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During the second half of the nineteenth century, infectious diseases were a prominent cause of morbidity and mortality. Almost one-third of the infants in the United States and Western Europe were unable to reach their first birthday due to causes attributable to infectious diseases.

Of 153 clinical isolates of shigellae examined, 64.7% belonged to Shigella flexneri, 18.9% to Sh. sonnei, 11.8% to Sh. boydii and 4.6% to Sh. dysenteriae. Part of these isolates were resistant to sulfamethoxazole and streptomycin (88.2% each), ampicillin (66.7%), tetracycline (63.4%) and co-trimoxazole (43.1%), with levels of resistance (MIC50 and MIC90) being invariably high. Resistance to three or more drugs (multidrug resistance) was seen in 77.8% of the isolates. All the 25 strains examined for transfer of resistance contained R-plasmids, both autotransferable and non-autotransferable (mobilized by transfer factor X). The frequency of transfer of different r-determinants varied from 2.7 X 10(-8) to 1.4 X 10(-3).

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