Antimicrobial-resistant Shigella infections from Iran: an overlooked problem?

Tajbakhsh, Mercedeh; Migura-García, Lourdes; Rahbar, Mohammad; Svendsen, Christina Aaby; Mohammadzadeh, Mona; Zali, Mohammad Reza; Aarestrup, Frank Møller; Hendriksen, René S.

doi:10.1093/jac/dks023

Cited by 69 publications

(50 citation statements)

References 27 publications

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“…Every isolate that was resistant to chloramphenicol (26 of 47) was also resistant to the three other antibiotics above. These findings are consistent with recent observations in PNG and other low-income settings [24][25][26][27]. Multiple antibiotic resistance was also observed in S. Typhi.…”

Section: Discussionsupporting

confidence: 92%

Antibiotic resistant Shigella is a major cause of diarrhoea in the Highlands of Papua New Guinea

Greenhill

Guwada

Siba

et al. 2014

J Infect Dev Ctries

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Introduction: Diarrhoea remains a major cause of illness in Papua New Guinea (PNG); however, little is known about its aetiology. As a result of the cholera outbreak that spread throughout PNG in 2009-2011, we conducted diarrhoeal surveillance in Eastern Highlands Province. Methodology: Following informed consent and a brief questionnaire, participants provided a stool sample or duplicate rectal swabs. Samples were tested for common bacterial pathogens Salmonella spp., Shigella spp., Vibrio spp., Campylobacter spp. and Yersinia enterocolitica using established culture methods. Enteric parasites were detected using microscopy. Results: A total of 216 participants were enrolled; where age was recorded, 42% were under 5 years of age, 6.7% were 5 to 17 years of age and 51.3% ≥18 years of age. One or more pathogens were detected in 68 (31.5%) participants, with Shigella (primarily S. flexneri) being the most commonly isolated (47 of 216 participants). Enteric parasites were detected in 23 of the 216 participants, occurring as a co-infection with another pathogen in 12 of 23 cases. No Vibrio cholerae was detected. Shigella isolates were commonly resistant to ampicillin, tetracycline, co-trimoxazole and chloramphenicol. Conclusions: Shigellae, specifically S. flexneri, are important pathogens in the highlands of PNG. While most studies in low-income settings focus on childhood aetiology, we have demonstrated the importance of Shigella in both children and adults. Enteric parasites remain present and presumably contribute to the burden of gastrointestinal illness. While improvements in sanitation and hygiene would help lower the burden of all aetiologies of infectious diarrhoea, additional control strategies targeting Shigella may also be warranted.

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Section: Discussionsupporting

confidence: 92%

Antibiotic resistant Shigella is a major cause of diarrhoea in the Highlands of Papua New Guinea

Greenhill

Guwada

Siba

et al. 2014

J Infect Dev Ctries

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“…Also one S. sonnei isolate had CMY-59 gene. The ESBL-producing Shigella isolates in this study were higher than previous studies in other countries (Tajbakhsh et al, 2012). Therefore, the prevalence of ESBL-producing GNB in the central part of Iran was between 2.3% and 89.8% and the average prevalence of ESBL-producing GNB in the central part of Iran was 43.55% in hospitals and community samples.…”

Section: Central Part Of Irancontrasting

confidence: 63%

“…Another study that was conducted in a major pediatric hospital in Tehran showed that 4 out of 55 Shigella isolates, including three S. sonnei and one S. flexneri, had ESBL-positive phenotype (Tajbakhsh et al, 2012). Also one S. sonnei isolate had CMY-59 gene.…”

Section: Central Part Of Iranmentioning

confidence: 99%

Extended-Spectrum Beta-Lactamase Producing Gram Negative Bacteria in Iran: A Review

