Qom University of Medical Sciences Journal

Background and objectives
As a common infectious disease in childhood, shigellosis has a variety of seasonal and
microbiologic patterns and there is a concerning trend of resistance in various parts of the
world and even a single country. Inappropriate empiric therapy for any acute episode of
gastroenteritis, which might be based on lab studies, could potentially lead to even further
resistance. In this report, the erythrocyte sedimentation rate was studied in patients with acute
gastroenteritis.
Methods
Medical records of 117 patients were reviewed in this study. The mean and standard
deviation of some of the acute phase inflammatory indicators were compared in two groups of
shigellosis and viral gastroenteritides using independent samples t test.
Results
The mean age of the patients was 49 months, and almost half of them were male. Shigella
sonnei was the commonest species isolated from these patients. Shigellosis was found to be
more frequent during August to October. After 2001, resistance to ampicillin and
cotrimoxazole was observed in 75% and 90% of isolates respectively. A few cases were
resistant to third generation of cephalosporins (< 3%). In shigellosis, the erythrocyte
sedimentation rate was significantly higher than viral gastroenteritis.
Conclusion
Empiric use of cotrimoxazole is no longer recommended in children suspicious of
contracting shigellosis in Tehran. To avoid unnecessary prescription of antibiotics for acute
gastroenteritis, a normal result of erythrocyte sedimentation rate might be helpful.