Serotyping and antibiotic susceptibility patterns of Vibrio and Shigella isolates from diarrheal patients visiting a Tropical and Infectious Diseases Hospital in central Nepal

Abstract

BackgroundDiarrheal diseases are the major infectious disease in developing countries like Nepal. Lack of proper sanitation and antimicrobial resistance gained by microbes have challenged to address diarrheal diseases in resource-limited countries. Early diagnosis of disease and proper antibiotic treatment can significantly reduce the disease burden. This study was designed to determine the recent antimicrobial susceptibility pattern of Vibrio cholerae and Shigella spp. to assure the proper antibiotic treatment. Stool specimens were processed following microbiological protocol and identified by biochemical and serological tests recommended by the Clinical Laboratory Standard Institute.ResultsOut of total 640 analyzed stool samples, 50 were culture positive, among them 29 were Shigella spp. (64.4%) and 21 were V. cholerae (46.6%). All V. cholerae strains belonged to the serogroup O1 and serovar Ogawa. Among the Shigella spp., Shigella flexneri 17 (59%) topped the list of serotype followed by Shigella sonnei 8 (28%), Shigella dysenteriae 3 (10%) and Shigella boydii 1 (3%) respectively. All the V. cholerae isolates (100%) were sensitive to cefotaxime while 71% were sensitive to tetracycline but 100 and 90.4% were resistance to co-trimoxazole and nalidixic acid respectively. Shigella isolates were mostly susceptible to cefotaxime (97%) while ciprofloxacin (48%) and ofloxacin (55%) were less effective drugs.ConclusionsThese results on the prevalence of enteropathogens and their antibiotic resistance pattern may help to guide accurate choice of therapy in clinical setting. Hence, development of evidence based National Guidelines for the treatment of diarrhea is needed.Electronic supplementary materialThe online version of this article (10.1186/s13104-017-2967-0) contains supplementary material, which is available to authorized users.

Antibiotic Susceptibility Pattern of Shigella spp. Isolated from Patients Suspected of Acute Gastroenteritis

“…This result is congruent to the studies performed by Dhital et al (2017), where 93% of Shigella isolates were susceptible to Ceftriaxone, and by Kansakar et al (2006), where 100% of Shigella isolates were susceptible. In similar settings, Maharjan et al (2017) found 97% of Shigella species, and Thapa et al (2017) found 71.4% of Shigella species susceptible to Ceftriaxone. Several studies across the world have also shown the increased resistance of Shigella species to third-generation cephalosporins (Radice et al, 2001;Vinh et al, 2009;Mandal et al, 2010).…”

“…In the studies in Nepal from 1995 to 2002, the prevalence of S. dysenteriae was higher than the S. flexneri, while in the studies done from 2003 to 2005, S. flexneri was found to be the predominant species (Kansakar et al, 2006). The recent studies conducted in India (Puzari et al, 2018), Nepal (Maharjan et al, 2017;Thapa et al, 2017), Iran (Nikfar et al, 2017), China (Chang et al, 2016), and Latin America (Sati et al, 2019) show that S. flexneri is the predominant species. On the other hand, nations such as England (Bardsley et al, 2020), Australia (O'Sullivan et al, 2002Ingle et al, 2020), and the United States (Kozyreva et al, 2016) showed a higher predominance of S. sonnei.…”