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Identification and management of Shigella infection in children caused by gram negative bacteria.

Daniel Warner

Humans are the primary reservoir of Shigella species, with captive subhuman primates as accidental hosts. In developing countries with prevailing conditions of inadequate sanitation and overcrowded housing, the infection is transmitted most often by the excreta of infected individuals via direct fecal-oral contamination. Flies may contribute to spread from feces to food. The most common species, S dysenteries and S Flexner, are also the most virulent. In developed countries, sporadic common-source outbreaks, predominantly involving S sonnet, are transmitted by uncooked food or contaminated water. The latter outbreaks usually involve semipublic water systems such as those found in camps, trailer parks, and Indian reservations. Direct fecal-oral spread can also occur in institutional environments such as child day-care centers. Mental hospitals and nursing homes. Homosexual men are also at increased risk for direct transmission of Shigella Flexner infections, and chronic, recrudescent illness complicating HIV infection has been reported.