Biomedical subjects

I Kabir

Publications and source records attributed to I Kabir.

At least 19 recordsLinked to original sources

PubMed2002

Tetracycline in the treatment of severe cholera due to Vibrio cholerae O139 Bengal.

Vibrio cholerae O139 synonym Bengal, recognized in 1993, is the second member in the list of about 200 serogroups of V. cholerae with epidemic and pandemic potential. Although replacement of fluids and electrolytes remains the cornerstone in the management of cholera, antimicrobial therapy can significantly shorten the duration of diarrhoea, and reduce stool volume and requirements ofrehydration fluids. The role of antimicrobial therapy on the natural course of the disease caused by this relatively new pathogen has not been systematically assessed. A randomized, double-blind, placebo-controlled clinical trial was conducted to evaluate the efficacy of tetracycline in the treatment of adults with severe cholera due to V. cholerae O139 Bengal. Forty-three adult males with severe cholera were randomly allocated to receive either 500 mg of tetracycline (n=21) or placebo (n=22) for three consecutive days. Demographic and clinical characteristics of these patients on admission were comparable. Tetracycline therapy was associated with significantly reduced total median (inter-quartile range) stool volume [216.48 (90.18-325.22) mL/kg vs 334.25 (215.12-537.64) mL/kg; p=0.001], higher rates of clinical cure (81% vs 27%; p<0.001), and shorter median (inter-quartile range) duration of diarrhoea [32 (24-48) hours vs 80 (48-104) hours; p<0.001]. The mean +/- (SD) requirement of intravenous fluid was not significantly different between the two groups [146.42 +/- 42.12 mL/kg vs 150.44 +/- 27.21 mL/kg; p=0.70]. The median (inter-quartile range) duration of faecal excretion of V. cholerae O139 was significantly shorter in the tetracycline group than the placebo group [1(1-2) day vs 5 (3-6) days; p<0.001]. The results of the study indicate that tetracycline therapy is clinically useful in the treatment of severe cholera due to V. cholerae O139 Bengal.

Adolescent↗

PubMed2002

Energy intake and expenditure of obese and non-obese urban Bangladeshi children.

A case control study was conducted in Dhaka city to measure the energy intake and expenditure among 220 obese children of 4-10 years age group and 220 randomly selected age and sex matched controls. A 24 hour dietary recall was used to assess the energy intake. Data on energy expenditure was obtained by 24 hour physical activity recall. The mean energy intake of obese children (2056 +/- 751 kcal/d) was found to be significantly higher (P<0.001) compared to the non obese (1508 +/- 529 kcal/d). No sex difference was found in both obese and non obese groups. Mean energy expenditure of the obese children (1868 +/- 313 kcal/d vs 1495 +/- 200 kcal/d) was significantly higher than the non-obese (P<0.001). Of the obese, boys expended more energy than the girls (P=0.01). Furthermore, physical activity level (1.40 +/- 0.09 vs 1.35 +/- 0.14) was significantly higher among the non obese than their obese counterpart (P<0.001). However, energy balance was significantly higher among the obese (P<0.001). Dose response of energy balance shows the estimated relative risk of obesity increases with higher level of energy balance (P<0.001). The findings of this study revealed that energy balance as a result of higher energy intake and lower energy expenditure was one of the important risk factors for the development of obesity among the children of Dhaka city. Thus, appropriate interventions like behavioural change regarding food habits and physical activities are recommended.

Bangladesh↗

PubMed2000

Effect of community-based peer counsellors on exclusive breastfeeding practices in Dhaka, Bangladesh: a randomised controlled trial [see commments].

