[Detection and drug resistance analysis of extended-spectrum beta-lactamases-producing Shigella in pediatric patients].
OBJECTIVE
To investigate the occurrence and drug resistance of extended-spectrum beta-lactamases (ESBLs)-producing strains of Shigella in pediatric patients, so as to provide information for clinical treatment.


METHODS
A total of 59 strains of Shigella were isolated from stool specimens of hospitalized children with shigellosis from January 2004 to December 2008. The broth dilution test recommended by Clinical and Laboratory Standards Institute (CLSI) was performed to detect the ESBLs producers. Susceptibility test was carried out by agar dilution method. Escherichia coli ATCC25922 and Klebsiella pneumonia ATCC700603 were used as quality control strains.


RESULTS
Of the 59 isolates, 21 (35.6%) strains were identified as ESBLs producers. All of the 21 strains were detected by cefotaxime and cefotaxime/clavulanic acid, only 5 (23.8%) were detected by ceftazidime and ceftazidime/clavulanic acid. Both ESBLs and non-ESBLs producers showed high resistance to penicillins. The resistance of ESBLs-producing strains to third and fourth-generation cephalosporins, aztreonam was significantly higher than that of non-ESBLs-producing strains, as well as sulphonamides and quinolones. The drugs sensitive to ESBLs producers were imipenem, meropenem, piperacillin/tazobactam, cefoperazone/sulbactam and cefoxitin, with resistance rate of 0.0%, 0.0%, 14.3%, 9.5%, 14.3%, respectively.


CONCLUSIONS
The prevalence of ESBLs-producing Shigella in pediatric patients is at a high level in this area, and the enzyme-producing strains are multidrug resistant. It is recommended that the detection of ESBLs in Shigella should be carried out by microbiological laboratories. Any of the above 5 antibiotics of low resistance should be used according to the patient's condition.
Department of Internal Medicine, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China.
Wen-jing
WJ
Ji
Xi-wei
XW
Xu
Fang
F
Dong
D002648:Child; D005243:Feces / Q000382:microbiology*; D006801:Humans; D008826:Microbial Sensitivity Tests; D012760:Shigella; D012762:Shigella dysenteriae / Q000187:drug effects* / Q000302:isolation & purification*; D018440:beta-Lactam Resistance