ケニア国南部海岸地区における細菌性下痢症
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概要
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The aim of this study is to clarify the etiology and ecology of diarrhoeal diseases in Kwale District, Coast Province, Kenya. Nine hundred and ninety-nine diarrhoeal specimens were collected during the period between October 1981 and July 1982, and they were bacteriologically examined. The isolation rates of enteropathogens were as follows: 22.8% for Shigella, 8.0% for enteropathogenic Escherichia colt (EPEC), and 3.5% for Salmonella. Vibrio cholerae and Vibrio parahaemolyticus were not isolated during this period. The isolation rates of the pathogens got high during the rainy season, such as 42.1% in April, 57.5% in May, and 53.0% in June. Shigella was the most predominant pathogen, and EPEC was isolated with relativery high frequency especially in October, March and June. In the bloody diarrhoeal stools, Shigella was isolated in 76.0% (124/163) while EPEC and Salmonella were 4.9% and 2.4% respectively. But the other 18.4% of the bloody diarrhoea was negative for these pathogens. Among a total of 228 Shigella isolates, the subgroup Sh. flexneri was most predominant (168/228=73.6%), and the second predominant subgroup was Sh. sonnei (12.2%). Regarding the serovar of 168 strains of Sh. flexneri, 71 strains belonged to type II-a (42.3%), and 39 strains revealed type I-b (23.6%). In the age group older than 5 years, the isolation rate of the enteropathogens was more than 30%, but in the group below 5 years, it was 20.8%. From these results, it can be stressed that the study on the infections with Campylobacter jejuni, enterotoxigenie E. coli, and rota virus should be carried out as said by WHO. In the drug sensitivity test using tetracycline, streptomycin, chloramphenicol, ampicillin and nalidixic acid, the resistant Shigella strains against tetracycline were outstanding. About 50% of the Shigella strains appeared clinically resistant (MIC>25mcg/ml). Highly resistant strains (MIC>100mcg/ml) were seen in 12.2%. The rate of resistant strains against the multiple drugs was low. In Kwale District, most of the diarrhoeal patients are treated with tetracycline, so it is possible that Tetracycline-resistant strain will increase and persist. Enteropathogenic E. coli was detected from the drinking tap water. It suggests that the tap water is one of the focus of infection.
- 長崎大学熱帯医学研究所の論文
- 1982-12-00
長崎大学熱帯医学研究所 | 論文
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