Emergence of antimicrobial-resistant shigellosis in Oregon

被引:54
作者
Replogle, ML
Fleming, DW
Cieslak, PR
机构
[1] Oregon Hlth Div, Portland, OR 97232 USA
[2] Oregon Hlth Sci Univ, Sch Med, Portland, OR 97201 USA
关键词
D O I
10.1086/313715
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Ampicillin and trimethoprim-sulfamethoxazole (TMP-SMZ) are currently considered acceptable empirical therapy for shigellosis in developed countries. However, there are few recently reported studies on antimicrobial resistance among shigellae isolated in the United States. We examined the epidemiology of shigellosis and the antimicrobial susceptibility of Shigella species isolated in Oregon from July 1995 through June 1998. Of 430 isolates, 410 were identified to the species level: Shigella sonnei accounted for 55% of isolates, and Shigella flexneri, for 40%. The overall annual incidence of shigellosis was 4.4 cases per 100,000 population. Children aged <5 years (annual incidence, 19.6 cases per 100,000 population) and Hispanics (annual incidence, 28.4 cases per 100,000 population) were at highest risk. Of 369 isolates tested, 59% were resistant to TMP-SMZ, 63% were resistant to ampicillin, 1% were resistant to cefixime, and 0.3% were resistant to nalidixic acid; none of the isolates were resistant to ciprofloxacin. Thirteen percent of the isolates had multidrug resistance to ampicillin, chloramphenicol, streptomycin, sulfisoxazole, and tetracycline. Infections due to multidrug-resistant shigellae are endemic in Oregon. Neither ampicillin nor TMP-SMZ should be considered appropriate empirical therapy for shigellosis any longer; when antibiotics are indicated, a quinolone or cefixime should be used.
引用
收藏
页码:515 / 519
页数:5
相关论文
共 38 条
  • [1] ANTIBIOTIC-RESISTANCE OF SHIGELLA STRAINS ISOLATED IN THE FEDERAL-REPUBLIC-OF-GERMANY 1989-1990
    ALEKSIC, S
    KATZ, A
    ALEKSIC, V
    BOCKEMUHL, J
    [J]. ZENTRALBLATT FUR BAKTERIOLOGIE-INTERNATIONAL JOURNAL OF MEDICAL MICROBIOLOGY VIROLOGY PARASITOLOGY AND INFECTIOUS DISEASES, 1993, 279 (04): : 484 - 493
  • [2] [Anonymous], REV INFECT DIS
  • [3] Aseffa A, 1997, E AFR MED J, V74, P708
  • [4] INCREASING ANTIMICROBIAL RESISTANCE OF SHIGELLA ISOLATES IN ISRAEL DURING THE PERIOD 1984 TO 1992
    ASHKENAZI, S
    MAYZAHAV, M
    SULKES, J
    ZILBERBERG, R
    SAMRA, Z
    [J]. ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 1995, 39 (04) : 819 - 823
  • [5] A RANDOMIZED, DOUBLE-BLIND-STUDY COMPARING CEFIXIME AND TRIMETHOPRIM-SULFAMETHOXAZOLE IN THE TREATMENT OF CHILDHOOD SHIGELLOSIS
    ASHKENAZI, S
    AMIR, J
    WAISMAN, Y
    RACHMEL, A
    GARTY, BZ
    SAMRA, Z
    VARSANO, I
    NITZAN, M
    [J]. JOURNAL OF PEDIATRICS, 1993, 123 (05) : 817 - 821
  • [6] BARTLETT JG, 1998, POCKET BOOK INFECT D, P297
  • [7] TREATMENT OF SHIGELLOSIS .3. COMPARISON OF ONE-DOSE OR 2-DOSE CIPROFLOXACIN WITH STANDARD 5-DAY THERAPY - A RANDOMIZED, BLINDED TRIAL
    BENNISH, ML
    SALAM, MA
    KHAN, WA
    KHAN, AM
    [J]. ANNALS OF INTERNAL MEDICINE, 1992, 117 (09) : 727 - 734
  • [8] ANTIMICROBIAL RESISTANCE OF SHIGELLA ISOLATES IN BANGLADESH, 1983-1990 - INCREASING FREQUENCY OF STRAINS MULTIPLY RESISTANT TO AMPICILLIN, TRIMETHOPRIM-SULFAMETHOXAZOLE, AND NALIDIXIC-ACID
    BENNISH, ML
    SALAM, MA
    HOSSAIN, MA
    MYAUX, J
    KHAN, EH
    CHAKRABORTY, J
    HENRY, F
    RONSMANS, C
    [J]. CLINICAL INFECTIOUS DISEASES, 1992, 14 (05) : 1055 - 1060
  • [9] ANTIBIOTIC-RESISTANCE PATTERNS AND PLASMID PROFILES FOR SHIGELLA SPP ISOLATED IN CORDOBA, ARGENTINA
    BRITOALAYON, NE
    BLANDO, AM
    MONZONMORENO, C
    [J]. JOURNAL OF ANTIMICROBIAL CHEMOTHERAPY, 1994, 34 (02) : 253 - 259
  • [10] Quinolone arthropathy in animals versus children
    Burkhardt, JE
    Walterspiel, JN
    Schaad, UB
    [J]. CLINICAL INFECTIOUS DISEASES, 1997, 25 (05) : 1196 - 1204