Objective: To understand the epidemiological characteristics of bacillary dysentery with multiple-onset in Henan province from 2005 to 2020. Methods: The reported cases of bacillary dysentery (including confirmed cases and clinically diagnosed cases) in Henan Province from January 2005 to December 2020 were collected through China's National Disease Supervision Information Management System. The main information included gender, age, home address, date of onset and date of diagnosis. The interval between two episodes of the same case was more than 15 days, which was judged as two episodes. The incidence characteristics of bacillary dysentery patients with two or more cases in Henan Province from 2005 to 2020 were analyzed, and the regional distribution map of cases was drawn using ArcGIS software. Results: From 2005 to 2020, a total of 250 430 cases of bacillary dysentery were reported in Henan Province, with a cumulative incidence rate of 228.66/100 000. There were 2 342 cases with two or more attacks. The incidence of recurrent cases of bacillary dysentery increased year by year (χ²_trend=2 932.28, P<0.001). There was no significant difference in the incidence of two or more cases of different sexes (χ²=0.39, P=0.540). There was significant difference in the incidence among different age groups (χ²=438.40, P<0.001). The incidence of two or more cases in the 60-69 age group was relatively high (1.70%). The shortest time interval between the onset of the disease was 16 days, and the longest was 5 579 days, with M (Q₁, Q₃) about 428 (237, 843) days. Compared with healthy people, those with a history of bacterial diseases had a higher risk of developing bacillary dysentery (RR: 4.12, 95%CI: 3.95‒4.29). Conclusion: The proportion of patients with multiple-onset shows an increasing trend, and there is an age difference.
Humans ; Dysentery, Bacillary/diagnosis* ; Incidence

The usefullness of monocytosis in routine CMC as an aid in diagnosis of several diseases was evaluated in infancy and children. 234 cases in which the absolute count was more than 750 mono cyte per cubic millimeter were the subject of this study. The following results were obtained; 1) 234 cases (2.9%) of total 8069 patients from Oct. 1977 to Aug. 1978 showed monocytosis. 2) monocytosis was found in infectious diseases, hematologic disorders and malignant diseases. Most common cause of absolue monocytosis was infectious diseases(73%). 3) The 171 cases in infectious diseases group included congenital syphilis, pneumonia, tuberculosis, bacterial meningitis, bacillary dysentery, etc. And weconcluded that the monocytosis is useful as an aid in diagnosing several disease.
Child ; Communicable Diseases ; Diagnosis ; Dysentery, Bacillary ; Humans ; Meningitis, Bacterial ; Pneumonia ; Syphilis, Congenital ; Tuberculosis

OBJECTIVEDual detection of Salmonella and Shigella using modified molecular beacons and real-time PCR was developed. The established method was applied to rapid diagnosis of Salmonella and Shigella' food poisoning, and for routine monitoring programs.

METHODSTwo sets of primers were designed based on the core sequence of invA gene and ssaR gene published on GenBank to detect Salmonella, and ipaH gene were selected to detect Shigella. Three corresponding modified molecular beacons labeled with different fluorophors were designed. The molecular beacons and primer sets were tested against numerous strains from 55 different bacterial species. Then the two assays were combined to establish the dual real-time PCR assay, and were applied to the food poisoning diagnosis and surveillance.

RESULTSFor the modified molecular beacons-based dual real-time PCR assay, the sensitivity achieved was 69-93 fg/microl, 32-64 CFU/ml or 1-2 CFU/PCR reaction. There was no cross-reaction with other bacteria served as control. The dual real-time PCR assay was used to detect 134 Salmonella strains and 67 Shigella strains but no false signals were observed. 1100 food poisoning samples were tested with 569 Salmonella and 42 were Shigella identified by real time PCR. Among the positive samples, 551 were detected Salmonella and 41 were Shigella by traditional culture method. The overall test could be finished within 2 hours to one day starting from sample preparation.

CONCLUSIONThe modified molecular beacons-based dual real-time PCR assay was rapid, sensitive, and specific. It could be applied to the rapid diagnosis of Salmonella and Shigella' food poisoning.

