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2.
BMC Pediatr ; 24(1): 311, 2024 May 06.
Artigo em Inglês | MEDLINE | ID: mdl-38711011

RESUMO

BACKGROUND: Diarrhea caused by Salmonella and Shigella species are the leading cause of illness especially in developing countries. These infections are considered as the main public health problems in children, including Ethiopia. This study aimed to assess the prevalence, associated factors, and antimicrobial susceptibility patterns of Salmonella and Shigella species in Sheik Hassan Yabere Referral Hospital Jigjiga, Eastern Ethiopia from August 05 to November 15, 2022. METHOD: A cross-sectional study was conducted among 239 under-five children with diarrhea selected through a convenient sampling technique. A structured questionnaire was used to collect associated factors. A stool sample was collected and processed for the identification of Salmonella and Shigella species using MacConkey adar, Xylose Lysine Deoxycholate agar (Oxoid Ltd) and Biochemical tests. The antimicrobial susceptibility pattern of isolates was performed using the Kirby-Bauer disc diffusion technique. The data was entered into Epi-data version 4.6 and exported to the statistical package of social science version 22 for analysis. The association between outcome and independent variables was assessed using bivariate, multivariable, and chi-square and P-value < 0.05 was considered as statistical significance. RESULT: Overall prevalence of Salmonella and Shigella species was 6.3% (95% CI, 5.7-6.9%), of which 3.8% (95 CI, 3.2-4.4%) were Salmonella species and 2.5% (95% CI, 1.95-3%) were Shigella species. Unimproved water source (AOR = 5.08, 95% CI = 1.45, 17.25), open field (AOR = 2.3, 95% CI = 1.3, 5.03), rural residence (AOR = 1.8, 95% CI = 1.4, 7.5), Hand-washing practice (p = 0.001), and raw meat consumption (p = 0.002) were associated with occurrence of Salmonella and Shigella species. Salmonella and Shigella isolates were resistant to Ampicilin (100%). However, Salmonella isolates was sensitive to Norfloxacin (100%). About 22.2% and 16.7% of Salmonella and Shigella isolates were multi-drug resistant, respectively. CONCLUSION: Prevalence of Salmonella and Shigella species were lower than most studies done in Ethiopia. Hand-washing habit, water source type, Open field waste disposal habit, raw meat consumption and rural residence were associated with Salmonellosis and shigellosis. All isolated Salmonella were sensitive to norfloxacin. The evidence from this study underscores the need for improved water, sanitation and hygiene (WASH) system and the imperative to implement drug susceptibility tests for the treatment of Salmonella and Shigella infection.


Assuntos
Diarreia , Disenteria Bacilar , Testes de Sensibilidade Microbiana , Salmonella , Shigella , Humanos , Etiópia/epidemiologia , Estudos Transversais , Pré-Escolar , Feminino , Salmonella/isolamento & purificação , Salmonella/efeitos dos fármacos , Masculino , Prevalência , Shigella/efeitos dos fármacos , Shigella/isolamento & purificação , Lactente , Diarreia/microbiologia , Diarreia/epidemiologia , Disenteria Bacilar/epidemiologia , Disenteria Bacilar/microbiologia , Disenteria Bacilar/tratamento farmacológico , Infecções por Salmonella/epidemiologia , Infecções por Salmonella/microbiologia , Infecções por Salmonella/tratamento farmacológico , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Fatores de Risco , Fezes/microbiologia , Farmacorresistência Bacteriana
3.
Emerg Infect Dis ; 29(7): 1473-1475, 2023 07.
Artigo em Inglês | MEDLINE | ID: mdl-37204919

RESUMO

In Los Angeles, California, USA, persistent, refractory shigellosis was diagnosed in an immunocompetent man who has sex with men. Whole-genome sequencing augmented phenotypic antimicrobial susceptibility testing to comprehensively profile bacterial drug resistance and appropriately guide therapy and clear the infection.


