Ashkenazi S, May-Zahav M, Dinari G, Gabbay U, Zilberberg R, Samra Z
Department of Pediatrics, Children's Hospital and Beilinson Medical Center, Petah Tiqva, Israel.
Clin Infect Dis. 1993 Nov;17(5):897-9. doi: 10.1093/clinids/17.5.897.
Trends in the epidemiology of infections due to Shigella species over a period of 6 years (1986-1991) in Israel were studied by analysis of the results of 51,300 stool cultures, of which 2,987 yielded Shigella species. In a university hospital, the relative prevalence of Shigella sonnei in patients with shigellosis increased over the years from 60% in 1986 to 91% in 1991 (r = 0.93; P = .007); concomitantly, the prevalence of Shigella flexneri decreased from 29% to only 8% (r = -0.80; P < .05). In the community, the increase in prevalence of S. sonnei was more moderate and occurred only from 1989 to 1991. Since 1990, S. sonnei has been isolated from more hospitalized patients than has S. flexneri, in contrast to their rates of isolation in the past. The increase in prevalence of S. sonnei was most prominent among children, in whom it caused 94% of shigella infections in 1991. Shigella boydii and Shigella dysenteriae remained relatively rare, causing approximately 5% and approximately 1%, respectively, of the cases of shigella infection. Concomitantly, the antimicrobial resistance of S. sonnei has become significantly greater, and it is currently 2.7 and 1.6 times higher than that of S. flexneri to trimethoprim-sulfamethoxazole and ampicillin, respectively. We conclude that the relative frequency of S. sonnei is increasing, especially in hospitalized patients, and hypothesize that this may be related to its increasing antimicrobial resistance. These trends have clinical implications.
通过分析51300份粪便培养结果，对以色列6年期间（1986 - 1991年）志贺氏菌属感染的流行病学趋势进行了研究，其中2987份培养结果显示为志贺氏菌属。在一家大学医院，患志贺氏菌病患者中宋内志贺氏菌的相对患病率多年来从1986年的60%上升至1991年的91%（r = 0.93；P = 0.007）；与此同时，福氏志贺氏菌的患病率从29%降至仅8%（r = -0.80；P < 0.05）。在社区中，宋内志贺氏菌患病率的上升较为平缓，且仅在1989年至1991年期间出现。自1990年以来，与过去的分离率相比，从住院患者中分离出的宋内志贺氏菌比福氏志贺氏菌更多。宋内志贺氏菌患病率的上升在儿童中最为显著，1991年该菌导致了94%的志贺氏菌感染。鲍氏志贺氏菌和痢疾志贺氏菌仍然相对少见，分别导致约5%和约1%的志贺氏菌感染病例。与此同时，宋内志贺氏菌的抗菌耐药性显著增强，目前其对甲氧苄啶 - 磺胺甲恶唑和氨苄西林的耐药性分别比福氏志贺氏菌高2.7倍和1.6倍。我们得出结论，宋内志贺氏菌的相对频率正在增加，尤其是在住院患者中，并推测这可能与其不断增加的抗菌耐药性有关。这些趋势具有临床意义。