BACKGROUND: Most mothers breastfeed in Bangladesh, but they rarely practise exclusive breastfeeding. Hospital-based strategies for breastfeeding promotion cannot reach them because about 95% have home deliveries. We postulated that with the intervention of trained peer counsellors, mothers could be enabled to breastfeed exclusively for the recommended duration of 5 months. METHODS: 40 adjacent zones in Dhaka were randomised to intervention or control groups. Women were enrolled during the last trimester of pregnancy between February and December, 1996. In the intervention group, 15 home-based counselling visits were scheduled, with two visits in the last trimester, three early postpartum (within 48 h, on day 5, between days 10 and 14), and fortnightly thereafter until the infant was 5 months old. Peer counsellors were local mothers who received 10 days' training. FINDINGS: 363 women were enrolled in each group. Peer counselling significantly improved breastfeeding practices. For the primary outcome, the prevalence of exclusive breastfeeding at 5 months was 202/228 (70%) for the intervention group and 17/285 (6%) for the control group (difference=64%; 95% CI 57%-71%, p>0.0001). For the secondary outcomes, mothers in the intervention group initiated breastfeeding earlier than control mothers and were less likely to give prelacteal and postlacteal foods. At day 4, significantly more mothers in the intervention group breastfed exclusively than controls. INTERPRETATION: Peer counsellors can effectively increase the initiation and duration of exclusive breastfeeding. We recommend incorporation of peer counsellors in mother and child health programmes in developing countries.

Adolescent↗

PubMed2000

Anaemia and iron deficiency among adolescent schoolgirls in peri-urban Bangladesh.

OBJECTIVE: To investigate the prevalence of anaemia and iron deficiency among adolescent schoolgirls in peri-urban Bangladesh, and to identify various factors associated with anaemia in this population. DESIGN: A cross-sectional design. SETTING: Girls' high schools in five sub-districts of Dhaka. SUBJECTS: Adolescent girls (n=548) aged 11-16 y from nine schools in Dhaka district participated in the study. Socio-economic, anthropometric and dietary information were collected. Blood haemoglobin (Hb), serum iron, total iron binding capacity (TIBC), transferrin saturation (TS), serum ferritin (SF) and serum retinol (vitamin A) were determined. RESULTS: The prevalence of anaemia (Hb<120 g/l) among the participants was 27%. Seventeen percent had depleted iron stores (SF<12 microg/l). Of all anaemic girls, 32% had iron deficiency anaemia (Hb<120 g/l and SF<12 microg/l). When the girls were classified by serum vitamin A, the third with the lowest serum retinol levels had significantly lower Hb and SF levels. Significant positive correlations were observed between Hb and serum iron, TS, SF and retinol, while there was a negative correlation with serum TIBC. Occupancy, frequency of consumption of large fish, serum iron, TIBC, TS, SF and serum vitamin A were strongly related to Hb by multiple regression analysis. For 1 microg/l change in SF concentration, there was a 0.046 g/l change in Hb, when adjusted for all other factors. CONCLUSION: Anaemia among these adolescent schoolgirls in peri-urban Bangladesh cannot be explained by iron deficiency alone, and other causes may also exist in this population.

Adolescent↗

PubMed2000

Neonatal diarrhea in a diarrhea treatment center in Bangladesh: clinical presentation, breastfeeding management and outcome.

OBJECTIVE: To study the clinical presentation and outcome of neonates admitted with diarrhea, and effect of counseling their mothers for exclusive breastfeeding. DESIGN: Prospective study. SETTING: Inpatient unit. RESULTS: Two hundred and forty-four neonates were studied during 1994-95. Their mean (SD) age was 18 (6.2) days, and body weight and length were 2.18 (0.52) kg and 47.5 (3.2) cm, respectively. More neonates had some dehydration than severe dehydration (78% vs. 11%), with mean (SD) serum bicarbonate values 9.6 (5.1) mmol/1. V. cholerae was isolated from 25 (12%), Shigella spp. from 8 (3%), and Salmonella spp. from 3 (1%) of the patients who had rectal swab cultures. Mean (SD) hospital stay was 3.6 (2.1) days, during which the majority (80%) recovered fully, but 29 (13%) left earlier. Eleven (4%) of the neonates had to be referred elsewhere for treatment of other problems and 7 (3%) died. None of the neonates were exclusively breastfed on admission. Excluding mothers of adopted neonates, breastfeeding counseling enabled 64% of the mothers to convert to exclusive breastfeeding during the hospital stay. CONCLUSIONS: Most of the neonates admitted with diarrhea were small and underweight, and had poor feeding practices. The majority of neonates recovered soon, and were exclusively breastfeeding when discharged from the hospital. Breastfeeding counseling should be included as an integral part of case management at all health facilities.

