Department of Microbiology, Faculty of Medicine, Kuwait University, Kuwait.
J Infect Public Health. 2010;3(1):35-42. doi: 10.1016/j.jiph.2009.10.001. Epub 2010 Feb 8.
Shigella species isolated from stool samples of symptomatic patients of all age groups at the Mubarak Al Kabir Hospital and Infectious Diseases Hospital, Kuwait and Tawam Hospital, UAE during a 2-year period were investigated for their susceptibility to tigecycline and several other antibiotics by determining the minimum inhibitory concentrations (MICs) using the E test method. A total of 100 and 42 strains were collected from UAE and Kuwait, respectively. The extent of drug resistance in the Shigella spp. isolates from these two countries was analyzed by criteria recommended by the Clinical and Laboratory Standards Institute (CLSI). Amikacin, cefotaxime, cefuroxime, ciprofloxacin, imipenem, meropenem, piperacillin-tazobactam and tigecycline had excellent activities against all isolates from UAE and Kuwait with MIC(90s) of 12, 0.094, 4, 0.012, 0.25, 0.032, 3 and 0.25 microg/ml and 4, 1, 4, 0.125, 0.38, 0.19, 3 and 0.25 microg/ml, respectively. Half of all isolates from both countries were resistant to ampicillin. None of the isolates in Kuwait was resistant to amoxicillin-clavulanic acid compared with 22% in UAE. Resistance to chloramphenicol was recorded in 50 and 36% of the isolates in Kuwait and UAE, respectively. The percentages of non-susceptibility to trimethoprim-sulfamethoxazole and tetracycline were very high in Kuwait and UAE (76% vs. 92% and 76% vs. 98%, respectively). Notably, one isolate, S. flexneri, from UAE had reduced susceptibility to ciprofloxacin (MIC, 0.25 microg/ml). Four (2.8%) of the isolates were ESBL producers by the E test ESBL method but could not be confirmed by PCR using primers for bla(CTX-M), bla(SHV) and bla(TEM). In conclusion, Shigella spp. isolated from symptomatic patients in Kuwait and the UAE demonstrated high rates of resistance to the first-line antibiotics but very susceptible to the carbapenems, cephalosporins, fluoroquinolones and tigecycline. Tigecycline holds promise as a potential drug of choice for the therapy of severe shigellosis.
从科威特的 Mubarak Al Kabir 医院和传染病医院以及阿联酋的 Tawam 医院的有症状患者的粪便样本中分离出的志贺氏菌属种，在两年期间对替加环素和其他几种抗生素的敏感性进行了研究，方法是通过 E 试验方法确定最小抑菌浓度 (MIC)。分别从阿联酋和科威特收集了 100 和 42 株菌株。通过临床和实验室标准研究所 (CLSI) 推荐的标准分析了来自这两个国家的志贺氏菌属种分离株的药物耐药程度。阿米卡星、头孢噻肟、头孢呋辛、环丙沙星、亚胺培南、美罗培南、哌拉西林-他唑巴坦和替加环素对来自阿联酋和科威特的所有分离株均具有优异的活性，MIC(90s)分别为 12、0.094、4、0.012、0.25、0.032、3 和 0.25μg/ml 和 4、1、4、0.125、0.38、0.19、3 和 0.25μg/ml。来自这两个国家的所有分离株中有一半对氨苄西林具有耐药性。与阿联酋的 22%相比，科威特没有分离株对阿莫西林-克拉维酸耐药。氯霉素耐药性分别记录在科威特和阿联酋的 50%和 36%的分离株中。来自科威特和阿联酋的分离株对甲氧苄啶-磺胺甲恶唑和四环素的不敏感性百分比非常高（分别为 76% vs. 92%和 76% vs. 98%）。值得注意的是，来自阿联酋的一株福氏志贺菌对环丙沙星（MIC，0.25μg/ml）的敏感性降低。通过 E 试验 ESBL 方法，有 4（2.8%）株分离物为 ESBL 产生者，但不能通过针对 bla(CTX-M)、bla(SHV) 和 bla(TEM) 的引物的 PCR 来确认。总之，从科威特和阿联酋有症状患者中分离出的志贺氏菌属种对一线抗生素的耐药率很高，但对碳青霉烯类、头孢菌素类、氟喹诺酮类和替加环素非常敏感。替加环素有望成为治疗严重志贺菌病的潜在首选药物。
