Occurrence of shigellosis in the young and elderly in rural China: results of a 12-month population-based surveillance study.

In 2002, population- and treatment center-based surveillance was used to study the disease burden of shigellosis in rural Hebei Province in the People's Republic of China. A total of 10,105 children with diarrhea or dysentery were enrolled. Infants were treated most frequently for diarrhea (1,388/1,000/year) followed by children < or = 5 years old (618/1,000/year). Shigellosis was treated most often in children 3-4 years old (32/1,000/year) and people > 60 years of age (7/1,000/year). Fifty-six percent (184 of 331) Shigella isolates were detected in patients who had non-bloody diarrhea. Shigella flexneri was identified in 93% of 306 isolates. The most common S. flexneri serotypes were 1a (34%), X (33%), and 2a (28%). More than 90% of the Shigella isolates were resistant to cotrimoxazole and nalidixic acid, but remained susceptible to ciprofloxacin, norfloxacin, and gentamicin. Widespread resistance to antibiotics adds urgency to the development and use of vaccines to control shigellosis.

Efficacy of IP-10 as a biomarker for monitoring tuberculosis treatment.

OBJECTIVES: IP-10 has been proposed as a promising alternative marker for the diagnosis of tuberculosis (TB). METHODS: In this exploratory study, we assessed the levels of serum IP-10 and TB antigen-dependent IP-10 at the time of diagnosis and after completing treatment in 32 patients with active TB. RESULTS: Significant changes in concentration between the time of diagnosis and the completion of therapy were observed for serum IP-10 (P < 0.001; median: 140.4 and 105.7 pg/ml, respectively) and TB antigen-dependent IP-10 (P = 0.002; median: 20,000 and 13,720 pg/ml, respectively). The proportion of TB antigen-dependent IP-10 responders did not change significantly between baseline and the completion of therapy (P = 0.35), whereas the proportion of serum IP-10 responders was significantly different (P = 0.001). CONCLUSIONS: Serum IP-10 and TB antigen-dependent IP-10 responses to QFT-GIT antigens might be a useful biomarker for monitoring the efficacy of therapy in patients with active TB.

Efficacy of inducible protein 10 as a biomarker for the diagnosis of tuberculosis.

OBJECTIVE: This study evaluated inducible protein 10 (IP-10) as a diagnostic biomarker for specific tuberculosis (TB) infection and evaluated the ability of IP-10 to distinguish between active TB and latent TB infection (LTBI). METHODS: Forty-six patients with active pulmonary TB, 22 participants with LTBI, and 32 non-TB controls were enrolled separately. We measured IP-10 in serum and in supernatants from whole blood stimulated with TB-specific antigens. RESULTS: TB antigen-dependent IP-10 secretion was significantly increased in the active TB patients and LTBI subjects compared with controls, but did not differ significantly between the active TB patients and LTBI subjects. Serum IP-10 levels were higher in active TB than in LTBI (174.9 vs. 102.7pg/ml, p=0.002). The respective rates of positive responders of TB antigen-dependent IP-10 were 97.8%, 90.9%, and 12.5% in active TB, LTBI, and non-TB controls, respectively. For serum IP-10, 87.5%, 45.5%, and 9.5% of responders were positive in the respective groups. CONCLUSIONS: The IP-10 response to TB antigen may constitute a specific biomarker for TB infection, but does not by itself distinguish between active TB and LTBI. Serum IP-10 may enhance the diagnostic performance when used in combination with another marker.