Multi drug resistance and Extended Spectrum Beta Lactamases in clinical isolates of Shigella: A study from New Delhi, India

Aggarwal, Praveen; Uppal, Beena; Ghosh, Rajesh; Prakash, S Krishna; Chakravarti, Anita; Jha, A. K.; Rajeshwari, K

doi:10.1016/j.tmaid.2016.05.006

Cited by 25 publications

(28 citation statements)

References 25 publications

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“…In our study, most Shigella isolates were resistant and intermediately resistant to trimethoprim-sulfamethoxazole and ampicillin, the first-line drugs suggested by the CLSI for shigellosis (30). These results are in line with the results of other studies (31,32). Quinolones are a good choice for the treatment of shigellosis (30).…”

Section: Discussionsupporting

confidence: 91%

“…In a study by Ghavam et al in Iran, a similar frequency for resistance to nalidixic acid was observed (26), but in some countries higher resistance rates have been reported (7,31). Multi-drug resistance to the antimicrobial agents used for the treatment of shigellosis has been reported in many parts of the world (31,33,34). The results of our study suggest that multidrug resistance is common amongst all Shigella species, and this property was more notable in the case of S. dysentrie.…”

Section: Discussionsupporting

confidence: 83%

“…We detected very little resistance to ciprofloxacin (1.92%), which is comparable with the results of other studies in Iran (12, 27, 36). However, a higher prevalence for ciprofloxacin-resistant Shigella isolates has been documented in other countries (31,33,34). In our study, the rate of resistance to ceftriaxone was 19.23%, which is higher than the rates reported by studies in Iran (11,27,37) and other countries (31,38).…”

Section: Resultscontrasting

confidence: 72%

“…However, more than 34% of Shigella isolates in our study were resistant and intermediately resistant to nalidixic acid. In a study by Ghavam et al in Iran, a similar frequency for resistance to nalidixic acid was observed (26), but in some countries higher resistance rates have been reported (7,31). Multi-drug resistance to the antimicrobial agents used for the treatment of shigellosis has been reported in many parts of the world (31,33,34).…”

Section: Discussionmentioning

confidence: 69%

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Determination of Antibiotic Resistance Pattern and frequency of CTX-M, TEM, and SHV Β-Lactamase Encoding Genes among Shigella Isolates from Inpatients in Tehran, Iran

2019

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Background and Objectives: The emergence of extended-spectrum β-lactamase (ESBL)-producing Shigella spp. is becoming a health concern worldwide. This study aimed to investigate antibiotic resistance pattern and frequency of blaCTX-M, blaSHV, and blaTEM genes among Shigella isolates from patients in hospitals of Tehran, Iran. Methods: In this cross-sectional study, 52 non-repeated Shigella strains were isolated from hospitalized patients in Milad, Emam Khomeini and Shariati hospitals in Tehran (Iran) from November 2015 to December 2016. Bacterial identification, serotyping, and antimicrobial susceptibility testing were performed according to the standard guidelines. The blaCTX-M, blaSHV, and blaTEM resistance genes were identified using multiplex polymerase chain reaction. Results: Among 52 Shigella isolates, S. sonnei (44.2%) was the predominant species, followed by S. flexneri and S. dysenteriae (23%). Over 67% of the isolates were multidrug resistant. The highest rates of resistance were observed against cefalotin (67.3%), tetracycline (67.3%), amikacin (63.5%), trimethoprim-sulphamethoxazole (48.1), and ampicillin (42.3%). The lowest resistance rate was against ciprofloxacin (1.9%). We detected the blaTEM and blaCTX-M genes in 61.5% and 19.2% of the isolates, respectively. However, the blaSHV gene was not detected in any of the isolates. In addition, 16.4% of the isolates harbored the blaTEM and blaCTX-M genes simultaneously. Ciprofloxacin was the most effective antibiotics according to the ESBL genes distribution. Conclusion: Our findings indicate the high prevalence of multidrug resistance and ESBL genes in Shigella isolates, which elucidates the need for appropriate infection control measures for limiting the spread of resistant strains.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 83%

Section: Resultscontrasting

confidence: 72%

Section: Discussionmentioning

confidence: 69%

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Determination of Antibiotic Resistance Pattern and frequency of CTX-M, TEM, and SHV Β-Lactamase Encoding Genes among Shigella Isolates from Inpatients in Tehran, Iran

