Bacteriophage use in the focus of hospital-acquired shigellosis

Aim. Evaluation of epidemiologic effectiveness of polyvalent dysentery bacteriophage use for management of infection outbreak caused by Shigella flexneri. Methods. Investigation was performed in Tula psychoneurological hospital where the persistent focus of shigellosis was formed by Sh. flexneri 2a. As part of the study, evaluation of efficacy of antibacterial treatment (ciprofloxacin 250 mg per day for 7 days - group 1) was performed by evaluating duration of bacterial excretion in 18 patients with mild, 21 with moderate and 2 with severe Shigella infection. At the same time efficacy of Shigella bacteriophage (group 2) was assessed during treatment of 19 patients with mild and 17 with moderate form of the infection. Prevention of hospital-acquired shigellosis was provided for all patients in the departments where the infection was diagnosed. In this case bacteriophage was administered as following: first 5 days - 2 pills of bacteriophage 4 times a day, then 2 pills once a day during the whole period of hospitalization. This scheme was administered also to all patients newly admitted to the involved departments from day 1 of hospital stay. Results. Treatment with antibiotics led to fast and full recovery not in all cases. Insufficient clinical effect (persistence of disease signs and bacterial excretion for more than 7 days) in the treatment of mild, moderate and severe forms of Shigella infection was 16.7, 61.9 and 50.0%, respectively. High clinical effectiveness was noted in the treatment of patients with the use of Shigella bacteriophage. Ratio of insufficient clinical recovery from mild and moderate forms of the disease was 5.3 and 17.6%, respectively. In the course of anti-epidemiological measures aimed at localization and elimination of the focus, about 1000 patients were exposed to mentioned regimen of prevention. No patients had manifested infection or bacterial excretion registered. Conclusion. The study confirmed clinical and epidemiological effectiveness of polyvalent dysentery bacteriophage use for management of outbreak caused by Sh. flexneri 2a.

Shigella infection, bacteriophage, antibiotic treatment, anti-epidemiological measures