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Death from multi-resistant shigellosis in Fiji Islands

C Watson1

  • 1Fiji School of Medicine, Suva, Fiji. chris_w@fsm.ac.fj

Pacific Health Dialog
|May 23, 2002
PubMed

Insights

Shigellosis management in Fiji is challenged by emerging multidrug resistance, particularly to common antibiotics like chloramphenicol. This necessitates exploring alternative, effective treatments for Shigella infections in the region.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Public Health

Background:

  • Shigellosis, a significant cause of mortality in developing nations, presents a unique challenge in Fiji despite its rarity in developed countries.
  • Emerging multidrug resistance in Shigella strains poses a growing threat to effective disease management globally and within Fiji.

Observation:

  • Fiji recorded a notable increase in Shigella cases from 1996 to 1998, with a single recorded death in 1998.
  • A high prevalence of chloramphenicol resistance (82%) was observed in Shigella cases in Fiji.
  • Shigella flexneri strains in Fiji demonstrated sensitivity to cephalothin and cefaclor.

Findings:

  • Intravenous treatments with chloramphenicol and ampicillin proved ineffective due to organism resistance.
  • Current Fiji antibiotic guidelines for moderate to severe dysentery recommend chloramphenicol or nalidixic acid (unavailable locally).
  • Ceftriaxone and cephalothin are the only effective intravenous options but are costly and restricted to regional hospitals.

Implications:

  • The study highlights the urgent need for updated antibiotic guidelines in Fiji to address emerging drug resistance in Shigellosis.
  • The high cost and limited availability of effective intravenous antibiotics pose a significant barrier to treating severe Shigella cases in Fiji.
  • Further research into affordable and accessible treatment options for Shigellosis in resource-limited settings like Fiji is crucial.

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