[Shigellosis Attended in the Emergency Department of a Regional Hospital in Southeastern Spain: from Their Presence to Multiresistance]

Overview

Journal Rev Esp Quimioter

Specialty Pharmacology

Date 2023 Mar 21

PMID 36942425

Authors

E Rodriguez-Guerrero

S Herrera-Leon

E Gomez-Vicente

J M Navarro-Mari

J Gutierrez-Fernandez

Affiliations

Soon will be listed here.

Abstract

Objective: In the bacterial etiology of severe acute infectious diarrhea, except that caused by Clostridioides difficile, most of them have an invasive character and antibiotic treatment will be necessary in specific situations. Shigella is a classic pathogen, in which it is crucial to know the sensitivity to different classic and alternative antimicrobials. The objective of this work was to analyze the presence of shigellosis and the rate of antibiotic resistance.

Methods: A descriptive-retrospective study of the reports of shigellosis of stool cultures issued between January 2016 and April 2022 was conducted.

Results: A total of 34 episodes (16 -47.1%- by Shigella sonnei) were observed, as of 2018. There were only 2 pediatric cases. The overall resistance rate to azithromycin, trimethoprim-sulfamethoxazole and ciprofloxacin was 52.9%, 64.7% and 44.1%, respectively. 26.5% were resistant to the 3 groups of antibiotics. There was a higher rate of resistance for S. sonnei. The emergence of resistance to cephalosporins in recent years stands out. Episodes of multidrug-resistant shigellosis were detected between 2020 (1 by S. flexneri) and 2022 (4 by S. sonnei).

Conclusions: The episodes of shigellosis are emerging in our environment with a higher rate of multi-resistance. In this context, current empirical treatments for acute enteroinvasive enteritis are at risk of failure, if necessary.

References

Chung The H, Baker S . Out of Asia: the independent rise and global spread of fluoroquinolone-resistant Shigella. Microb Genom. 2018; 4(4). PMC: 5989582. DOI: 10.1099/mgen.0.000171. View

Sivapalasingam S, Nelson J, Joyce K, Hoekstra M, Angulo F, Mintz E . High prevalence of antimicrobial resistance among Shigella isolates in the United States tested by the National Antimicrobial Resistance Monitoring System from 1999 to 2002. Antimicrob Agents Chemother. 2005; 50(1):49-54. PMC: 1346809. DOI: 10.1128/AAC.50.1.49-54.2006. View

Liu G, Qian H, Tang B, Chen Y, Kang H, Jiang F . Prevalence and characterisation of third-generation cephalosporin-resistant Shigella flexneri isolates from Jiangsu Province, China, 2013-2015. J Glob Antimicrob Resist. 2018; 15:283-287. DOI: 10.1016/j.jgar.2018.08.012. View

Baker K, Dallman T, Field N, Childs T, Mitchell H, Day M . Horizontal antimicrobial resistance transfer drives epidemics of multiple Shigella species. Nat Commun. 2018; 9(1):1462. PMC: 5899146. DOI: 10.1038/s41467-018-03949-8. View

Schroeder G, Hilbi H . Molecular pathogenesis of Shigella spp.: controlling host cell signaling, invasion, and death by type III secretion. Clin Microbiol Rev. 2008; 21(1):134-56. PMC: 2223840. DOI: 10.1128/CMR.00032-07. View

Mitchell H, Thomson N, Jenkins C, Dallman T, Painset A, Kirwan P . Linkage of Whole Genome Sequencing, Epidemiological, and Clinical Data to Understand the Genetic Diversity and Clinical Outcomes of Shigella flexneri among Men Who Have Sex with Men in England. Microbiol Spectr. 2021; 9(3):e0121321. PMC: 8672885. DOI: 10.1128/Spectrum.01213-21. View

Gu B, Cao Y, Pan S, Zhuang L, Yu R, Peng Z . Comparison of the prevalence and changing resistance to nalidixic acid and ciprofloxacin of Shigella between Europe-America and Asia-Africa from 1998 to 2009. Int J Antimicrob Agents. 2012; 40(1):9-17. DOI: 10.1016/j.ijantimicag.2012.02.005. View

