Shigellosis Caused by CTX-M Type ESBL ProducingShigella flexneriin Two Siblings of Rural Nepal: First Case Report from the Country.
Shigellosis is an acute infectious disease characterized as severe bloody diarrhea (dysentery) and is accountable for a significant burden of morbidity and mortality especially in children under the age of 5 years. Antimicrobial therapy is required in the cases of severe dysentery associated withShigella. However, emergence of multidrug resistant (MDR) strains ofShigellaspp. over the last two decades has restricted the use of common therapeutic antimicrobials. In MDR strains, the third-generation cephalosporins have been used for the treatment, but, unfortunately, emerging reports of enzyme mediatedβ-lactam resistance amongShigellaisolates from various parts of the world have greatly compromised the therapy of pediatric dysentery. In Nepal, drug resistant strains ofShigellaspp. have been reported, but MDR and extended spectrumβ-lactamase (ESBL) producing strains were previously unknown. Here, we report twoShigella flexneriisolates harboring ESBL genotype-CTX-M associated with acute dysentery in two siblings which were presented and treated in a tertiary care teaching hospital of Kathmandu, Nepal.
Department of Clinical Laboratory Services, Manmohan Memorial Medical College and Teaching Hospital, Kathmandu, Nepal; Department of Laboratory Medicine, Manmohan Memorial Institute of Health Sciences, Kathmandu, Nepal.
Narayan Prasad
0000-0002-3228-9908
NP
Parajuli
Department of Laboratory Medicine, Manmohan Memorial Institute of Health Sciences, Kathmandu, Nepal; Kathmandu Center for Genomics and Research Laboratory (KCGRL), Kathmandu, Nepal.
Govardhan
G
Joshi
Department of Laboratory Medicine, Manmohan Memorial Institute of Health Sciences, Kathmandu, Nepal.
Bashu Dev
BD
Pardhe
Department of Laboratory Medicine, Manmohan Memorial Institute of Health Sciences, Kathmandu, Nepal.
Jyotsna
J
Shakya
Department of Laboratory Medicine, Manmohan Memorial Institute of Health Sciences, Kathmandu, Nepal.
Anjeela
0000-0001-8627-9150
A
Bhetwal
Department of Laboratory Medicine, Manmohan Memorial Institute of Health Sciences, Kathmandu, Nepal.
Shreena
S
Shakya
Department of Laboratory Medicine, Manmohan Memorial Institute of Health Sciences, Kathmandu, Nepal.
Roshan
R
Pandit
Department of Laboratory Medicine, Manmohan Memorial Institute of Health Sciences, Kathmandu, Nepal.
Sumesh Shreekhanda
SS
Shrestha
Department of Laboratory Medicine, Manmohan Memorial Institute of Health Sciences, Kathmandu, Nepal.
Puspa Raj
PR
Khanal