Antimicrobial susceptibility of Shigella isolates in eight Asian countries, 2001-2004
Chen-Yen Kuo, Lin-Hui Su, Jennifer Perera, Celia Carlos, Ban Hock Tan, Gamini Kumarasinghe, Thomas So, Pham Hung Van, Anan Chongthaleong, Jae-Hoon Song, Cheng-Hsun Chiu
Department of Pediatrics, Chang Gung Children’s Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan; Department of Microbiology, University of Colombo, Colombo, Sri Lanka; Research Institute for Tropical Medicine, Department of Health, Manila, The Philippines; Department of Internal Medicine, Singapore General Hospital, National University of Singapore, Singapore; Department of Medicine, Princess Margaret Hospital, Hong Kong; Department of Microbiology, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam; Department of Microbiology, Chulalongkorn University, Bangkok, Thailand; and Division of Infectious Diseases, Samsung Medical Center, Seoul, Korea
Received: April 24, 2007 Revised: June 6, 2007 Accepted: August 26, 2007
Background and purpose:
Shigellosis is a major health problem in developing countries, causing 91 million episodes and 414,000 deaths in Asia annually. Because of increasing trends towards drug resistance, this study was undertaken to monitor local resistance patterns of Shigella isolates from 8 Asian countries.
Ninety eight Shigella isolates collected from 8 centers in 8 Asian countries from July 2001 to July 2004 were analyzed in terms of serogroup distribution and antimicrobial susceptibility.
The most common serogroup of Shigella isolates was Shigella flexneri (49/98, 50%), followed by Shigella sonnei (44/98, 45%). The highest resistance rate was found for trimethoprim-sulfamethoxazole (81%), followed by tetracycline (74%) and ampicillin (53%). Overall, 76 Shigella isolates (78%) were multidrug-resistant strains; S. flexneri had a higher multidrug resistance rate than S. sonnei (74% vs 23%). Increasing ciprofloxacin and ceftriaxone resistance was observed; approximately 10% and 5% of isolates were resistant to ciprofloxacin and ceftriaxone, respectively. Five ceftriaxone-non-susceptible strains (from Taiwan , Hong Kong  and The Philippines ) and 10 ciprofloxacin-non-susceptible strains (from Hong Kong , The Philippines , Korea , Vietnam  and Sri Lanka ) were isolated.
High rates of multidrug resistance and steady increases in ceftriaxone and ciprofloxacin resistance of Shigella are serious pubic health concerns in Asian countries. Continuous monitoring of resistance patterns among Shigella isolates is necessary.
Asia; Microbial sensitivity tests; Shigella
J Microbiol Immunol Infect. 2008;41:107-111.