Gastrointestinal and extra-intestinal manifestations of childhood shigellosis in a region where all four species of Shigella are endemic.
Gastrointestinal and extra-intestinal manifestations of childhood shigellosis in a region where all four species of Shigella are endemic.
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在所有四种志贺氏菌的地区，儿童志氏病的胃肠道和肠外表现都是地方性的。
DOI：
10.1371/journal.pone.0064097
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发表时间：
2013
期刊：
影响因子：
3.7
通讯作者：
Bennish ML
中科院分区：
文献类型：
--
作者：
Khan WA;Griffiths JK;Bennish ML
目的探讨不同种类志贺菌感染儿童的临床表现及转归。我们确定了一年内所有在B达卡icddr医院住院的<15岁的志贺氏菌感染患者。研究工作人员每天审查入院记录并重复患者的体格检查和病史。在792例儿童志贺菌病中，63%的儿童感染志贺菌。弗氏志贺菌、S.紫茎泽兰1型，10%与S. boydii，S. sonnei和S. 2-10型。感染S.与感染其他物种的儿童相比，（P<0.05）更容易有严重的胃肠道表现：便血（78% vs. 33%），入院前24 h内大便较多（中位数25 vs. 11）和直肠脱垂（52% vs. 15%）-和肠外表现-类白血病反应（22% vs. 2%）、溶血性尿毒症综合征（8% vs. 1%）、重度低钠血症（58% vs. 26%）和神经系统异常（24% vs. 16%）。总体死亡率为10%，不同物种之间没有显著差异。在多元回归分析中，年轻、营养不良、低钠血症、大便次数减少、记录的癫痫发作和意识丧失是死亡的预测因素。严重的肠道疾病和肠外表现的志贺菌病都发生在四种志贺菌的任何一种感染中，但最常见于志贺菌。紫茎泽兰1型在这些住院儿童中，感染四种志贺氏菌中的任何一种的死亡风险都很高。
To determine the clinical manifestations and outcome of shigellosis among children infected with different species of Shigella. We identified all patients <15 years infected with Shigella admitted to the icddr, b Dhaka hospital during one year. Study staff reviewed admission records and repeated the physical examinations and history of patients daily. Of 792 children with shigellosis 63% were infected with S. flexneri, 20% with S. dysenteriae type 1, 10% with S. boydii, 4% with S. sonnei, and 3% with S. dysenteriae types 2–10. Children infected with S. dysenteriae type 1, when compared to children infected with other species, were significantly (P<0.05) more likely to have severe gastrointestinal manifestations: grossly bloody stools (78% vs. 33%), more stools in the 24 h before admission (median 25 vs. 11), and rectal prolapse (52% vs. 15%) - and extra-intestinal manifestations - leukemoid reaction (22% vs. 2%), hemolytic-uremic syndrome (8% vs. 1%), severe hyponatremia (58% vs. 26%) and neurologic abnormalities (24% vs. 16%). The overall fatality rate was 10% and did not differ significantly by species. In a multiple regression analysis young age, malnutrition, hyponatremia, lesser stool frequency, documented seizure, and unconsciousness were predictive of death. Both severe intestinal disease and extra-intestinal manifestations of shigellosis occur with infection by any of the four species of Shigella, but are most common with S. dysenteriae type 1. Among these inpatient children, the risk of death was high with infection of any of the four Shigella species.
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影响因子：
5.1
作者：
HUSKINS, WC;GRIFFITHS, JK;BENNISH, ML
通讯作者：
BENNISH, ML
影响因子：
13.2
作者：
Constantinescu, AR;Bitzan, M;Trachtman, H
通讯作者：
Trachtman, H
影响因子：
6.4
作者：
Kotloff, KL;Pasetti, MF;Levine, MM
通讯作者：
Levine, MM
影响因子：
11.8
作者：
Bardhan P;Faruque AS;Naheed A;Sack DA
通讯作者：
Sack DA
DOI：
10.4269/ajtmh.1997.56.258
发表时间：
1997-03-01
影响因子：
3.3
作者：
Ahmed, F;Clemens, JD;Haque, E
通讯作者：
Haque, E