Comparison of resistance to third-generation cephalosporins inShigellabetween Europe-America and Asia-Africa from 1998 to 2012

Abstract

We conducted a systematic review to compare resistance to third-generation cephalosporins (TGCs) in Shigella strains between Europe-America and Asia-Africa from 1998 to 2012 based on a literature search of computerized databases. In Asia-Africa, the prevalence of resistance of total and different subtypes to ceftriaxone, cefotaxime and ceftazidime increased markedly, with a total prevalence of resistance up to 14·2% [95% confidence interval (CI) 3·9-29·4], 22·6% (95% CI 4·8-48·6) and 6·2% (95% CI 3·8-9·1) during 2010-2012, respectively. By contrast, resistance rates to these TGCs in Europe-America remained relatively low--less than 1·0% during the 15 years. A noticeable finding was that certain countries both in Europe-America and Asia-Africa, had a rapid rising trend in the prevalence of resistance of S. sonnei, which even outnumbered S. flexneri in some periods. Moreover, comparison between countries showed that currently the most serious problem concerning resistance to these TGCs appeared in Vietnam, especially for ceftriaxone, China, especially for cefotaxime and Iran, especially for ceftazidime. These data suggest that monitoring of the drug resistance of Shigella strains should be strengthened and that rational use of antibiotics is required.

Safety and Immunogenicity of a Candidate Bioconjugate Vaccine against Shigella flexneri 2a Administered to Healthy Adults: a Single-Blind, Randomized Phase I Study

“…However, growing evidence supporting the link between shigellosis and chronic health consequences (e.g., reactive arthritis and irritable bowel syndrome) (35, 36), the association between travelers' diarrhea (TD) (treated and untreated) and colonization with extended-spectrum beta-lactamase-producing Enterobacteriaceae (37), as well as concern for multidrug-resistant strains of Shigella, further complicate treatment (6, 38, 39), making primary prevention a desired goal. More studies are needed to better understand the true prevalence of Shigella among travelers, with application of culture-independent diagnostic techniques.…”

“…Vaccine development remains a high priority given the disease burden (4, 5), increasing antibiotic resistance (6), and an increasing appreciation of the postinfectious sequelae associated with shigellosis (7, 8). Shigella flexneri accounts for 30 to 60% of shigellosis cases in developing regions, necessitating coverage of prevalent S.…”

A Case of Encephalopathy Caused by Ceftriaxone Resistant Shigella flexneri

“…According to US National Antimicrobial Surveillance system data, 41 percent of Shigella species are resistant to ampicillin, 48 percent are resistant to TMP-SMX and 2 percent are resistant against ciprofloxacin, whereas ceftriaxone resistance was reported to be less than 1 percent in 2010 (10). There is an increasing resistance to aminoglycosides and quinolones in Asia and Africa, whereas resistance to ceftriaxone was reported to be less than 14.2 percent (11). In a study conducted in Turkey in 2002, resistance to TMP-SMX was reported to be 90.4 percent, whereas sensitivity to ampicillin was 86.4 percent, sensitivity to cefotaxime was 98 percent and sensitivity to ciprofloxacin was 100 percent (4).…”

Gastroenteritis in Japanese Females Caused by Shigella flexneri without Definite Infection Route: A Case Report and Mini-Review of Literature

“…Furthermore, quinolone resistance (PMQR) determinants are qnr, aac(6')-Ib-cr, and qepA [40,46]. Considering the above, monitoring of the drug resistance of Shigella strains should be strengthened, and rational use of antibiotics is required [17,50]. In addition, guidelines for therapy should be monitored and modified based on regional reports of resistance to antimicrobial agents [11].…”