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Volume 22, Number 4—April 2016
CME ACTIVITY - Research

Shiga Toxin 1–Producing Shigella sonnei Infections, California, United States, 2014–2015

Katherine LambaComments to Author , Jennifer A. Nelson, Akiko C. Kimura, Alyssa Poe, Joan Collins, Annie S. Kao, Laura Cruz, Gregory Inami, Julie Vaishampayan, Alvaro Garza, Vishnu Chaturvedi, and Duc Vugia
Author affiliations: California Department of Public Health, Richmond, California, USA (K. Lamba, A.C. Kimura, A. Poe, L. Cruz, G. Inami, V. Chaturvedi, D.J. Vugia); County of San Diego Health and Human Services Agency, San Diego, California, USA (J.A. Nelson, A.S. Kao); San Joaquin County Public Health Services, Stockton, California, USA (J. Collins, J. Vaishampayan, A. Garza)

Main Article

Table 1

Clinical characteristics of patients with Shiga toxin 1–producing Shigella sonnei infections, California, June 2014–April 2015*

Characteristic Value
Symptoms
  Diarrhea 56/56 (100.0)
  Abdominal cramps 45/52 (86.5)
  Fever† 36/50 (72.0)
  Bloody diarrhea 36/51 (70.6)
  Chills 26/41 (63.4)
  Nausea 22/39 (56.4)
  Vomiting 21/48 (43.8)
  Headache
 10/33 (30.3)
Outcomes
  Emergency department visit 27/51 (52.9)
  Hospitalization 12/56 (21.4)
  Hemolytic uremic syndrome 0/43
  Death 0/56
  Median duration of symptoms, d (IQR) 5 (3–7)‡
  Median length of hospitalization, d (IQR)
 3 (1.5–4)§
Antimicrobial resistance
  Trimethoprim/sulfamethoxazole 27/29 (93.1)
  Ampicillin 6/25 (24.0)
  Ciprofloxacin 0/22
  Ceftriaxone
 0/13
Treatment
  Received any treatment 48/54 (88.9)
  Treated with antimicrobials 43/53 (81.1)
  Antimicrobial treatment¶
    Ciprofloxacin 19 (45.2)
    Metronidazole 12 (28.6)
    Ceftriaxone 5 (11.9)
    Levofloxacin 5 (11.9)
    Trimethoprim/sulfamethoxazole 4 (9.5)
    Azithromycin 4 (9.5)
    Ampicillin 3 (7.1)
    Amoxicillin 2 (4.8)
    Other or unknown
 3 (7.1)
Median interval from diarrhea onset to start of antimicrobial treatment, d (IQR) 3 (1–5)#
Treated with intravenous fluids 23/46 (50.0)
Received other treatment** 17/54 (31.5)

*Values are no. patients/no. with information available (%) excepted as indicated. IQR, interquartile range.
†Based on self-reported data; 19 (52.8%) of 36 patients had documented temperature of ≥38°C.
‡n = 39; includes 6 patients in cluster 2 still symptomatic at time of interview. Illness duration range 5–12 d.
§n = 11.
¶n = 42. Because 10 case-patients were treated with >1 antimicrobial drug, total is >100%.
#n = 35.
**Antiemetics, pain medication, nonprescription antidiarrheal medication.

Main Article

Page created: March 15, 2016
Page updated: March 15, 2016
Page reviewed: March 15, 2016
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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