Decreased Susceptibility to Ciprofloxacin among
            <i>Shigella</i>
            Isolates in the United States, 2006 to 2009

Folster, Jason P.; Pecic, Gary; Bowen, Anna; Rickert, Regan; Carattoli, Alessandra; Whichard, Jean M.

doi:10.1128/aac.01463-10

Cited by 49 publications

(31 citation statements)

References 20 publications

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“…Of the 18 patients for whom travel to India was documented, isolates from 55.6% were resistant to ciprofloxacin, a finding that supports previous reports of importation of ciprofloxacin-resistant Shigella from India to Europe and the United States ( 11 , 12 ) and emphasizes the need to obtain travel information from patients receiving treatment for shigellosis. Furthermore, therapeutic efficiency of fluoroquinolones may be decreased because of the presence of PMQR determinants in phenotypically susceptible strains.…”

Section: The Studysupporting

confidence: 79%

ShigellaAntimicrobial Drug Resistance Mechanisms, 2004–2014

Nüesch‐Inderbinen¹,

Heini²,

Zurfluh³

et al. 2016

Emerg. Infect. Dis.

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Section: The Studysupporting

confidence: 79%

ShigellaAntimicrobial Drug Resistance Mechanisms, 2004–2014

Nüesch‐Inderbinen¹,

Heini²,

Zurfluh³

et al. 2016

Emerg. Infect. Dis.

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“…From 2005 to 2014, there was also a gradual increase in the prevalence of Shigella bacteria resistant to cefotaxime and ciprofloxacin, which have become the first-line agents for treating bacillary dysentery in adults. Such increase in ciprofloxacin-resistant Shigella bacteria have also been observed in the United States [40, 41]. If introduced to populations in nursing homes or childcare settings, Shigella bacteria may spread rapidly and cause large protracted outbreaks.…”

Section: Discussionmentioning

confidence: 94%

The changing epidemiology of bacillary dysentery and characteristics of antimicrobial resistance of Shigella isolated in China from 2004–2014

Chang

Zhang

et al. 2016

BMC Infect Dis

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BackgroundBacillary dysentery caused by bacteria of the genus Shigella is a significant public health problem in developing countries such as China. The objective of this study was to analyze the epidemiological pattern of bacillary dysentery, the diversity of the causative agent, and the antimicrobial resistance patterns of Shigella spp. for the purpose of determining the most effective allocation of resources and prioritization of interventions.MethodsSurveillance data were acquired from the National Infectious Disease Information Reporting System (2004–2014) and from the sentinel hospital-based surveillance system (2005–2014). We analyzed the spatial and temporal distribution of bacillary dysentery, age and sex distribution, species diversity, and antimicrobial resistance patterns of Shigella spp.ResultsThe surveillance registry included over 3 million probable cases of bacillary dysentery during the period 2004–2014. The annual incidence rate of bacillary dysentery decreased from 38.03 cases per 100,000 person-years in 2004 to 11.24 cases per 100,000 person-years in 2014. The case-fatality rate decreased from 0.028% in 2004 to 0.003% in 2014. Children aged <1 year and 1–4 years were most affected, with higher incidence rates (228.59 cases per 100,000 person-years and 92.58 cases per 100,000 person-years respectively). The annual epidemic season occurred between June and September. A higher incidence rate of bacillary dysentery was found in the Northwest region, Beijing and Tianjin during the study period. Shigella flexneri was the most prevalent species that caused bacillary dysentery in China (63.86%), followed by Shigella sonnei (34.89%). Shigella isolates were highly resistant to nalidixic acid (89.13%), ampicillin (88.90%), tetracycline (88.43%), and sulfamethoxazole (82.92%). During the study period, isolates resistant to ciprofloxacin and cefotaxime increased from 8.53 and 7.87% in 2005 to 44.65 and 29.94% in 2014, respectively.ConclusionsThe incidence rate of bacillary dysentery has undergone an obvious decrease from 2004 to 2014. Priority interventions should be delivered to populations in northwest China and to individuals aged <5 years. Antimicrobial resistance of Shigella is a serious public health problem and it is important to consider the susceptibility profile of isolates before determining treatment.