Bangladesh↗

PubMed2000

Effect of an energy-dense diet on the clinical course of acute shigellosis in undernourished children.

To date there have been few reports on the impact of dietary intervention on the clinical course of acute shigellosis. Current management of acute shigellosis is primarily focused on antibiotic therapy with less emphasis on nutritional management. In a randomised clinical trial, we examined the role of an energy-dense diet on the clinical outcome in malnourished children with acute dysentery due to shigellosis. Seventy-five children aged 12--48 months with acute dysentery randomly received either a milk--cereal formula with an energy density of 4960 kJ/l (test group) or a milk-cereal formula with energy of 2480 kJ/l (control group) for 10 d in hospital. In both milk-cereal formulas, protein provided 11 % energy. In addition, the standard hospital diet was offered to all children and all children received an appropriate antibiotic for 5 d. The mean food intakes (g/kg per d) in the test and control groups were: 112 (SE 2.28) and 116 (SE 3.48) on day 1; 118 (SE 2.72) and 107 (SE 3.13) on day 5; 120 (SE 2.25) and 100 (SE 3.83) on day 10. The mean energy intakes (kJ/kg per d) in the test and control groups respectively were: 622 (SE 13.2) and 315 (SE 11.3) on day 1; 655 (SE 15.1) and 311 (SE 7.98) on day 5; 672 (SE 14.7) and 294 (SE 11.1) on day 10. The food and energy intakes were mostly from the milk-cereal diet. There was no difference between two groups in resolution of fever, dysenteric (bloody and or mucoid) stools, stool frequency and tenesmus. However, vomiting was more frequently observed among the test-group children during the first 5 d of intervention (67 % v. 41 %, There was an increase in the mean weight-for-age (%) in the test group compared with the control group after the 10 d of dietary intervention (6.2 (SE 0.6) v. 2.7 (SE 0.4), In addition, resolution of rectal prolapse was better (26 % v. 8 %, in the test group v. control group after 5 d, and 13 % v. 6 %, after 10 d of dietary intervention. Supplementation with a high-energy diet does not have any adverse effect on clinical course of acute shigellosis and reduces the incidence of rectal prolapse in malnourished children.

Acute Disease↗

PubMed1999

Are breastfeeding promotion messages influencing mothers in Bangladesh? Results from an urban survey in Dhaka, Bangladesh.

Despite the launching of a national breastfeeding promotion campaign in Bangladesh in 1989, exclusive breastfeeding rates remain low. To understand mothers' perceptions of the campaign messages and the reasons for current practices, a random sample of 1100 lower middle class mothers in Dhaka, with infants aged 0-6 months, were interviewed in 1995. Although 99 per cent of mothers fed colostrum within 3 days of delivery, 92 per cent also gave one or more traditional prelacteals, and 68 per cent gave postlacteals. This could be due to ambiguity of the message, which simply advocated giving colostrum without indicating its exclusive use, thereby appearing compatible with traditional perceptions that colostrum alone is insufficient. Ninety-nine per cent of mothers reported hearing the breastfeeding messages or receiving advice, and 97 per cent stated that they understood the meaning of exclusive breastfeeding. But this concept was not correctly understood, as many thought it meant feeding breastmilk and water. The prevalence of exclusive breastfeeding was 15 per cent, and complementary foods were introduced early (median 30 days). Many mothers doubted the message that breastmilk alone is sufficient for 5 months. Messages to promote improved breastfeeding practices in Bangladesh need to be revised to clear misconceptions.

