Temu M M, Kaatano G M, Miyaye N D, Buhalata S N, Shushu M L, Kishamawe C, Changalucha J M
National Institute for Medical Research, Mwanza Research Centre, P.O. Box 1462, Mwanza, Tanzania.
Tanzan Health Res Bull. 2007 Sep;9(3):186-9.
This study was conducted to determine frequency and pattern of antimicrobial susceptibility of Shigella species isolated from stool specimens collected from patients presenting with bloody diarrhoea in Mwanza City, Tanzania. The study was carried out from October 2004 to October 2005 and involved patients attending Sekou Toure Regional Hospital and Butimba Health Centre. Bacteriological cultures were done at the National Institute for Medical Research laboratory. A total of 489 patients (median age = 20 years) participated in the study and were able to provide stool specimens. Shigella species were isolated from 14% (69/489) of the stool specimens collected. Of the sixty nine strains of Shigella spp isolated, 62 (90%) were S. flexneri and 7 (10%) were S. dysenteriae. All Shigella strains isolated showed high resistance to ampicillin, tetracycline, trimethoprim-sulphamethoxazole and chloramphenicol, drugs commonly used for management of shigellosis in Tanzania. However all isolates were fully susceptible to ciprofloxacin, nalidixic acid, erythromycin, cefuroxime and gentamycin. S. flexneri showed resistance to amoxy-clavulanic_acid and azithromycin in 5% and 2% of isolates, respectively. None of the S. dysenteriae isolates were resistant to these two drugs. Entamoeba histolytica, Giardia lamblia and Schistosoma mansoni were microscopically detected in 16.5%, 4.4% and 5.3% of patients, respectively. These findings suggest that there is a need to carry out extensive susceptibility studies in different parts of the country with view of re-appraising the current guidelines for management of bloody diarrhoea in Tanzania.
本研究旨在确定从坦桑尼亚姆万扎市出现血性腹泻的患者粪便标本中分离出的志贺氏菌属的抗菌药敏频率和模式。该研究于2004年10月至2005年10月进行，涉及就诊于塞古·杜尔地区医院和布廷巴健康中心的患者。细菌培养在国家医学研究所实验室进行。共有489名患者（中位年龄 = 20岁）参与了研究并能够提供粪便标本。从收集的14%（69/489）的粪便标本中分离出了志贺氏菌属。在分离出的69株志贺氏菌属菌株中，62株（90%）为福氏志贺菌，7株（10%）为痢疾志贺菌。所有分离出的志贺氏菌菌株对氨苄青霉素、四环素、甲氧苄啶 - 磺胺甲恶唑和氯霉素均表现出高度耐药性，这些药物是坦桑尼亚治疗志贺菌病常用的药物。然而，所有分离株对环丙沙星、萘啶酸、红霉素、头孢呋辛和庆大霉素均完全敏感。福氏志贺菌分别有5%和2%的分离株对阿莫西林 - 克拉维酸和阿奇霉素耐药。痢疾志贺菌的分离株对这两种药物均无耐药性。分别在16.5%、4.4%和5.3%的患者中通过显微镜检测到溶组织内阿米巴、蓝氏贾第鞭毛虫和曼氏血吸虫。这些发现表明，有必要在该国不同地区进行广泛的药敏研究，以便重新评估坦桑尼亚目前治疗血性腹泻的指南。
