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Abstract
Background
Shigella is a major cause of diarrhea in young children worldwide. Multiple vaccines targeting Shigella are in development, and phase 3 clinical trials are imminent to determine efficacy against shigellosis.
Methods
The Enterics for Global Health (EFGH) Shigella surveillance study is designed to determine the incidence of medically attended shigellosis in 6- to 35-month-old children in 7 resource-limited settings. Here, we describe the microbiological methods used to isolate and identify Shigella. We developed a standardized laboratory protocol for isolation and identification of Shigella by culture. This protocol was implemented across all 7 sites, ensuring consistency and comparability of results. Secondary objectives of the study are to determine the antibiotic resistance profiles of Shigella, compare isolation of Shigella from rectal swabs versus whole stool, and compare isolation of Shigella following transport of rectal swabs in Cary-Blair versus a modified buffered glycerol saline transport medium.
Conclusions
Data generated from EFGH using culture methods described herein can potentially be used for microbiological endpoints in future phase 3 clinical trials to evaluate vaccines against shigellosis and for other clinical and public health studies focused on these organisms.
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Details
1 Center for Vaccine Development and Global Health, University of Maryland School of Medicine , Baltimore, Maryland , USA
2 Medical Research Council Unit The Gambia, London School of Hygiene and Tropical Medicine , Fajara , The Gambia
3 International Centre for Diarrhoeal Disease Research, Bangladesh , Dhaka , Bangladesh
4 Asociación Benéfica PRISMA , Iquitos, Loreto , Peru
5 Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool , Liverpool , United Kingdom
6 Department of Pediatrics and Child Health, The Aga Khan University , Karachi , Pakistan
7 Centre pour le Développement des Vaccins du Mali , Bamako , Mali
8 Center for Global Health Research, Kenya Medical Research Institute , Kisumu , Kenya
9 Department of Global Health, University of Washington , Seattle, Washington , USA
10 Malawi Liverpool Wellcome Research Programme , Blantyre , Malawi
11 Division of Infectious Diseases and International Health, University of Virginia , Charlottesville, Virginia , USA