Ann Lab Med.  2013 Mar;33(2):111-115. 10.3343/alm.2013.33.2.111.

Surveillance of Antimicrobial Susceptibility Patterns among Shigella Species Isolated in China during the 7-Year Period of 2005-2011

• Yang H
• Chen G
• Zhu Y
• Liu Y
• Cheng J
• Hu L
• Ye Y
• Li J

• KMID: 1781309
• DOI: http://doi.org/10.3343/alm.2013.33.2.111

Abstract

BACKGROUND
Shigella is a frequent cause of bacterial dysentery in the developing world. Treatment with antibiotics is recommended for shigellosis, but the options are limited due to globally emerging resistance. This study was conducted to determine the frequency and pattern of antimicrobial susceptibility of Shigella in China.
METHODS
We studied the antimicrobial resistance profiles of 308 Shigella spp. strains (260 S. flexneri, 40 S. sonnei, 5 S. boydii, and 3 S. dysenteriae) isolated from fecal samples of patients (age, from 3 months to 92 yr) presenting with diarrhea in different districts of Anhui, China. The antimicrobial resistance of strains was determined by the agar dilution method according to the CSLI guidelines.
RESULTS
The most common serogroup in the Shigella isolates was S. flexneri (n=260, 84.4%), followed by S. sonnei (n=40, 13.0%). The highest resistance rate was found for nalidixic acid (96.4%), followed by ampicillin (93.2%), tetracycline (90.9%), and trimethoprim/sulfamethoxazole (80.8%). Among the isolates tested, 280 (91.0%) were multidrug resistant (resistant to > or =2 agents). The most common resistance pattern was the combination of ampicillin, tetracycline, and trimethoprim/sulfamethoxazole (70.8%). Resistance to ampicillin and tetracycline were more common among S. flexneri than among S. sonnei isolates.
CONCLUSIONS
S. flexneri is predominant in Anhui, China, and its higher antimicrobial resistance rate compared with that of S. sonnei is a cause for concern. Continuous monitoring of resistance patterns is necessary to control the spread of resistance in Shigella. The recommendations for antimicrobial treatment must be updated regularly based on surveillance results.

Keyword

Antimicrobial susceptibility; Antimicrobial resistance; Shigella

MeSH Terms

Adolescent
Adult
Aged
Aged, 80 and over
Ampicillin/pharmacology
Anti-Infective Agents/*pharmacology
Child
Child, Preschool
China
Drug Resistance, Bacterial/drug effects
Dysentery, Bacillary/*diagnosis/microbiology
Feces/microbiology
Humans
Infant
Microbial Sensitivity Tests
Middle Aged
Nalidixic Acid/pharmacology
Shigella/*drug effects/isolation & purification
Shigella flexneri/drug effects/isolation & purification
Shigella sonnei/drug effects/isolation & purification
Tetracycline/pharmacology
Time Factors
Trimethoprim-Sulfamethoxazole Combination/pharmacology
Young Adult
Anti-Infective Agents
Nalidixic Acid
Tetracycline
Ampicillin
Trimethoprim-Sulfamethoxazole Combination

Figure

• 

  Fig. 1 Yearly distribution of Shigella isolates.

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