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.authorRahman, Mahbuburen_US
dc.contributor.authorShoma, Shereenen_US
dc.contributor.authorRashid, Harunuren_US
dc.contributor.authorEl Arifeen, Shamsen_US
dc.contributor.authorBaqui, A Hen_US
dc.contributor.authorSiddique, A Ken_US
dc.contributor.authorNair, G Ben_US
dc.contributor.authorSack, D Aen_US
dc.date.accessioned2007-06-08en_US
dc.date.accessioned2009-05-27T03:49:32Z
dc.date.available2007-06-08en_US
dc.date.available2009-05-27T03:49:32Z
dc.date.issued2007-06-08en_US
dc.descriptionJournal of Health, Population, and Nutrition.en_US
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 > or =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] > or =32 microg/mL) and had 10-fold higher MIC90 (0.25 microg/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 microg/mL) and nalidixic acid (MIC 128 micdrog/mL) and low to ceftriaxone (MIC 0.023 microg/mL). Conjugative R-plasmids-encoded extended-spectrum beta-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_US
dc.description.affiliationLaboratory Sciences Division, ICDDR,B GPO Box 128, Dhaka 1000 (Mohakhali, Dhaka 1212), Bangladesh. mahbubur@icddrb.orgen_US
dc.identifier.citationRahman M, Shoma S, Rashid H, El Arifeen S, Baqui AH, Siddique AK, Nair GB, Sack DA. Increasing spectrum in antimicrobial resistance of Shigella isolates in Bangladesh: resistance to azithromycin and ceftriaxone and decreased susceptibility to ciprofloxacin. Journal of Health, Population, and Nutrition. 2007 Jun; 25(2): 158-67en_US
dc.identifier.urihttps://imsear.searo.who.int/handle/123456789/547
dc.language.isoengen_US
dc.source.urihttps://www.icddrb.org/pub/publication.jsp?classificationID=30&typeClassificationID=2en_US
dc.source.urihttps://www.icddrb.org/publication.cfm?classificationID=30&pubID=8772en_US
dc.subject.meshAnti-Bacterial Agents --pharmacologyen_US
dc.subject.meshAzithromycin --pharmacologyen_US
dc.subject.meshBangladeshen_US
dc.subject.meshCeftriaxone --pharmacologyen_US
dc.subject.meshCiprofloxacin --pharmacologyen_US
dc.subject.meshColony Count, Microbialen_US
dc.subject.meshDose-Response Relationship, Drugen_US
dc.subject.meshDrug Resistance, Bacterialen_US
dc.subject.meshDrug Resistance, Multiple, Bacterialen_US
dc.subject.meshDysentery, Bacillary --drug therapyen_US
dc.subject.meshHumansen_US
dc.subject.meshMicrobial Sensitivity Testsen_US
dc.subject.meshSentinel Surveillanceen_US
dc.subject.meshShigella --drug effectsen_US
dc.subject.meshSpecies Specificityen_US
dc.subject.meshTreatment Outcomeen_US
dc.titleIncreasing spectrum in antimicrobial resistance of Shigella isolates in Bangladesh: resistance to azithromycin and ceftriaxone and decreased susceptibility to ciprofloxacin.en_US
dc.typeJournal Articleen_US
dc.typeResearch Support, Non-U.S. Gov'ten_US
dc.typeResearch Support, U.S. Gov't, Non-P.H.S.en_US
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