title: Genetic characterization of antimicrobial resistance of Shigella flexneri 1c isolates from patients in Egypt and Pakistan.
abstract: BACKGROUND
  Shigella flexneri serotype 1c emerged as a critical isolate from children in Egypt and Pakistan. The pattern of antimicrobial susceptibility (AMS) and resistance genes of this serotype have yet to be characterized.
  
  
  RESULTS
  Sixty nine S. flexneri 1c isolates isolates were identified from both Egypt (n-46) and Pakistan (n = 23) and tested for AMS by disk diffusion method and minimal inhibitory concentrations were also determined. Isolates were genotyped by pulsed field gel electrophoresis (PFGE) and five relevant resistance genes (bla(TEM), bla(SHV), bla(OXA), sulI and sulII) were detected by polymerase chain reaction (PCR) and confirmed by DNA sequencing. High resistance was observed in all isolates for ampicillin (AM >96%); trimethoprim-sulphamethoxazole and tetracycline (>88%). Most AM-resistant isolates from Egypt (70%) harbored bla(TEM) resistance, while 52% of isolates from Pakistan expressed bla(OXA). All isolates were closely related by PFGE, irrespective of source or time of collection. The sulII gene was present in 100% of isolates from pediatric cases in Egypt, 65% of Pakistan isolates, and 53% of isolates from older Egyptian patients.
  
  
  CONCLUSIONS
  While different Shigella serotypes gathered in specific genotypic groups, 1c serotype isolates formed multiple clusters. Although AMS was considerably high to most commonly used drugs, genetic determinants were variable between countries over time. The data stress the need for a more careful selection of antibiotics in the treatment of shigellosis.
authors: Research Science Directorate, United States Naval Medical Research Unit No. 3, Cairo, Egypt. salwa.fouad.eg@med.navy.mil
authors: Salwa F
authors: SF
authors: Ahmed
authors: John
authors: J
authors: Klena
authors: Tupur
authors: T
authors: Husain
authors: Jesse
authors: J
authors: Monestersky
authors: Amel
authors: A
authors: Naguib
authors: Momtaz O
authors: MO
authors: Wasfy
mesh_terms: D000293:Adolescent; D000667:Ampicillin / Q000494:pharmacology; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001426:Bacterial Proteins / Q000235:genetics; D015373:Bacterial Typing Techniques; D002352:Carrier Proteins / Q000235:genetics; D002648:Child; D002675:Child, Preschool; D052978:Disk Diffusion Antimicrobial Tests; D024901:Drug Resistance, Multiple, Bacterial; D004405:Dysentery, Bacillary / Q000175:diagnosis; D004534:Egypt; D005798:Genes, Bacterial; D006801:Humans; D010154:Pakistan; D012763:Shigella flexneri / Q000145:classification / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification*; D014295:Trimethoprim / Q000494:pharmacology; D055815:Young Adult; D001618:beta-Lactamases / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; D002352:Carrier Proteins; C491369:Sul2 protein, bacteria; D000667:Ampicillin; D014295:Trimethoprim; D001618:beta-Lactamases
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