Articles

Shigella flexneri: a three-year antimicrobial resistance monitoring of isolates in a Children Hospital, Ahvaz, Iran

Abstract

Background and Objectives: Shigellosis is an acute gastroenteritis that is one of the most common causes of morbidity and mortality in children with diarrhea in developing countries. The purpose of this study was to describe the distribution of Shigella serogroups and serotypes and their antibacterial drug resistance profiles.
Materials and Methods: Fecal samples of all children suffering from shigellosis who had been admitted to Abuzar Children’s Hospital in Ahvaz, southwestern Iran, from September 2008 to August 2010 were examined. Antibiotics susceptibility testing was performed  according to the Kirby Bauer disk diffusion method.
Results: Shigella flexneri was the predominant serogroup and being identified in 87 isolates (49.8%). The most common S. flexneri serotypes were type 2 (57.5%) and type 1 (21.8%). High rates of resistance were observed to trimethoprime- sulfamethpxazole (85%) and ampicillin (87.5%).
Conclusion: S. flexneri and its serotypes was the most frequently isolated Shigella species from southwest of Iran, Ahvaz. Identification of predominant S. flexneri serotypes in developing countries can help in prioritizing strategies such as development of effective vaccines.

Von Seidlein L, Kim DR, Ali M, Lee, H, Wang XY, Thiem VD et al. A multicenter study of Shigella diarrhea in six Asian countries: disease burden, clinical manifestation, and microbiology. PLoS Med 2006;3:e353.

Bhattacharya D, Sugunan AP, Bhattacharjee H,Thamizhmani R, Sayi DS, Thanasekaran K, et al. Shigella dysenteriae 1 and Shigella flexneri. Health Place 2008; 14: 96–105.

Bhattacharya D, Sugunan AP, Bhattacharjee H, Thamizhmani R, Sayi DS, Thanasekaran K, et al. Antimicrobial resistance in Shigella rapid increase & widening of spectrum in Andaman Islands,India.

Indian J Med Res. 2012;135:365.

Maurelli AT, Lampel KA, Hui YH, Pierson MD, Gorham JR (2001) Foodborne disease handbook. Vol.1. Bacterial pathogens. 2nd ed. New York: Dekker. 323-43.

Liu B, Knirel YA, Feng L, Perepelov AV, Senchenkova SN, Wang Q, et al.Structure and genetics of Shigella O antigens. FEMS MIcrobiol Rev 2008;.32:627-653.

Simmons DA, Romanowska E .Structure and biology of Shigella flexneri O antigens. J Med Microbiol Rev 1987; 23 :289-302.

Clemens J, Kotloff K, Kay B. (1999) .Generic protocol to estimate the burden of Shigella diarrhoea and dysenteric mortality. WHO/VandB/99.26.World Health Organization, Geneva, Switzerland.

Shrestha CD, Malla S, Maharjan L. Multi drug resistant Shigella species in Nepal, a retrospective study conducted at National Public Health Laboratory (NPHL), 1999 to 2002. J Nepal Health Res Counc 2002;4:51-55.

Wilson G, Easow JM, Mukhopadhyay C, Shivananda PG. Isolation & antimicrobial susceptibility of Shigella from patients with acute gastroenteritis in western Nepal. Indian J Med Res 2006; 123:145-150.

Ghosh AR, Sehgal SC. Shigella infections among children in Andaman -an archipelago of tropical islands in Bay of Bengal. Epidemiol Infect 1998;121:43-48.

Ashkenazi S, May-Zahar M, Dinari G, Gabbay U, Zilberberg R, Samra Z. Recent trends in the epidemiology of Shigella species in Israel. Clin Infect Dis 1993; 17: 897-9.

Rasolofo-Razanamparany V, Cassel-Beraud AM, Roux J, Sansonetti PJ, Phalipon A. Predominance of serotype-specific mucosal antibody response in Shigella flexneri infected humans living in an area of endemicity. Infect Immun 2001; 69(9):5230-4.

Oaks EV, Turbyfill KR. Ross Turbyfill. Development and evaluation of a Shigella flexneri 2a and S. sonnei bivalent invasin complex (Invaplex) vaccine. Vaccine 2006; 24:2290-301.

National Committee for Clinical Laboratory Standards. (2000). Performance Standards for Antimicrobial Disk Susceptibility Tests:Approved Standard M2-A7. NCCLS, Villanova, PA, USA.

Carlin NI, Rahman M, Sack A, Zaman A, Kay B, Lindberg AA. Use of monoclonal antibodies to type Shigella flexneri in Bangladesh. J Clin Microbiol 1989;27:1163–1166.

Haider K, Huq MI, Talukder KA, Ahmad QS.

Electropherotyping of plasmid deoxyribonucleic acid (DNA) of different serotypes of Shigella flexneri strains isolated in Bangladesh. Epidemiol Infect 1989;102:421– 428.

Mutanda LN, Kibriya AKMG, Mansur MN, Huq M I.Antibiotic-resistance and pattern of Shigella flexneri serotypes in Dacca. Bangladesh Med J 1980; 9:1–7.

