Multidrug Resistant Shigella Infection in Bangladesh

University of Virginia

Status: Unknown

Conditions: Diarrhea; Shigella

Study type: Observational

Funder types: Other; Other U.S. Federal agency

Identifiers

NCT03778125

PR-18078 (Other Identifier)

21166

Details and patient eligibility

About

The purpose of this project is to systematically collect clinical and nutritional outcomes information on patients treated for Shigella infection so that physicians and clinical laboratories can better define which Shigella infections are "resistant" to antibiotics and which are "susceptible", focusing on azithromycin a last-line drug to treat drug resistant Shigella

Full description

2000 suspected Shigella cases will be recruited from International Centre for Diarrhoeal Disease Research hospital, Dhaka who are presenting with diarrhea at the hospital. A stool sample will be collected from the participants after consenting by the study staff. Stool microscopy will be performed to see the white blood cells(WBC) and red blood cells (RBC). If WBC > 10 HPF (4) with any RBC present, culture will be performed from this stool to identify Shigella. Such patients with invasive diarrhea are treated with azithromycin per local standard of care. Enrolled participant will be invited for further follow up when culture from the stool is Shigella positive. Minimal inhibitory concentration (MIC) testing of Shigella isolates and Molecular testing of Shigella isolates will be performed from Shigella cultures. This is an observational study. This study does not provide any treatment to the study participants; they will receive treatment as per International Centre for Diarrhoeal Disease Research Dhaka hospital guidelines. We will then examine the effect of the azithromycin minimal inhibitory concentration on clinical outcome.

Enrollment: 2,000 estimated patients

Sex: All

Volunteers: No Healthy Volunteers

Inclusion criteria

• diarrheal illness less than 96 hours duration
• microscopic evidence of inflammatory diarrhea
• plus mucus in stool
• plus abdominal pain/cramps
• Subject or parents or legal guardian willing to come for follow up at hospital or allow study staff for home visit
• residence in Dhaka region
• presentation during daytime hours

Exclusion criteria

• Not receiving treatment with azithromycin at enrolment