DNA Primers ; Dysentery, Bacillary ; diagnosis ; Genes, Bacterial ; Humans ; Polymerase Chain Reaction ; methods ; Salmonella ; genetics ; Salmonella Food Poisoning ; diagnosis ; Sensitivity and Specificity ; Shigella ; genetics

Twenty one infants and children were entered into the study protocol when bacteriologic diagnosis of shigellosis was made by stool culture indenification. Fifteen patients were treated at Inje Hospital in Kangwon Do and six patients were treated at Severance Hospital in Seoul. Susceptibility studies were revealed that ampicillin was resistant in all cases. Gentamicin and Panimycin which are aminoglycosides were quite effective. But their use was limited because of their nephrotoxicity and those antibiotics should be used only by parenteral route. A daily dose of 20microgram per kilogram of body weight of rifampin was given by mouth divided every 6 hrs for 7 days routinely except 2 cases. After that follow up stool culture were performed on 13 patient. The results were negative except one case. There was no untoward reaction of rifampin during therapy except for the red coloring of urine and stool. To prevent developing the resistance of shigella to rifampin, it is necessary to confirm that negative conversion of stool cultures has been achieved. Our experience should encourge the use of rifampin in the treatment of shigellosis.
Aminoglycosides ; Ampicillin ; Anti-Bacterial Agents ; Body Weight ; Child ; Diagnosis ; Dysentery, Bacillary* ; Follow-Up Studies ; Gangwon-do ; Gentamicins ; Humans ; Infant ; Mouth ; Rifampin* ; Seoul ; Shigella

Using three reference strains of Brachyspira hyodysenteriae (B204, B234, B169), one B. pilosicoli (P43/6/78), one B. murdochii (56-150), one B. intermedia (PWS/A), one B. innocens (B256) and ten Korean isolates, PCR-RFLP analysis of DNA encoding 23S rRNA was performed to establish a rapid and accurate method for characterizing porcine intestinal spirochetes. Consequently, B. hyodysenteriae and B. pilosicoli revealed different restriction patterns; however, the other three species shared the same pattern. These findings are not consistent with a prior report. Differences in 23S rRNA gene sequences, between two B. murdochii strains, 56-150 and 155-20, were observed. These results indicate that 23S rRNA PCR-RFLP could be used as an identification method for pathogenic Brachyspira spp. (B. hyodysenteriae and B. pilosicoli) as well as an epidemiological tool for characterizing spirochetes isolated from swine.
Animals ; DNA, Bacterial/genetics ; Dysentery, Bacillary/diagnosis/microbiology/*veterinary ; Korea ; Phylogeny ; Polymerase Chain Reaction/methods/*veterinary ; Polymorphism, Restriction Fragment Length ; RNA, Ribosomal, 23S/chemistry/*genetics ; Spirochaetales/*genetics/*isolation&purification ; Spirochaetales Infections/diagnosis/microbiology/*veterinary ; Swine ; Swine Diseases/diagnosis/*microbiology

PURPOSE: In this study, we tried to evaluate the clinical characteristics or circumstances that lead to unintentionally the delay in the diagnosis of intussusception or to the wrong direction that prevent the proper management early. METHODS: All the patients of intussusception with delayed diagnosis in the department of pediatrics or emergency room at Gyeongsang National University Hospital from 1990 to 2003 were enrolled and reviewed retrospectively. RESULTS: There were 8 boys and 6 girls and their median age was 8 months (range 2 months to 10 years). Their initial symptoms and signs were vomiting, seizure, diarrhea, lethargy, irritability, bloody stool, palpable abdominal mass, foul odor of urine and tachycardia. Clinical diagnosis or impressions at admission consisted of acute gastroenteritis, shigellosis and toxic encephalopathy, convulsive disorders, urinary tract infections, sepsis, abdominal mass and intestinal obstruction. Eight patients were luckily diagnosed due to the delayed manifestations of cyclic irritability or currant jelly stool. Six patients were not paid attentions for the possibilities of intussusception and diagnosed serendipitiously by the abdominal sonography or CT during the evaluation of the abdominal mass or distension. Only five of 14 cases (35.7%) were successfully managed by barium or air reductions. The other 9 cases needed surgical operations. CONCLUSION: Delayed diagnosis of intussusception arise when doctors initially diagnose the patients incorrectly due to the unusual presentations or when they overlook the newly arising symptoms or signs suggestive intussusception after the admission because they are ardently attached to the first impressions or initial clinical diagnosis.
Attention ; Barium ; Delayed Diagnosis ; Diagnosis* ; Diarrhea ; Dysentery, Bacillary ; Emergency Service, Hospital ; Female ; Gastroenteritis ; Humans ; Intestinal Obstruction ; Intussusception* ; Lethargy ; Neurotoxicity Syndromes ; Odors ; Pediatrics ; Retrospective Studies ; Seizures ; Sepsis ; Tachycardia ; Urinary Tract Infections ; Vomiting

