Gastroenterology and Hepatology from Bed to Bench

Abstract

Aim: To evaluate antimicrobial resistance pattern of Shigella spp. isolated from patients with acute diarrhea in Tehran, Iran.

Background: Infectious diarrheal diseases caused by Shigella spp. are significant health concern world wide. They are responsible for considerable morbidity and mortality especially in developing countries.

Patients and methods: A total of 1120 fecal samples from patients with acute diarrhea from May 2003 to May 2005 were investigated to evaluate antimicrobial susceptibility patterns of predominant isolates from different hospitals in Tehran, Iran. Identification of isolates was carried out according to standard methods.

Results: Among isolated enteropathogens, Shigella spp. were found in 14%. Shigella sonnei was commonest (56.1%) followed by Shigella flexneri, boydii and dysenteriae that were found in 30.6%, 8.3% and 5.1% of isolates, respectively. Of all isolates, 66.3% were detected in patients less than 5 years old. Resistance pattern was as follow: tetracycline 95.5%, ampicillin 51.5% and trimethoprim-sulfamethoxazole 91.7%. None of the isolates were resistant to ciprofloxacin, ceftriaxone and ceftazidime. An interesting finding in our study was a high degree of multidrug resistance to 3 and more antibiotics among isolates 91%.

Conclusion: In conclusion, Shigella species isolated from acute diarrhea in Iran have a high degree of resistance to commonly used antibiotics. The emergence of multidrug-resistance demands continues monitoring of susceptibility pattern of Shigella isolates. The changing of resistance pattern to common antibiotics in Iran indicates that designing a monitoring system for detection of antimicrobial resistance and guidelines for the appropriate use of antibiotics are urgently needed.