Increase of Trimethoprim Resistance among Shigella Species, 1975-1988: Analysis of Resistance Mechanisms

Heikkilä, Elli; Siitonen, Anja; Jahkola, M; Fling, Mary E.; Sundström, Lars; Huovinen, Pentti

doi:10.1093/infdis/161.6.1242

Cited by 46 publications

(51 citation statements)

References 37 publications

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“…However, surveillance studies to determine the changes occurring in the patterns of antimicrobial susceptibility have not been conducted. There have also been reports in the literature that the high prevalence of resistance to TMP in Shigella species is paralleled by a similar increase among isolates of E. coli [6,7]. Because of our recent observations of the high percentage of antimicrobial resistance among Shigella spp.…”

Section: Introductionmentioning

confidence: 79%

Transferable high-level trimethoprim resistance among isolates ofEscherichia colifrom urinary tract infections in Ontario, Canada

Harnett¹

1992

Epidemiol. Infect.

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SUMMARYOf 1171 isolates of Escherichia coli isolated from urine samples at the Public Health Laboratory, Toronto, Ontario, Canada, between May 1990 and December 1991, 120 (10-3 %) were resistant to trimethoprim (TMP), cotrimoxazole (TMP/SMX), sulfamethoxazole (SMX) and other antimicrobial agents; 110 of the 120 isolates (91-7 %) were resistant to four or more agents. The majority of Nalidixic acid resistance was present among 22 (18-3 %) of the 120 resistant isolates, however, nalidixic acid resistance was not transferred to E. coli K-12.

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Section: Introductionmentioning

confidence: 79%

Transferable high-level trimethoprim resistance among isolates ofEscherichia colifrom urinary tract infections in Ontario, Canada

Harnett¹

1992

Epidemiol. Infect.

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“…As sulfas foram as primeiras drogas utilizadas para esse fim. Entretanto, espé-cies multiresistentes, especialmente a essas duas drogas, foram descritas por vários autores 8,18 . Ling et.…”

Section: Discussionunclassified

“…Entretanto, vários estudos oriundos de diversas localidades do mundo têm demonstrado alta e crescente resistência de espécies de Shigella aos antimicrobianos 2,6,7 . As drogas rotineiramente recomendadas para o tratamento -ampicilina e sulfametoxazol-trimetoprim -apresentam, no momento, altos percentuais de resistência [7][8][9] . Assim, algumas outras drogas têm sido utilizadas para o tratamento da shigelose.…”

Section: Introductionunclassified

Study of in vitro antimicrobial resistance of positive coprocultures to Shigella sp.

Ba¹,

A²,

Ar³

et al. 1997

J Pediatr (Rio J)

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ResumoIntrodução: A gastroenterite causada pela Shigella sp (shigelose) representa importante causa de morbimortalidade, especialmente em crianças abaixo de 2 anos de idade. Sabe-se que o tratamento antimicrobiano adequado pode melhorar o quadro clíni-co e diminuir a disseminação da doença. Têm sido descritos níveis crescentes de resistência aos antimicrobianos comumente usados para o tratamento, e a sensibilidade da Shigella não foi recentemente avaliada em nosso meio.Objetivo: Avaliar a resistência antimicrobiana das espécies de Shigella em nosso meio.Método: Delineou-se um estudo retrospectivo, utilizando-se 106 coproculturas de pacientes, hospitalizados ou não, que tenham procurado atendimento no HCPA ou no HPV durante o período de 1994 a 1996 com diagnóstico de shigelose firmado por coprocultura e que tenham realizado teste de sensibilidade bacteriana a pelo menos um antibiótico através da técnica de difusão de disco de Kirby-Bauer.Resultados: Das 106 coproculturas estudadas, 35 (33%) foram provenientes do HPV e 71 (67%) do HCPA. Em relação às espécies, 58,5% foram S.flexneri, 39,6% S. sonnei, 0,9% S. dysenteriae e 0,9% S. boydii. Os níveis de resistência aos antibióticos usualmente recomendados para o tratamento foram: ampicilina -57,5%, sulfametoxazol-trimetoprim -75,5% e ácido nalidíxico -7,5%.Conclusões: Esses resultados mostram significativa (p < 0,001) resistência antimicrobiana in vitro à ampicilina e ao sulfametoxazol-trimetoprim e baixa resistência ao ácido nalidíxico entre Shigella sp. Assim, o ácido nalidíxico pode ser considerado uma opção para o tratamento de infecções causadas por organismos resistentes. J. pediatr. (Rio J.). 1997; 73(6):395-400: diarréia bacteriana, shigelose, resistência antimicrobiana. AbstractBackground: The gastroenteritis caused by Shigella sp (shigellosis) represents an important cause of morbimortality, especially in children under two years old. It is well known that the proper antimicrobial therapy can improve clinical state and diminish the disease dissemination. Increasing levels of resistance to drugs commonly used in the treatment of shigellosis have been described, and its sensibility has not been recently evaluated in our setting.Objective: To evaluate the Shigella antimicrobial resistance in our setting.Methods: A retrospective study was conducted using 106 coprocultures of patients, hospitalized or not, who have been assisted at HCPA and at HPV, during the period of 1994 to 1996, with the sensibility test done through the Kirby-Bauer technique of diffusion discs.Results: Out of the 106 coprocultures studied, 35 (33%) came from HPV and 71 (67%), from HCPA. Considering the species, 58.8% were S.flexneri, 39.6%, S.sonnei, 0.9%, S.disenteriae and 0.9%, S. boydii. The resistance levels to usually indicated antibiotics were: ampicillin -57.5%, trimethropim-sulfamethoxazol -75.5%, and nalidixic acid -7.5%.Conclusions: These results show significant (p <0.001) in vitro antimicrobial resistance to ampicillin and trimethoprimsulfamethoxazol and low resistance to nalidi...

