Abbasi Elnaz, Abtahi Hamid, van Belkum Alex, Ghaznavi-Rad Ehsanollah
Department of Microbiology & Immunology, Faculty of Medicine, Arak University of Medical Sciences, Arak, Iran.
Department of Microbiology & Immunology, Khomein University of Medical Sciences, Khomein, Iran.
Infect Drug Resist. 2019 Jun 7;12:1535-1544. doi: 10.2147/IDR.S203654. eCollection 2019.
spp. are primary pathogens of diarrhea in children worldwide. Emergence of resistance to fluoroquinolones and third-generation cephalosporins is crucial in the management of pediatric shigellosis. We determined the prevalence and the antibiotic resistance patterns of species isolated from pediatric patients in central Iran. Pediatric diarrhea samples (n=230) were cultured on MacConkey and XLD agar media and in GN broth. Genus-specific PCR for was also used for detection directly from fecal specimens. Antibiotic resistance and the frequency of ESBL and AmpC genes were determined. Out of the 230 samples, 19 (8.2%) cases of spp. were identified using culture. Twenty-six samples were positive by PCR (11.3%), (4/19; 21%) and (15/19; 78.9%) being the most detected. The highest antibiotic resistance rates were found for cotrimoxazole (19/19; 100%), ampicillin (16/19; 84.2%), cefixime (13/19; 68.4%) and ceftriaxone (12/19; 63.1%). Ten cases showed phenotypic ESBL presence and all these strains were positive for , , and . Three strains were AmpC positive, all of which harbored and two contained . Of the 19 isolates 5 (26.3%), 2 (10.5%), and 1 (5.2%) were phenotypically resistant to nalidixic acid, ciprofloxacin, and norfloxacin, respectively. Class 1 integron was found in 18 (94.7%) isolates whereas class 2 integron was found in 19 (100%) strains. We found a considerable presence of species with elevated antibiotic resistance levels. In particular, the resistance to third-generation cephalosporins (ESBL) and ciprofloxacin must be taken seriously.
志贺氏菌属是全球儿童腹泻的主要病原体。对氟喹诺酮类和第三代头孢菌素耐药性的出现对小儿志贺氏菌病的治疗至关重要。我们确定了从伊朗中部儿科患者中分离出的志贺氏菌属的流行情况和抗生素耐药模式。将儿科腹泻样本（n = 230）接种于麦康凯和XLD琼脂培养基以及GN肉汤中进行培养。还使用针对志贺氏菌属的属特异性PCR直接从粪便标本中进行检测。确定了抗生素耐药性以及ESBL和AmpC基因的频率。在230个样本中，通过培养鉴定出19例（8.2%）志贺氏菌属病例。26个样本通过PCR呈阳性（11.3%），其中宋内志贺氏菌（4/19；21%）和福氏志贺氏菌（15/19；78.9%）检出率最高。发现对复方新诺明（19/19；100%）、氨苄西林（16/19；84.2%）、头孢克肟（13/19；68.4%）和头孢曲松（12/19；63.1%）的抗生素耐药率最高。10例表现出表型ESBL存在，所有这些菌株blaCTX-M、blaSHV和blaTEM均为阳性。3株AmpC呈阳性，所有这些菌株均携带blaDHA，2株含有blaCMY。在19株志贺氏菌分离株中，分别有5株（26.3%）、2株（10.5%）和1株（5.2%）对萘啶酸、环丙沙星和诺氟沙星表型耐药。在18株（94.7%）分离株中发现了1类整合子，而在19株（100%）菌株中发现了2类整合子。我们发现存在相当数量的抗生素耐药水平升高的志贺氏菌属。特别是，对第三代头孢菌素（ESBL）和环丙沙星的耐药性必须予以重视。