Adult↗

PubMed1998

Single dose vitamin A treatment in acute shigellosis in Bangladesh children: randomised double blind controlled trial.

OBJECTIVE: To evaluate the efficacy of a single large oral dose of vitamin A in treating acute shigellosis in children in Bangladesh. DESIGN: Randomised double blind controlled clinical trial. SETTING: Dhaka Hospital, International Centre for Diarrhoeal Disease Research, Bangladesh. SUBJECTS: 83 children aged 1-7 years with bacteriologically proved shigellosis but no clinical signs of vitamin A deficiency; 42 were randomised to treatment with vitamin A and 41 formed a control group. INTERVENTION: Children were given a single oral dose of 200,000 IU of vitamin A plus 25 IU vitamin E or a control preparation of 25 IU vitamin E. MAIN OUTCOME MEASURES: Clinical cure on study day 5 and bacteriological cure. RESULTS: Baseline characteristics of the subjects in the two treatment groups were similar. Significantly more children in the vitamin A group than in the control group achieved clinical cure (19/42 (45%) v 8/14 (20%); chi 2 = 5.14, 1 df, P = 0.02; risk ratio = 0.68 (95% confidence interval; 0.50 to 0.93)). When cure was determined bacteriologically, the groups had similar rates (16/42 (38%) v 16/41 (39%); chi 2 = 0.02, 1 df, P = 0.89; risk ratio = 0.98 (0.70 to 1.39)). CONCLUSIONS: Vitamin A reduces the severity of acute shigellosis in children living in areas where vitamin A deficiency is a major public health problem.

Acute Disease↗

PubMed1998

Intra- and extracellular water dynamics on rehydration in cholera and noncholera patients.

To estimate the intra- and extracellular body water compartments during rehydration of patients with cholera and noncholera diarrhea by bioimpedance analyzer, we studied 30 patients with acute watery diarrhea. Total body water (TBW), intracellular water (ICW), and extracellular water (ECW) of severely dehydrated adult patients were measured with a dual frequency bioimpedance analyzer at different phases of rehydration. Fluid compartments between cholera and noncholera patients were compared. Cholera patients gained more TBW than noncholera patients during recovery. Unlike patients with noncholera diarrhea, the gain in cholera patients was mainly contributed by the ICW (1.5 +/- 1.6 vs 3.0 +/- 1.2 liters, respectively, P < 0.01). It was also observed that the recovery of the ICW compartment in cholera patients occurred rapidly within the first 2 hr after infusion. Differential dynamics of body water compartments in cholera compared to noncholera patients as observed in this study may contribute further to understanding the mechanism of dehydration in diarrheal disease, which might help in improving case management.

Adult↗

PubMed1998

Increased height gain of children fed a high-protein diet during convalescence from shigellosis: a six-month follow-Up study.

The impact of dietary supplementation on catch-up growth was evaluated in 69 malnourished children ages 24-60 mo after recovery from shigellosis. They were fed either a high-protein (HP) diet with 15% of energy as protein, or a standard-protein (SP) diet with 7.5% energy as protein, for 3 wk in a metabolic study ward. Children were followed up bi-weekly for 6 mo by trained health assistants when anthropometric measurements and information of any illness were collected. Thirty-one children in the HP group and 28 children in the SP group completed 6-mo follow-up. The increase in height (mean +/- SD) was 5.3 +/- 1.0 cm vs. 4.1 +/- 1.1 cm for HP and SP groups, respectively (P < 0.001), whereas increase in body weight was 1.39 +/- 0.58 and 1.29 +/- 0.72 kg for children fed HP and SP, respectively (P = 0.59). The proportion of children who were severely stunted (< -2 SD height-for-age) decreased from 45 to 29% in the HP group compared to 50 to 46% in the SP group (P < 0.05) at 6-mo follow-up. The number of diarrheal episodes per child tended to be lower in the HP vs. SP than in the SP group (1.9 vs. 2.3, P = 0.41). These results demonstrate that feeding an HP diet to the malnourished children during recovery from shigellosis enhanced linear growth with a modest reduction in diarrheal morbidity during the 6-mo follow-up period.

