Isolation & antimicrobial susceptibility of Shigella from patients with acute gastroenteritis in Western Nepal.

Department of Microbiology, Manipal College of Medical Sciences, Pokhara, Nepal.
The Indian Journal of Medical Research (Impact Factor: 1.4). 03/2006; 123(2):145-50.
Source: PubMed


Shigellae play an important role as a causative organism of acute gastroenteritis, which is a global health problem with significant morbidity and mortality in especially in developing countries. This study was carried out to determine the isolation and pattern of antimicrobial resistance of Shigella in patients with acute gastroenteritis in western Nepal.
The study included all patients with acute gastroenteritis who visited a tertiary care hospital at Pokhara, Nepal during a 2-year period (2002-2004). The isolates was confirmed as Shigella by biochemical reaction and slide agglutination test using specific antisera. Antibiotic sensitivity test was determined by agar diffusion method and minimum inhibitory concentration (MIC) of the drugs was detected.
Of the 770 stool samples, 83 (10.8%) yielded Shigella. Shigella flexneri caused 56 (67.4%) of the total cases of shigellosis followed by S. dysenteriae 12 (14.5%), S. sonnei 10 (12%) and S. boydii 5 (6%). Of the 83 isolates, 67 (80.7%) showed resistance to various drugs and 62 (74.7%) were resistant to two or more drugs. Resistance to cotrimoxazole was 80.7 per cent followed by tetracycline 74.7 per cent, ampicillin 53.0 per cent, nalidixic acid 31.3 per cent and ciprofloxacin 2.4 per cent. The MIC(50) and MIC(90) values of those drugs were also very high. All isolates were sensitive to cefotaxime and ceftriaxone.
The findings of our study suggested that Shigellae was an important etiological agent for acute gastroenteritis, with a high rate of drug resistance and requires constant monitoring in this region.

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    • "The causative pathogens include a wide variety of microorganisms like bacteria, viruses and parasites. [4] [5] [6] [7]. Diarrheagenic Escherichia coli (E.coli) represented one of the most frequent causes of acute diarrhea in children under five years old in developing countries [8] [9] [10]. "

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    • "This disease remains a major public health challenge, particularly in developing countries where it is a leading cause of death (1-3). A variety of microorganisms including bacteria, viruses and parasites can be associated with severe AID in children (4-7). Many studies have reported that among the bacterial pathogens, diearrheagenic Escherichia coli (E. "
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    ABSTRACT: Background:Acute infectious diarrhea is one of the most important causes of morbidity and mortality worldwide.Objectives:The objective of this study was to characterize antimicrobial resistant diarrheagenic Escherichia coli strains isolated from diarrheic children in Tehran, IR Iran.Patients and Methods:In total, 550 stool samples from diarrheic pediatric patients, aged less than 60 months, were collected and immediately transferred to the laboratory. Isolation and identification of E. coli strains was done using bacteriological methods. Antimicrobial susceptibility testing was performed using the disk diffusion technique. Multiplex PCR was used to detect aadA1, tetA, tetB, dfrA1, qnr, aac (3)-IV, sul1, blaSHV, CITM, cat1, and cmlA antibiotic resistance genes.Results:From the total of 550 fecal samples examined, 154 samples (28%) were positive for diarraheagenic E. coli. High rates of antibiotic resistance were seen against penicillin ﴾100%), ampicillin ﴾89.6%﴿ and tetracycline ﴾83.1%﴿. Resistance against ciprofloxacin was low ﴾28.6%﴿. The prevalence of different resistance genes in the studied strains varied from 96.10% for aadA1 gene to 40.25% for sul1 gene. The frequencies of aadA1, tetA, tetB, dfrA1, qnr, aac(3)-IV, sul1, blaSHV, CITM, cat1, and cmlA genes were 96.10%, 85.06%, 84.41%, 51.94%, 72.07%, 54.54%, 40.25%, 57.79%, 90.25%, 59.74% and 60.38%, respectively.Conclusions:Our results indicated that antibiotic resistance is increasing in diarraheagenic E. coli strains in Iran. It is imperative to develop strategies for prevention and control of resistant organisms. Changes in patterns of resistance against commonly used antibiotics in Iran indicate that an applied surveillance system and introduction of guidelines for appropriate antibiotic prescription are necessary.
    Full-text · Article · Apr 2014
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    • "In India, Over 70% of Shigella isolates were resistant to two or more drugs including ampicillin and co-trimoxazole during 2002 to 2007 [15] . Reports from Indonesia, Bangladesh, Malaysia, and Nepal showed increasing frequency of Shigella with multiple resistance to ampicillin, trimethoprimsulphamethoxazole , tetracycline, and nalidixic acid [16] [17] [18] [19] . "
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    ABSTRACT: Objective To determine the antimicrobial resistance patterns of Shigella species to the most commonly used antibiotics in mid and far western part of Nepal. Methods Stool samples were collected from 458 patients who came from mid and far western region of Nepal, attending OPD & IPD Departments of Nepalgunj Medical College, Nepal, between the periods of September 2011 to March 2013. Standard microbiological procedures were used for isolation and identification of Shigella species while the disc diffusion test was used to determine the antimicrobial resistance patterns of the recovered isolates. Results A total of 65 isolates were identified as Shigella species. Shigella flexneri, Shigella dysenteriae, Shigella boydii and Shigella sonnei were accounted respectively for 43.07%, 27.69%, 21.53% and 7.69% of the total number of Shigella isolated. Resistances to nalidixic acid (95.38%), ampicillin (84.62%), co-trimoxazole (81.54%) and ciprofloxacin (46.15%) were observed. Greater number of isolates (38.46%) was recovered from those aged 1-10 years. This was statistically significant (P<0.05), compared to the other age groups. Conclusions The study revealed the endemicity of shigellosis with Shigella flexneri as the predominant serogroup. Children were at a higher risk of severe shigellosis. The results also suggest that nalidixic acid, ampicillin, co-trimoxazole and ciprofloxacin should not be used empirically as the first line drugs in the treatment of shigellosis. Periodic analysis of resistance patterns is necessary for the appropriate selection of empirical antimicrobial therapy.
    Full-text · Article · Feb 2014 · Asian Pacific Journal of Tropical Disease
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