Duong V, Tuyen H, Van Minh P, Campbell J, Le Phuc H, Nhu T . No Clinical Benefit of Empirical Antimicrobial Therapy for Pediatric Diarrhea in a High-Usage, High-Resistance Setting. Clin Infect Dis. 2017; 66(4):504-511. PMC: 5850041. DOI: 10.1093/cid/cix844. View

Bowen A, Hurd J, Hoover C, Khachadourian Y, Traphagen E, Harvey E . Importation and domestic transmission of Shigella sonnei resistant to ciprofloxacin - United States, May 2014-February 2015. MMWR Morb Mortal Wkly Rep. 2015; 64(12):318-20. PMC: 4584528. View

10.

Fagundes-Neto U, Scaletsky I . The gut at war: the consequences of enteropathogenic Escherichia coli infection as a factor of diarrhea and malnutrition. Sao Paulo Med J. 2000; 118(1):21-9. PMC: 11166243. DOI: 10.1590/s1516-31802000000100006. View

11.

DuPont H . Approach to the patient with infectious colitis. Curr Opin Gastroenterol. 2011; 28(1):39-46. DOI: 10.1097/MOG.0b013e32834d3208. View

12.

Kahsay A, Muthupandian S . A review on Sero diversity and antimicrobial resistance patterns of Shigella species in Africa, Asia and South America, 2001-2014. BMC Res Notes. 2016; 9(1):422. PMC: 5004314. DOI: 10.1186/s13104-016-2236-7. View

13.

Moreno-Mingorance A, Espinal P, Rodriguez V, Goterris L, Fabrega A, Serra-Pladevall J . Circulation of multi-drug-resistant Shigella sonnei and Shigella flexneri among men who have sex with men in Barcelona, Spain, 2015-2019. Int J Antimicrob Agents. 2021; 58(3):106378. DOI: 10.1016/j.ijantimicag.2021.106378. View

14.

Seral C, Gude M, Castillo F . [Emergence of plasmid mediated AmpC β-lactamasas: Origin, importance, detection and therapeutical options]. Rev Esp Quimioter. 2012; 25(2):89-99. View

15.

Vinh H, Wain J, Chinh M, Tam C, Trang P, Nga D . Treatment of bacillary dysentery in Vietnamese children: two doses of ofloxacin versus 5-days nalidixic acid. Trans R Soc Trop Med Hyg. 2000; 94(3):323-6. DOI: 10.1016/s0035-9203(00)90343-2. View

16.

Chang Z, Zhang J, Ran L, Sun J, Liu F, Luo L . The changing epidemiology of bacillary dysentery and characteristics of antimicrobial resistance of Shigella isolated in China from 2004-2014. BMC Infect Dis. 2016; 16(1):685. PMC: 5116132. DOI: 10.1186/s12879-016-1977-1. View

17.

Murray K, Reddy V, Kornblum J, Waechter H, Chicaiza L, Rubinstein I . Increasing Antibiotic Resistance in Shigella spp. from Infected New York City Residents, New York, USA. Emerg Infect Dis. 2017; 23(2):332-335. PMC: 5324786. DOI: 10.3201/eid2302.161203. View

18.

Naimi T, Wicklund J, Olsen S, Krause G, Wells J, Bartkus J . Concurrent outbreaks of Shigella sonnei and enterotoxigenic Escherichia coli infections associated with parsley: implications for surveillance and control of foodborne illness. J Food Prot. 2003; 66(4):535-41. DOI: 10.4315/0362-028x-66.4.535. View

19.

He Y, Li H, Lu X, Stratton C, Tang Y . Mass spectrometry biotyper system identifies enteric bacterial pathogens directly from colonies grown on selective stool culture media. J Clin Microbiol. 2010; 48(11):3888-92. PMC: 3020868. DOI: 10.1128/JCM.01290-10. View

20.

Albert M, Purohit P, Poirel L, Carter G, Bulach D . Diarrhea in an infant due to Shigella flexneri 1 carrying multiple cephalosporinase-encoding genes. Gut Pathog. 2021; 13(1):18. PMC: 7981867. DOI: 10.1186/s13099-021-00413-9. View