Maharjan Sujan, Rayamajhee Binod, Shreshtha Anima, Acharya Jyoti
St. Xavier's College (Tribhuvan University), Maitighar, Kathmandu, Nepal.
Kathmandu Research Institute for Biological Sciences (KRIBS), 19533, Lalitpur, Nepal.
BMC Res Notes. 2017 Nov 28;10(1):626. doi: 10.1186/s13104-017-2967-0.
Diarrheal diseases are the major infectious disease in developing countries like Nepal. Lack of proper sanitation and antimicrobial resistance gained by microbes have challenged to address diarrheal diseases in resource-limited countries. Early diagnosis of disease and proper antibiotic treatment can significantly reduce the disease burden. This study was designed to determine the recent antimicrobial susceptibility pattern of Vibrio cholerae and Shigella spp. to assure the proper antibiotic treatment. Stool specimens were processed following microbiological protocol and identified by biochemical and serological tests recommended by the Clinical Laboratory Standard Institute.
Out of total 640 analyzed stool samples, 50 were culture positive, among them 29 were Shigella spp. (64.4%) and 21 were V. cholerae (46.6%). All V. cholerae strains belonged to the serogroup O1 and serovar Ogawa. Among the Shigella spp., Shigella flexneri 17 (59%) topped the list of serotype followed by Shigella sonnei 8 (28%), Shigella dysenteriae 3 (10%) and Shigella boydii 1 (3%) respectively. All the V. cholerae isolates (100%) were sensitive to cefotaxime while 71% were sensitive to tetracycline but 100 and 90.4% were resistance to co-trimoxazole and nalidixic acid respectively. Shigella isolates were mostly susceptible to cefotaxime (97%) while ciprofloxacin (48%) and ofloxacin (55%) were less effective drugs.
These results on the prevalence of enteropathogens and their antibiotic resistance pattern may help to guide accurate choice of therapy in clinical setting. Hence, development of evidence based National Guidelines for the treatment of diarrhea is needed.
腹泻病是尼泊尔等发展中国家的主要传染病。缺乏适当的卫生设施以及微生物产生的抗微生物耐药性对资源有限国家应对腹泻病构成了挑战。疾病的早期诊断和适当的抗生素治疗可显著减轻疾病负担。本研究旨在确定霍乱弧菌和志贺氏菌属近期的抗菌药敏模式，以确保适当的抗生素治疗。粪便标本按照微生物学规程进行处理，并通过临床实验室标准协会推荐的生化和血清学试验进行鉴定。
在总共640份分析的粪便样本中，50份培养呈阳性，其中29份为志贺氏菌属（64.4%），21份为霍乱弧菌（46.6%）。所有霍乱弧菌菌株均属于O1血清群和小川血清型。在志贺氏菌属中，福氏志贺菌17株（59%）在血清型列表中位居榜首，其次分别是宋内志贺菌8株（28%）、痢疾志贺菌3株（10%）和鲍氏志贺菌1株（3%）。所有霍乱弧菌分离株（100%）对头孢噻肟敏感，而71%对四环素敏感，但分别有100%和90.4%对复方新诺明和萘啶酸耐药。志贺氏菌分离株大多对头孢噻肟敏感（97%），而环丙沙星（48%）和氧氟沙星（55%）的疗效较差。
这些关于肠道病原体流行率及其抗生素耐药模式的结果可能有助于指导临床环境中准确的治疗选择。因此，需要制定基于证据的国家腹泻治疗指南。
