A Study of prevalence of Shigella species and antimicrobial resistance patterns in paediatric medical center, Ahvaz, Iran

Background and Objectives Shigella infections are one of the major causes of diarrhea worldwide, and especially in developing countries. Antimicrobial resistance has complicated the empirical treatment. The aim of this study was to define the clinical and antibiotic resistance patterns of Shigella gastroenteritis cases. Materials and Methods Stool samples of patients with diarrhea and fever diagnosed with shigellosis were collected, from June 2013 to May 2014 at Abuzar Hospital, Iran. All samples were cultured for Shigella spp on selective and differential media. Shigella isolates were evaluated for antimicrobial resistance. Results Among 193 Shigella isolates, S. flexneri (64.8%) was the predominant species followed by S. sonnei (32.6%). The most frequent antibiotic resistance observed, was towards co-trimoxazole (89%), ampicillin (77%) and ceftriaxone (51%) and the lowest resistance were seen in ciprofloxacin (1.5%), azithromycin (7%). Conclusion Due to the high resistance to ceftriaxone, this drug is not recommended as an empirical therapy for shigellosis. However, azithromycin should be used as the first-line treatment for paediatric patients, suffering from shigellosis and ciprofloxacin can be used as an alternative.