Regional Medical Research Centre (Indian Council of Medical Research), Port Blair, Andaman & Nicobar Islands, India.
Microb Drug Resist. 2011 Jun;17(2):329-32. doi: 10.1089/mdr.2010.0084. Epub 2011 Feb 25.
Shigellosis is a major cause of diarrheal diseases among children in Andaman & Nicobar Islands, India, which have a population of 350,000 people, including settlers from mainland India and 6 indigenous tribes. From the last one-and-half decade, we have been monitoring the species distribution and emergence of antibiotic resistance among the isolates of Shigella. The circulating Shigella strains have been found rapidly acquiring resistance to a wide spectrum of antibiotics. The recent data indicate that a significant proportion of Shigella isolates have been resistant to newer generation of cephalosporins, which are used as an alternative of quinolones to treat the patients with shigellosis. In this communication, we report the antibiotic-resistant pattern of Shigella isolates that are recently isolated from these islands. From January 2008 to December 2009, 311 stool samples were processed and 44 (14%) Shigella isolates were recovered. Out of these 44 Shigella isolates, 6 (14%) were found to be resistant to all the three third-generation cephalosporins tested. The minimum inhibitory concentrations of the resistant isolates were all above the breakpoint for reduced susceptibility as per the Clinical and Laboratory Standards Institute guidelines. All of the cephalosporin-resistant Shigella strains were confirmed to produce extended-spectrum β-lactamases. By analyzing trends in the resistance patterns of the various Shigella species, we found that Shigella dysenteriae (40%) is currently more resistant, followed by Shigella flexneri (14%), than the other Shigella species in these islands of India, especially to the third-generation cephalosporins. The acquisition of resistance by enteric pathogens to the increasing number of antibacterial drugs is becoming a grave concern, particularly in developing countries where shigellosis is of a common occurrence.
在印度安达曼和尼科巴群岛，志贺菌病是导致儿童腹泻病的主要原因，该群岛人口约 35 万，包括来自印度大陆的移民和 6 个土著部落。在过去的十五年中，我们一直在监测这些岛屿上志贺菌的分离株的物种分布和抗生素耐药性的出现。循环的志贺菌菌株已经被发现迅速获得对广泛抗生素的耐药性。最近的数据表明，相当一部分志贺菌分离株对新型头孢菌素具有耐药性，这些头孢菌素被用作治疗志贺菌病患者的喹诺酮类药物的替代品。在本通讯中，我们报告了最近从这些岛屿分离出的志贺菌分离株的抗生素耐药模式。2008 年 1 月至 2009 年 12 月，处理了 311 份粪便样本，从中分离出 44（14%）株志贺菌。在这 44 株志贺菌分离株中，有 6 株（14%）被发现对所有三种第三代头孢菌素均耐药。根据临床和实验室标准研究所的指南，耐药分离株的最低抑菌浓度均高于降低敏感性的折点。所有头孢菌素耐药的志贺菌菌株均被证实产生了超广谱β-内酰胺酶。通过分析各种志贺菌的耐药模式趋势，我们发现志贺氏痢疾杆菌（40%）目前更耐药，其次是志贺氏福氏菌（14%），比印度这些岛屿上的其他志贺菌更耐药，尤其是对第三代头孢菌素。肠病原体对越来越多的抗菌药物的耐药性的获得，特别是在志贺菌病普遍发生的发展中国家，引起了严重关注。