Assuntos
Disenteria Bacilar , Shigella , Masculino , Humanos , Shigella flexneri/genética , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Disenteria Bacilar/diagnóstico , Disenteria Bacilar/tratamento farmacológico , Disenteria Bacilar/epidemiologia , Farmacorresistência Bacteriana , Los Angeles , Testes de Sensibilidade Microbiana
4.
Emerg Infect Dis ; 29(8): 1708-1711, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-37486233

RESUMO

We report extensively drug-resistant (XDR) Shigella sonnei infection in an immunocompromised patient in Texas, USA. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry failed to identify XDR Shigella, but whole-genome sequencing accurately characterized the strain. First-line antimicrobials are not effective against emerging XDR Shigella. Fosfomycin, carbapenems, and tigecycline are potential alternatives.


Assuntos
Anti-Infecciosos , Disenteria Bacilar , Shigella , Humanos , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Anti-Infecciosos/farmacologia , Disenteria Bacilar/diagnóstico , Disenteria Bacilar/tratamento farmacológico , Disenteria Bacilar/epidemiologia , Testes de Sensibilidade Microbiana , Shigella sonnei/genética , Estados Unidos/epidemiologia
5.
Emerg Infect Dis ; 29(8): 1668-1671, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-37486309

RESUMO

Increased invasive bloodstream infections caused by multidrug resistant Shigella sonnei were noted in Vancouver, British Columbia, Canada, during 2021-2023. Whole-genome sequencing revealed clonal transmission of genotype 3.6.1.1.2 (CipR.MSM5) among persons experiencing homelessness. Improvements in identifying Shigella species, expanding treatment options for multidrug resistant infections, and developing public health partnerships are needed.


Assuntos
Bacteriemia , Disenteria Bacilar , Pessoas Mal Alojadas , Shigella , Humanos , Shigella sonnei/genética , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Colúmbia Britânica/epidemiologia , Disenteria Bacilar/tratamento farmacológico , Disenteria Bacilar/epidemiologia , Farmacorresistência Bacteriana Múltipla/genética , Bacteriemia/tratamento farmacológico , Bacteriemia/epidemiologia , Testes de Sensibilidade Microbiana
6.
J Clin Microbiol ; 61(3): e0165222, 2023 03 23.
Artigo em Inglês | MEDLINE | ID: mdl-36853032

RESUMO

Fecal culture for isolation and identification of Shigella may take days. The BioFire FilmArray Gastrointestinal (GI) panel (bioMérieux, France) is a PCR-based assay that detects enteric pathogens including Shigella/enteroinvasive Escherichia coli (EIEC) in about an hour. The aim of this study was to evaluate the impact of GI panel detection of Shigella in a pediatric emergency department (ED) during an outbreak. Stool samples from children with acute gastroenteritis were tested by the GI panel. Test results were either withheld in preintervention (PRE) or reported to clinicians/families in the postintervention (POST) period. The impact of the GI panel testing on patient management and outcomes was measured. Shigella/EIEC was identified by the GI panel in the PRE (n = 30) and POST (n = 21) phase. The GI panel detected more Shigella infections than did culture; six of 31 (19.4%) Shigella GI panel-positive patients who also had stool cultures were missed by culture. Azithromycin therapy was prescribed for 20% of subjects in the PRE phase and 71.4% of subjects in the POST phase (P < 0.001). Time from the clinical encounter until starting azithromycin therapy was shorter in the POST phase (n = 9), 8.25 h (range, 6.37 to 52.37 h), than in the PRE phase (n = 1), 72 h. Six subjects in the PRE phase visited additional providers compared with one in the POST phase. Prompt diagnosis of shigellosis with the GI panel may provide the opportunity for prompt antimicrobial therapy and avoid additional visits to providers due to early definitive diagnosis. Prompt diagnosis of Shigella at an ED visit may optimize patient management and reduce transmission.


