The bacteria Shigella spp. and entero-invasive Escherichia coli (EIEC) cause a watery or bloody diarrhea in humans. This disease is known as dysentery or shigellosis. Shigella spp. and EIEC are related to that extent that distinction with culture or molecular methods at laboratories is challenging. As in many other countries, the Netherlands regulates only the control of infections with Shigella spp. through laws and guidelines. However, the problematic distinction of Shigella spp. and EIEC hampers the compliance to these regulations. The RIVM, UMCG and Certe collaborated to investigate the diagnostics, the clinical implications of Shigella spp. and EIEC and their impact on public health in the Netherlands. These studies are described in this thesis. First, different opportunities for the improvement of current diagnostics were examined. Unfortunately, it appeared that distinction of Shigella spp. and EIEC remained difficult, even with modern methods. Second, a study was conducted in cooperation with multiple health care institutions in which the consequences of infections with Shigella spp. and EIEC were assessed. The results indicated that there were no differences in severity of disease caused by these bacteria. Third, it was demonstrated that the detailed assessment of the genomes of the bacteria improved the determination of both the similarity of bacteria isolated from different patients and the source of the infections. Finally, suggestions for improvement of the shigellosis guidelines were made, which are now part of a reconsideration of these guidelines.
|Kwalificatie||Doctor of Philosophy|
|Datum van toekenning||11-dec-2019|
|Plaats van publicatie||[Groningen]|
|Status||Published - 2019|