Amdinocillin Pivoxil↗

PubMed1997

Early feeding of an energy dense diet during acute shigellosis enhances growth in malnourished children.

In a controlled clinical trial, we examined the effect of the short-term feeding of an energy-dense milk cereal formula in malnourished children with clinically severe dysentery due to acute shigellosis. Seventy-five malnourished children, aged 12-48 mo, passing blood or blood with mucous in the stool for < or = 96 h, were offered a hospital diet. In addition, study children (n = 36) were offered a milk-cereal formula with an energy of 5 kJ/g (an 11% protein diet); similarly, control children (n = 39) were offered a milk-cereal formula with an energy content of 2.5 kJ/g (an 11% protein diet). Patients were admitted to the metabolic ward of the Clinical Research and Service Centre, Dhaka, at the International Centre for Diarrhoeal Disease Research, Bangladesh. Patients were studied for 10 hospital days and were then followed up at home after 30 d. After 10 d of dietary intervention, children in the study group had a significantly greater increase vs. controls in weight-for-age (6 vs. 3%, P < 0.001) and in weight-for-height (7 vs. 3%, P < 0.001). Serum prealbumin concentrations were significantly higher (study vs. control) after 5 d (0.214 vs. 0.170 g/L, P = 0.01) and after 10 d (0.244 vs. 0.193 g/L, P = 0.006) of the study. Greater weight-for-age was sustained at home 1 mo after discharge (8 vs. 5%, P = 0.005) from the hospital. Similarly, higher weight-for-height was sustained 1 mo after discharge (8 vs. 5%, P = 0.01). During their stay at home, there was no dietary intervention. The results of this study suggest that short-term feeding of an energy-dense diet enhances growth in malnourished children with acute dysentery due to shigellosis.

Acute Disease↗

PubMed1997

Reasons for failure of breast-feeding counselling: mothers' perspectives in Bangladesh.

During the hospitalization in the Dhaka hospital of the international Centre for Diarrhoeal Disease Research, Bangladesh, of a group of partially breast-fed infants aged 1-12 weeks who had been admitted with acute diarrhoea, their mothers were individually counselled by breast-feeding counsellors to start exclusive breast-feeding. The counselling was repeated 1 week later at home, and the women's infant-feeding practices were evaluated 2 weeks after their infants had been discharged from hospital. A total of 25% of the mothers failed to breast-feed exclusively despite having been counselled. The case studies of these mothers illustrate that although they generally complained about having "insufficient breast milk" various factors such as domineering grandmothers, lack of financial support by their husbands, too much housework, or disinterest contributed to their failure to breast-feed exclusively. While family support is essential for all lactating mothers, women with familial or financial problems require special attention and extra counselling sessions so that they can be helped to identify how to achieve and sustain exclusive breast-feeding.

Adult↗

PubMed1997

Bioelectrical impedance measurements at various frequencies to estimate human body compositions.

Bioelectrical impedance analyses (BIA) operating at various frequencies were used to estimate body composition parameters and compared with the biochemically determined parameters by using isotopic dilution method in 22 healthy adult (30-50 years old) male human subjects. BIA instruments, operating at 50,100 KHz and 5 to 500 KHz range, were used to measure body compositions, namely total body water (TBW), fat free mass (FFM), and fat mass (FM). TBW of these subjects was also determined by deuterium dilution method. BIA methods measured at 100 KHz and using multifrequencies appear to be more accurate than at 50 KHz when compared with isotopic dilution method as standard. This accuracy could be attributed due to measurements made at higher frequencies that falls in the region where current passes through both extra- and intracellularly, thereby giving an appropriate measure of TBW. All the subjects participated in this study belong socioeconomically to the middle class and do not apparently look obese or fatty. However, the mean of their body fat, as estimated by the standard deuterium dilution method, was about 30% which is suggestive of an unapparent obesity prevailing in this class of people in Bangladesh.

