Bennish M L, Harris J R, Wojtyniak B J, Struelens M
International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka.
J Infect Dis. 1990 Mar;161(3):500-6. doi: 10.1093/infdis/161.3.500.
The total number of admissions and deaths of patients with shigellosis were ascertained at the Dhaka Treatment Centre of the International Centre for Diarrhoeal Disease Research, Bangladesh, 1974-1988, and the characteristics of 67 patients who died were compared with those of 134 discharged alive. Of 9780 Shigella-infected inpatients, 889 (9.1%) died; 32.3% of deaths occurred in children less than 1 year of age. Fatality rates were highest (10.3%) in Shigella sonnei-infected patients and lowest (6.7%) in Shigella dysenteriae type 1-infected patients. Age less than 1 year, lack of breast feeding in patients 1-2 years of age, hypothermia, severe malnutrition, severe dehydration, altered consciousness, abdominal distension, thrombocytopenia, hypoproteinemia, hyponatremia, hypoglycemia, renal failure, and bacteremia were all significantly more common in case patients. In a multivariate analysis, younger age, decreased serum protein, altered consciousness, and thrombocytopenia were predictive of death. Thus in Bangladesh the fatality rate for hospitalized patients infected with any species of Shigella remains high despite relatively intensive inpatient care, and young, hypoproteinemic patients are at greatest risk of fatal illness.
1974年至1988年期间，在孟加拉国腹泻病研究国际中心达卡治疗中心确定了志贺氏菌病患者的入院总数和死亡人数，并将67例死亡患者的特征与134例存活出院患者的特征进行了比较。在9780例感染志贺氏菌的住院患者中，889例（9.1%）死亡；32.3%的死亡发生在1岁以下儿童。索氏志贺氏菌感染患者的病死率最高（10.3%），痢疾志贺氏菌1型感染患者的病死率最低（6.7%）。1岁以下、1-2岁患者未进行母乳喂养、体温过低、严重营养不良、严重脱水、意识改变、腹胀、血小板减少、低蛋白血症、低钠血症、低血糖、肾衰竭和菌血症在病例患者中均明显更为常见。在多变量分析中，年龄较小、血清蛋白降低、意识改变和血小板减少是死亡的预测因素。因此，在孟加拉国，尽管住院治疗相对密集，但感染任何志贺氏菌属的住院患者病死率仍然很高，年轻的低蛋白血症患者患致命疾病的风险最大。