2019

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“…Shigella spp. is highly necessary to start a prompt and rational antibiotic regimen to minimize the clinical effects of severe dysentery and its complications [31]. We could not able to perform confirmatory tests like other biochemical tests, molecular level test like PCR, gel electrophoresis due to lack of resources and additional clinical patients issues like clinical complication and informed consents.…”

Section: Discussionmentioning

confidence: 99%

Antibiotic Resistance Pattern of Shigella spp. Among Gastroenteritis Patients at Tertiary Care Hospital in Pokhara, Nepal

et al. 2017

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Shigellosis, a disease caused by Shigella species. It is a major public health problem in developing nations like Nepal, where communities having poverty; poor sanitation, personal hygiene, and water supplies. The main aim of our study is to isolate and identify Shigella spp. from gastroenteritis patients and to find out its drug resistance pattern. A cross-sectional study was carried out based on routinely attending outpatients and inpatients. A total of 225 stool samples collected from gastroenteritis patients were processed from 20 April to 24 September 2014 in Western Regional Hospital, Pokhara, Nepal. Standard microbiological procedures were followed for the isolation of Shigella spp. After that slide agglutination kit method was used for identification of Shigella spp. Finally, Kirby-Bauer disc diffusion method was done for an antimicrobial resistance test. Of the total 225 gastroenteritis patients, 133 were detected as bacterial positive cases. Among positive cases, Shigella spp. was identified in 10.5%. Age wise, an infection rate of Shigella in patients <15-years old was found higher i.e. 7.3% than in patients ≥ 15 years old i.e. 4.5% with the (p = 0.432) at 95% CI. The infection rate of S. dysenteriae, S. flexneri, and S. sonnei was detected in 28.6%, 57.1%, and 14.3% respectively. For the antimicrobial test, eight types of antibiotics were used. The most resistance pattern of isolated Shigella spp. was found in nalidixic acid, and co-trimoxazole 92.8% followed by ampicillin 64.3% and ciprofloxacin 42.8% etc. Our study reported that endemicity of Shigellosis with S. flexneri is the predominant group in gastroenteritis patients. This finding suggests that co-trimoxazole, nalidixic acid, ciprofloxacin and ampicillin should not be used experimentally as first-line drugs for shigellosis treatment.

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Shigella and Enteroinvasive Escherichia Coli

Belotserkovsky

Sansonetti

2018

Current Topics in Microbiology and Immunology

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Shigella and enteroinvasive Escherichia coli (EIEC) are gram-negative bacteria responsible for bacillary dysentery (shigellosis) in humans, which is characterized by invasion and inflammatory destruction of the human colonic epithelium. Different EIEC and Shigella subgroups rose independently from commensal E. coli through patho-adaptive evolution that included loss of functional genes interfering with the virulence and/or with the intracellular lifestyle of the bacteria, as well as acquisition of genetic elements harboring virulence genes. Among the latter is the large virulence plasmid encoding for a type three secretion system (T3SS), which enables translocation of virulence proteins (effectors) from the bacterium directly into the host cell cytoplasm. These effectors enable the pathogen to subvert epithelial cell functions, promoting its own uptake, replication in the host cytosol, and dissemination to adjacent cells while concomitantly inhibiting pro-inflammatory cell death. Furthermore, T3SS effectors are directly involved in Shigella manipulation of immune cells causing their dysfunction and promoting cell death. In the current chapter, we first describe the evolution of the enteroinvasive pathovars and then summarize the overall knowledge concerning the pathogenesis of these bacteria, with a particular focus on Shigella flexneri. Subversion of host cell functions in the human gut, both epithelial and immune cells, by different virulence factors is especially highlighted.

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Multi drug resistance and Extended Spectrum Beta Lactamases in clinical isolates of Shigella: A study from New Delhi, India

Cited by 25 publications

References 25 publications

Determination of Antibiotic Resistance Pattern and frequency of CTX-M, TEM, and SHV Β-Lactamase Encoding Genes among Shigella Isolates from Inpatients in Tehran, Iran

Determination of Antibiotic Resistance Pattern and frequency of CTX-M, TEM, and SHV Β-Lactamase Encoding Genes among Shigella Isolates from Inpatients in Tehran, Iran

Antibiotic Resistance Pattern of Shigella spp. Among Gastroenteritis Patients at Tertiary Care Hospital in Pokhara, Nepal

Shigella and Enteroinvasive Escherichia Coli

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