Clinical and immunological aspects of shigellosis and the effectiveness of modern therapy methods

Shigellosis remains a significant public health concern, particularly in regions with poor sanitation and limited access to healthcare. The disease is characterized by acute intestinal inflammation, leading to diarrhea, fever, and systemic intoxication. Standard treatment involves rehydration, antibiotics, and symptomatic therapy. However, the growing antimicrobial resistance of Shigella strains necessitates exploring adjunctive treatments to enhance therapeutic outcomes.

Objective: To study the clinical-epidemiological and laboratory characteristics of shigellosis and current approaches to treatment, with a focus on the efficacy of Polisorb in improving clinical outcomes.

Methods: A comparative analysis was conducted on 140 patients diagnosed with shigellosis, divided into two groups. The first group (n=62) received standard therapy supplemented with Polisorb, while the second group (n=65) received only standard therapy. Clinical symptoms, laboratory parameters, and recovery dynamics were assessed. Statistical analysis included Student’s t-test and non-parametric methods.

Results: Patients treated with Polisorb demonstrated a more rapid resolution of intoxication symptoms, normalization of stool frequency, and improvement in laboratory markers of inflammation compared to the standard therapy group. The duration of fever, diarrhea, and abdominal pain was significantly shorter in the Polisorb group (p < 0.05). Additionally, economic evaluation indicated reduced hospitalization duration and lower treatment costs in this group.

Conclusion: The inclusion of Polisorb in the treatment regimen for shigellosis contributes to a faster clinical recovery, improved laboratory parameters, and potential cost-effectiveness. This suggests that Polisorb can be an effective adjunctive therapy in managing shigellosis.

1. Jennison A.V., Verma N.K. Shigella flexneri infection: Pathogenesis and vaccine development // FEMS Microbiology Reviews. – 2004. – Vol. 28, №1. – P. 43–58. – DOI: 10.1016/j.femsre.2003.09.002.

2. Niyogi S.K. Shigellosis //journal of Microbiology. – 2005. – Vol. 43, №2. – P. 133–143.

3. Sharma A., Singh S.K., Bajpai D. Phenotypic and genotypic characterization of Shigella spp. with reference to its virulence genes and antibiogram analysis from river Narmada // Microbiological Research. – 2010. – Vol. 165, №1. – P. 33–42. – DOI: 10.1016/j.micres.2008.05.001.

4. Schroeder G.N., Hilbi H. Molecular pathogenesis of Shigella spp.: Controlling host cell signaling, invasion, and death by type III secretion // Clinical Microbiology Reviews. – 2008. – Vol. 21, №1. – P. 134–156. – DOI: 10.1128/CMR.00032-07.

5. Emch M., Ali M., Yunus M. Risk areas and neighborhoodlevel risk factors for Shigella dysenteriae 1 and Shigella flexneri // Health & Place. – 2008. – Vol. 14, №1. – P. 96–105. – DOI: 10.1016/j.healthplace.2007.04.002.

6. Livio S., и др. Shigella isolates from the global enteric multicenter study inform vaccine development // Clinical Infectious Diseases. – 2014. – Vol. 59, №7. – P. 933–941. – DOI: 10.1093/cid/ciu468.

7. Ram P.K., и др. Part II. Analysis of data gaps pertaining to Shigella infections in low and medium human development index countries, 1984–2005 // Epidemiology & Infection. – 2008. – Vol. 136, №5. – P. 577–603. – DOI: 10.1017/S0950268807008792.

8. Bhattacharya S.K., Sur D., Mahalanabis D. Public health significance of shigellosis // Indian Pediatrics. – 2012. – Vol. 49, №4. – P. 269–270.

9. Yushchuk N.D., Kulagina M.G., SHut’ko S.A., Mitrikova L.C. Ostrye diarejnye infekcii: principy racional’noj terapii // Infekcionnye bolezni: Novosti. Mneniya. Obuchenie. – 2019. – T. 8, №4. – S. 103–108. – DOI: 10.24411/2305-3496-201914013.

10. Farfán M.J., и др. Shigella enterotoxin-2 is a type III effector that participates in Shigella-induced interleukin 8 secretion by epithelial cells // FEMS Immunology & Medical Microbiology. – 2011. – Vol. 61, №3. – P. 332–339. – DOI: 10.1111/j.1574-695X.2010.00778.x.

11. Faherty C., и др. Chromosomal and plasmid-encoded factors of Shigella flexneri induce secretogenic activity ex vivo // PLoS ONE. – 2012. – Vol. 7, №11. – e49980. – DOI: 10.1371/journal.pone.0049980.

12. Matkowskyj K.A., и др. Galanin-1 receptor up-regulation mediates the excess colonic fluid production caused by infection with enteric pathogens // Nature Medicine. – 2000. – Vol. 6, №9. – P. 1048–1051. – DOI: 10.1038/79651.

13. Novokshonov A.A., Sokolova N.V. Metod enterosorbcii i ego klinicheskaya effektivnost’ v kompleksnoj terapii OKI u detej // Voprosy sovremennoj pediatrii. – 2011. – T. 10, №1. – S. 140–144.