Bacteriologic Studies in an Epidemic of Bacillary Dysentery in Korea: Serotypes of Shigella and Salmonella Recovered and Bacteriologic Response to Sulfadiazine, Chloramphenicol, Terramycin, Aureomycin and Streptomycin

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Abstract
A study of enteric diseases occurring in epidemic proportions among recently captured N. Korean prisoners-of-war was made by the 8217th Mobile Medical Laboratory during the winter of 1950-1951. From Jan. through April, 1951, 734 Shigella cultures were obtained. S. flexneri 4 was the most prevalent serotype, accounting for 59.2% of the total; next was S. flexneri 3. The inadequacy of sulfadiazine therapy of shigellosis was demonstrated. Of a series of 78 patients with established Shigella dysentery, more than 25% continued to have positive stool cultures after 8 days of sulfadiazine therapy. Chloramphenicol, terramycin, and aureomycin were all highly effective in rapidly clearing the stools of Shigella. Streptomycin was of more value than sulfadiazine though less effective than the newer antibiotics. 56 of 104 Shigella strains were sensitive to 1 [mu]g. per ml. chloramphenicol while the remainder were sensitive to 5 [mu]g. per ml. in vitro. 14 strains were sensitive to 5 [mu]g/ml. of terramycin, 4 to 10 [mu]g. Half of 56 strains were sensitive to 5 [mu]g./ml. of streptomycin, 24 to 10 [mu]g., 3 to 20 [mu]g., and 1 was resistant. Aureomycin and sulfonamide sensitivity tests were not made. An interesting feature of this outbreak of bacillary dysentery was the prevalence of S. flexneri 4. Although Flexner types are universally preponderant. S. flexneri 4 is an infrequently encountered type. Previous studies in Japan had indicated S. flexneri 4 to represent only 4.1% of Shigella cultures obtained from American and Japanese patients.