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Antimicrobial resistance of Shigella isolates causing traveler's diarrhea
1Department of Microbiology, University of Barcelona, School of Medicine, Spain.
Abstract:
Shigella isolates were identified as a cause of traveler's diarrhea in 67 (10%) of 675 patients and were tested for resistance to seven antimicrobial agents in a comparative study with those causing nontraveler's diarrhea in Spain. Ampicillin and chloramphenicol resistance was more frequent in Shigella flexneri (60 and 46%, respectively) than in Shigella sonnei (32 and 18%, respectively) and in travel-related isolates (P < 0.05 and 0.04, respectively). Of S. sonnei isolates from patients with traveler's diarrhea, 73 and 54% showed tetracycline and trimethoprim-sulfamethoxazole resistance, respectively, compared with only 8% of isolates from patients without a history of travel to developing countries (P < 0.007 and P < 0.0002). Low-level resistance to cephalosporins was found, whereas quinolone-resistant strains were not detected among travel-related Shigella isolates. Thus, quinolones may be an effective alternative therapy for travel-related shigellosis.
Insights
Shigella bacteria cause traveler's diarrhea, with higher resistance to common antibiotics like ampicillin and tetracycline in travel-related cases. Quinolones show promise as an effective treatment for this infection.
Area of Science:
- Infectious Diseases
- Microbiology
- Public Health
Background:
- Traveler's diarrhea is frequently caused by Shigella species.
- Antimicrobial resistance in Shigella poses a significant public health challenge, particularly for travelers.
Purpose of the Study:
- To compare antimicrobial resistance patterns of Shigella isolates from traveler's diarrhea versus non-traveler's diarrhea in Spain.
- To identify effective treatment options for travel-related shigellosis.
Main Methods:
- Comparative study of Shigella isolates from 675 patients.
- Antimicrobial susceptibility testing against seven agents (ampicillin, chloramphenicol, tetracycline, trimethoprim-sulfamethoxazole, cephalosporins, quinolones).
Main Results:
- Ampicillin and chloramphenicol resistance were higher in Shigella flexneri and travel-related isolates.
- Shigella sonnei from traveler's diarrhea showed significantly higher resistance to tetracycline (73%) and trimethoprim-sulfamethoxazole (54%) compared to non-travelers.
- No quinolone-resistant Shigella strains were detected in travel-related isolates.
Conclusions:
- Travel-related Shigella infections exhibit distinct antimicrobial resistance profiles.
- Quinolones represent a potentially effective therapeutic option for travel-related shigellosis due to the absence of detected resistance.