A study on the antibiotic resistance of Shigella
Keywords:
dysentery, shigellosis, children, antibiotics, antibiotic resistance, antibiotic sensitivity
Abstract
Background The hospital morbidity caused by Shigella or dysen-tery ranges between 0.3 to 2.9%. Irrational use of antibiotics causes
a persistent diarrhea and may lead to drug resistance.
Objectives With various kinds of antibiotics available in Indone-
sia at the moment, this study aimed to anticipate the kinds of anti-
biotics appropriate for shigellosis and to evaluate the clinical spec-
trum of dysentery in children in Indonesia.
Method The study involved 50 children diagnosed with dysentery
or dysentery-like syndrome, aged 1 to 12 years, who came to four
different hospitals in Jakarta, from November 2001 to April 2002.
Parents were asked for their consent. Interviewers recorded de-
tails of the children’s history of illness and the physical examina-
tions. Stool culture and resistance tests were done.
Results Fifty dysentery cases, comprising 30 males and 20 fe-
males, 98% aged from 1 to 5 years, came to the four hospitals
during the study period. Only 24 cases had positive Shigella cul-
tures, of which 87% were Shigella flexneri and 17% were Shigella
sonnei. The clinical manifestations of shigellosis were bloody stools
(83%), mucus in the stool (75%), and watery diarrhea (96%). Fe-
ver and tenesmus were absent in 67% and 92% of subjects, re-
spectively. Almost 87% of shigellosis cases were resistant to
cotrimoxazole; all were sensitive to colistin and most were sensi-
tive to nalidixic acid.
Conclusion This data suggests that colistin and nalidixic acid are
drugs of choice for dysentery syndrome. The clinical manifesta-
tion of dysentery is not always accompanied by bloody stools but
mostly incorporates watery diarrhea and mucus in the stool
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Tansuphaswadikul S, Hoge CW, et al. Ciprofloxacin and
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Clin North Am 2001;30:817-36.
14. Helvaci M, Bektasiar D, Ozkaya B. Comparative effi-
cacy of cefixime and ampicillin-sulbactam in shigello-
sis in children. Acta Pediatr 1998;40:131-6.
15. Martin JM, Pietti R, Maffei F, Tritt J, Smail K, Wald
ER. Treatment of shigellosis with cefixime: two days
vs. five days. Pediatr Infect Dis J 2000;19:522-6.
Bahroen C, editors. Survei Kesehatan Rumah Tangga
(SKRT) 1995. Jakarta: Badan Penelitian dan Pe-
ngembangan Kesehatan; 1997.
2. Widodo, editor. Hasil evaluasi program pemberantasan
diare tahun 1992-1993. Jakarta: Departemen
Kesehatan RI Dirjen P2MPLP; 1996.
3. Lopez EL, Prado-Jimenez V, O’Ryan-Gallardo, Contrini
MM. Emerging and re-emerging disease in Latin
America: Shigella and Shiga toxin-producing Escheri-
chia coli causing bloody diarrhea in Latin America. In-
fect Dis Clin North Am 2000;14:41-65.
4. Anh NT, Cam PD, Dalsgaard A. Antimicrobial resis-
tance of Shigella spp isolated from diarrhea patients
between 1989 and 1998 in Vietnam. South East Asian
J Trop Med Public Health 2001;32:856-62.
5. Mache A. Antibiotic resistance and sero-groups of
Shigella among pediatric out-patients in Southwest
Ethiopia. East Afr Med J 2001;78:296-9.
6. Diarrheal disorders. In: Roy CC, Silverman A, Alagille
D, editors. Pediatric clinical gastroenterology. 4 th ed.
St Louis: Mosby–Year Book; 1995. p. 242-4.
7. Brunser O, Espinoza J, Brunser AM. Etiology of diar-
rhea: bacteria and parasites. In: Gracey M, Walker-
Smith JA, editors. Diarrheal disease. 1 st ed. Philadel-
phia: Lippincot-Raven; 1997. p. 13-37.
8. Taylor D, Echeverria P, Pal T, Sethabur O, Saiborisuth
S, Sricharmorn S, et al. The role of Shigella spp.;
enteroinvasive Eschericia coli and other entero-
pathogens as causes of childhood dysentery in Thai-
land. J Infect Dis 1986;153:1132-8.
9. Farthing MJG. Acute diarrhea: Pathophysiology. In:
Gracey M, Walker-Smith JA, editors. Diarrheal dis-
ease. 1 st ed. Philadelphia: Lippincot-Raven; 1997. p.
55-73.
10. Bower JR. Food-borne disease: Shiga toxin-producing
E. coli (STEC). J Pediatr Infect Dis 1999;18:909-10.
11. Iwalokum BA, Gbenle GO, Smith SI, Ogunledun A,
Akinsinde KA, Omonigbehin EA. Epidemiology of
shigellosis in Lagos, Nigeria: trends in antimicrobial
resistance. J Health Popul Nutr 2001;19:183-90.
12. Murphy G, Bodhidatta L, Echeverria P, Echeverria P,
Tansuphaswadikul S, Hoge CW, et al. Ciprofloxacin and
loperamide in the treatment of bacillary dysentery. Ann
Intern Med 1993; 118:582-6.
13. Oldfield EC 3 rd , Wallace MR. The role of antibiotics
in the treatment of infectious diarrhea. Gastroenterol
Clin North Am 2001;30:817-36.
14. Helvaci M, Bektasiar D, Ozkaya B. Comparative effi-
cacy of cefixime and ampicillin-sulbactam in shigello-
sis in children. Acta Pediatr 1998;40:131-6.
15. Martin JM, Pietti R, Maffei F, Tritt J, Smail K, Wald
ER. Treatment of shigellosis with cefixime: two days
vs. five days. Pediatr Infect Dis J 2000;19:522-6.
Published
2016-10-10
How to Cite
1.
Dwipoerwantoro P, Pulungsih S, Susanti N, Sadikin H, Firmansyah A. A study on the antibiotic resistance of Shigella. PI [Internet]. 10Oct.2016 [cited 13Nov.2024];45(2):49-4. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/798
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Received 2016-10-05
Accepted 2016-10-05
Published 2016-10-10
Accepted 2016-10-05
Published 2016-10-10
