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Diarrhea associated with Shigella in children and susceptibility to antimicrobials

Maria Rosário C M Nunes1, Paula P Magalhães, Francisco J Penna

  • 1Departamento de Parasitologia e Microbiologia, Centro de Ciências da Saúde, Universidade Federal do Piauí, Teresina, PI, Brazil.

Jornal De Pediatria
|November 18, 2011
PubMed

Insights

Shigella infections were found in children with diarrhea in Brazil, showing resistance to common antibiotics like ampicillin and sulphametoxazole-trimethoprim. Extended-spectrum beta-lactamase (ESBL) was not detected in these Shigella strains.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Pediatrics

Background:

  • Shigella is a significant cause of bacterial gastroenteritis in children worldwide.
  • Antimicrobial resistance in Shigella poses a growing public health challenge, complicating treatment options.
  • Understanding local resistance patterns is crucial for effective management of shigellosis.

Purpose of the Study:

  • To determine the prevalence and antimicrobial susceptibility of Shigella isolates from children with and without acute diarrhea in Teresina, Piauí, Brazil.
  • To assess the presence of extended-spectrum beta-lactamase (ESBL) production in Shigella strains.
  • To inform local treatment guidelines for shigellosis.

Main Methods:

  • A study involving 400 children (up to 60 months) in Teresina, Brazil, from January 2004 to August 2007.
  • Stool samples were collected and analyzed for Shigella identification using conventional microbiological methods.
  • Antimicrobial susceptibility testing (antibiogram) and screening for extended-spectrum beta-lactamase (ESBL) production via agar diffusion were performed.

Main Results:

  • Shigella was identified in 10.4% (26/250) of children with acute diarrhea, predominantly in those aged 6-24 months during the rainy season.
  • All identified Shigella strains were susceptible to ceftriaxone, ciprofloxacin, and nalidixic acid.
  • Over 50% of Shigella strains exhibited resistance to sulphametoxazole-trimethoprim and ampicillin; no ESBL production was detected.

Conclusions:

  • Shigella flexneri is a common pathogen causing diarrhea in children in Teresina.
  • The high prevalence of resistance to ampicillin and sulphametoxazole-trimethoprim is concerning due to their widespread use in clinical practice and treatment recommendations.
  • The absence of ESBL-producing strains suggests alternative treatment options may still be viable, but continuous monitoring for resistance is essential.
Abstract

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