Assuntos
Disenteria Bacilar , Shigella , Humanos , Criança , Azitromicina , Fezes , Disenteria Bacilar/diagnóstico , Disenteria Bacilar/tratamento farmacológico , Disenteria Bacilar/epidemiologia , Escherichia coli , Surtos de Doenças
7.
J Antimicrob Chemother ; 78(4): 975-982, 2023 04 03.
Artigo em Inglês | MEDLINE | ID: mdl-36760088

RESUMO

BACKGROUND: Several countries have recently reported the detection of ESBL-producing Shigella sonnei associated with transmission among MSM. In a previous study by our group, 2.8% of Shigella spp. obtained from MSM in Barcelona between 2015 and 2019 were ESBL producers. OBJECTIVES: To describe and characterize the emerging ESBL-producing Shigella spp. associated with sexual transmission among MSM detected from 2020 to 2021 in Barcelona, elucidating their connectivity with contemporaneous ESBL-producing Shigella spp. from other countries. RESULTS: From 2020 to 2021, we identified that among MSM, 68% of S. sonnei were XDR harbouring blaCTX-M-27 and 14% of Shigella flexneri were MDR harbouring blaCTX-M-27. WGS analysis showed that the ESBL-producing S. sonnei were part of a monophyletic cluster, which included isolates responsible for the prolonged outbreak occurring in the UK. Our data also reveal the first emergence and clonal dissemination of ESBL-producing and fluoroquinolone-resistant S. flexneri 2a among MSM. CONCLUSIONS: We report an increasing trend of antimicrobial resistance in Shigella spp. among MSM in Barcelona since 2021, mainly as a consequence of the dissemination of XDR ESBL-producing S. sonnei, previously reported in the UK. These results highlight the importance of international collaborative surveillance of MDR/XDR S. sonnei and S. flexneri for rapid identification of their emergence and the prevention of the transmission of these pathogens.


Assuntos
Disenteria Bacilar , Minorias Sexuais e de Gênero , Shigella , Masculino , Humanos , Shigella flexneri , Shigella sonnei , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Disenteria Bacilar/epidemiologia , Disenteria Bacilar/tratamento farmacológico , Homossexualidade Masculina , Farmacorresistência Bacteriana , Testes de Sensibilidade Microbiana , Surtos de Doenças
8.
Appl Environ Microbiol ; 89(12): e0107423, 2023 12 21.
Artigo em Inglês | MEDLINE | ID: mdl-38032177

RESUMO

IMPORTANCE: Shigella sonnei is a major human enteric pathogen that causes bacillary dysentery. The increasing spread of drug-resistant S. sonnei strains has caused an emergent need for the development of new antimicrobial agents against this pathogenic bacterium. In this study, we demonstrate that Stattic employs two antibacterial mechanisms against S. sonnei. It exerted both anti-virulence activity and bactericidal activity against S. sonnei, suggesting that it shows advantages over traditional antibiotics. Moreover, Stattic showed excellent synergistic effects with kanamycin, ampicillin, chloramphenicol, and gentamicin against S. sonnei. Our findings suggest that Stattic has promising potential for development as a new antibiotic or as an adjuvant to antibiotics for infections caused by S. sonnei.


Assuntos
Disenteria Bacilar , Shigella , Humanos , Shigella sonnei , Antibacterianos/farmacologia , Disenteria Bacilar/tratamento farmacológico , Disenteria Bacilar/microbiologia , Ampicilina/farmacologia , Testes de Sensibilidade Microbiana
9.
Environ Sci Technol ; 57(12): 4971-4983, 2023 03 28.
Artigo em Inglês | MEDLINE | ID: mdl-36929874

