A study on the antibiotic resistance of Shigella

  • Pramita G Dwipoerwantoro
  • Sri P Pulungsih
  • Nuraini I Susanti
  • Hartaniah Sadikin
  • Agus Firmansyah
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

Author Biographies

Pramita G Dwipoerwantoro
Department of Child Health, Medical School, University of
Indonesia, Jakarta, Indonesia
Sri P Pulungsih
Sulianti Saroso Hospital for
Infectious Disease, Jakarta, Indonesia
Nuraini I Susanti
Fatmawati Hospital, Jakarta,
Indonesia
Hartaniah Sadikin
UKI Hospital, Jakarta, Indonesia
Agus Firmansyah
Department of Child Health, Medical School, University of
Indonesia, Jakarta, Indonesia

References

1. Soemantri S, Budiarso RL, Suhardi, Sarimawar,
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 29Mar.2024];45(2):49-4. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/798
Section
Articles
Received 2016-10-05
Accepted 2016-10-05
Published 2016-10-10