Quinolone-resistant Shigella flexneri Isolated in a Patient Who Travelled to India.
10.3343/alm.2012.32.5.366
- Author:
You La JEON
1
;
You Sun NAM
;
Gayoung LIM
;
Sun Young CHO
;
Yun Tae KIM
;
Ji Hyun JANG
;
Junyoung KIM
;
Misun PARK
;
Hee Joo LEE
Author Information
1. Department of Medicine, Graduate School, Kyung Hee University, Seoul, Korea.
- Publication Type:Case Reports
- Keywords:
Quinolone resistance;
Shigella flexneri;
Ciprofloxacin resistance
- MeSH:
Anti-Bacterial Agents/pharmacology;
Bacterial Proteins/genetics/metabolism;
Drug Resistance, Bacterial/drug effects;
Dysentery, Bacillary/microbiology;
Feces/microbiology;
Female;
Humans;
India;
Mutation;
Quinolones/*pharmacology;
Shigella flexneri/drug effects/*isolation & purification/metabolism;
Travel;
Young Adult
- From:Annals of Laboratory Medicine
2012;32(5):366-369
- CountryRepublic of Korea
- Language:English
-
Abstract:
We report a recent case in which ciprofloxacin-resistant Shigella flexneri was isolated from a 23-yr-old female patient with a history of travel to India. Prior to her admission to our internal medicine department, she experienced symptoms of high fever and generalized weakness from continuous watery diarrhea that developed midway during the trip. S. flexneri was isolated from the stool culture. Despite initial treatment with ciprofloxacin, the stool cultures continued to show S. flexneri growth. In the susceptibility test for antibiotics of the quinolone family, the isolate showed resistance to ciprofloxacin (minimum inhibitory concentration [MIC], 8 microg/mL), norfloxacin (MIC, 32 microg/mL), ofloxacin (MIC, 8 microg/mL), nalidixic acid (MIC, 256 microg/mL), and intermediate resistance to levofloxacin (MIC, 4 microg/mL). In molecular studies for quinolone resistance related genes, plasmid borne-quinolone resistance genes such as qnrA, qnrB, qnrS, aac(6')-Ib-cr, qepA, and oqxAB were not detected. Two mutations were observed in gyrA (248C-->T, 259G-->A) and 1 mutation in parC (239G-->T). The molecular characteristics of the isolated S. flexneri showed that the isolate was more similar to the strains isolated from the dysentery outbreak in India than those isolated from Korea.