RESUMO

Shigella flexneri infection is the main cause of diarrhea in humans worldwide. The emergence of antimicrobial resistance (AMR) of S. flexneri is a growing public health threat worldwide, while large-scale studies monitoring the longitudinal AMR trends of isolates remain scarce. Here, the AMR gene (ARG) profiles of 717 S. flexneri isolates from 1920 to 2020 worldwide were determined. The results showed that the average number of ARGs in isolates has increased significantly, from 19.2 ± 2.4 before 1970 to 29.6 ± 5.3 after 2010. In addition, mobile genetic elements were important contributors to ARGs in S. flexneri isolates. The results of the structural equation model showed that the human development index drove the consumption of antibiotics and indirectly promoted the antibiotic resistance. Finally, a machine learning algorithm was used to predict the antibiotic resistance risk of global terrestrial S. flexneri isolates and successfully map the antibiotic resistance threats in global land habitats with over 80% accuracy. Collectively, this study monitored the longitudinal AMR trends, quantitatively surveilled the health risk of S. flexneri AMR, and provided a theoretical basis for mitigating the threat of antibiotic resistance.


Assuntos
Antibacterianos , Disenteria Bacilar , Humanos , Antibacterianos/farmacologia , Shigella flexneri/genética , Farmacorresistência Bacteriana/genética , Testes de Sensibilidade Microbiana , Disenteria Bacilar/epidemiologia , Disenteria Bacilar/tratamento farmacológico
10.
J Appl Microbiol ; 134(2)2023 Feb 16.
Artigo em Inglês | MEDLINE | ID: mdl-36626757

RESUMO

AIMS: A rapid rise in resistance to conventional antibiotics for Shigella spp. has created a problem in treating shigellosis. Hence, there is an urgent need for new and non-conventional anti-bacterial agents. The aim of this study is to show how Asiatic acid, a plant-derived compound, inhibits the intracellular growth of Shigella flexneri. METHODS AND RESULTS: Shigella flexneri sensitive and resistant strains were used for checking antimicrobial activity of Asiatic acid by gentamicin protection assay. Asiatic acid inhibited the intracellular growth of all strains. Gene expression analysis showed antimicrobial peptide (AMP) up-regulation by Asiatic acid in intestinal cells. Further western blot analysis showed that ERK, p38, and JNK are activated by Asiatic acid. ELISA was performed to check IL-8, IL-6, and cathelicidin secretion. The antibacterial effect of Asiatic acid was further verified in an in vivo mouse model. CONCLUSIONS: The reason behind the antibacterial activities of Asiatic acid is probably over-expression of antimicrobial peptide genes. Besides, direct antimicrobial activities, antimicrobial peptides also carry immunomodulatory activities. Here, Asiatic acid increased IL-6 and IL-8 secretion to induce inflammation. Overall, Asiatic acid up-regulates antimicrobial peptide gene expression and inhibits intracellular S. flexneri growth. Moreover, Asiatic acid reduced bacterial growth and recovered intestinal tissue damages in in vivo mice model.


Assuntos
Disenteria Bacilar , Shigella , Animais , Camundongos , Antibacterianos/farmacologia , Disenteria Bacilar/tratamento farmacológico , Disenteria Bacilar/microbiologia , Expressão Gênica , Interleucina-6/genética , Interleucina-8/genética , Testes de Sensibilidade Microbiana , Shigella/genética , Shigella flexneri/genética , Peptídeos Antimicrobianos/farmacologia
11.
Isr Med Assoc J ; 25(1): 5-7, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36718728

RESUMO

BACKGROUND: Clinical dysentery causes hundreds of thousands of deaths annually worldwide. However, current recommendations reserve antibiotics for those either clinically sick or with highly suspected cases of shigellosis. This treatment stems from rising antibiotic resistance. Children diagnosed with clinical dysentery in the pediatric emergency department (PED) are regarded more cautiously. OBJECTIVES: To explore the use of antibiotics in children diagnosed with clinical dysentery in the PED. METHODS: A retrospective case study of children with clinical dysentery at a single PED during the years 2015 and 2018. Demographics as well as clinical findings were compared to culture results and antibiotic treatment. RESULTS: The study included 281 children who were diagnosed with clinical dysentery during the study period; 234 (83%) were treated with antibiotics. However, cultures were positive in only 162 cases (58%). Only 32% were Shigella spp. Younger age, fever, and leukocytosis were related to antibiotic treatment. CONCLUSIONS: The diagnosis of clinical dysentery is misgiven commonly in the PED leading to widespread use of antibiotics when not indicated. This treatment may impact antibiotic resistance patterns. Further studies and interventions are necessary to create clear guidelines in the PED setting.


