Regional Medical Research Centre, Indian Council of Medical Research, (Department of Health Research, Ministry of Health & Family Welfare, Government of India), Post Bag No. 13, Port Blair, 744101, Andaman & Nicobar Islands, India.
Eur J Clin Microbiol Infect Dis. 2014 Feb;33(2):157-70. doi: 10.1007/s10096-013-1937-2. Epub 2013 Aug 29.
This study aims to determine the clinical features and seasonal patterns associated with shigellosis, the antimicrobial resistance frequencies of the isolates obtained during the period 2006-2012 for 22 antibiotics, and the molecular characterization of multidrug-resistant strains isolated from endemic cases of shigellosis in the remote islands of India, with special reference to fluoroquinolone and third-generation cephalosporins resistance. During the period from January 2006 to December 2011, stool samples were obtained and processed to isolate Shigella spp. The isolates were evaluated with respect to their antibiotic resistance pattern and various multidrug resistance determinants, including resistance genes, quinolone resistance determinants, and extended-spectrum β-lactamase (ESBL) production. Morbidity for shigellosis was found to be 9.3 % among children in these islands. Cases of shigellosis occurred mainly during the rainy seasons and were found to be higher in the age group 2-5 years. A wide spectrum of resistance was observed among the Shigella strains, and more than 50 % of the isolates were multidrug-resistant. The development of multidrug-resistant strains was found to be associated with various drug-resistant genes, multiple mutations in the quinolone resistance-determining region (QRDR), and the presence of plasmid-mediated quinolone-resistant determinants and efflux pump mediators. This report represents the first presentation of the results of long-term surveillance and molecular characterization concerning antimicrobial resistances in clinical Shigella strains in these islands. Information gathered as part of the investigations will be instrumental in identifying emerging antimicrobial resistance, for developing treatment guidelines appropriate for that community, and to provide baseline data with which to compare outbreak strains in the future.
本研究旨在确定志贺菌病的临床特征和季节性模式，研究期间（2006-2012 年）获得的分离物对 22 种抗生素的抗菌药物耐药频率，以及印度偏远岛屿地方性志贺菌病分离株的耐药株的分子特征，特别关注氟喹诺酮类和第三代头孢菌素的耐药性。在 2006 年 1 月至 2011 年 12 月期间，采集粪便样本并进行处理以分离志贺菌属。评估分离物的抗生素耐药模式和各种多药耐药决定因素，包括耐药基因、喹诺酮类耐药决定因素和扩展谱β-内酰胺酶（ESBL）的产生。这些岛屿的儿童志贺菌病发病率为 9.3%。志贺菌病病例主要发生在雨季，2-5 岁年龄组的发病率较高。志贺菌属菌株表现出广泛的耐药性，超过 50%的分离物为多药耐药。多药耐药菌株的发展与各种耐药基因、喹诺酮类耐药决定区（QRDR）的多种突变以及质粒介导的喹诺酮类耐药决定因素和外排泵介质有关。本报告首次介绍了这些岛屿临床志贺菌属菌株的长期监测和耐药基因分子特征的结果。调查过程中收集的信息将有助于确定新出现的抗菌药物耐药性，为该社区制定适当的治疗指南，并提供基准数据，以便将来与暴发菌株进行比较。
