Grupo de Microbiología, Dirección de Redes en Salud Pública, Instituto Nacional de Salud, Bogotá, D.C., Colombia.
Biomedica. 2021 Mar 19;41(1):65-78. doi: 10.7705/biomedica.5113.
Shigellosis is endemic in low-and middle-income countries, causing approximately 125 million episodes of diarrhea and leading to approximately 160 .000 deaths annually one-third of which is associated with children.
To describe the characteristics and antimicrobial resistance profiles of Shigella species recovered in Colombia from 1997 to 2018.
We received isolates from laboratories in 29 Colombian departments. We serotyped with specific antiserum and determined antimicrobial resistance and minimal inhibitory concentrations for ten antibiotics with Kirby-Bauer tests following the Clinical and Laboratory Standards Institute recommendations.
We analyzed 5,251 isolates of Shigella spp., most of them obtained from stools (96.4%); 2,511 (47.8%) were from children under five years of age. The two most common species were S. sonnei (55.1%) and S. flexneri (41.7%). The highest resistance rate was that of tetracycline (88.1%) followed by trimethoprim-sulfamethoxazole (79.3%) and ampicillin (65.5%); 50.8% of isolates were resistant to chloramphenicol, 43.6% to amoxicillin/clavulanic acid, and less than 1% to cefotaxime, ceftazidime, gentamicin, and ciprofloxacin. In S. sonnei, the most common resistance profile corresponded to trimethoprim-sulfamethoxazole (92%) whereas in S. flexneri the most common antibiotic profiles were multidrug resistance.
In Colombia, children under five years are affected by all Shigella species. These findings should guide funders and public health officials to make evidence based decisions for protection and prevention measures. The antimicrobial resistance characteristics found in this study underline the importance of combating the dissemination of the most frequently isolated species, S. sonnei and S. flexneri.
志贺菌病在中低收入国家流行，每年导致约 1.25 亿例腹泻，并导致约 16 万人死亡，其中三分之一与儿童有关。
描述 1997 年至 2018 年期间在哥伦比亚分离的志贺菌属物种的特征和抗菌药物耐药谱。
我们收到了来自哥伦比亚 29 个省实验室的分离株。我们用特异性抗血清进行血清分型，并根据临床和实验室标准协会的建议，用 Kirby-Bauer 试验测定了十种抗生素的抗菌药物耐药性和最小抑菌浓度。
我们分析了 5251 株志贺菌属，其中大部分来自粪便（96.4%）；2511 株（47.8%）来自五岁以下儿童。最常见的两种菌种是 S. sonnei（55.1%）和 S. flexneri（41.7%）。耐药率最高的是四环素（88.1%），其次是甲氧苄啶-磺胺甲恶唑（79.3%）和氨苄西林（65.5%）；50.8%的分离株对氯霉素耐药，43.6%对阿莫西林/克拉维酸耐药，对头孢噻肟、头孢他啶、庆大霉素和环丙沙星的耐药率低于 1%。在 S. sonnei 中，最常见的耐药谱是甲氧苄啶-磺胺甲恶唑（92%），而在 S. flexneri 中，最常见的抗生素谱是多药耐药。
在哥伦比亚，五岁以下儿童受到所有志贺菌属的影响。这些发现应指导资金提供者和公共卫生官员做出基于证据的决定，以采取保护和预防措施。本研究发现的抗菌药物耐药特征强调了打击最常分离的菌种 S. sonnei 和 S. flexneri 传播的重要性。