Assuntos
Disenteria Bacilar , Disenteria , Criança , Humanos , Lactente , Antibacterianos/uso terapêutico , Estudos Retrospectivos , Disenteria/tratamento farmacológico , Disenteria Bacilar/diagnóstico , Disenteria Bacilar/tratamento farmacológico , Serviço Hospitalar de Emergência
12.
Molecules ; 28(6)2023 Mar 08.
Artigo em Inglês | MEDLINE | ID: mdl-36985439

RESUMO

Shigellosis is a serious foodborne diarrheal disease caused by the Shigella species. It is a critical global health issue. In developing countries, shigellosis causes most of the mortality in children below 5 years of age. Globally, around 165 million cases of diarrhea caused by Shigella are reported, which accounts for almost 1 million deaths, in which the majority are recorded in Third World nations. In this study, silver nanoparticles were synthesized using Mangifera indica kernel (MK-AgNPs) seed extracts. The biosynthesized M. indica silver nanoparticles (MK-AgNPs) were characterized using an array of spectroscopic and microscopic tools, such as UV-Vis, scanning electron microscopy, particle size analyzer, Fourier transform infrared spectroscopy, and X-ray diffractometer. The nanoparticles were spherical in shape and the average size was found to be 42.7 nm. The MK-AgNPs exhibited remarkable antibacterial activity against antibiotic-resistant clinical Shigella sp. The minimum inhibitory concentration (MIC) value of the MK-AgNPs was found to be 20 µg/mL against the multi-drug-resistant strain Shigella flexneri. The results clearly demonstrate that MK-AgNPs prepared using M. indica kernel seed extract exhibited significant bactericidal action against pathogenic Shigella species. The biosynthesized nanoparticles from mango kernel could possibly prove therapeutically useful and effective in combating the threat of shigellosis after careful investigation of its toxicity and in vivo efficacy.


Assuntos
Disenteria Bacilar , Mangifera , Nanopartículas Metálicas , Shigella , Criança , Humanos , Mangifera/química , Nanopartículas Metálicas/química , Prata/farmacologia , Prata/química , Disenteria Bacilar/tratamento farmacológico , Extratos Vegetais/farmacologia , Extratos Vegetais/química , Testes de Sensibilidade Microbiana , Espectroscopia de Infravermelho com Transformada de Fourier , Antibacterianos/farmacologia , Antibacterianos/química , Sementes
13.
Clin Infect Dis ; 74(3): 455-460, 2022 02 11.
Artigo em Inglês | MEDLINE | ID: mdl-33993224

