Centro de Investigação em Saúde de Manhiça, Maputo, Mozambique.
ISGlobal, Barcelona Centre for International Health Research, Barcelona, Spain.
Int J Antimicrob Agents. 2018 Jun;51(6):881-887. doi: 10.1016/j.ijantimicag.2018.02.005. Epub 2018 Feb 12.
The objective of this study was to assess antibiotic resistance and the molecular epidemiology of shigella isolates from a case-control study of diarrhoea, conducted from 2007 to 2012 in children aged less than 5 years in Manhiça district, southern Mozambique. All isolates were tested for antimicrobial susceptibility using the disc diffusion method. Polymerase chain reaction was used to detect different molecular mechanisms of antibiotic resistance. Serotyping was performed using specific antisera. The clonal relationship of Shigella flexneri and Shigella sonnei was assessed by pulsed-field gel electrophoresis (PFGE). Of the 67 shigella isolates analysed, 59 were diarrhoeal cases and eight were controls. S. flexneri (70.1%; 47/67) was the most common species, followed by S. sonnei (23.9%; 16/67). The most prevalent S. flexneri serotypes were 2a (38.3%; 18/47), 6 (19.2%; 9/47) and 1b (14.9%; 7/47). High rates of antimicrobial resistance were observed for trimethoprim-sulfametoxazole (92.5%; 62/67), tetracycline (68.7%; 46/67), chloramphenicol (53.7%; 36/67) and ampicillin (50.7%; 34/67). Multi-drug resistance (MDR) was present in 55.2% (37/67) of the isolates and was associated with a case fatality rate of 8.1% (3/37). PFGE revealed 22 clones (16 S. flexneri and 6 S. sonnei), among which P1 (31.9%; 15/47), P9 (17%; 8/47) and P2 (10.6%; 5/47) were the most prevalent clones of S. flexneri. In conclusion, S. flexneri was the most prevalent species, with MDR isolates mainly belonging to three specific clones (P1, P9 and P2). The case fatality rate observed among MDR isolates is a matter of concern, indicating the need for appropriate treatment.
本研究的目的是评估来自 2007 年至 2012 年莫桑比克南部马希齐区 5 岁以下儿童腹泻病例对照研究中屎肠球菌分离株的抗生素耐药性和分子流行病学。使用圆盘扩散法检测所有分离株的抗菌药物敏感性。聚合酶链反应用于检测不同的抗生素耐药分子机制。血清分型使用特定的抗血清进行。通过脉冲场凝胶电泳（PFGE）评估福氏志贺菌和宋内志贺菌的克隆关系。在分析的 67 株志贺菌分离株中，59 株为腹泻病例，8 株为对照。福氏志贺菌（70.1%；47/67）是最常见的菌种，其次是宋内志贺菌（23.9%；16/67）。最常见的福氏志贺菌血清型为 2a（38.3%；18/47）、6（19.2%；9/47）和 1b（14.9%；7/47）。甲氧苄啶-磺胺甲恶唑（92.5%；62/67）、四环素（68.7%；46/67）、氯霉素（53.7%；36/67）和氨苄西林（50.7%；34/67）的抗菌药物耐药率较高。55.2%（37/67）的分离株存在多药耐药（MDR），MDR 分离株的病死率为 8.1%（3/37）。PFGE 显示 22 个克隆（16 个福氏志贺菌和 6 个宋内志贺菌），其中 P1（31.9%；15/47）、P9（17%；8/47）和 P2（10.6%；5/47）是福氏志贺菌最常见的克隆。总之，福氏志贺菌是最常见的菌种，MDR 分离株主要属于三个特定的克隆（P1、P9 和 P2）。MDR 分离株的病死率令人担忧，表明需要进行适当的治疗。
