Tetracycline and Azithromycin Resistance Investigation on Shigella spp. Isolated from the Stool of Children with Diarrhea in Tehran, Iran

Abstract

Background & objectives: Shigella spp. are gram negative bacteria that can cause shigellosis in human. It is important in young children as well as elderly and immunocompromised people. Threatening complications can occur in severe cases with multidrug resistance species. It has been observed that Shigella spp. have become resistant to antibiotics like other bacteria. Investigation of resistance to azithromycin, tetracycline and pattern of resistance are the objectives of this study. Methods: Fifty isolates of Shigella spp. which have been collected from three hospitals in Tehran were studied. Isolates identified and confirmed as Shigella spp. by biochemical, serological and molecular methods (ipaH, wbgz, rfc genes). Antimicrobial susceptibility test was performed for ampicillin, azithromycin, ciprofloxacin, doxycycline, levofloxacin, minocycline, nalidixic acid, norfloxacin, streptomycin, trimethoprim-sulfamethoxazole and tetracycline by disc agar diffusion method. Minimal inhibition concentrations were performed for azithromycin and tetracycline. Results: From a total of 50 Shigella spp. isolates, 16% of them were Shigella flexneri and 84% Shigella sonnei. The majority of isolates were multidrug resistant. The most resistance was seen to doxycycline, streptomycin, trimethoprim-sulfamethoxazole and tetracycline. Resistance to azithromycin was 6%  and all of the isolates were susceptible to norfloxacin and levofloxacin. Nine patterns of resistance were revealed to these isolates. Conclusion: High resistance to tetracycline was observed and resistance to azithromycin as an alternative treatment choice was also considerable.

Keywords

• Shigella
• Multidrug Resistance
• Tetracycline
• Azithromycin