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Widespread Antibiotic Resistance of Diarrheagenic Escherichia Coli and Shigella Species



Sadeghabadi AF1 ; Ajami A1 ; Fadaei R1 ; Zandieh M1 ; Heidari E1 ; Sadeghi M1 ; Ataei B2 ; Hoseini SG3
Authors
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Authors Affiliations
  1. 1. Isfahan Provincial Health Center, Isfahan University of Medical Sciences, Isfahan, Iran
  2. 2. Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
  3. 3. Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran

Source: Journal of Research in Medical Sciences Published:2014

Abstract

Background: Antibiotic resistance of enteric pathogens particularly Shigella species, is a critical world-wide problem and monitoring their resistant pattern is essential, because the choice of antibiotics is absolutely dependent on regional antibiotic susceptibility patterns. During summer 2013, an unusual increase in number of diarrheal diseases was noticed in Isfahan, a central province of Iran. Th erefore, the antibiotic resistance of diarrheagenic Escherichia coli and Shigella species isolated were evaluated. Materials and Methods: According to the guideline on National Surveillance System for Foodborn Diseases, random samples from patients with acute diarrhea were examined in local laboratories of health centers and samples suspicious of Shigella spp. were further assessed in referral laboratory. Isolated pathogens were identifi ed by standard biochemical and serologic tests and antibiotic susceptibility testing was carried out by disc diff usion method. Results: A total of 1086 specimens were obtained and 58 samples suspicious of Shigella were specifi cally evaluated. Th e most prevalent isolated pathogen was Shigella sonnei (26/58) followed by E. coli (25/58) and Shigella fl exneri (3/58). A large number of isolated bacteria were resistant to co-trimoxazole (Shigella spp: 100%, E. coli: 80%), azithromycin (Shigella spp: 70.4%, E. coli: 44.0%), ceftriaxone (Shigella spp: 88.9%, E. coli: 56.0%) and cefi xime (Shigella spp: 85.2%, E. coli: 68.0%). About88.3% of S. sonnei isolates, one S. fl exneri isolate, and 56% of E. coli strains were resistant to at least three antibiotic classes (multidrug resistant). Conclusion: Due to high levels of resistance to recommended and commonly used antibiotics for diarrhea, continuous monitoring of antibiotic resistance seems essential for determining best options of empirical therapy.
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