RESUMO

BACKGROUND: In 2018, the Centers for Disease Control and Prevention and the Vermont Department of Health investigated an outbreak of multidrug-resistant Shigella sonnei infections in a retirement community that offered a continuum of care from independent living through skilled nursing care. The investigation identified 24 culture-confirmed cases. Isolates were resistant to trimethoprim-sulfamethoxazole, ampicillin, and ceftriaxone, and had decreased susceptibility to azithromycin and ciprofloxacin. METHODS: To evaluate clinical and microbiologic response, we reviewed inpatient and outpatient medical records for treatment outcomes among the 24 patients with culture-confirmed S. sonnei infection. We defined clinical failure as diarrhea (≥3 loose stools per day) for ≥1 day after treatment finished, and microbiologic failure as a stool culture that yielded S. sonnei after treatment finished. We used broth microdilution to perform antimicrobial susceptibility testing, and whole genome sequencing to identify resistance mechanisms. RESULTS: Isolates contained macrolide resistance genes mph(A) and erm(B) and had azithromycin minimum inhibitory concentrations above the Clinical and Laboratory Standards Institute epidemiological cutoff value of ≤16 µg/mL. Among 24 patients with culture-confirmed Shigella infection, 4 were treated with azithromycin; all had clinical treatment failure and 2 also had microbiologic treatment failure. Isolates were susceptible to ciprofloxacin but contained a gyrA mutation; 2 patients failed treatment with ciprofloxacin. CONCLUSIONS: These azithromycin treatment failures demonstrate the importance of clinical breakpoints to aid clinicians in identifying alternative treatment options for resistant strains. Additionally, these treatment failures highlight a need for comprehensive susceptibility testing and systematic outcome studies, particularly given the emergence of multidrug-resistant Shigella among an expanding range of patient populations.


Assuntos
Disenteria Bacilar , Shigella , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Azitromicina/farmacologia , Azitromicina/uso terapêutico , Ciprofloxacina/farmacologia , Ciprofloxacina/uso terapêutico , Surtos de Doenças , Farmacorresistência Bacteriana/genética , Disenteria Bacilar/tratamento farmacológico , Disenteria Bacilar/epidemiologia , Humanos , Macrolídeos/uso terapêutico , Testes de Sensibilidade Microbiana , Aposentadoria , Shigella sonnei/genética , Resultado do Tratamento , Vermont
14.
Antimicrob Agents Chemother ; 66(7): e0029322, 2022 07 19.
Artigo em Inglês | MEDLINE | ID: mdl-35727058

RESUMO

Shigella flexneri has become a significant public health concern accounting for the majority of shigellosis cases worldwide. Even though a multitude of efforts is being made into the development of a vaccine to prevent infections, the absence of a licensed global vaccine compels us to enormously depend on antibiotics as the major treatment option. The extensive-unregulated use of antibiotics for treatment along with natural selection in bacteria has led to the rising of multidrug-resistance Shigella strains. Out of the various mechanisms employed by bacteria to gain resistance, efflux transporters are considered to be one of the principal contributors to antimicrobial resistance. The small multidrug-resistance family consists of unique small proteins that act as efflux pumps and are involved in extruding various antimicrobial compounds. The present study aims to demonstrate the role of an efflux transporter YnfA belonging to the SMR family and its functional involvement in promoting antimicrobial resistance in S. flexneri. Employing various genetic, computational, and biochemical techniques, we show how disrupting the YnfA transporter, renders the mutant Shigella strain more susceptible to some antimicrobial compounds tested in this study, and significantly affects the overall transport activity of the bacteria against ethidium bromide and acriflavine when compared with the wild-type Shigella strain. We also assessed how mutating some of the conserved amino acid residues of YnfA alters the resistance profile and efflux activity of the mutant YnfA transporter. This study provides a functional understanding of an uncharacterized SMR transporter YnfA of Shigella.


Assuntos
Anti-Infecciosos , Disenteria Bacilar , Shigella , Antibacterianos/farmacologia , Disenteria Bacilar/tratamento farmacológico , Disenteria Bacilar/microbiologia , Humanos , Proteínas de Membrana Transportadoras/genética , Shigella flexneri/genética
15.
Antimicrob Agents Chemother ; 66(7): e0033422, 2022 07 19.
Artigo em Inglês | MEDLINE | ID: mdl-35762798

RESUMO

We describe the first occurrence in Spain of community cases of CTX-M-27-producing Shigella sonnei sequence type 152 (ST152), resistant to quinolones and azithromycin. The cases included adult males and also one pediatric case. The isolates were clustered together with an Australian isolate and differed from other outbreak-causing strains in England by more than 50 alleles. They carried the blaCTX-M-27 gene on an 83-Kb F2:A-:B- plasmid, similar to that found in a British isolate.


