title: Clinical characteristics and antibiotic resistance of Shigella gastroenteritis in Ankara, Turkey between 2003 and 2009, and comparison with previous reports.
abstract: OBJECTIVE
  The aim of this study was to define the epidemiological, clinical, and antibiotic susceptibility patterns of Shigella gastroenteritis cases occurring during the years 2003-2009 and to compare results with those of the years 1987-2002.
  
  
  METHODS
  A hospital-based study was conducted over a 22-year period. All 238 Shigella strains isolated between 2003 and 2009 were compared to 618 isolates from the period 1987-1994 and 218 Shigella strains isolated during 1995-2002 with regard to antimicrobial resistance patterns and patient clinical characteristics.
  
  
  RESULTS
  The predominant species during all periods was Shigella sonnei, with an increasing predominance across the periods (64.0%, 71.5%, and 87.8%, respectively; p<0.001). Neither the prevalence of bloody diarrhea nor other clinical characteristics changed across the study periods, except for the prevalence of dehydration, which increased (11.0%, 20.6%, and 28.6%, respectively; p<0.001). During the period 2003-2009, 69.9% of Shigella were resistant to trimethoprim/sulfamethoxazole, 35.8% to ampicillin, and 4.7% to nalidixic acid. No case resistant to ciprofloxacin was detected. Multidrug resistance was also found to be similar in the last two periods (24.0% vs. 28.1%, respectively).
  
  
  CONCLUSIONS
  There was both a microbiological and a clinical change in childhood Shigella gastroenteritis cases over the 22 years. The antibiotic resistance pattern appears to have remained stable over the last two periods. There is a need to re-examine the criteria and clinical management guidelines for suspected shigellosis cases.
authors: Department of Pediatrics, Social Pediatrics Unit, Hacettepe University Faculty of Medicine, 06100 Ankara, Turkey.
authors: Elif Nursel
authors: EN
authors: Özmert
authors: Osman Tolga
authors: OT
authors: İnce
authors: Emel
authors: E
authors: Örün
authors: Songül
authors: S
authors: Yalçın
authors: Kadriye
authors: K
authors: Yurdakök
authors: Deniz
authors: D
authors: Gür
mesh_terms: D000293:Adolescent; D000667:Ampicillin / Q000494:pharmacology / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D003428:Cross Infection / Q000188:drug therapy / Q000453:epidemiology / Q000382:microbiology; D003681:Dehydration / Q000150:complications; D024901:Drug Resistance, Multiple, Bacterial; D004405:Dysentery, Bacillary / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D005759:Gastroenteritis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D006801:Humans; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D009268:Nalidixic Acid / Q000494:pharmacology / Q000627:therapeutic use; D015995:Prevalence; D012760:Shigella / Q000145:classification* / Q000187:drug effects / Q000302:isolation & purification; D012764:Shigella sonnei / Q000187:drug effects / Q000302:isolation & purification; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000494:pharmacology / Q000627:therapeutic use; D014421:Turkey / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents; D009268:Nalidixic Acid; D000667:Ampicillin; D015662:Trimethoprim, Sulfamethoxazole Drug Combination