title: Antimicrobial susceptibility patterns of Shigella isolates in Foodborne Diseases Active Surveillance Network (FoodNet) sites, 2000-2010.
abstract: BACKGROUND
  Treatment of shigellosis with appropriate antimicrobial agents shortens duration of illness and bacterial shedding, but resistance to commonly used agents is increasing.
  
  
  METHODS
  We describe resistance patterns among Shigella isolates in the United States with use of linked data from the Foodborne Diseases Active Surveillance Network (FoodNet) and National Antimicrobial Resistance Monitoring System (NARMS). FoodNet sites send every 20th Shigella isolate to the NARMS laboratory for susceptibility testing.
  
  
  RESULTS
  During 2000-2010, the NARMS laboratory tested 1376 Shigella isolates from FoodNet sites. Of 1118 isolates (81%) linked to FoodNet, 826 (74%) were resistant to ampicillin, 649 (58%) to streptomycin, 402 (36%) to trimethoprim-sulfamethoxazole (TMP-SMX), 355 (32%) to sulfamethoxazole-sulfisoxazole, 312 (28%) to tetracycline, 19 (2%) to nalidixic acid, and 6 (0.5%) to ciprofloxacin. The proportion of Shigella isolates with resistance to TMP-SMX was 40% among white persons, 58% among Hispanic persons, and 75% among persons with a history of international travel. Resistance to at least TMP-SMX and ampicillin was present in 25% of isolate, and 5% were resistant to ampicillin, TMP-SMX, and chloramphenicol. Overall, 5% of isolates showed multidrug resistance to ampicillin, chloramphenicol, streptomycin, sulfamethoxazole-sulfisoxazole, and tetracycline, including 49 Shigella flexneri (33%) and 3 Shigella sonnei (0.3%) isolates. Male individuals were more likely than female individuals to be infected with a multidrug-resistant strain (7% versus 3%; P < .01).
  
  
  CONCLUSIONS
  Antimicrobial resistance differed by race, ethnicity, age, travel, and species. Resistance to commonly used antibiotics is high; therefore, it is important to look at the susceptibility pattern before starting treatment.
authors.affiliation: Oregon Public Health Division, 800 NE Oregon St, Ste 772, Portland, OR 97232, USA. beletshachew.shiferaw@state.or.us
authors.forename: Beletshachew
authors.initials: B
authors.lastname: Shiferaw
authors.forename: Suzanne
authors.initials: S
authors.lastname: Solghan
authors.forename: Amanda
authors.initials: A
authors.lastname: Palmer
authors.forename: Kevin
authors.initials: K
authors.lastname: Joyce
authors.forename: Ezra J
authors.initials: EJ
authors.lastname: Barzilay
authors.forename: Amy
authors.initials: A
authors.lastname: Krueger
authors.forename: Paul
authors.initials: P
authors.lastname: Cieslak
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000890:Anti-Infective Agents / Q000494:pharmacology*; D002487:Centers for Disease Control and Prevention, U.S.; D002648:Child; D002675:Child, Preschool; D024901:Drug Resistance, Multiple, Bacterial; D004405:Dysentery, Bacillary / Q000208:ethnology / Q000382:microbiology*; D005260:Female; D005517:Foodborne Diseases / Q000208:ethnology / Q000382:microbiology*; D006630:Hispanic or Latino; D006801:Humans; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D012760:Shigella / Q000187:drug effects* / Q000302:isolation & purification*; D014195:Travel; D014481:United States; D044465:White People; D055815:Young Adult
chemical_list: D000890:Anti-Infective Agents