Emergence of Ceftriaxone Resistant Shigella

Goel, Neeraj; Wattal, Chand; Kaul, Dinesh; Khanna, Varun

doi:10.1007/s12098-011-0669-5

Cited by 9 publications

(10 citation statements)

References 6 publications

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“…In addition, one study in China reported a decrease in susceptibility to ciprofloxacin in approximately 80% of isolates (564). In contrast, resistance against the two other current therapeutics of choice, azithromycin and ceftriaxone, is still rare, but reports of sporadic incidences are on the rise (457,565,566). Antibiotic resistance in EIEC/Shigella is most commonly plasmid and/or chromosome borne (424,567).…”

Section: Clinical Considerationsmentioning

confidence: 99%

Recent Advances in Understanding Enteric Pathogenic Escherichia coli

et al. 2013

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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 .

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Section: Clinical Considerationsmentioning

confidence: 99%

Recent Advances in Understanding Enteric Pathogenic Escherichia coli

et al. 2013

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“…Shigella species, resistant to ciprofloxacin, ceftriaxone and azithromycin (MIC>32 µg/ml) caused infections in refugees and local residents in Austria and other EU countries imposing a new health problem [15]. Even the last resource meropenem was used to treat ceftriaxone-resistant Shigella infection because MIC values of meropenem (MIC range <0.06 µg/ml) and imipenem (MIC range <0.06-0.25 µg/ml) showed susceptibility of all resistant Shigella isolates tested [16,17]. In Bangladesh, during 2001-2002 S. sonnei comprised only 16% of 266 Shigella isolates studied and a low resistance to ampicillin (16%) and high resistance to cotrimoxazole (87%) were reported among S. sonnei isolates [3].…”

Section: Introductionmentioning

confidence: 99%

Emergence of Extensively Drug-resistant Shigella sonnei in Bangladesh

Rahman¹,

Haque²,

Deeba³

et al. 2017

iid

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The objective of the study was to investigate current species distribution and growing antimicrobial resistance (AMR) of Shigella isolates for proper treatment. Shigellae, isolated from faecal samples in International Centre for Diarrhoeal Disease research, Bangladesh, Dhaka hospital in 2015, were tested for antimicrobial susceptibility by disc diffusion method to ampicillin, co-trimoxazole, ciprofloxacin, azithromycin, mecillinam, ceftriaxone/cefixime and meropenem. Extensively drug-resistant (XDR, resistant to 5 or 6 of 7 useful anti-Shigella drugs tested) Shigella isolates resistant to 6 drugs were analyzed for ESBL and AmpC phenotypes, plasmid profiles, R-plasmids transfer, bla SHV , bla TEM , bla CTX-M , bla OXA; and mphA, mphB, ermA, ermB, ermC, ereA, ereB, mefA and msrA genes by PCR; and clonality of S. sonnei by PFGE. Of 134 isolates cultured from 3722 (3.6%) diarrhoeal faecal samples, 46% were S. sonnei, 37% S. flexneri, 4% S. boydii, 5% S. dysenteriae and 7% non-typeable. Multidrug-resistant (MDR, resistant simultaneously to ≥3 drugs) S. sonnei were 95% compared to 66% (P<0.01) MDR S. flexneri including 18% & 14% XDR types, respectively. All isolates were susceptible to meropenem. Four (6%) S. sonnei, 2 (4%) S. flexneri and 1 (17%) S. boydii (total of 7 isolates) were six-drugs XDR; 5 of them had ESBL phenotypes. Three S. sonnei and 1 S. flexneri had bla TEM and bla CTX-M ; 1 S. boydii had bla SHV, bla TEM and bla CTX-M ; 1 S. sonnei had bla TEM β-lactamase. All but one S. flexneri had only mphA gene on 62-MDa conjugative-R-plasmid coding azithromycin resistance. PFGE identified MDR-S. sonnei Global III clade. Thus, MDR-S. sonnei replaced S. flexneri as predominant isolate in Dhaka, Bangladesh; many emerged as XDR strains requiring treatment by meropenem. The findings demand judicial use of antibiotics to contain emergence and spread of resistance locally and globally. Physicians should be informed about MDR and XDR Shigella for judicious prescribing of antimicrobial therapy.

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“…However, strains resistant to the first-line drugs commonly used in the treatment of shigellosis like ampicillin, cotrimoxazole, and nalidixic and even ciprofloxacin and norfloxacin has also been reported from various studies in Nepal and worldwide [9–12, 15]. Ceftriaxone has been used as a reserved antibiotic for treatment of multidrug-resistant (MDR) Shigella infection [16]. However, some studies have also reported emerging ceftriaxone resistance in Shigella .…”

Section: Introductionmentioning

confidence: 99%

Shigellosis in Nepal: 13 years review of nationwide surveillance

Shakya

Acharya

Adhikari

et al. 2016

J Health Popul Nutr

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Background Shigella is a major cause of gastroenteritis especially in children. In developing countries, the incidence is frequent and results are often life threatening. Changing epidemiology and emerging antibiotic resistance warrants continuous monitoring of susceptibility. The present study highlights the changing epidemiology and drug resistance patterns of Shigella isolated at different hospitals of Nepal over a period of 13 years (Jan. 2003–Dec. 2015).MethodsThis study was carried out in 12 participating laboratories. Stool specimens received at respective laboratories were processed for isolation and identification of Shigella species and confirmed by serotyping at National Public Health Laboratory. Antimicrobial resistance patterns were determined by Kirby Baeur disc diffusion test.ResultsA total of 332 isolates were identified as Shigella species of which Shigella flexneri (50 %) was the predominant serotype. Shigella dysenteriae, Shigella sonnei, Shigella boydii, and untypable Shigella spp. respectively, accounted for 28.6, 27.54, 10.2, 4.5, and 6.6 % of the total number. Change in prevalent serotype is noted over the years. S. dysenteriae was the prevalent species in Nepal in 2003 and 2004, but since 2005, S. flexneri remained prevalent. Majority of the isolates were recovered from children aged 1–10 years and was statistically significant (p = 0.023) compared to the other age groups. High resistance among all Shigella species to the first-line drugs like ampicillin (88 %), cotrimoxazole (76 %), ciprofloxacin (39 %,) and nalidixic acid (80 %) was observed; 46.1 % of total isolates were multidrug resistant (MDR), and the most common MDR profile was ampicillin, nalidixic acid, and co-trimoxazole. Prevalence of MDR increased significantly in 2010 as compared to 2003. Only few Shigella isolates were resistant to ceftriaxone.ConclusionsThe study revealed S. flexneri as the predominant serogroup in Nepal. Children below 10 years were more prone to the disease. Nalidixic acid, ampicillin, co-trimoxazole, and ciprofloxacin should not be used empirically as the first-line drugs in treatment of shigellosis. Since the distribution of different species of Shigella and their antibiotic susceptibility profile may vary from one geographical location to another and may also change with time, continuous local monitoring of resistance patterns is necessary for appropriate antimicrobial therapy.

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Emergence of Ceftriaxone Resistant Shigella

Cited by 9 publications

References 6 publications

Recent Advances in Understanding Enteric Pathogenic Escherichia coli

Recent Advances in Understanding Enteric Pathogenic Escherichia coli

Emergence of Extensively Drug-resistant Shigella sonnei in Bangladesh

Shigellosis in Nepal: 13 years review of nationwide surveillance

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