Newer Procedures in Laboratory Diagnosis and Therapy in the Control of Bacillary Dysentery

Abstract

Laboratory procedures for the diagnosis of Shigella infections described are: (1) fecal specimen obtained by rectal swab; (2) streaking the entire surface of a S.S. (Shigella-Salmonella) agar plate with the swab; (3) suspicious colonies are picked to Kligler''s iron agar, Russell''s double or Krumwiede''s triple sugar agar. Cultures showing typical reactions on these media are planted in mannitol, xylose and rhamnose. Flexner, Sonne, Schmitz and Al-kalescens are thus differentiated. Agglutination tests using 3 diagnostic sera, polyvalent Flexner (including Boyd 88), Sonne and Schmitz are set up using the growth from Kligler, Russell or Krumwiede tubes. More extensive cultural tests are used for organisms neither clearly negative or positive. Absorbed sulfonamides (sulfapyrazine, sulfadiazine, sulfa-methazine, sulfamerizine and sulfathiazole) are recommended for treatment of shigellosis. Sulfanilamide or sulfa-pyridine are not recommended. Follow-up cultures should be taken not later than the 4th and again on the 6th day of treatment. If positive, and particularly if the organism is "Sonne," a change to sulfasuxidine is desirable. Sonne infections. were more resistant to all sulfonamides. Adult, child and infant dosages are given. The application of these newer control procedures to the prevention and control of Shigella infections is discussed.