Antimicrobial susceptibility of Shigella isolates in eight Asian countries, 2001-2004.
OBJECTIVE
Shigellosis is a major health problem in developing countries, causing 91 million episodes and 414,000 deaths in Asia annually. Because of increasing trends towards drug resistance, this study was undertaken to monitor local resistance patterns of Shigella isolates from 8 Asian countries.


METHODS
Ninety eight Shigella isolates collected from 8 centers in 8 Asian countries from July 2001 to July 2004 were analyzed in terms of serogroup distribution and antimicrobial susceptibility.


RESULTS
The most common serogroup of Shigella isolates was Shigella flexneri (49/98, 50%), followed by Shigella sonnei (44/98, 45%). The highest resistance rate was found for trimethoprim-sulfamethoxazole (81%), followed by tetracycline (74%) and ampicillin (53%). Overall, 76 Shigella isolates (78%) were multidrug-resistant strains; S. flexneri had a higher multidrug resistance rate than S. sonnei (74% vs 23%). Increasing ciprofloxacin and ceftriaxone resistance was observed; approximately 10% and 5% of isolates were resistant to ciprofloxacin and ceftriaxone, respectively. Five ceftriaxone-non-susceptible strains (from Taiwan [3], Hong Kong [1] and The Philippines [1]) and 10 ciprofloxacin-non-susceptible strains (from Hong Kong [2], The Philippines [1], Korea [2], Vietnam [4] and Sri Lanka [1]) were isolated.


CONCLUSIONS
High rates of multidrug resistance and steady increases in ceftriaxone and ciprofloxacin resistance of Shigella are serious pubic health concerns in Asian countries. Continuous monitoring of resistance patterns among Shigella isolates is necessary.
Kuo
Chen-Yen
CY
Department of Pediatrics, Chang Gung Children's Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan.
Su
Lin-Hui
LH
Perera
Jennifer
J
Carlos
Celia
C
Tan
Ban Hock
BH
Kumarasinghe
Gamini
G
So
Thomas
T
Van
Pham Hung
PH
Chongthaleong
Anan
A
Song
Jae-Hoon
JH
Chiu
Cheng-Hsun
CH
D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001208:Asia; D024901:Drug Resistance, Multiple, Bacterial; D004405:Dysentery, Bacillary / Q000382:microbiology*; D006801:Humans; D008826:Microbial Sensitivity Tests; D012703:Serotyping; D012760:Shigella / Q000145:classification / Q000187:drug effects* / Q000302:isolation & purification*
D000900:Anti-Bacterial Agents