Frost J A, Willshaw G A, Barclay E A, Rowe B, Lemmens P, Vandepitte J
J Hyg (Lond). 1985 Apr;94(2):163-72. doi: 10.1017/s0022172400061362.
A widespread epidemic of severe dysentery in Zaire and neighbouring Central African countries was caused by a multiply drug-resistant strain of Shigella dysenteriae 1. Early isolations were resistant to ampicillin, chloramphenicol, streptomycin, sulphonamides and tetracyclines (R-type = ACSSuT). Later in the epidemic strains resistant to trimethoprim (Tm) became prevalent and a few strains resistant to kanamycin (K) or nalidixic acid were also isolated. All resistances except nalidixic acid were encoded by plasmids of incompatibility groups X (ACT) or I1 (ACSSuTTm) and the epidemic strain also carried an SSu plasmid and a number of cryptic plasmids. The Inc X plasmid from this epidemic is the same as that in Sh. dysenteriae 1 strains isolated in Somalia in 1976 whereas the epidemic strains from the Shiga outbreaks in Central America, 1969 to 1971, and Sri Lanka, 1979, carried plasmids of group B. This epidemic demonstrates that when a multiresistant strain includes resistance to trimethoprim, nalidixic acid is a suitable alternative therapeutic agent.
扎伊尔和邻国中非国家爆发的严重痢疾疫情是由多重耐药的痢疾志贺氏菌1型菌株引起的。早期分离出的菌株对氨苄青霉素、氯霉素、链霉素、磺胺类药物和四环素耐药（R型=ACSSuT）。在疫情后期，对甲氧苄啶（Tm）耐药的菌株变得普遍，还分离出了少数对卡那霉素（K）或萘啶酸耐药的菌株。除萘啶酸外，所有耐药性均由不相容群X（ACT）或I1（ACSSuTTm）的质粒编码，流行菌株还携带一个SSu质粒和一些隐蔽质粒。此次疫情中的Inc X质粒与1976年在索马里分离出的痢疾志贺氏菌1型菌株中的质粒相同，而1969年至1971年中美洲和1979年斯里兰卡志贺氏菌疫情中的流行菌株携带B组质粒。此次疫情表明，当多重耐药菌株包括对甲氧苄啶的耐药性时，萘啶酸是一种合适的替代治疗药物。
