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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    ABSTRACT: SUMMARY Although Escherichia coli can be an innocuous resident of the gastrointestinal tract, it also has the pathogenic capacity to cause significant diarrheal and extraintestinal diseases. Pathogenic variants of E. coli (pathovars or pathotypes) cause much morbidity and mortality worldwide. Consequently, pathogenic E. coli is widely studied in humans, animals, food, and the environment. While there are many common features that these pathotypes employ to colonize the intestinal mucosa and cause disease, the course, onset, and complications vary significantly. Outbreaks are common in developed and developing countries, and they sometimes have fatal consequences. Many of these pathotypes are a major public health concern as they have low infectious doses and are transmitted through ubiquitous mediums, including food and water. The seriousness of pathogenic E. coli is exemplified by dedicated national and international surveillance programs that monitor and track outbreaks; unfortunately, this surveillance is often lacking in developing countries. While not all pathotypes carry the same public health profile, they all carry an enormous potential to cause disease and continue to present challenges to human health. This comprehensive review highlights recent advances in our understanding of the intestinal pathotypes of E. coli.
    Preview · Article · Oct 2013 · Clinical microbiology reviews