Rodríguez-Guerrero E, Herrera-León S, Gómez-Vicente E, Navarro-Marí J M, Gutiérrez-Fernández J
José Gutiérrez-Fernández. Servicio de Microbiología. Hospital Universitario Virgen de las Nieves. Avenida de las Fuerzas Armadas, 2. E-18012 Granada, Spain.
Rev Esp Quimioter. 2023 Jun;36(3):282-290. doi: 10.37201/req/121.2022. Epub 2023 Mar 21.
In the bacterial etiology of severe acute infectious diarrhea, except that caused by Clostridioides difficile, most of them have an invasive character and antibiotic treatment will be necessary in specific situations. Shigella is a classic pathogen, in which it is crucial to know the sensitivity to different classic and alternative antimicrobials. The objective of this work was to analyze the presence of shigellosis and the rate of antibiotic resistance.
A descriptive-retrospective study of the reports of shigellosis of stool cultures issued between January 2016 and April 2022 was conducted.
A total of 34 episodes (16 -47.1%- by Shigella sonnei) were observed, as of 2018. There were only 2 pediatric cases. The overall resistance rate to azithromycin, trimethoprim-sulfamethoxazole and ciprofloxacin was 52.9%, 64.7% and 44.1%, respectively. 26.5% were resistant to the 3 groups of antibiotics. There was a higher rate of resistance for S. sonnei. The emergence of resistance to cephalosporins in recent years stands out. Episodes of multidrug-resistant shigellosis were detected between 2020 (1 by S. flexneri) and 2022 (4 by S. sonnei).
The episodes of shigellosis are emerging in our environment with a higher rate of multi-resistance. In this context, current empirical treatments for acute enteroinvasive enteritis are at risk of failure, if necessary.
在严重急性感染性腹泻的细菌病因中，除艰难梭菌引起的腹泻外，大多数具有侵袭性，在特定情况下需要进行抗生素治疗。志贺菌是一种典型病原体，了解其对不同经典和替代抗菌药物的敏感性至关重要。这项工作的目的是分析志贺菌病的存在情况及抗生素耐药率。
对2016年1月至2022年4月期间发布的粪便培养志贺菌病报告进行描述性回顾性研究。
截至2018年，共观察到34例病例（16例 - 占47.1% - 由宋内志贺菌引起）。仅有2例儿科病例。对阿奇霉素、复方磺胺甲恶唑和环丙沙星的总体耐药率分别为52.9%、64.7%和44.1%。26.5%的病例对这三组抗生素均耐药。宋内志贺菌的耐药率更高。近年来对头孢菌素的耐药情况较为突出。在2020年（1例由福氏志贺菌引起）至2022年（4例由宋内志贺菌引起）期间检测到多重耐药志贺菌病病例。
在我们的环境中，志贺菌病病例正在出现，且多重耐药率较高。在此背景下，目前针对急性侵袭性肠炎的经验性治疗如有必要可能面临失败风险。
