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Arvelo W et al. – During a large daycare center–associated shigellosis outbreak, strains were highly resistant to ampicillin and trimethoprim–sulfamethoxazole. Children were frequently treated with azithromycin and occasionally fluoroquinolones. Appropriate handwashing and diapering infrastructure are necessary to minimize spread of shigellosis within daycare centers, and could reduce use of antimicrobial agents.

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