Leylabadlo¹,

Pourlak²,

Bialvaei³

et al. 2017

AJID

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Background: The emergence and spread of extended spectrum β-lactamase (ESBL)-producing Gram-negative bacteria (GNB), particularly in Enterobacteriaceae, Acinetobacter baumannii, and Pseudomonas aeruginosa, have increased all over the world. ESBLs are characterized by their ability to hydrolyze β-lactams, early cephalosporins, oxyimino-thiazolyl cephalosporins, and monobactams, but not cephamycins or carbapenems. The rate of nosocomial infections caused by ESBL-producing GNB in Asia Pacific has increased and several studies have identified their prevalence in the region. The aim of this study is to review the prevalence of ESBL-producing GNB in the West Asia and the Middle East with a particular focus on Iran. Materials and Methods: The available evidence from various studies (Microbia and clinical studies, retrieved from the PubMed, and Scopus databases) regarding the ESBL producing Gram negative bacteria in Iran were evaluated. Results:In almost all parts of the country, high resistance has been observed, especially in the central part of Iran. Up to 89.8% Escherichia coli, 72.1% Klebsiella pneumonia, 84.2% Acinetobacter baumannii, and 83.8% Pseudomonas aeruginosa isolates are ESBL positive. Conclusion:The present study showed the increasing prevalence of ESBLs in different regions of Iran, which could be useful to strategic policy towards reducing reduce their prevalence.

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“…Shigellosis is predominantly caused by S. sonnei in industrialized countries, whereas S. flexneri prevails in the developing world (17,18). In this study, S. sonnei (61.1%, n = 22) was the most common, followed by S. flexneri (27.8%, n=10), S. boydii (8.3%, n = 3), and S. dysenteriae (2.8%, n = 1).…”

Section: Discussionmentioning

confidence: 58%

Prevalence and Antibiotic Susceptibility of Shigella Species Isolated From Pediatric Patients in Tehran

Talebreza

Memariani

et al. 2015

Arch Pediatr Infect Dis

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Background: Dysentery accounts for a significant proportion of morbidity and mortality cases, especially in children with diarrhea in developing countries. Shigellosis remains a public health problem in Iran. Objectives: The objectives of this study were to investigate the presence and the frequency of Shigella spp. among children younger than 10 years with diarrhea and to determine the antimicrobial resistance patterns of these isolates in Tehran, Iran. Patients and Methods: This cross-sectional study was conducted in two pediatric hospitals in Tehran, from October, 2013 to October, 2014. Nine hundred and thirty-eight (n = 938) stool samples were collected (one stool per patient) from children less than 10 years of age. The stools were primarily cultured on MacConkey agar and xylose lysine deoxycholate (XLD). (Selenite-F broth is also used as an enrichment medium for the isolation of Shigella spp.) All of the isolates were confirmed as Shigella species by biochemical and serological tests. Molecular confirmation of Shigella isolates was determined by polymerase chain reaction (PCR) using specific primers for the ipaH gene. The antibiotic susceptibility of the Shigella isolates was tested using the Kirby-Bauer disc-diffusion method. Results: Amongst 938 stool samples, 36 were Shigella spp. S. sonnei (61.1%, n = 22), which was the most common, followed by S. flexneri (27.8%, n = 10), S. boydii (8.3%, n = 3), and S. dysenteriae (2.8%, n = 1). Furthermore, most Shigella isolates showed resistance to amoxicillin (83.3%), tetracycline (61.1%), and co-trimoxazole (83.3%). No resistance was found against ciprofloxacin and imipenem. This study showed that S. sonnei is currently the predominant species in Tehran, Iran. Conclusions: Because resistance to antibiotics changes constantly, Shigella strains should be under surveillance in order to monitor local susceptibility and subsequently formulate policies for the use of antimicrobial drugs.

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Antimicrobial-resistant Shigella infections from Iran: an overlooked problem?

Cited by 69 publications

References 27 publications

Antibiotic resistant Shigella is a major cause of diarrhoea in the Highlands of Papua New Guinea

Antibiotic resistant Shigella is a major cause of diarrhoea in the Highlands of Papua New Guinea

Extended-Spectrum Beta-Lactamase Producing Gram Negative Bacteria in Iran: A Review

Prevalence and Antibiotic Susceptibility of Shigella Species Isolated From Pediatric Patients in Tehran

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