Mutanda LN, Kibriya AKMG, Mansur M N. Pattern of Shigella flexneri serotypes and drug-resistance in Dacca. Indian J Med Res 1981; 73:8–12.19. Kotloff KL, Winickoffm JP, Ivanoff B, Clemens JD, Swerdlow DL, Sansonetti PJ, et al. Global burden of Shigella infections: implications for vaccine development and implementation of control strategies. Bull WHO 1999;77: 651-666.

Nandy S, Mitra U, Rajendran K, Dutta P, Dutta S. Subtypes prevalence, plasmid profiles and growing fluoroquinolone resistant in shigella from Kolkata,India(2001-2007): a hospital- based study. Trop Med Int Health 2010; 15:1499-507.

Kaisar A, Talukder, Dilip K, Dutta, Ashrafus Safa, M.Ansaruzzaman, Ferdaus Hassan, Khorshed Alam, K. M. N. Islam, N. I. A. Carlin, G. B. et al. Altering trends in the dominance of Shigella flexneri serotypes and emergence of serologically atypical S. flexneri strains in Dhaka, Bangladesh. J Clin Microbiol 2001;39:3757-3759.

Savadkoohi R, Ahmadpour-Kacho M. Prevalence of Shigella Species and Their Antimicrobial Resistance Patterns at Amirkola Children’s Hospital, North of Iran. Iran J Ped 2007; 17:118-122.

Peirano G, Santos Souza F D, Prazeres Rodrigues DD.Frequency of serovars and antimicrobial resistance in Shigella spp. from Brazil. Mem Inst Oswaldo Cruz Rio de Janeiro 2006;101(3): 245-250.

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 Kerachi, Pakistan. Int J Infect Dis 2009; 13: 668-672.

Ahmed SF, Riddle MS, Wierzba TF, Messih IA, Monteville MR, Sanders JW, et al . Epidemiology and genetic characterization of Shigella flexneri strains isolated from three paediatric populations in Egypt (2000–2004). Epidemiol Infect 2006; 134(6):1237–1248.

World Health Organization. Guidelines for the Control of. Shigellosis, including epidemics due to Shigella dysenteriae type 1. Geneva: WHO;2005. Available from: ttp://whqlibdoc.who.int/ publications/2005/9241592330.pdf, accessed on September 22, 2010.

Naheed A, Kalluri P, Talukder KA, Faruque AS, Khatun F, Nair GB, et al. Fluoroquinolone- resistant Shigella dysenteriae type 1 in northeastern Bangladesh. Lancet Infect Dis 2004; 4: 607-608.

Hirose K, Terajima J, Izumiya H, Tamura K, Arakawa E, Takai N, et al. Antimicrobial susceptibility of Shigella sonnei isolates in Japan and molecular analysis of S. sonnei isolates with reduced susceptibility to fluoroquinolones. Antimicrob Agents Chemother 2005;49 :1203-1205.

Roy S, Bhattacharya D, Thanasekaran K, Ghosh. AR, Manimunda SP, Bharadwaj AP, et al. Emergence of fluoroquinolone resistance in Shigella isolated from Andaman & Nicobar Islands, India. Indian J Med Res 2010; 131: 720-722.

Ayazi P .Prevalence of clinical symptoms and antimicrobial sensitivity of shigella in children. J Qazvin Univ Med Sciences. 2001;16:46-50. (In Persian)

Pazhani GP, Ramamurthy T, Mitra U, Bhattacharya SK, Niyog SK. Species diversity and antimicrobial resistance of Shigella spp isolated between 2001 and 2004 from hospitalized children with diarrhoea in Kolkata (Calcutta), Epidemiol Infect 2005;133:1089–1095.

Zafar A, Sabir N, Bhutta ZA. Frequency of isolation of shigella serogroups/serotypes and their antimicrobial susceptibility pattern in children from slum areas in Karachi. J Pak Med Assoc. 2005;55:184–188.

Soltan-Dallal MM, Ranjbar R, Pourshafie MR .The study of antimicrobial resistance among Shigella flexneri strains isolated in Tehran, Iran. J Pediatr Infect Dis 2011; 6:125–129.

Yang H, Chen G, Zhu Y, Liu Y, Cheng J, Hu L, et al.Surveillance of antimicrobial susceptibility patterns among Shigella specie isolated in China during the 7-years period of 2005-2011 Ann Lab Med 2013; 33:115-5.

Tanej M, Mewara A,Kumar A, Verma G , Sharma M.Cephalosporin-resistant shigella flexneri over 9 years(2001-2009) in India. J Antimicrob Chemother2012;7:1347-1353.

Pullukcu H, Aydemir S, Sipahi OR, Yamazhan T.Species Distribution and antibacterial resistance patterns of 439 Shigella spp. strains isolated from stool cultures between 1999-2006. ANKEM Derg 2007;21:137-141.

Sivapalasingam S, Nelson JM, Joyce K, Hoekstra M, Angulo FJ, Mintz ED. High prevalence of antimicrobial resistance among Shigella isolates in the United States tested by the national antimicrobial resistance monitoring system from 1999 to 2002. Antimicrob Agents Chemother 2006;50:49-54.

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Keywords
Shigella flexneri antimicrobial resistance children

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How to Cite
1.
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. 1;6(4):225-229.