Shigellosis

Bennish, Michael L.; Albert, M. John

doi:10.1002/9781118148594.ch15

Cited by 1 publication

(1 citation statement)

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“…Although shigellosis is a typically dysenteric illness with blood, pus and mucus in the stool [ 27 ], children often present with diarrhea only [ 28 ]. Our patient had watery diarrhea.…”

Section: Case Presentationmentioning

confidence: 99%

Diarrhea in an infant due to Shigella flexneri 1 carrying multiple cephalosporinase-encoding genes

et al. 2021

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Background Infections caused by multidrug-resistant shigellae resistant to broad-spectrum cephalosporins are becoming more prevalent in the Middle East. We report a case of severe diarrhea due to a multiresistant Shigella flexneri 1 strain carrying four different ß-lactamase genes. Case presentation A one-year-old Syrian infant presented with severe acute diarrhea, vomiting and dehydration. She did not respond to empirical treatment with amoxicillin-clavulanic acid followed by cefotaxime. Later, stool culture revealed S. flexneri 1 resistant to both these drugs. The patient was successfully treated with meropenem to which S. flexneri 1 was susceptible. The isolate was resistant to eight classes of antibiotics, and the whole genome sequence (WGS) identified four ß-lactamase genes (blaCTX-M-15, blaEC-8, blaOXA-1, and blaTEM-1) along with genes mediating resistance to seven other antibiotic classes. The WGS also identified several virulence genes including senA that encodes ShET-2 which induces watery diarrhea. Phylogenetically, the isolate was closely related to isolates from South Asia. Conclusions This report highlights the emergence of extremely resistant Shigella that has acquired multiple resistance genes to cephalosporins rendering these drugs ineffective.

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“…Although shigellosis is a typically dysenteric illness with blood, pus and mucus in the stool [ 27 ], children often present with diarrhea only [ 28 ]. Our patient had watery diarrhea.…”

Section: Case Presentationmentioning

confidence: 99%