Gene

Shigellosis

Bacteria

Biology

Shigella flexneri

Cefpodoxime

Diarrhea

Cephalosporin

Shigella sonnei

Biochemistry

Shigella

MacConkey agar

Antibiotic resistance

Ceftriaxone

Salmonella

Genetics

Cefixime

Agar

Nalidixic acid

Antibiotics

Microbiology

Escherichia coli

Internal medicine

Integron

Ciprofloxacin

Medicine

Gastroenterology

Ampicillin

Norfloxacin

Cefotaxime

Multiple drug resistance

Infection and Drug Resistance

Background:Shigella spp. are primary pathogens of diarrhea in children worldwide. Emergence of resistance to fluoroquinolones and third-generation cephalosporins is crucial in the management of pediatric shigellosis. We determined the prevalence and the antibiotic resistance patterns of Shigella species isolated from pediatric patients in central Iran. Materials and methods: Pediatric diarrhea samples (n=230) were cultured on MacConkey and XLD agar media and in GN broth. Genus-specific PCR for ipaH was also used for detection directly from fecal specimens. Antibiotic resistance and the frequency of ESBL and AmpC genes were determined. Results: Out of the 230 samples, 19 (8.2%) cases of Shigella spp. were identified using culture. Twenty-six samples were positive by PCR (11.3%), S. flexneri (4/19; 21%) and S. sonnei (15/19; 78.9%) being the most detected. The highest antibiotic resistance rates were found for cotrimoxazole (19/19; 100%), ampicillin (16/19; 84.2%), cefixime (13/19; 68.4%) and ceftriaxone (12/19; 63.1%). Ten cases showed phenotypic ESBL presence and all these strains were positive for blaTEM, blaCTX-M-1, and blaCTX-M-15. Three strains were AmpC positive, all of which harbored blaCMY-2 and two contained blaCIT. Of the 19 Shigella isolates 5 (26.3%), 2 (10.5%), and 1 (5.2%) were phenotypically resistant to nalidixic acid, ciprofloxacin, and norfloxacin, respectively. Class 1 integron was found in 18 (94.7%) isolates whereas class 2 integron was found in 19 (100%) strains. Conclusion: We found a considerable presence of Shigella species with elevated antibiotic resistance levels. In particular, the resistance to third-generation cephalosporins (ESBL) and ciprofloxacin must be taken seriously.

&lt;p&gt;Multidrug-resistant &lt;em&gt;Shigella&lt;/em&gt; infection in pediatric patients with diarrhea from central Iran&lt;/p&gt;

&lt;p&gt;Multidrug-resistant &lt;em&gt;Shigella&lt;/em&gt; infection in pediatric patients with diarrhea from central Iran&lt;/p&gt;

<p>Multidrug-resistant <em>Shigella</em> infection in pediatric patients with diarrhea from central Iran</p>