Ries A A, Wells J G, Olivola D, Ntakibirora M, Nyandwi S, Ntibakivayo M, Ivey C B, Greene K D, Tenover F C, Wahlquist S P
Foodborne and Diarrheal Diseases Branches, Centers for Disease Control and Prevention, Atlanta, Georgia.
J Infect Dis. 1994 May;169(5):1035-41. doi: 10.1093/infdis/169.5.1035.
An epidemic of Shigella dysenteriae type 1 infections has affected Africa since 1979. Reported dysentery cases increase sharply in Burundi during September through December. Of stool samples from 189 patients reporting bloody diarrhea in November 1990, a pathogen was identified in 123 (65%). The pathogen was S. dysenteriae type 1 in 82 (67%). All S. dysenteriae type 1 isolates were resistant to ampicillin, chloramphenicol, nalidixic acid, streptomycin, sulfisoxazole, tetracycline, and trimethoprim-sulfamethoxazole. Thirty-two specimens (26%) yielded other Shigella species. Patients with S. dysenteriae type 1 were more likely than those with other Shigella infections to have abdominal pain, "lots of blood" in the stool, blood in the stool specimen examined by the interviewer, recent contact with a person with dysentery, or recent antimicrobial treatment. Thus, the seasonal increase in dysentery was due largely to multidrug-resistant S. dysenteriae type 1, clinical and epidemiologic features may predict such infection, and efforts to control this epidemic must focus on preventing transmission.
自1979年以来，1型志贺氏痢疾杆菌感染疫情一直在影响非洲。在布隆迪，9月至12月期间报告的痢疾病例急剧增加。在1990年11月报告有血性腹泻的189名患者的粪便样本中，123份（65%）检测出病原体。其中82份（67%）的病原体为1型志贺氏痢疾杆菌。所有1型志贺氏痢疾杆菌分离株均对氨苄西林、氯霉素、萘啶酸、链霉素、磺胺异恶唑、四环素和甲氧苄啶-磺胺甲恶唑耐药。32份样本（26%）检测出其他志贺氏菌属。与其他志贺氏菌感染患者相比，1型志贺氏痢疾杆菌感染患者更易出现腹痛、粪便“大量带血”、接受访视者检查的粪便样本带血、近期与痢疾患者接触或近期接受过抗菌治疗。因此，痢疾的季节性增加主要归因于多重耐药的1型志贺氏痢疾杆菌，临床和流行病学特征可能预示此类感染，控制这一疫情的努力必须侧重于预防传播。
