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Iran J Microbiol. 2013 Dec;5(4):334-8.

Magnitude of drug resistant shigellosis in Nepalese patients.

Iranian journal of microbiology

Salman Khan, Priti Singh, Asnish Asthana, Mukhtar Ansari

Affiliations

  1. Department of Microbiology, Nepalgunj Medical College, Nepal.
  2. Department of Biochemistry, Nepalgunj Medical College, Nepal.
  3. Department of Microbiology, Neta ji Subhash Chandra bose subharti Medical College, Swami Vivekanand Subharti University, India.
  4. Department of Pharmacology, National Medical College, Nepal.

PMID: 25848501 PMCID: PMC4385157

Abstract

BACKGROUND AND OBJECTIVES: Shigella plays an important role as a causative organism of acute gastroenteritis, in children and others. Rapid emergence of antibiotic resistance warrants continuous monitoring of susceptibility pattern of bacterial isolates. We report here our findings about Shigella spp. isolates and their drug resistance patterns in Nepalese patients.

MATERIALS AND METHODS: The study was conducted on 507 Nepalese patients with acute gastroenteritis attending outpatient and inpatient departments of Nepalgunj Medical college and teaching Hospital, Banke, Nepal from September 2011 to April 2013. Stool specimens were processed for isolation and identification of Shigella species following the standard microbiological methods while the disc diffusion test was used to determine antimicrobial resistance patterns of the recovered isolates at the central Laboratory of Microbiology.

RESULTS: Sixty nine isolates were identified as Shigella species. S. flexneri, S. dysenteriae, S. boydii and S. sonnei accounted, respectively, for 42.03%, 27.54%, 21.74% and 8.70% of the total number of Shigella isolates. Resistance to nalidixic acid (95.65%), ampicillin (85.51%), co-trimoxazole (82.61%) and ciprofloxacin (47.83%) was observed. Among 69 isolates, 29 (42.03%) were from children aged 1-10 years and this group was statistically significant (P < 0.05), compared to the other age groups.

CONCLUSIONS: The study revealed endemicity of shigellosis with S. flexneri as the predominant serogroup in Nepalese patients. Children were at a higher risk of severe shigellosis. Nalidixic acid, ampicillin, co-trimoxazole and ciprofloxacin should not be used empirically as the first line drugs in treatment of shigellosis. Continuous local monitoring of resistance patterns is necessary for the appropriate selection of empirical antimicrobial therapy.

Keywords: Antimicrobial resistance; Nepal; Shigella; gastroenteritis

References

  1. Clin Infect Dis. 2000 Jul;31(1):192-6 - PubMed
  2. Jpn J Infect Dis. 2001 Jun;54(3):121-2 - PubMed
  3. Indian J Med Microbiol. 2009 Oct-Dec;27(4):358-60 - PubMed
  4. Indian J Med Res. 2010 May;131:720-2 - PubMed
  5. Bull World Health Organ. 1999;77(8):651-66 - PubMed
  6. J Health Popul Nutr. 2002 Dec;20(4):356-8 - PubMed
  7. Diagn Microbiol Infect Dis. 1997 Aug;28(4):165-71 - PubMed
  8. J Pak Med Assoc. 1991 Apr;41(4):75-8 - PubMed
  9. Antimicrob Agents Chemother. 2005 Mar;49(3):1203-5 - PubMed
  10. Wkly Epidemiol Rec. 1997 Mar 14;72(11):73-9 - PubMed
  11. J Clin Microbiol. 2001 Jun;39(6):2134-9 - PubMed
  12. Epidemiol Infect. 2004 Aug;132(4):773-7 - PubMed
  13. Clin Infect Dis. 1992 May;14(5):1055-60 - PubMed
  14. Am J Clin Pathol. 1966 Apr;45(4):493-6 - PubMed
  15. Indian J Med Res. 2006 Feb;123(2):145-50 - PubMed
  16. J Health Popul Nutr. 2005 Dec;23(4):339-42 - PubMed
  17. Indian J Med Res. 2002 Jan;115:11-3 - PubMed
  18. J Microbiol. 2005 Apr;43(2):133-43 - PubMed
  19. Clin Infect Dis. 1997 Jan;24 Suppl 1:S102-5 - PubMed
  20. J Health Popul Nutr. 2001 Sep;19(3):183-90 - PubMed
  21. J Antimicrob Chemother. 1994 Aug;34(2):253-9 - PubMed
  22. Pak J Biol Sci. 2012 Feb 1;15(3):156-9 - PubMed
  23. J Infect Dis. 1985 Dec;152(6):1114-9 - PubMed
  24. Indian J Med Res. 2012 Mar;135:365-70 - PubMed
  25. J Trop Pediatr. 1995 Oct;41(5):303-7 - PubMed
  26. Lancet Infect Dis. 2004 Oct;4(10):607-8 - PubMed
  27. Ann Intern Med. 1997 May 1;126(9):697-703 - PubMed
  28. Trop Doct. 1996 Apr;26(2):70-1 - PubMed
  29. Emerg Infect Dis. 2001 Jan-Feb;7(1):137-40 - PubMed
  30. Ann Trop Med Parasitol. 1996 Apr;90(2):105-14 - PubMed
  31. J Infect Dis. 1970 Sep;122(3):170-80 - PubMed

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