Drug resistance and molecular epidemiology of Shigella isolated from children with diarrhea.
- Author:
Chuan-ling ZHANG
1
;
Li-meng SHEN
;
Xu CHU
;
Jian-feng MAO
;
Hua-li DONG
Author Information
- Publication Type:Journal Article
- MeSH: Adolescent; Anti-Bacterial Agents; pharmacology; Child; Child, Preschool; Diarrhea; drug therapy; epidemiology; microbiology; Drug Resistance, Multiple, Bacterial; Feces; microbiology; Female; Genotype; Humans; Male; Microbial Sensitivity Tests; Molecular Epidemiology; Penicillanic Acid; analogs & derivatives; pharmacology; Piperacillin; pharmacology; Polymerase Chain Reaction; Sequence Analysis, DNA; Shigella; classification; drug effects; genetics; isolation & purification; beta-Lactamases; genetics; metabolism
- From: Chinese Journal of Pediatrics 2012;50(10):777-781
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo investigate the prevalence and antibiotic resistance of Shigella isolated from children with diarrhea for the guidance of clinical treatment and prevention and control of bacillary dysentery.
METHODA total of 156 strains of Shigella were isolated from feces of children with diarrhea in Zhejiang Xiaoshan Hospital from January 2008 to December 2010. The antimicrobial resistance of the strains was detected by disk diffusion method and the extended-spectrum beta-lactamases (ESBLs) in these isolates were determined using phenotypic confirmatory test; the isolates of ESBLs producing Shigella sonnei were analyzed by REP-PCR.
RESULTAmong 156 strains of Shigella isolated, the most common groups were Shigella sonnei (130 strains, accounting for 83.3%) and Shigella fleaneri (26 strains, accounting for 16.7%), and 81 (51.9%) strains were identified as ESBLs producers, and the positive rates in 2008, 2009 and 2010 were 32.0%, 41.4% and 59.8%, respectively. The results of antibiotic susceptibility test displayed that the resistance rates of ESBLs producing Shigella to ampicillin, cotrimoxazole, cefotaxime, piperacillin were higher than 90%. However, the resistance rates to cefepime, ceftazidime, levofloxacin and ciprofloxacin were low; The resistance of ESBLs producing strains to piperacillin (100% vs. 77.3%), cefotaxime (100% vs. 0), ceftazidime (14.8% vs. 0), cefepime (28.4% vs. 0), cotrimoxazole (95.1% vs. 86.7%) was significantly higher than that of non-ESBLs producing strains (χ(2) = 20.605, 156.000, 12.037, 24.979, 45.040, respectively; P < 0.05). No isolate was resistant to piperacillin/tazobactam and imipenem. There were 7 genotypes among 74 ESBLs producing Shigella sonnei, respectively type A (50), type B (12), type C (8), type D (1), type E (1), type F (1), and type G (1).
CONCLUSIONThe isolation rate of ESBLs-producing isolate was high in Shigella from pediatric patients with diarrhea, and the number is going up year by year, and these ESBLs producing Shigella sonnei strains in genotype A are dominant in recent years, Piperacillin/tazobactam is the drug of choice for children with ESBLs producing Shigella infection.
