Increasing spectrum in antimicrobial Resistance of shigella isolates in Bangladesh: resistance to azithromycin and ceftriaxone and decreased susceptibility to ciprofloxacin

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dc.contributor.authorMahbubur Rahman, Mahbubur-
dc.contributor.authorShoma, Shereen-
dc.contributor.authorRashid, Harunur-
dc.contributor.authorArifeen, Shams El-
dc.contributor.authorBaqui, A.H.-
dc.contributor.authorSiddique, A.K.-
dc.contributor.authorNair, G.B.-
dc.contributor.authorSack, David A.-
dc.description.abstractAntimicrobial resistance of Shigella isolates in Bangladesh, during 2001-2002, was studied and com­pared with that of 1991-1992 to identify the changes in resistance patterns and trends. A significant increase in resistance to trimethoprim-sulphamethoxazole (from 52% to 72%, p<0.01) and nalidixic acid (from 19% to 51%, p<0.01) was detected. High, but unchanged, resistance to tetracycline, am­picillin, and chloramphenicol, low resistance to mecillinam (resistance 3%, intermediate 3%), and to emergence of resistance to azithromycin (resistance 16%, intermediate 62%) and ceftriaxone/ce­fixime (2%) were detected in 2001-2002. Of 266 recent isolates, 63% were resistant to ≥3 anti-Shigella drugs (multidrug-resistant [MDR]) compared to 52% of 369 strains (p<0.007) in 1991-1992. Of 154 isolates tested by E-test in 2001-2002, 71% were nalidixic acid-resistant (minimum inhibitory con­centration [MIC] ≥32 µg/mL) and had 10-fold higher MIC 90 (0.25 µg/mL) to ciprofloxacin than that of nalidixic acid-susceptible strains exhibiting decreased ciprofloxacin susceptibility, which were de­tected as ciprofloxacin-susceptible and nalidixic acid-resistant by the disc-diffusion method. These strains were frequently associated with MDR traits. High modal MICs were observed to azithromy­cin (MIC 6 µg/mL) and nalidixic acid (MIC 128 µg/mL) and low to ceftriaxone (MIC 0.023 µg/mL). Conjugative R-plasmids-encoded extended-spectrum ß-lactamase was responsible for resistance to ceftriaxone/cefixime. The growing antimicrobial resistance of Shigella is worrying and mandates monitoring of resistance. Pivmecillinam or ciprofloxacin might be considered for treating shigellosis with caution.en
dc.format.extent210093 bytes-
dc.relation.ispartofseriesJ Health Popul Nutr-
dc.relation.ispartofseries2007 Jun;25(2):158-167-
dc.subjectDrug resistanceen
dc.subjectMicrobial sensitivity testsen
dc.subjectNalidixic aciden
dc.titleIncreasing spectrum in antimicrobial Resistance of shigella isolates in Bangladesh: resistance to azithromycin and ceftriaxone and decreased susceptibility to ciprofloxacinen
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