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Antibiotic resistance and molecular characterization of Shigella isolates recovered from children less than 5 years in Manhiça, Southern Mozambique.

Int J Antimicrob Agents; 2018 Feb 12.
Artigo em Inglês | MEDLINE | ID: mdl-29448013
The objective of the study was to assess antibiotic resistance and the molecular epidemiology of Shigella isolates from a case-control study of diarrhea, conducted from 2007-2012 in children less than 5 years of age in Manhiça district, southern Mozambique. All isolates were tested for antimicrobial susceptibility using the disc-diffusion method. PCR was used to detect different molecular mechanisms of antibiotic resistance. Serotyping was performed using specific antisera. The clonal relationship of S. flexneri and S. sonnei was assessed by Pulsed-Field Gel Electrophoresis (PFGE). Of the 67 Shigella isolates analyzed, 59 were diarrheal cases and 8 controls. S. flexneri (70.1%; 47/67) was the most frequent species followed by S. sonnei (23.9%; 16/67).The most prevalent S. flexneri serotypes were 2a (38.3%; 18/47), 6 (19.2%; 9/47) and 1b (14.9%; 7/47). High rates of antimicrobial resistance were observed for trimethoprim/ sulfametoxazole (92.5%; 62/67), tetracycline (68.7%; 46/67), chloramphenicol (53.7%; 36/67) and ampicillin (50.7%; 34/67). Multidrug resistance was present in 55.2% (37/67) of the isolates and was associated with an 8.1% (3/37) case fatality rate. PFGE revealed 22 clones (16 S. flexneri and 6 S. sonnei), among which, P1 (31.9%; 15/47), P9 (17%; 8/47) and P2 (10.6%; 5/47) were the most prevalent S. flexneri clones. In conclusion, S. flexneri was the most prevalent species with MDR isolates mainly belonging to three specific clones (P1, P9 and P2). The case fatality rate observed among MDR isolates is a matter of concern indicating the need for appropriate treatment.