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. 1995 Jan;39(1):256–259. doi: 10.1128/aac.39.1.256

High frequency of strains multiply resistant to ampicillin, trimethoprim-sulfamethoxazole, streptomycin, chloramphenicol, and tetracycline isolated from patients with shigellosis in northeastern Brazil during the period 1988 to 1993.

A A Lima 1, N L Lima 1, M C Pinho 1, E A Barros Juñior 1, M J Teixeira 1, M C Martins 1, R L Guerrant 1
PMCID: PMC162521  PMID: 7695319

Abstract

The occurrence and antimicrobial resistance pattern of Shigella isolates obtained from persons in community and hospital-based studies of diarrhea and matched controls in northeastern Brazil were studied. The isolation rate of Shigella spp. from patients with diarrhea during 1988 to 1993 varied from 4.5% (26 of 575) for the urban community of Gonçalves Dias to 6.7% (12 of 179) and 5.9% (7 of 119) for Hospital Infantil and Hospital Universitário, respectively. Of the 55 Shigella isolates (45 from patients with diarrhea, 8 from controls, and 2 undetermined) 73% (40 of 55) were Shigella flexneri, 16% (9 of 55) were S. sonnei, 7% (4 of 55) were S. boydii, and 4% (2 of 55) were S. dysenteriae. Of 39 S. flexneri strains, over half were resistant to ampicillin, trimethoprim-sulfamethoxazole, or both. Over 64% were resistant to streptomycin, chloramphenicol, and tetracycline. Overall, 82% of all S. flexneri isolates were resistant to four or more antimicrobial agents tested. As elsewhere, in the northeast of Brazil, ampicillin and trimethoprim-sulfamethoxazole are no longer reliable for treatment of S. flexneri infection. Most Shigella strains were resistant to four or more antimicrobial agents. Nalidixic acid was still useful for treatment of infections due to S. flexneri.