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“…The declining susceptibility of bacteria to antimicrobials has become one of the most serious world public health concerns (18)(19)(20)(21). In this study, we found a high prevalence of Shigella isolates with resistance to many antimicrobials.…”

mentioning

confidence: 99%

High Prevalence of Antibiotic Resistance and Molecular Characterization of Integrons among Shigella Isolates in Eastern China

Shen

Qian

Gong

et al. 2013

Antimicrob Agents Chemother

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A total of 747 Shigella isolates were collected from hospitals in Jiangsu Province of China. Susceptibilities to antimicrobials and integrons were tested. A total of 78.3% of S. flexneri isolates and a total of 74.3% S. sonei isolates were resistant to at least three antibiotics. Of the Shigella isolates, 74.7% had integron I and 82.6% had integron II. The conjunction of the high prevalence of integrons in Shigella and high resistance to antimicrobials will lead to rapid dissemination of resistant genes in this region. Bacterial diarrhea caused by Shigella remains a considerable public health problem in the world, especially in developing countries, where the disease may cause as many as 167 million episodes of diarrhea and over a million deaths annually (1). The surveillance of shigellosis studies from multicenters showed that shigellosis was more ubiquitous than previously thought (2). In China, it was estimated that over 800 million diarrhea episodes occurred annually (3), and Shigella is one of the principal etiologic organisms for diarrhea (4). Shigella species are classified by four serogroups, including S. dysenteriae, S. flexneri, S. boydii, and S. sonnei. Of them, S. flexneri is the predominant species in most of developing countries (2, 5). Antibiotic therapy can limit the duration of shigellosis and shedding of the organism. However, resistance to the most often administered antibiotics has been increasing (5-7). The evidence from Hebei Province of China, Kuwait, and the United States showed that China has a far higher prevalence of resistance for all the bacteria studied (8).Integrons play an important role in the dissemination and recombination of antimicrobial drug resistance genes (9). They are common in Salmonella enterica and make an important contribution to the extent of antimicrobial resistance in this species (10,11). Recent studies also showed that integrons contributed to the spread of antimicrobial drug resistance genes among shigellosis cases (12). However, there are few data available to describe the prevalence of integrons of Shigella spp. circulating in China.In this study, we collected a total of 747 clinical Shigella isolates from the hospitals located in Jiangsu Province of China between January 2008 and November 2010. Stool specimens from patients with either diarrhea or dysentery were collected before the patients received antibiotics therapy and were then screened for Shigella spp. by conventional biochemical methods in local hospitals. The ages of patients ranged from 1 to 88 years. We defined diarrhea as the passage of Ն3 watery stools in a 24-h period. All isolates were identified using Rapid ID32E strips (bioMérieux Corp., Singapore) on an automatic biochemistry analyzer (Hitachi 917; Boehringer Mannheim, Japan) again. O and H antigens were characterized by slide agglutination with hyperimmune sera (Ningbo Tianrong Bio-pharmaceutical Company Limited), and the serotype was assigned to the Kauffmann-White scheme. Of these Shigella isolates, 716 were identified as Shigella; 491...

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Decreased Susceptibility to Ciprofloxacin among Shigella Isolates in the United States, 2006 to 2009

Cited by 49 publications

References 20 publications

ShigellaAntimicrobial Drug Resistance Mechanisms, 2004–2014

ShigellaAntimicrobial Drug Resistance Mechanisms, 2004–2014

The changing epidemiology of bacillary dysentery and characteristics of antimicrobial resistance of Shigella isolated in China from 2004–2014

High Prevalence of Antibiotic Resistance and Molecular Characterization of Integrons among Shigella Isolates in Eastern China

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