Antibiotic susceptibility pattern of Shigella isolates in a tertiary healthcare center

Abstract

BACKGROUND AND OBJECTIVES: Shigellosis is one of the most common causes of morbidity and mortality in children in developing countries. To the best of our knowledge, there is no published data in the study area on the antimicrobial susceptibility pattern and prevalence of Shigella species among diarrheagenic cases. Therefore, a retrospective analysis was done to find the Shigella serotypes, common age group affected, and antimicrobial resistance pattern of Shigella isolates in South Kerala METHODS: Stool samples collected from cases of dysentery and diarrhea from January 2011 to December 2016 were processed. Standard bacteriological methods were used to isolate, identify, and determine the antimicrobial susceptibility pattern of Shigella isolates. The data were analyzed using SPSS version 16. RESULTS: Among 1585 stool samples, 48(3%) yielded Shigella . The most common serogroup isolated was Shigella sonnei (62.5%) followed by Shigella flexneri. Of 48 isolates, 44(91.6%) isolates were found to be multidrug resistant. Over the 5-year period, the isolates show 100% resistance to nalidixic acid, ciprofloxacin, and cotrimoxazole. Eight isolates were found to be resistant to ceftriaxone and cefotaxime. The presence of Extended spectrum betalactamase (ESBL) was phenotypically confirmed in five isolates. CONCLUSION: Even though S. flexneri is the most common Shigella-causing diarrhea, S. sonnei was found to be the most important species responsible in our study. Multidrug resistance was common (91.6%) and the most common multidrug resistance profile was ampicillin-nalidixic acid-cotrimoxazole-ciprofloxacin. Regular monitoring of antibiotic susceptibility pattern including detection of beta lactamases should be done in all microbiology laboratories. Guidelines for therapy should be monitored and modified based on regional susceptibility reports.

Antibiotic Susceptibility Pattern of Shigella spp. Isolated from Patients Suspected of Acute Gastroenteritis

“…Several studies across the world have also shown the increased resistance of Shigella species to third-generation cephalosporins (Radice et al, 2001;Vinh et al, 2009;Mandal et al, 2010). More recent research also consistently supports the fact that third-generation cephalosporins cannot be relied on treating Ciprofloxacin resistant Shigella species due to surge in third-generation cephalosporin-resistant Shigella species (Hosseini Nave et al, 2016;Nüesch-Inderbinen et al, 2016;Madhavan et al 2018;Abbasi et al, 2019;Bian et al, 2019). Therefore, although our study has shown the high susceptibility of Shigella species to a third-generation cephalosporin (Cefotaxime), we still suggest using thirdgeneration cephalosporin with caution.…”

“…The high resistance level in Shigella can be attributed to the transfer of resistant determinants such as plasmids, integrons and transposons (Barrantes & Achí, 2016). Due to the rise in resistance to thirdgeneration cephalosporins (Abbasi et al, 2019), a recent study has suggested using Azithromycin and Piperacillin tazobactam as an alternative (Madhavan et al, 2018). However, resistance to Azithromycin has also been reported (Nüesch-Inderbinen et al, 2016).…”

Distribution of Antibiotic-Resistant Enterobacteriaceae Pathogens in Potable Spring Water of Eastern Indian Himalayas: Emphasis on Virulence Gene and Antibiotic Resistance Genes in Escherichia coli

“…In another study, Shigella flexneri (21%) isolates from Iran were found to show resistance to cotrimoxazole (100%), ampicillin (100%), tetracycline (75%), chloramphenicol (50%), cefixime (50%), and ampicillin (33.30%) (Abbasi et al, 2019). A study from Kerala, India reported Shigella flexneri isolates to display resistance to nalidixic acid (88.80%), ampicillin (83.30%), cotrimoxazole (83.30%), ciprofloxacin (77.70%), and furazolidone (38.80%) (Madhavan et al, 2018). The Oceanic region of Australia had also reported ampicillin (77%), tetracycline (74%), chloramphenicol (60%), and sulfamethoxazole/trimethoprim (49%) resistant Shigella flexneri (Malau et al, 2018).…”

Prevalence and antimicrobial susceptibility pattern of Salmonella and Shigella in stool among patients presenting with diarrhea in a tertiary care centre in south India

“…A recent study conducted in North India showed that nearly 20% of S. flexneri were resistant to third generation cephalosporin by disc diffusion and 33.7% had MIC ≥1 μg/mL ( 31 ). Another study conducted in India showed that 91.6% of the Shigella isolates were multi drug resistant and presence of ESBL (Extended spectrum betalactamase) was detected in five isolates ( 32 ). Our patient who had MDR Shigella in stool was a 21 year old female, who was successfully managed with cotrimoxazole and other supportive measures.…”