PURPOSE: Acute febrile illness in children frequently accompanies with abdominal symptoms such as vomiting, diarrhea, and abdominal pain, even if its etiology is not occured from the gastrointestinal tract. If the etiology of fever was unknown and the fever was accompanied with abdominal symptoms, we should be concerned about whether the etiology of fever was originated from the gastrointestinal tract or interpretated from the abnormality in the gastrointestinal tract. This study was performed to evaluate the diagnostic value of abdominal ultrasonography in patients with fever and abdominal symptoms. METHODS: We reviewed retrospectively the medical records of abdominal ultrasonographic (US) findings of 60 cases of acute febrile illness with abdominal symptoms at department of Pediatrics, Ulsan Dongang General RESULTS: (100%), splenomegaly in 4 cases (66.7%), ileocecitis in 1 case (16.7%), enlarged mesenteric lymph nodes and splenomegaly in 4 cases (66.7%), enlarged mesenteric lymph nodes, splenomegaly and ileocecitis in 1 cases (16.7%). 6) The enlarged mesenteric lymph nodes and the abnormalities around the appendix were seen in 7 cases (11.7%), which were confirmed as appendicitis all. 7) The thickening of wall in urinary bladder was seen in 2 cases (3.3%) of acute cystitis and acute hemorrhagic cystitis. 8) The subtle thickening of wall in colon was seen in 1 cases (1.7%) of shigellosis. CONCLUSIONS: The enlarged mesenteric lymph nodes, splenomegaly and ileocolitis on the abdominal ultrasonography in patients with fever and abdominal symptoms aree suggestive findings of typhoid fever. The enlarged mesenteric lymph nodes and the abnormalities around the appendix on abdominal ultrasonography make the rapid diagnosis of acute appendicitis and its complications, when physical examination is difficult in small children and diagnosis of their illnesses is obscure in patients with fever and abdominal pain.
Abdominal Pain ; Appendicitis ; Appendix ; Child ; Colon ; Crohn Disease ; Cystitis ; Diagnosis ; Diarrhea ; Dysentery, Bacillary ; Fever* ; Gastrointestinal Tract ; Humans ; Lymph Nodes ; Medical Records ; Pediatrics ; Physical Examination ; Retrospective Studies ; Splenomegaly ; Typhoid Fever ; Ulsan ; Ultrasonography ; Urinary Bladder ; Vomiting

Bacillary dysentery is still an important food-borne infection worldwide. Because a small inoculum can establish the infection, contact, food, and water are the usual transmission route. Abdominal pain and diarrhea are the early symptoms, followed by bloody and mucoid stool and tenesmus. Although the diagnosis of shigellosis is based on the stool culture, diarrhea with general symptoms persisting for several days and intrafamilial spread suggest the shigellosis. The high resistance rate against the first-line antimicrobials is a serious social problem in developing countries. In countries showing a high resistance rate of trimethoprim-sulfamethoxazole or ampicillin, including Korea, the treatment choice for shigellosis is fluoroquinolone for 3 days in adults. In Korea, there has been a dramatic increase of shigellosis from 1998. Shigella sonnei is the most common pathogen, and S. flexneri has been isolated continuously in a small number. Analyzing the incidence by age and provinces, the infection occurred most frequently in the age group under twenties, and Cheju, Kyeongnam, Chonnam, and Kangwon show the high incidence rate of shigellosis. Although seasonal variation of shigellosis was influenced by regional outbreaks, the infection occurred most commonly in late spring and early autumn. The resistance rate of trimethoprim-sulfamethoxazole was very high, over 90%, but ampicillin resistance varied widely according to the epidemics or regions. The analyses of several epidemics of shigellosis from 1998 to 2000 indicate that the school lunch program is the most important cause for the recent increase of shigellosis in Korea. The strict regulation of mass food handling is critical for the control of shigellosis.
Abdominal Pain ; Adult ; Ampicillin ; Ampicillin Resistance ; Developing Countries ; Diagnosis ; Diarrhea ; Disease Outbreaks ; Dysentery, Bacillary* ; Food Handling ; Gangwon-do ; Gyeongsangnam-do ; Humans ; Incidence ; Jeju-do ; Jeollanam-do ; Korea ; Lunch ; Seasons ; Shigella sonnei ; Social Problems ; Trimethoprim, Sulfamethoxazole Drug Combination