Adult↗

PubMed1996

Early complementary feeding is associated with low nutritional status of young infants recovering from diarrhoea.

Young infants admitted to hospital for diarrhoea were studied to identify and understand the reasons for early complementary feeding and to examine its effect on nutritional status. Of 132 infants, 71 percent were being breastfed, 24 percent had already stopped, and 5 percent had never been breastfed. Complementary feeds were started by the mothers when infants' median age (range) was 27 (1-180) days. Mothers' perceptions regarding breastmilk being insufficient (53 per cent) or causing diarrhoea (19 percent), were the major reasons for complementary feeding. The mean weight-for-age of the infants given complementary feeds before the age of 2 months was 72 percent of the National Centre for Health Statistics (NCHS) standards, compared to 82 percent in those starting after 2 months of age (P = 0.01). Similarly, the mean weight-for-length in these two groups were 86 and 91 percent, respectively (P = 0.04). Initiation of early complementary feeding is associated with infant malnutrition and this alarming trend should be strongly discouraged.

Adolescent↗

PubMed1996

Absorption of macronutrients from a calorie-dense diet in malnourished children during acute shigellosis.

A metabolic balance study was performed to determine the absorption of macronutrients and energy from different food items in 23 malnourished children aged 12 to 48 months with clinically severe acute dysentery due to shigellosis. In a 72-h balance period, the absorption of carbohydrate, protein, fat, and total energy was determined. All the children received a standard hospital diet; 12 children in the test group were offered an additional calorie-dense milk (5.0 kJ/ml with a protein-energy ratio of 11.0), and 11 children in the control group, on the other hand, received a milk formula with an energy of 2.5 kJ/ml with a protein-energy ratio of 11.0. The intakes (g/kg/day) of protein, fat, carbohydrate, and energy between test and control groups were 4.25 versus 2.32 (p = 0.01), 7.63 versus 3.00 (p = 0.01), 21.09 versus 11.14 (p = 0.01), and 711 kJ/kg/day versus 338 kJ/kg/day (p = 0.01), respectively. The coefficients of absorption of protein, fat, carbohydrate, and energy between test and control groups were 61 versus 67% (p = 0.45), 69 versus 82% (p = 0.11), 77 versus 86% (p = 0.13), and 72 versus 82% (p = 0.13), respectively. The losses (g/kg/day) of protein, fat, carbohydrate, and energy between the two groups were 1.61 versus 0.76 (p = 0.00), 2.44 versus 0.55 (p = 0.00), 5.0 versus 1.6 (p = 0.00), and 204 kJ/kg/day versus 60 kJ/kg/day, respectively. The results of this study indicate that during the acute stage of shigellosis (with a substantially enhanced total intake of protein, fat, carbohydrate, and energy), by adding calorie-dense meals in malnourished children younger than 5 years, the absorption of macronutrients is not significantly different from that with the usual diet but suboptimal dietary energy intake, as is the case under ordinary treatment conditions.

Absorption↗

PubMed1996

Breast-feeding counselling in a diarrhoeal disease hospital.

