Frequency of isolation of various subtypes and antimicrobial resistance of Shigella from urban slums of Karachi, Pakistan

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• 作者：Afia Zafar ; Rumina Hasan ; Shaikh Qamaruddin Nizami ; Lorenz von Seidlein ; Sajid Soofi ; Tanwir Ahsan ; Saeeda Ch ; io ; Atif Habib ; Naveed Bhutto ; Fahad J. Siddiqui ; Arjum ; Rizvi ; John D. Clemens ; Zulfiqar
• 关键词：Shigella subtypes ; Species distribution ; Antimicrobial resistance ; Multi-drug resistance
• 刊名：International Journal of Infectious Diseases
• 出版年：2009
• 出版时间：November 2009
• 年：2009
• 卷：13
• 期：6
• 页码：668-672
• 全文大小：251 K

文摘

Summary

Objectives

Shigellosis remains a major public health problem in developing countries. Antimicrobial resistance has complicated the empirical treatment. Knowledge of serotypes is crucial in vaccine development, as cross-protection between various serotypes is limited. Therefore we conducted a prospective study to determine the frequency of isolation of Shigella serotypes and antimicrobial resistance.

Methods

Stool samples from 8155 individuals, collected through a surveillance study conducted in four slums of Karachi from January 2002 to March 2004, were cultured. Results: Shigella was isolated in 394 (4.8 % ) of 8155 patients presenting with diarrhea. Two hundred and forty-two (62 % ) isolates were Shigellaflexneri, 72 (18 % ) were Shigellasonnei, 43 (11 % ) were Shigellaboydii, and 37 (9 % ) were Shigelladysenteriae. Thirteen S.flexneri serotypes were identified, of which the most frequent were 2a (38), 6 (37), and 1b (25), followed by 2b (23). Only 22 (5.6 % ) Shigella isolates were found to be pan-susceptible. Large proportions of isolates were resistant to co-trimoxazole (89 % S.flexneri, 81 % S.dysenteriae, 80 % S.sonnei, and 56 % S.boydii) and ampicillin (87 % S.flexneri, 68 % Sdysenteriae, 35 % S.boydii, and 4 % S.sonnei).

Conclusions

Concurrent circulation of multiple strains with high resistance is worrying and mandates surveillance at the national level to facilitate the control of shigellosis.