Antimicrobial resistance in Shigella species: Our five years (2015–2019) experience in a tertiary care center in north India

Prevalence of Multidrug-Resistant and Extended-Spectrum Beta-Lactamase-Producing Shigella Species in Asia: A Systematic Review and Meta-Analysis

“…Even though S. sonnei is traditionally most commonly found in developed countries, the species is currently dominant and undergoing an unprecedented expansion across developing countries in Asia, Latin America and the Middle East [ 3 ]. A previous study reported that Shigella infections increase during the monsoon and summer seasons, when the humidity and temperature are high [ 65 ]. S. flexneri , together with S. sonnei , are responsible for more than 90% of the global shigellosis cases [ 2 ].…”

“…In India, 67.9% of the total Shigella isolates were reported to be resistant to ciprofloxacin, and 60.2% of S. flexneri and 57.6% of S. dysenteriae were found to be resistant to the antibiotic between 2004 and 2008 [ 68 ]. In a more recent study published in 2021, resistance to ciprofloxacin was recorded in 61.5% of the total Shigella isolates in the country, and resistance rates in S. flexneri and S. sonnei isolates were reported at 63.9% and 58.3%, respectively [ 65 ]. A study in China found that the rate of resistance against ciprofloxacin was comparatively low, recorded at 11.6% of the total Shigella isolates in the past decade [ 75 ], while another study reported a higher rate of resistance of 27.9% against the antibiotic within the same period [ 71 ].…”

Functional Role of YnfA, an Efflux Transporter in Resistance to Antimicrobial Agents in Shigella flexneri

“…Extensive research work is under way to develop a Shigella vaccine but the current absence of one makes us heavily dependent on the available treatment options ( 6 ). Antimicrobial therapy along with oral rehydration is the recommended treatment by the WHO for shigellosis cases ( 8 , 10 – 12 ); however, the overuse or incorrect use of antibiotics can increase the issue of antimicrobial resistance in Shigella ( 14 – 16 , 94 – 96 ). Infections with resistant Shigella strains increase the time taken and overall cost of medical care needed which is even more problematic in developing and underdeveloped countries ( 14 – 16 , 94 – 96 ).…”

“…Antimicrobial therapy along with oral rehydration is the recommended treatment by the WHO for shigellosis cases ( 8 , 10 – 12 ); however, the overuse or incorrect use of antibiotics can increase the issue of antimicrobial resistance in Shigella ( 14 – 16 , 94 – 96 ). Infections with resistant Shigella strains increase the time taken and overall cost of medical care needed which is even more problematic in developing and underdeveloped countries ( 14 – 16 , 94 – 96 ). Resistant strains of S. flexneri and S. sonnei have already been reported over the past decades, which have shown resistance to antibiotics like ciprofloxacin, azithromycin, ceftriaxone, chloramphenicol, tetracyclines, etc., which are part of the first and second line of treatment recommended by WHO ( 14 – 16 , 94 – 96 ).…”

“…Infections with resistant Shigella strains increase the time taken and overall cost of medical care needed which is even more problematic in developing and underdeveloped countries ( 14 – 16 , 94 – 96 ). Resistant strains of S. flexneri and S. sonnei have already been reported over the past decades, which have shown resistance to antibiotics like ciprofloxacin, azithromycin, ceftriaxone, chloramphenicol, tetracyclines, etc., which are part of the first and second line of treatment recommended by WHO ( 14 – 16 , 94 – 96 ). The generation of antimicrobial resistance in bacteria can be due to various intrinsic and acquired resistance mechanisms ( 18 , 19 ), out of which the extrusion of drugs by active efflux pumps is one of the primary factors ( 18 , 19 ).…”