Emergence of resistance to third-generation cephalosporin in Shigella--a case report.
The emergence of ciprofloxacin resistance in Shigella has shifted the attention to cephalosporins. The first occurrence of third generation cephalosporin-resistant Shigella flexneri was from France. This article reports the first case of cephalosporin-resistant S. flexneri from India. A 12-month-old child was admitted for a 20-day episode of loose stools, non-fetid, with mucus and blood. The stool sample showed the presence of blood and mucus and S. flexneri which was resistant to Ampicillin, Nalidixic acid, Ciprofloxacin, Furoxone, Ceftriaxone and sensitive only to Cefoperazone and sulbactam combination. The child was promptly admitted and treated with a combination of Cefoperazone and sulbactam. The use of this combination was met with success in the present case, and may be considered as a temporary answer to the emerging cephalosporin-resistance.
Mandal
Jharna
J
Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry 605006, India.
Mondal
Nivedita
N
Mahadevan
S
S
Parija
Subhash Chandra
SC
D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D002438:Cefoperazone / Q000494:pharmacology* / Q000627:therapeutic use; D004338:Drug Combinations; D024901:Drug Resistance, Multiple, Bacterial; D004405:Dysentery, Bacillary / Q000175:diagnosis / Q000188:drug therapy* / Q000382:microbiology; D005243:Feces / Q000382:microbiology; D006801:Humans; D007194:India; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D012763:Shigella flexneri / Q000187:drug effects* / Q000302:isolation & purification; D013407:Sulbactam / Q000494:pharmacology* / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D004338:Drug Combinations; D002438:Cefoperazone; D013407:Sulbactam