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Selected References

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  1. Bauer A. W., Kirby W. M., Sherris J. C., Turck M. Antibiotic susceptibility testing by a standardized single disk method. Am J Clin Pathol. 1966 Apr;45(4):493–496. [PubMed] [Google Scholar]
  2. Bennish M. L., Azad A. K., Yousefzadeh D. Intestinal obstruction during shigellosis: incidence, clinical features, risk factors, and outcome. Gastroenterology. 1991 Sep;101(3):626–634. doi: 10.1016/0016-5085(91)90518-p. [DOI] [PubMed] [Google Scholar]
  3. Bennish M. L., Harris J. R., Wojtyniak B. J., Struelens M. Death in shigellosis: incidence and risk factors in hospitalized patients. J Infect Dis. 1990 Mar;161(3):500–506. doi: 10.1093/infdis/161.3.500. [DOI] [PubMed] [Google Scholar]
  4. Bennish M. L. Potentially lethal complications of shigellosis. Rev Infect Dis. 1991 Mar-Apr;13 (Suppl 4):S319–S324. doi: 10.1093/clinids/13.supplement_4.s319. [DOI] [PubMed] [Google Scholar]
  5. Bennish M. L., Salam M. A., Hossain M. A., Myaux J., Khan E. H., Chakraborty J., Henry F., Ronsmans C. Antimicrobial resistance of Shigella isolates in Bangladesh, 1983-1990: increasing frequency of strains multiply resistant to ampicillin, trimethoprim-sulfamethoxazole, and nalidixic acid. Clin Infect Dis. 1992 May;14(5):1055–1060. doi: 10.1093/clinids/14.5.1055. [DOI] [PubMed] [Google Scholar]
  6. Bennish M. L., Wojtyniak B. J. Mortality due to shigellosis: community and hospital data. Rev Infect Dis. 1991 Mar-Apr;13 (Suppl 4):S245–S251. doi: 10.1093/clinids/13.supplement_4.s245. [DOI] [PubMed] [Google Scholar]
  7. Bennish M., Eusof A., Kay B., Wierzba T. Multiresistant Shigella infections in Bangladesh. Lancet. 1985 Aug 24;2(8452):441–441. doi: 10.1016/s0140-6736(85)92756-4. [DOI] [PubMed] [Google Scholar]
  8. Bratoeva M. P., John J. F., Jr Dissemination of trimethoprim-resistant clones of Shigella sonnei in Bulgaria. J Infect Dis. 1989 Apr;159(4):648–653. doi: 10.1093/infdis/159.4.648. [DOI] [PubMed] [Google Scholar]
  9. Butler T., Dunn D., Dahms B., Islam M. Causes of death and the histopathologic findings in fatal shigellosis. Pediatr Infect Dis J. 1989 Nov;8(11):767–772. doi: 10.1097/00006454-198911000-00008. [DOI] [PubMed] [Google Scholar]
  10. Ferreccio C., Prado V., Ojeda A., Cayyazo M., Abrego P., Guers L., Levine M. M. Epidemiologic patterns of acute diarrhea and endemic Shigella infections in children in a poor periurban setting in Santiago, Chile. Am J Epidemiol. 1991 Sep 15;134(6):614–627. doi: 10.1093/oxfordjournals.aje.a116134. [DOI] [PubMed] [Google Scholar]
  11. Frost J. A., Willshaw G. A., Barclay E. A., Rowe B., Lemmens P., Vandepitte J. Plasmid characterization of drug-resistant Shigella dysenteriae 1 from an epidemic in Central Africa. J Hyg (Lond) 1985 Apr;94(2):163–172. doi: 10.1017/s0022172400061362. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Haider K., Chatkaeomorakot A., Kay B. A., Talukder K. A., Taylor D. N., Echeverria P., Sack D. A. Trimethoprim resistance gene in Shigella dysenteriae 1 isolates obtained from widely scattered locations of Asia. Epidemiol Infect. 1990 Apr;104(2):219–228. doi: 10.1017/s0950268800059380. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Haltalin K. C., Nelson J. D., Ring R., 3rd, Sladoje M., Hinton L. V. Double-blind treatment study of shigellosis comparing ampicillin, sulfadiazine, and placebo. J Pediatr. 1967 Jun;70(6):970–981. doi: 10.1016/s0022-3476(67)80275-0. [DOI] [PubMed] [Google Scholar]
  14. Heikkilä E., Siitonen A., Jahkola M., Fling M., Sundström L., Huovinen P. Increase of trimethoprim resistance among Shigella species, 1975-1988: analysis of resistance mechanisms. J Infect Dis. 1990 Jun;161(6):1242–1248. doi: 10.1093/infdis/161.6.1242. [DOI] [PubMed] [Google Scholar]
  15. Henry F. J. The epidemiologic importance of dysentery in communities. Rev Infect Dis. 1991 Mar-Apr;13 (Suppl 4):S238–S244. doi: 10.1093/clinids/13.supplement_4.s238. [DOI] [PubMed] [Google Scholar]
  16. Hossain M. A., Albert M. J., Hasan K. Z. Epidemiology of shigellosis in Teknaf, a coastal area of Bangladesh: a 10-year survey. Epidemiol Infect. 1990 Aug;105(1):41–49. doi: 10.1017/s0950268800047622. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Kagalwalla A. F., Khan S. N., Kagalwalla Y. A., Alola S., Yaish H. Childhood shigellosis in Saudi Arabia. Pediatr Infect Dis J. 1992 Mar;11(3):215–219. doi: 10.1097/00006454-199203000-00009. [DOI] [PubMed] [Google Scholar]
