Emerging Ceftriaxone Resistance in Paediatric Shigella sonnei: A 10-Year Retrospective Study

Area of Science:

• Microbiology
• Infectious Diseases
• Public Health

Background:

• Antimicrobial resistance (AMR) is a growing global health threat.
• Shigella sonnei infections are common in children, posing a significant public health challenge.
• Emerging resistance to key antibiotics like ceftriaxone complicates treatment options.

Purpose of the Study:

• To evaluate temporal trends in antimicrobial resistance patterns of Shigella sonnei.
• To specifically investigate the emergence and prevalence of ceftriaxone-resistant Shigella sonnei strains.
• To analyze clinical features associated with ceftriaxone resistance in pediatric patients.

Main Methods:

• A 10-year retrospective study of pediatric Shigella sonnei cases diagnosed via stool culture.
• Review of clinical data, laboratory results, and length of hospital stay.
• Analysis of trends in ceftriaxone resistance and comparison between resistant and sensitive isolates.

Main Results:

• 180 pediatric Shigella sonnei cases were analyzed; 11.9% of isolates were ceftriaxone-resistant.
• A significant increase in ceftriaxone resistance was observed, particularly from 2022 onwards (p < 0.001).
• Resistant cases were associated with lower neutrophil and sodium levels.

Conclusions:

• Ceftriaxone-resistant Shigella sonnei has emerged rapidly in pediatric populations in Israel since 2022.
• This trend mirrors increasing global antimicrobial resistance patterns.
• Urgent need for enhanced AMR surveillance and updated empiric treatment guidelines for childhood shigellosis.