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0 for Windows (SPSS Inc., Chicago, IL, USA). A P-value of <0.05 was considered statistically significant. Written consent was obtained from parents (or guardians) of all study children after explaining to them the purpose of this study. The study received approval from institutional ethical committee and scientific advisory committee, NICED, Kolkata. Patients were treated as per routine clinical management guideline of the hospital. Diarrhoea was defined as three or more loose bowel movements during a 24-h period, dysentery as one or more loose bowel movements with mucous or visible blood. A shigellosis episode was defined as a diarrhoea episode during which any Shigella species was isolated from a faecal specimen. A total of 4478 samples (3045, 68.0% rectal swabs; 1433, 32.0% stool) were collected from children (<5?years) with a clinical diagnosis of acute diarrhoea over <a href="http://www.selleck.cn/products/blz945.html">BLZ945 a span of 7?years (January 2001�CDecember 2007). Macroscopically, 1103 (77.0%) stool samples contained blood mucus, 115 (8.0%) were watery in nature, and only mucus was present in 215 (15.0%) samples. After processing all specimens, 516 (11.5%) samples yielded Shigella with distribution as follows: S.?flexneri (312, 7.0%) being the major serogroup followed by S.?sonnei (123, 2.7%), S.?dysenteriae (48, 1.1%) and S.?boydii (33, 0.7%). Relatively higher isolation of Shigella was noted during the second half (2004�C2007) of the study period [OR 1.90 (1.44�C2.50); P?<?0.001]. Of the 516 Shigella-positive children, 439 (85.0%) complained of blood-tinged mucoid stool, 35 (6.8%) had watery diarrhoea and 39 (7.5%) had mucus diarrhoea. On examination, 335 (65.0%) <a href="http://www.selleckchem.com/products/GDC-0941.html">Pictilisib children had no dehydration, 176 (34.0%) had mild dehydration and one was moderately dehydrated. Children aged 1�C5?years had significantly higher isolation of Shigella than infants (63.0%vs. 35.0%; P?<?0.05). Boys (53.0%) were marginally more affected than girls (46.0%). Most (85.0%) patients belonged <a href="http://www.selleckchem.com/products/ldk378.html">Selleckchem Ceritinib to low socioeconomic class and presented with features of malnutrition. Figure?1 shows that S.?flexneri was the most predominant serogroup throughout the study period. Relative isolation frequency of S.?flexneri (60.0�C70.0%) was significantly higher than that of S.?sonnei (20.0�C30.0%), S.?dysenteriae (5.0�C15.0%) and S.?boydii (4.0�C9.0%) (P?<?0.05). No specific seasonal variation was observed for Shigella isolation, although increased attendance of diarrhoeal children in the hospital was noted during pre-monsoon and monsoon months (April to August). The distributions of Shigellae serogroups and subtypes of S.?flexneri are shown in Figure?2. Although 10 subtypes of S.?flexneri were isolated, the predominant circulating subtypes in the order of descending frequency were S.?flexneri 2a (179/312; 57.4%), S.?flexneri 6 (38/312; 12.2%) and S.?flexneri 3a (36/312; 11.5%). Seven strains became non-viable and were lost during the study period. Six isolates, biochemically identical with Shigella, were agglutinable with S.</div>
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