Prevalence and Antibiotic Susceptibility of Shigella Species Isolated From Pediatric Patients in Tehran

Abstract

Background: Dysentery accounts for a significant proportion of morbidity and mortality cases, especially in children with diarrhea in developing countries. Shigellosis remains a public health problem in Iran. Objectives: The objectives of this study were to investigate the presence and the frequency of Shigella spp. among children younger than 10 years with diarrhea and to determine the antimicrobial resistance patterns of these isolates in Tehran, Iran. Patients and Methods: This cross-sectional study was conducted in two pediatric hospitals in Tehran, from October, 2013 to October, 2014. Nine hundred and thirty-eight (n = 938) stool samples were collected (one stool per patient) from children less than 10 years of age. The stools were primarily cultured on MacConkey agar and xylose lysine deoxycholate (XLD). (Selenite-F broth is also used as an enrichment medium for the isolation of Shigella spp.) All of the isolates were confirmed as Shigella species by biochemical and serological tests. Molecular confirmation of Shigella isolates was determined by polymerase chain reaction (PCR) using specific primers for the ipaH gene. The antibiotic susceptibility of the Shigella isolates was tested using the Kirby-Bauer disc-diffusion method. Results: Amongst 938 stool samples, 36 were Shigella spp. S. sonnei (61.1%, n = 22), which was the most common, followed by S. flexneri (27.8%, n = 10), S. boydii (8.3%, n = 3), and S. dysenteriae (2.8%, n = 1). Furthermore, most Shigella isolates showed resistance to amoxicillin (83.3%), tetracycline (61.1%), and co-trimoxazole (83.3%). No resistance was found against ciprofloxacin and imipenem. This study showed that S. sonnei is currently the predominant species in Tehran, Iran. Conclusions: Because resistance to antibiotics changes constantly, Shigella strains should be under surveillance in order to monitor local susceptibility and subsequently formulate policies for the use of antimicrobial drugs.

Investigating the Prevalence of Shigella Species and Their Antibiotic Resistance Pattern in Children With Acute Diarrhea Referred to Selected Hospitals in Tehran, Iran

“…The prevalence of Shigella species pattern is different among developing and developed countries, while S. sonnei is the most common species in developed countries, the predominant Shigella species in developing countries is S. flexneri. The present study shows that the most prevalent Shigella strains in Tehran are belonged to S. sonnei and it is in agreement with Rahbar et al, 26 Talebreza et al, 27 Jafari et al, 28 Tajbakhsh et al, 29 Ranjbar et al, 30 Eftekhari et al, 31 and Farshad et al 32 reports. It is while in the not-too-distant past, S. flexneri was the most common species in Tehran 33,34 (P<0.05), which indicates the improvement of hygiene level in this city.…”

Prevalence and Antibiotic Susceptibility Patterns of Salmonella and Shigella Species Isolated from Pediatric Diarrhea in Tehran

“…The prevalence of Shigella spp., in the current investigation, was 8.9%, which is similar to that reported by studies from Ethiopia (8.7%) (16) and South Africa (8.5%) (17), but higher than those reported in other similar studies in Iran as (5.1%) and (3.8%) (18,19). The prevalence of shigellosis reported in other developing countries such as Cameroon (4.5%) (20), India (5%) (21), and Ghana (5%) (22) was also lower than that observed in the current study.…”

Burden of Shigella spp and Vibrio spp, and their antibiotic sensitivity pattern in the patients with acute gastroenteritis in tertiary care hospital in Nepal

“…In the present study, Shigella sonnei 10 (58.8%) remained the most common species followed by Shigella flexneri 7 (41.17%), which is in consistent with the results of the study in pediatric population from Teharan n Farahani et al, where 60.8% reported to be Shigella sonnei and 39.2% S. flexeneri [27]. A similar results were shown by Telebreza et al [28] in pediatric population; 61.1% Shigella sonnei, followed by S. flexneri (27.8%). However, in pediatric population in Nepal a low prevalence of Shigella sonnei (25%) and S. flexneri 20.83% were found [26].…”