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“…Shigella is a highly infectious agent, and antibiotic treatment may be necessary to manage infection and reduce fecal excretion of the bacterium to prevent further transmission. Treatment of shigellosis has been confounded by widespread resistance to commonly used antibiotics such as ampicillin, trimethoprimsulfamethoxazole (cotrimoxazole), nalidixic acid, and tetracycline (5,10,12,13,17,20). Resistance to these antibiotics may be plasmid, transposon, and/or chromosome mediated (5, 18).…”

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confidence: 99%

Epidemic Strains of Shigella sonnei Biotype g Carrying Integrons

et al. 2002

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Class 2 integrons (Tn7) were found in all randomly selected epidemic (n ‫؍‬ 27) and preepidemic (n ‫؍‬ 13) strains of multiresistant Shigella sonnei biotype g. A class 1 integron was also found in two epidemic strains. Gene cassettes within these integrons account for resistance to commonly used therapeutic agents.Shigella species are a common cause of severe gastroenteritis characterized by excretion of stools containing white cells and blood. Infection may lead to dehydration and sometimes death, particularly in immunocompromised individuals. Shigella is a highly infectious agent, and antibiotic treatment may be necessary to manage infection and reduce fecal excretion of the bacterium to prevent further transmission. Treatment of shigellosis has been confounded by widespread resistance to commonly used antibiotics such as ampicillin, trimethoprimsulfamethoxazole (cotrimoxazole), nalidixic acid, and tetracycline (5,10,12,13,17,20). Resistance to these antibiotics may be plasmid, transposon, and/or chromosome mediated (5, 18). Mobile genetic elements (integrons) are found on these genetic entities and are responsible for the horizontal transfer of antibiotic resistance among gram-negative bacilli (11,26). Integrons containing the resistance genes dfrA1 and oxa-1 have been shown to confer Shigella sonnei resistant to trimethoprim (dfrA1) and ampicillin (oxa-1), respectively (17). In this study, we focused on multiresistant strains of S. sonnei biotype g isolated in Sydney, Australia. Isolates collected during an epidemic of shigellosis among homosexual men were compared with strains from the previous 3 years for resistance phenotypes and genotypes. The aim of this study was to determine whether integrons are present in a random selection of strains representative of this epidemic and the antecedent 3-year period and whether these mobile genetic elements contribute to the antibiotic susceptibility pattern detected.In Sydney, between January and July 2000, 148 cases of gastrointestinal infections caused by S. sonnei biotype g were reported to the South Eastern Sydney Public Health Unit (1). In the previous 10 years there had been an average of 95 cases of shigellosis in this state, approximately 50% of which were attributable to S. sonnei biotype g. Over 90% of cases during the epidemic occurred in homosexual men aged 20 to 40 years and were strongly linked with having attended sex-on-premises venues (B. O'Sullivan, V. Delpech, G. Pontivivo, and J. McAnulty, Abstr. Communicable Diseases Control Conf., Canberra, abstr. 31, 2001). A number of these patients were HIV-positive and required hospitalization (1). Antibiotic susceptibility surveillance since 1997 by a laboratory within the eastern Sydney area (St Vincent's Hospital, Darlinghurst) detected a change in susceptibility pattern to commonly used therapeutic agents. Of 126 strains tested, those isolated during 2000 (epidemic strains) were more likely to be resistant to ampicillin than strains isolated during the previous 3 years (86 versus 16%) ( Table 1). In t...

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Increase of Trimethoprim Resistance among Shigella Species, 1975-1988: Analysis of Resistance Mechanisms

Cited by 46 publications

References 37 publications

Transferable high-level trimethoprim resistance among isolates ofEscherichia colifrom urinary tract infections in Ontario, Canada

Transferable high-level trimethoprim resistance among isolates ofEscherichia colifrom urinary tract infections in Ontario, Canada

Study of in vitro antimicrobial resistance of positive coprocultures to Shigella sp.

Epidemic Strains of Shigella sonnei Biotype g Carrying Integrons

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