Shigella spp.

Shigella organisms (4)(4)

1. S. dysentariae (A)

2. S. flexneri (B)

   1. #2 important in US

   2. #1 important world wide

3. S. boydi (C)

4. S. sonnei (D)

   1. Ornithine +

   2. #1 important in US

How is Shigella transmitted (5)

1. Lowest infectious dose (100 cells)

2. 4Fs

   1. Fleas

   2. Feces

   3. Fingers

   4. Fomites (intimate objects)

Distribution (2)

1. Daycares are epicenter for outbreaks

2. 20,000 Shigella in U.S. (Death very rate)

Symptoms and Incubation (6)

1. Incubation is 1-4 days

2. Watery diarrhea

3. Fever

4. Dysentery

   1. Scant, bloody, pus stool

   2. WBC in stool

   3. Can be shed days to weeks after

CLSI Recomendation

1. CLIS does not advocate for susceptibility testing on stool pathogens, but Shigella is the exception

2. Antibiotic therapy reduces shedding

CLSI Antibiotics

1. Ampicillin

2. T/S

3. Ciprofloxin (Liver metabolism)