Jamal W Y, Rotimi V O, Chugh T D, Pal T
Department of Microbiology, Faculty of Medicine, Kuwait University, Safat.
J Chemother. 1998 Aug;10(4):285-90. doi: 10.1179/joc.1998.10.4.285.
During the 5-year period 1990-1993 and 1996, 202 Shigella spp. were isolated from stool specimens of symptomatic patients of all age groups seen in our hospital. Over these periods the trend of the incidence of shigellosis showed that 18% of the total strains were isolated during the invasion year (1990) followed by an upsurge (24%) during the Gulf War period (1991) and a steady decline in the post-war period, 17% in 1992 and 14% in 1993. There was another wave of increased isolation rate (27%) during a period of relative calm in the country (1996) studied for comparison. The predominant Shigella species was S. flexneri which accounted for 46% of the 202 isolates, followed by S. sonnei (42%), S. dysenteriae (7%) and S. boydii (5%). Fifty-four percent of the 202 Shigella isolates were resistant to ampicillin, 56% to trimethoprim/sulfamethoxazole, 35% to chloramphenicol, 13% and 9% to cephalothin and amoxicillin/clavulanic acid respectively. All the isolates were fully susceptible to ciprofloxacin, the aminoglycosides and the second- and third-generation cephalosporins. Eighty-seven (43%) of the 202 isolates were resistant to two or more antibiotics. Of the 87 multiply resistant Shigella spp., 58 (67%) were S. flexneri while 19 (22%) were S. sonnei. Shigella resistance to the first-line antibiotics is a major problem that frequently limits the therapeutic options with orally available active antibiotic therapy.
在1990 - 1993年以及1996年这5年期间，从我院各年龄组有症状患者的粪便标本中分离出202株志贺菌属细菌。在这些时间段里，志贺菌病发病率的趋势显示，在侵袭年（1990年）分离出的菌株占总菌株数的18%，随后在海湾战争期间（1991年）出现激增（24%），而在战后时期呈稳步下降，1992年为17%，1993年为14%。在作为对照研究的该国相对平静时期（1996年），又出现了一波分离率上升（27%）的情况。主要的志贺菌种类是福氏志贺菌，占202株分离菌的46%，其次是宋内志贺菌（42%）、痢疾志贺菌（7%）和鲍氏志贺菌（5%）。202株志贺菌分离株中，54%对氨苄西林耐药，56%对甲氧苄啶/磺胺甲恶唑耐药，35%对氯霉素耐药，分别有13%和9%对头孢噻吩和阿莫西林/克拉维酸耐药。所有分离株对环丙沙星、氨基糖苷类药物以及第二代和第三代头孢菌素均完全敏感。202株分离株中有87株（43%）对两种或更多种抗生素耐药。在87株多重耐药的志贺菌属细菌中，58株（67%）是福氏志贺菌，19株（22%）是宋内志贺菌。志贺菌对一线抗生素的耐药性是一个主要问题，常常限制了口服有效抗生素治疗的治疗选择。
