Ashraful KhanAbu Faruque
Jul 1, 2015·The American Journal of Tropical Medicine and Hygiene·Gayatri NairAlejandro Castellanos-Gonzalez
Jun 27, 2000·Gastroenterology·S Banerjee, J T LaMont

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