相比发展中国家,在发达国家中细菌性痢疾通常引起较低的并发症发病率和死亡率。这主要是因为病原体是宋内氏志贺氏菌。[1]Kotloff KL, Winickoff JP, Ivanoff B, et al. Global burden of Shigella infections: implications for vaccine development and implementation of control strategies. Bull World Health Organ. 1999;77:651-666.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2557719/pdf/10516787.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/10516787?tool=bestpractice.com比较容易获得基层医疗(必要时也可得到专科医生的治疗)也是可能的因素之一。
预后
在发展中国家,大多数志贺氏杆菌病例都是轻度和自限性的,慢性携带者不常见。不采用抗生素治疗,病程可能会持续稍长一些,粪便中排出病原体会持续约 4 至 6 周的时间。[2]Gastrointestinal infections and food poisoning. In: Bannister BA, Gillespie SH, Jones J. Infection: microbiology and management. 3rd ed. Oxford, UK: Blackwell Publishing Ltd.; 2006:167-201.在发达国家,即使非常严重的疾病,死亡率也很低,在美国总的死亡率估计为 0.4%。[1]Kotloff KL, Winickoff JP, Ivanoff B, et al. Global burden of Shigella infections: implications for vaccine development and implementation of control strategies. Bull World Health Organ. 1999;77:651-666.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2557719/pdf/10516787.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/10516787?tool=bestpractice.com
基本的卫生措施,包括严格洗手和避免接触可能被污染的食物和水,对于预防在家庭成员或同居者中的传播或再感染非常有用。[2]Gastrointestinal infections and food poisoning. In: Bannister BA, Gillespie SH, Jones J. Infection: microbiology and management. 3rd ed. Oxford, UK: Blackwell Publishing Ltd.; 2006:167-201.[3]Centers for Disease Control and Prevention (CDC). National Shigella surveillance. http://www.cdc.gov/ (last accessed 22 April 2016).http://www.cdc.gov/nationalsurveillance/shigella-surveillance.html[11]World Health Organization. Guidelines for the control of shigellosis, including epidemics due to Shigella dysenteriae type 1. 2005. http://www.who.int/ (last accessed 22 April 2016).http://apps.who.int/iris/bitstream/10665/43252/1/924159330X.pdf