Alici Ozlem, Açikgöz Z Cibali, Gamberzade Söhret, Göcer Safiye, Karahocagil M Kasim
Fatih Universitesi Tip Fakültesi, infeksiyon Hastaliklari ve Klinik Mikrobiyoloji Anabilim Dali, Ankara.
Mikrobiyol Bul. 2006 Jan-Apr;40(1-2):9-14.
In this study, species distribution, seasonal isolation rates and antibiotic susceptibilitiy patterns of 115 Shigella spp, isolated from 5396 stool samples in our microbiology laboratory between 1999 and 2003, were investigated. Of the isolates, 96 (83.5%) were S. sonnei, 15 (13%) were S. flexneri, 3 (2.6%) were S. dysenteriae and 1 (1.9%) was S. boydii. Maximum isolation rates were observed at summer and fall seasons, especially in August, September and November (24%, 40%, 17%, respectively). The resistance rates against trimetoprime-sulphametoxasole and ampicillin were 79.1% and 19.1%, respectively. The rate of co-resistance against these two drugs was 12.2 percent. No isolate was found to be resistant to ciprofloxacin. Only one S. sonnei isolate had extended spectrum beta-lactamase detected by double-disk synergy test. In conclusion, ciprofloxacin is the drug of choice for empirical treatment of shigellosis. However, to avoid the loss of this choice, ampicillin which still has an high effectivity rate, should be preferred for the treatment of shigellosis with the guidence of antibiogram results. On the other hand, emergence of ESBL production among Shigella spp. after Salmonella spp. should warn us about the unexpected results of inappropriate antibiotic therapy.
本研究调查了1999年至2003年间从我们微生物实验室的5396份粪便样本中分离出的115株志贺氏菌属的菌种分布、季节性分离率和抗生素敏感性模式。在这些分离株中，96株（83.5%）为宋内志贺氏菌，15株（13%）为福氏志贺氏菌，3株（2.6%）为痢疾志贺氏菌，1株（1.9%）为鲍氏志贺氏菌。在夏季和秋季观察到最高分离率，尤其是在8月、9月和11月（分别为24%、40%、17%）。对甲氧苄啶-磺胺甲恶唑和氨苄西林的耐药率分别为79.1%和19.1%。对这两种药物的共同耐药率为12.2%。未发现分离株对环丙沙星耐药。通过双纸片协同试验检测，仅1株宋内志贺氏菌分离株产超广谱β-内酰胺酶。总之，环丙沙星是志贺菌病经验性治疗的首选药物。然而，为避免失去这一选择，在药敏试验结果指导下治疗志贺菌病时，仍具有较高有效率的氨苄西林应优先选用。另一方面，志贺氏菌属中出现超广谱β-内酰胺酶的情况应引起我们对不恰当抗生素治疗意外结果的警惕。
