A study on the antibiotic resistance of Shigella

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

Keywords

• dysentery
• shigellosis
• children
• antibiotics
• antibiotic resistance
• antibiotic sensitivity