Ceftriaxone resistant Shigella flexneri, an emerging problem

Area of Science:

• Microbiology
• Infectious Diseases
• Antimicrobial Resistance

Background:

• Shigellosis is a significant public health concern, particularly in developing nations, presenting with symptoms ranging from mild diarrhea to severe dysentery.
• The global rise of multi-drug resistant (MDR) Shigella strains poses a serious threat to effective treatment strategies.
• Ceftriaxone and ciprofloxacin are primary therapeutic choices for managing MDR Shigella infections.

Observation:

• This report details a case of MDR Shigella flexneri infection in an immunocompromised individual.
• The identified Shigella flexneri strain exhibited resistance to ceftriaxone (minimum inhibitory concentration [MIC] ≥ 64 μg/ml) and ciprofloxacin (MIC ≥ 4 μg/ml).

Findings:

• The MDR Shigella flexneri isolate demonstrated resistance to both ceftriaxone and ciprofloxacin, critical antibiotics for MDR cases.
• Notably, the strain remained susceptible to ceftazidime, with an MIC of 4 μg/ml.
• This case represents the first documented instance of ceftriaxone-resistant Shigella species within the reporting hospital's records.

Implications:

• The emergence of ceftriaxone-resistant Shigella strains necessitates a review of current treatment guidelines for shigellosis.
• Susceptibility to ceftazidime in this MDR strain highlights its potential as an alternative therapeutic option.
• This finding underscores the importance of ongoing surveillance and antimicrobial resistance monitoring to combat the spread of resistant pathogens.