The recent trends of shigellosis- A JIPMER perspective


Background: The multi-drug resistant Shigella has posed a therapeutic challenge in most parts of the world. In the last few years, there has been a tremendous change in the anti-microbial susceptibility profile of this organism.
Aim: This present study was carried out to determine the current anti-microbial susceptibility pattern of the members of the genus, Shigella in our region.
Materials and Methods: 2658 stool samples from patients with diarrhoea were received between 2008 and 2010. The disc diffusion testing was performed by the Kirby-Bauer method and the minimum inhibitory concentrations (MICs) of ciprofloxacin and ceftriaxone were obtained by the agar dilution method and the E-test. The double disk synergy test was used to confirm the status of the extended beta-lactamase producers.
Results: 74 (2.78%) Shigella spp were isolated, out of which S.flexneri was 90.54%, S.dysenteriae was 2.70%, S.boydii was 1.35% and S.sonnei was 5.40%. 43 (58.108%) strains were isolated from children of 0 to ≤5 years, 13(17.56%) were isolated from children who were >5 years but ≤ 15 years of age and the rest of the 18 (24.32%) were isolated from adult patients. 79% of the strains were resistant to ampicillin, followed by 51% which were resistant to nalidixic acid, followed by 50% which were resistant to ciprofloxacin (the MIC of ciprofloxacin was 16μg/ml), and 39.4% which were resistant to furoxone and chloramphenicol respectively. 2 (3%) strains of S.flexneri were found to be resistant to ceftriaxone, which had MICs of > 256µg/ml. The ceftriaxone resistant S. flexneri isolates were confirmed to be extended spectrum beta-lactamase producers by the double disk synergy test.
Conclusion: The continuous assessment of the anti-microbial susceptibility patterns and the periodic reporting in this context is important

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