Changing species distribution and antimicrobial susceptibility pattern of Shigella over a 29-year period (1980-2008).
We studied changes in species distribution and antimicrobial resistance patterns of Shigella during 1980-2008, using the Diarrhoeal Diseases Surveillance system of Dhaka Hospital of ICDDR,B. In hospitalized patients Shigella prevalence decreased steadily from 8-12% in the 1980s to 3% in 2008. Endemic S. flexneri was the most commonly isolated species (54%). Epidemic S. dysenteriae type 1 had two peaks in 1984 and 1993, but was not found after 2000, except for one case in 2004. The therapeutic options are now limited: in 2008 a total of 33% of S. flexneri were resistant to ciprofloxacin and 57% to mecillinam. In the <5 years age group, severely underweight, wasted and stunted children were more at risk of shigellosis compared to well-nourished children (P<0·001). Although hospitalization for Shigella diarrhoea is decreasing, the high levels of antimicrobial resistance and increased susceptibility of malnourished children continue to pose an ongoing risk.
Khatun
F
F
International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh. kfatema@icddrb.org
Faruque
A S G
AS
Koeck
J L
JL
Olliaro
P
P
Millet
P
P
Paris
N
N
Malek
M A
MA
Salam
M A
MA
Luby
S
S
D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001459:Bangladesh / Q000453:epidemiology; D002648:Child; D015362:Child Nutrition Disorders / Q000150:complications; D002675:Child, Preschool; D024881:Drug Resistance, Bacterial; D004405:Dysentery, Bacillary / Q000453:epidemiology* / Q000382:microbiology*; D005260:Female; D006760:Hospitalization; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008826:Microbial Sensitivity Tests; D015995:Prevalence; D012307:Risk Factors; D012762:Shigella dysenteriae / Q000187:drug effects* / Q000302:isolation & purification; D012763:Shigella flexneri / Q000187:drug effects* / Q000302:isolation & purification; D055815:Young Adult
D000900:Anti-Bacterial Agents