Volume 22, Number 4—April 2016
CME ACTIVITY - Research
Shiga Toxin 1–Producing Shigella sonnei Infections, California, United States, 2014–2015
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.