  18. Lee L. A., Shapiro C. N., Hargrett-Bean N., Tauxe R. V. Hyperendemic shigellosis in the United States: a review of surveillance data for 1967-1988. J Infect Dis. 1991 Nov;164(5):894–900. doi: 10.1093/infdis/164.5.894. [DOI] [PubMed] [Google Scholar]
  19. Levine O. S., Levine M. M. Houseflies (Musca domestica) as mechanical vectors of shigellosis. Rev Infect Dis. 1991 Jul-Aug;13(4):688–696. doi: 10.1093/clinids/13.4.688. [DOI] [PubMed] [Google Scholar]
  20. Lew J. F., Swerdlow D. L., Dance M. E., Griffin P. M., Bopp C. A., Gillenwater M. J., Mercatante T., Glass R. I. An outbreak of shigellosis aboard a cruise ship caused by a multiple-antibiotic-resistant strain of Shigella flexneri. Am J Epidemiol. 1991 Aug 15;134(4):413–420. doi: 10.1093/oxfordjournals.aje.a116103. [DOI] [PubMed] [Google Scholar]
  21. Lima N. L., Pereira C. R., Souza I. C., Facanha M. C., Lima A. A., Guerrant R. L., Farr B. M. Selective surveillance for nosocomial infections in a Brazilian hospital. Infect Control Hosp Epidemiol. 1993 Apr;14(4):197–202. doi: 10.1086/646715. [DOI] [PubMed] [Google Scholar]
  22. Lolekha S., Vibulbandhitkit S., Poonyarit P. Response to antimicrobial therapy for shigellosis in Thailand. Rev Infect Dis. 1991 Mar-Apr;13 (Suppl 4):S342–S346. doi: 10.1093/clinids/13.supplement_4.s342. [DOI] [PubMed] [Google Scholar]
  23. Munshi M. H., Sack D. A., Haider K., Ahmed Z. U., Rahaman M. M., Morshed M. G. Plasmid-mediated resistance to nalidixic acid in Shigella dysenteriae type 1. Lancet. 1987 Aug 22;2(8556):419–421. doi: 10.1016/s0140-6736(87)90957-3. [DOI] [PubMed] [Google Scholar]
  24. Murray B. E. Resistance of Shigella, Salmonella, and other selected enteric pathogens to antimicrobial agents. Rev Infect Dis. 1986 May-Jun;8 (Suppl 2):S172–S181. doi: 10.1093/clinids/8.supplement_2.s172. [DOI] [PubMed] [Google Scholar]
  25. Pal S. C. Epidemic bacillary dysentery in West Bengal, India, 1984. Lancet. 1984 Jun 30;1(8392):1462–1462. doi: 10.1016/s0140-6736(84)91948-2. [DOI] [PubMed] [Google Scholar]
  26. Ronald A. R., Turck M., Petersdorf R. G. A critical evaluation of nalidixic acid in urinary-tract infections. N Engl J Med. 1966 Nov 17;275(20):1081–1089. doi: 10.1056/NEJM196611172752001. [DOI] [PubMed] [Google Scholar]
  27. Ronsmans C., Bennish M. L., Wierzba T. Diagnosis and management of dysentery by community health workers. Lancet. 1988 Sep 3;2(8610):552–555. doi: 10.1016/s0140-6736(88)92669-4. [DOI] [PubMed] [Google Scholar]
  28. Salam M. A., Bennish M. L. Antimicrobial therapy for shigellosis. Rev Infect Dis. 1991 Mar-Apr;13 (Suppl 4):S332–S341. doi: 10.1093/clinids/13.supplement_4.s332. [DOI] [PubMed] [Google Scholar]
  29. Salam M. A., Bennish M. L. Therapy for shigellosis. I. Randomized, double-blind trial of nalidixic acid in childhood shigellosis. J Pediatr. 1988 Nov;113(5):901–907. doi: 10.1016/s0022-3476(88)80029-5. [DOI] [PubMed] [Google Scholar]
  30. Tauxe R. V., Puhr N. D., Wells J. G., Hargrett-Bean N., Blake P. A. Antimicrobial resistance of Shigella isolates in the USA: the importance of international travelers. J Infect Dis. 1990 Nov;162(5):1107–1111. doi: 10.1093/infdis/162.5.1107. [DOI] [PubMed] [Google Scholar]
  31. Thisyakorn U. S., Rienprayoon S. Shigellosis in Thai children: epidemiologic, clinical and laboratory features. Pediatr Infect Dis J. 1992 Mar;11(3):213–215. doi: 10.1097/00006454-199203000-00008. [DOI] [PubMed] [Google Scholar]
  32. Tiemens K. M., Shipley P. L., Correia R. A., Shields D. S., Guerrant R. L. Sulfamethoxazole-trimethoprim-resistant Shigella flexneri in northeastern Brazil. Antimicrob Agents Chemother. 1984 May;25(5):653–654. doi: 10.1128/aac.25.5.653. [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. Voogd C. E., Schot C. S., van Leeuwen W. J., van Klingeren B. Monitoring of antibiotic resistance in shigellae isolated in The Netherlands 1984-1989. Eur J Clin Microbiol Infect Dis. 1992 Feb;11(2):164–167. doi: 10.1007/BF01967070. [DOI] [PubMed] [Google Scholar]
  34. WATANABE T. Infective heredity of multiple drug resistance in bacteria. Bacteriol Rev. 1963 Mar;27:87–115. doi: 10.1128/br.27.1.87-115.1963. [DOI] [PMC free article] [PubMed] [Google Scholar]

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