We report a case of CTX-M-55-type extended-spectrum beta-lactamase (ESBL)-producing Shigella sonnei infection in a 27-year-old Korean woman who had traveled to China. The patient was admitted to the hospital due to abdominal pain, watery diarrhea, and fever (39.3degrees C). S. sonnei was isolated from her stool specimens, and the pathogen was found to be resistant to cefotaxime due to CTX-M-55-type ESBL. Insertion sequence (IS)Ecp1 was found upstream of the blaCTX-M-55 gene. The blaCTX-M-55 gene was transferred from the S. sonnei isolate to an Escherichia coli J53 recipient by conjugation. Pulsed-field gel electrophoresis and Southern blotting revealed that the blaCTX-M-55 gene was located on a plasmid of approximately 130 kb.
Adult ; Anti-Bacterial Agents/pharmacology ; Asian Continental Ancestry Group ; Cefotaxime/pharmacology ; China ; Drug Resistance, Bacterial/drug effects ; Dysentery, Bacillary/diagnosis/*microbiology ; Electrophoresis, Gel, Pulsed-Field ; Escherichia coli/metabolism ; Feces/microbiology ; Female ; Humans ; Plasmids/chemistry/genetics ; Republic of Korea ; Shigella sonnei/enzymology/*isolation & purification ; Travel ; beta-Lactamases/genetics/*metabolism

BACKGROUND: Shigella is a frequent cause of bacterial dysentery in the developing world. Treatment with antibiotics is recommended for shigellosis, but the options are limited due to globally emerging resistance. This study was conducted to determine the frequency and pattern of antimicrobial susceptibility of Shigella in China. METHODS: We studied the antimicrobial resistance profiles of 308 Shigella spp. strains (260 S. flexneri, 40 S. sonnei, 5 S. boydii, and 3 S. dysenteriae) isolated from fecal samples of patients (age, from 3 months to 92 yr) presenting with diarrhea in different districts of Anhui, China. The antimicrobial resistance of strains was determined by the agar dilution method according to the CSLI guidelines. RESULTS: The most common serogroup in the Shigella isolates was S. flexneri (n=260, 84.4%), followed by S. sonnei (n=40, 13.0%). The highest resistance rate was found for nalidixic acid (96.4%), followed by ampicillin (93.2%), tetracycline (90.9%), and trimethoprim/sulfamethoxazole (80.8%). Among the isolates tested, 280 (91.0%) were multidrug resistant (resistant to > or =2 agents). The most common resistance pattern was the combination of ampicillin, tetracycline, and trimethoprim/sulfamethoxazole (70.8%). Resistance to ampicillin and tetracycline were more common among S. flexneri than among S. sonnei isolates. CONCLUSIONS: S. flexneri is predominant in Anhui, China, and its higher antimicrobial resistance rate compared with that of S. sonnei is a cause for concern. Continuous monitoring of resistance patterns is necessary to control the spread of resistance in Shigella. The recommendations for antimicrobial treatment must be updated regularly based on surveillance results.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Ampicillin/pharmacology ; Anti-Infective Agents/*pharmacology ; Child ; Child, Preschool ; China ; Drug Resistance, Bacterial/drug effects ; Dysentery, Bacillary/*diagnosis/microbiology ; Feces/microbiology ; Humans ; Infant ; Microbial Sensitivity Tests ; Middle Aged ; Nalidixic Acid/pharmacology ; Shigella/*drug effects/isolation & purification ; Shigella flexneri/drug effects/isolation & purification ; Shigella sonnei/drug effects/isolation & purification ; Tetracycline/pharmacology ; Time Factors ; Trimethoprim-Sulfamethoxazole Combination/pharmacology ; Young Adult