Diarrhea in an Infant Due to Shigella Flexneri 1 Carrying Multiple Cephalosporinase-encoding Genes

Overview

Journal Gut Pathog

Publisher Biomed Central

Specialty Gastroenterology

Date 2021 Mar 21

PMID 33743818

Citations 2

Authors

M John Albert

Prashant Purohit

Laurent Poirel

Glen Carter

Dieter Bulach

Affiliations

Soon will be listed here.

Abstract

Background: Infections caused by multidrug-resistant shigellae resistant to broad-spectrum cephalosporins are becoming more prevalent in the Middle East. We report a case of severe diarrhea due to a multiresistant Shigella flexneri 1 strain carrying four different ß-lactamase genes.

Case Presentation: A one-year-old Syrian infant presented with severe acute diarrhea, vomiting and dehydration. She did not respond to empirical treatment with amoxicillin-clavulanic acid followed by cefotaxime. Later, stool culture revealed S. flexneri 1 resistant to both these drugs. The patient was successfully treated with meropenem to which S. flexneri 1 was susceptible. The isolate was resistant to eight classes of antibiotics, and the whole genome sequence (WGS) identified four ß-lactamase genes (bla, bla, bla, and bla) along with genes mediating resistance to seven other antibiotic classes. The WGS also identified several virulence genes including senA that encodes ShET-2 which induces watery diarrhea. Phylogenetically, the isolate was closely related to isolates from South Asia.

Conclusions: This report highlights the emergence of extremely resistant Shigella that has acquired multiple resistance genes to cephalosporins rendering these drugs ineffective.

Citing Articles

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[Shigellosis attended in the emergency department of a regional hospital in southeastern Spain: from their presence to multiresistance].

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