The 130th Annual Meeting of APHA

3014.1: Monday, November 11, 2002 - 8:30 AM

Abstract #49701

Clinical and epidemiological aspects of hospitalized pediatric shigellosis in Cluj – Napoca (Romania), 1995-1999

Ioan Stelian Bocsan, MD, PhD, Institute of Public Health; School of Medicine, Iuliu Hatieganu University of Medicine and Pharmacy, 13, Emil Isac Street, RO-3400 Cluj-Napoca, Romania, 40-64-199891, isbocsan@ispcj.ro, Irina Brumboiu, Epidemiology Department, The Iuliu Hatieganu University of Medicine and Pharmacy, 13, Emil Isac Street, Cluj-Napoca, Romania, and Dumitru Carstina, Infectious Diseases Department, The Iuliu Hatieganu University of Medicine and Pharmacy, 13, Emil Isac Street, Cluj-Napoca, Romania.

Introduction: Shigellosis remains an endemo-epidemic infection, mainly in pediatric population. The development of antibiotic resistance is frequently described. Material and methods: Data on 549 cases of shigellosis admitted in a teaching hospital of infectious diseases (years 1995 – 1999) were collected and studied using Access and EpiInfo software. Results: 68,7% of cases occurred in urban pediatric population (1-4 years old: 24,4%, 5-9 years old: 14,4%, infants: 9,7%), through person-to-person transmission, in families (45,3%) and in schools (22,8%). Most of the adult cases were from the poorest groups (50,2% unemployed and fired). The highest incidence was in August (18,4%) and September (14,6%). S. flexneri was identified in 67,5% of cases. Comparing with S. sonnei, S. flexneri produced mild clinical cases (82,7% vs 72,6%) and severe cases (5,1% vs 1,8%). Shigella spp. proved being frequently resistant to trimethoprim–sulfamethoxazole (82,8%), streptomycin (78,1%), ampicillin (76,4%), tetracycline (74,9%) and nitrofurantoin (40,4 %). Conclusions: Shigellosis is more frequent in urban areas, in children in families, and in adults of poor conditions, mostly in the warm season. Shigella flexneri is the most frequent etiological agent. Its resistance for trimethoprim – sulfamethoxazole, ampicillin and nitrofuran occurred, drugs frequently used in outpatients’ treatment. Changing behaviors by sustained health education programs can be more efficient in shigellosis control.

Learning Objectives:

Keywords: Diarrhea, Epidemiology

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

Clinical and epidemiological aspects of hospitalized pediatric shigellosis in Cluj – Napoca (Romania), 1995-1999

The 130th Annual Meeting of APHA