Trends in antimicrobial resistance in Shigella species in Karachi, Pakistan

Abstract

Background: Shigellosis is a common cause of morbidity, especially in the very young and old, in developing countries. The disease is treated with antibiotics. Surveillance of antimicrobial resistance trends is essential owing to the global emergence of antimicrobial resistance. Methodology: The study involved 1,573 isolates of Shigella species (1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007) that were analyzed for trends in antimicrobial resistance. Results: The majority of the specimens (1046; 66.5%) were from the pediatric population, and of these 887 (84.8%) were under 5 years of age (p = 0.001). S. flexineri was the most frequent species (54.5%) isolated. Isolation of S. sonnei increased from 15.4 % (1996) to 39% (2007) (p = 0.001). Although none of the isolates was found sensitive to all the antibiotics tested, 58% (n =9 07) were resistant to ampicillin and 85% (n = 1,338) were resistant to trimethoprim-sulfamethoxazole (TMP-SMX). Out of a total of 198 (12.6%) nalidixic acid resistant isolates, 6 (3.0%) were also resistant to ofloxacin. Overall 1.7 % of isolates were resistant to ofloxacin, 2.4% to ceftriaxone and 2.3% were resistant to combination of ampicillin, nalidixic acid and TMP-SMX. Conclusion: Ofloxacin is still an effective drug for treatment of acute shigellosis in Pakistan. Emergence of resistance to ceftriaxone in Shigella may have grave implications in treatment of severe shigellosis in very young patients.

Increasing Trend of Resistance to Penicillin, Tetracycline, and Fluoroquinolone Resistance inNeisseria gonorrhoeaefrom Pakistan (1992–2009)

“…We had not evaluated the exact reason for this finding, but probable reasons could be its continuous use despite higher rate of resistance and poor disease control in the community. Increased resistance rates to quinolones have been reported from the country in other community acquired pathogens highlighting the overall misuse of quinolones as the major reason of increased resistance [17, 18]. …”

The Bacteriological Quality, Safety, and Antibiogram ofSalmonellaIsolates from Fresh Meat in Retail Shops of Bahir Dar City, Ethiopia

“…There are several reports on outbreaks of food-borne illnesses because of consumption of meat [6, 7]. Moreover, antibiotic resistance levels are also elevated among food-borne pathogens such as Salmonella , E. coli , and Shigella [8–10]. …”

A 10-year surveillance of antimicrobial susceptibility patterns in Shigella sonnei isolates circulating in Jiangsu Province, China

“…In China, up to 1.7 million episodes of shigellosis occurred each year, with up to 0.20 million patients hospitalised [2]. Among the four species of Shigella (Shigella dysenteriae, Shigella flexneri, Shigella boydii and Shigella sonnei), S. sonnei has been the predominant species in developed countries and is often the second most prevalent species in developing countries for many years [3][4][5]. Recently, S. sonnei has become increasingly important due to the growing rate of this species in many developing countries [6,7].…”