Multiresistant Shigella species from African AIDS patients: antibacterial resistance patterns and application of the E-test for determination of minimum inhibitory concentration.

The antibacterial resistance pattern and minimum inhibitory concentrations (MIC) of 25 Shigella flexneri, 5 S. boydii, 8 S. sonnei, and 3 strains of S. dysenteriae type 2 isolated from Kenyan prostitutes with bacillary dysentery and AIDS were determined, and the applicability of the E-test for MIC determination evaluated. All strains were resistant to > or = 3 of 9 different antibacterial agents tested. All strains were resistant to tetracycline and erythromycin, 95% to trimethoprim/sulfonamide, 93% to streptomycin, 54% to ampicillin, 39% to chloramphenicol, 2% to nalidixic acid and none to gentamicin and ciprofloxacin. Six different resistance patterns were observed. The most common pattern was resistance to tetracycline, erythromycin, trimethoprim/sulfa and streptomycin (39%). The E-test was shown to be well-suited for susceptibility testing of multiresistant Shigella spp.; the reproducibility was excellent and the correlation with the microtiter dilution method and the disk diffusion method were 98% in both instances. The MIC measured with E-test and the microdilution method were within +/- 1 dilution step for 94.4% of the combinations tested.