A Study of prevalence of Shigella species and antimicrobial resistance patterns in paediatric medical center, Ahvaz, Iran
AbstractBackground and Objectives: Shigella infections are one of the major causes of diarrhea worldwide, and especially in developing countries. Antimicrobial resistance has complicated the empirical treatment. The aim of this study was to define the clinical and antibiotic resistance patterns of Shigella gastroenteritis cases.Materials and Methods: Stool samples of patients with diarrhea and fever diagnosed with shigellosis were collected, from June 2013 to May 2014 at Abuzar Hospital, Iran. All samples were cultured for Shigella spp on selective and differential media. Shigella isolates were evaluated for antimicrobial resistance.Results: Among 193 Shigella isolates, S. flexneri (64.8%) was the predominant species followed by S. sonnei (32.6%). The most frequent antibiotic resistance observed, was towards co-trimoxazole (89%), ampicillin (77%) and ceftriaxone (51%) and the lowest resistance were seen in ciprofloxacin (1.5%), azithromycin (7%).Conclusion: Due to the high resistance to ceftriaxone, this drug is not recommended as an empirical therapy for shigellosis. However, azithromycin should be used as the first-line treatment for paediatric patients, suffering from shigellosis and ciprofloxacin can be used as an alternative.
Sousa MÂB, Mendes EN, Collares GB, Péret-Filho LA, Penna FJ, Magalhães PP. Shigella in Brazilian children with acute diarrhoea: prevalence, antimicrobial resistance and virulence genes. Mem Inst Oswaldo Cruz 2013; 108(1):30-35.
Ray K, Bobard A, Danckaert A, Paz-Haftel I, Clair C, Ehsani S, et al. Tracking the dynamic interplay between bacterial and host factors during pathogen-induced vacuole rupture in real time. Cell Microbiol 2010; 12:545-556.
Gu B, Cao Y, Pan S, Zhuang L, Yu R, Peng Z, et al. Comparison of the prevalence and changing resistance to nalidixic acid and ciprofloxacin of Shigella between Europe–America and Asia–Africa from 1998 to 2009. Int J Antimicrob Agents 2012; 40:9-17.
Vinh H, Baker S, Campbell J, Hoang NVM, Loan HT, Chinh MT, et al. Rapid emergence of third generation cephalosporin resistant Shigella spp. in southern Vietnam. J Med Microbiol 2009; 58:281-283.
Zafar A, Hasan R, Nizami SQ, von Seidlein L, Soofi S, Ahsan T, et al. Frequency of isolation of various subtypes and antimicrobial resistance of Shigella from urban slums of Karachi, Pakistan. Int J Infect Dis 2009; 13:668-672.
Barrow GI, Feltham RKA. Cowan and Steel’s Manual for the Identification of Medical Bacteria. Cambridge University Press; 2003.
Cockerill FR. Performance standards for antimicrobial susceptibility testing: twenty-first informational supplement. Clinical and Laboratory Standards Institute (CLSI); 2011.
Khaghani S, Shamsizadeh A, Nikfar R, Hesami A. Shigella flexneri: a three-year antimicrobial resistance monitoring of isolates in a Children Hospital, Ahvaz, Iran. Iran J Microbiol 2014; 6:225-229.
Pourakbari B, Mamishi S, Mashoori N, Mahboobi N, Ashtiani MH, Afsharpaiman S, et al. Frequency and antimicrobial susceptibility of Shigella species isolated in Children Medical Center Hospital, Tehran, Iran, 2001-2006. Braz J Infect Dis 2010; 14:153-157.
Lluque A, Mosquito S, Gomes C, Riveros M, Durand D, Tilley DH, et al. Virulence factors and mechanisms of antimicrobial resistance in Shigella strains from periurban areas of Lima (Peru). Int J Med Microbiol 2015; 305:480-490.
Ranjbar R, Behnood V, Memariani H, Najafi A, Moghbeli M, Mammina C. Molecular characterisation of quinolone-resistant Shigella strains isolated in Tehran, Iran. J Glob Antimicrob Resist 2016; 5:26-30.
Alizadeh-Hesar M, Bakhshi B, Najar-Peerayeh S. Clonal dissemination of a single Shigella sonnei strain among Iranian children during Fall 2012 in Tehran, I.R. Iran. Infect Genet Evol 2015; 34:260-266.
Zamani A, Rahbarimanesh A-A, Raeeskarami S-R, Dejakam A. Clinical and Paraclinical Findings in Shigelosis. Iran J Pediatr 2007; 17:243-248.
Sangeetha AV, Parija SC, Mandal J, Krishnamurthy S. Clinical and microbiological profiles of shigellosis in children. J Health Popul Nutr 2014; 32:580-586.
Shamsizadeh A, Nikfar R, Bavarsadian E. Neurological manifestations of shigellosis in children in southwestern Iran. Pediatr Int 2012; 54:127-130.
Özmert EN, İnce OT, Örün E, Yalçın S, Yurdakök K, Gür D. Clinical characteristics and antibiotic resistance of Shigella gastroenteritis in Ankara, Turkey between 2003 and 2009, and comparison with previous reports. Int J Infect Dis 2011; 15:e849-853.
Zhang J, Jin H, Hu J, Yuan Z, Shi W, Yang X, et al. Antimicrobial resistance of Shigella spp. from humans in Shanghai, China, 2004-2011. Diagn Microbiol Infect Dis 2014; 78:282-286.
Qu F, Bao C, Chen S, Cui E, Guo T, Wang H, et al. Genotypes and antimicrobial profiles of Shigella sonnei isolates from diarrheal patients circulating in Beijing between 2002 and 2007. Diagn Microbiol Infect Dis 2012; 74:166-170.
Kansakar P, Baral P, Malla S, Ghimire GR. Antimicrobial susceptibilities of enteric bacterial pathogens isolated in Kathmandu, Nepal, during 2002-2004. J Infect Dev Ctries 2011; 5:163-168.
Erdogan H, Erdogan A. Antimicrobial resistance of Shigella isolates in Alanya, Turkey. Proc Natl Acad Sci India Sect B Biol Sci 2015; 85:277-280.