Lactation counsellors were trained to advise mothers of partially breast-fed infants who were admitted to hospital because of diarrhoea, so that they could start exclusive breast-feeding during their hospital stay. Infants (n = 250) up to 12 weeks of age were randomized to intervention and control groups. Mothers in the intervention group were individually advised by the counsellors while mothers in the control group received only routine group health education. During follow-up at home by the counsellors a week later, only the mothers in the intervention group were counselled. All the mothers were evaluated for infant feeding practices at home two weeks after discharge. Among the 125 mother-infant pairs in each group, 60% of mothers in the intervention group were breast-feeding exclusively at discharge compared with only 6% in the control group (P < 0.001); two weeks later, these rates rose to 75% and 8% in the intervention and control groups, respectively (P < 0.001). However, 49% of mothers in the control group reverted back to bottle-feeding compared with 12% in the intervention group (P < 0.001). Thus, individual counselling had a positive impact on mothers to start exclusive breast-feeding during hospitalization and to continue the practice at home. Maternal and child health facilities should include lactation counselling as an integral part of their programme to improve infant feeding practices.

Adult↗

PubMed1996

Erythromycin and trimethoprim-sulphamethoxazole in the treatment of cholera in children.

To evaluate the efficacy of erythromycin and trimethoprim-sulphamethoxazole (TMP-SMX) in the treatment of cholera in children aged 1-8 years, a randomised clinical trial was conducted at a diarrhoea treatment centre in Bangladesh from December 1991 to June 1992. Fifteen children received erythromycin, 50 mg/kg per day, in four equally divided doses, 18 children received 10 mg/kg per day of trimethoprim and 50 mg/kg per day of sulphamethoxazole in two equally divided doses (12 hourly) for five days, and 15 children received no antibiotic; children in all three groups received intravenous cholera saline for severe dehydration and for mild to moderate dehydration, a rice-based oral rehydration solution. The mean stool volumes in mL/kg body weight in the two treatment groups were less than that of the control group, and there were no significant differences in stool volume among the two treatment groups. However, 67% of the children in the erythromycin group and 82% in the TMP-SMX group recovered within 72 hours compared to 33% in the control group (p < 0.01). Similarly, the bacteriological cures were 80% in the erythromycin group and 83% in the TMP-SMX group compared to only 27% in the control group (p < 0.001). These results confirm that both erythromycin and trimethoprim-sulphamethoxazole are effective antimicrobials in the treatment of cholera. These drugs are of value specially in younger children in whom tetracycline is contraindicated or when the infecting Vibrio cholerae are resistant to tetracycline.

Anti-Bacterial Agents↗

PubMed1995

Development of an improved animal model of shigellosis in the adult rabbit by colonic infection with Shigella flexneri 2a.

Rabbits are not usually susceptible to intestinal Shigella infection without extensive pretreatment, including starvation and administration of antimicrobial, antimotility, and toxic agents (carbon tetrachloride). Most animals infected this way die rapidly and do not always develop colonic lesions and signs of dysentery. We describe here a successful experimental infection in the adult rabbit which does not require preparatory treatment and which reproduced characteristic features of human shigellosis. Unstarved, untreated adult rabbits were infected by direct inoculation of virulent Shigella flexneri 2a (10 ml of 10(7) bacteria per ml) into the proximal colon after ligation of the distal cecum (cecal bypass). Within 24 h of infection, most inoculated animals consistently developed clinical dysentery, characterized by liquid stool mixed with mucus and blood, leukocytosis, anorexia, and weight loss. Histologically, there were edema, exudation, superficial ulceration, and polymorphonuclear infiltrations in the lamina propria; crypt abscess formation; focal hemorrhages; and the presence of immunohistochemically stained S. flexneri in the colonic mucosa. Successful bacterial colonization was indicated by the isolation of the challenge strain of S. flexneri 2a from the colonic contents. None of the control rabbits challenged with nonvirulent S. flexneri or without cecal bypass developed dysentery or colitis. We conclude that successful Shigella infection can be induced by direct colonic inoculation with virulent S. flexneri 2a in adult rabbits without starvation and pretreatment. The colitis is dependent on the virulence of the bacteria and on the cecal bypass. This model should be useful in studies of the immunopathogenesis of Shigella infection.

Animals↗