Assuntos
Disenteria Bacilar , Shigella sonnei , Adulto , Antibacterianos/farmacologia , Austrália , Criança , Células Clonais , Disenteria Bacilar/tratamento farmacológico , Disenteria Bacilar/epidemiologia , Humanos , Masculino , Plasmídeos/genética , Shigella sonnei/genética , Espanha/epidemiologia , beta-Lactamases/genética
16.
J Clin Microbiol ; 60(1): e0177421, 2022 01 19.
Artigo em Inglês | MEDLINE | ID: mdl-34669456

RESUMO

Molecular diagnostic methods improve the detection of Shigella, yet their ability to detect Shigella drug resistance on direct stool specimens is less clear. We tested 673 stool specimens from a Shigella treatment study in Bangladesh, including 154 culture-positive stool specimens and their paired Shigella isolates. We utilized a TaqMan array card that included quantitative PCR (qPCR) assays for 24 enteropathogens and 36 antimicrobial resistance (AMR) genes. Shigella was detected by culture in 23% of stool specimens (154/673), while qPCR detected Shigella at diarrhea-associated quantities in 49% (329/673; P < 0.05). qPCR for AMR genes on the Shigella isolates yielded >94% sensitivity and specificity compared with the phenotypic susceptibility results for azithromycin and ampicillin. The performance for trimethoprim-sulfamethoxazole susceptibility was less robust, and the assessment of ciprofloxacin was limited because most isolates were resistant. The detection of AMR genes in direct stool specimens generally yielded low specificities for predicting the resistance of the paired isolate, whereas the sensitivity and negative predictive values for predicting susceptibility were often higher. For example, the detection of ermB or mphA in stool yielded a specificity of 56% but a sensitivity of 91% and a negative predictive value of 91% versus the paired isolate's azithromycin resistance result. Patients who received azithromycin prior to presentation were universally culture negative (0/112); however, qPCR still detected Shigella at diarrhea-associated quantities in 34/112 (30%). In sum, molecular diagnostics on direct stool specimens greatly increase the diagnostic yield for Shigella, including in the setting of prior antibiotics. The molecular detection of drug resistance genes in direct stool specimens had low specificity for confirming resistance but could potentially "rule out" macrolide resistance.


Assuntos
Disenteria Bacilar , Shigella , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Farmacorresistência Bacteriana/genética , Disenteria Bacilar/diagnóstico , Disenteria Bacilar/tratamento farmacológico , Fezes , Humanos , Macrolídeos/farmacologia , Testes de Sensibilidade Microbiana , Shigella/genética
17.
J Med Primatol ; 51(6): 374-380, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-36045594

RESUMO

BACKGROUND: Shigella spp. are common enteric pathogens in captive non-human primates. Treatment of symptomatic infections involves supportive care and antibiotic therapy, typically with an empirical choice of antibiotic. METHODS: Twenty-four clinically ill, Shigella PCR-positive animals were randomly assigned to one of four treatment groups: single-dose ceftiofur crystalline free acid (CCFA), single-dose azithromycin gavage, a 5-day tapering azithromycin dose, or 7-day course of enrofloxacin. We hypothesized that all antimicrobial therapies would have similar efficacy. RESULTS: Animals in all groups cleared Shigella, based on fecal PCR, and had resolution of clinical signs 2 weeks after treatment. Eight out of nine clinically ill and PCR-positive animals tested negative by fecal culture. CONCLUSIONS: Single-dose CCFA, single-dose azithromycin, and a 5-day tapering course of azithromycin all performed as well as a 7-day course of enrofloxacin in eliminating Shigella infection. Fecal PCR may be a better diagnostic than culture for Shigella.


Assuntos
Disenteria Bacilar , Shigella , Animais , Disenteria Bacilar/tratamento farmacológico , Disenteria Bacilar/veterinária , Macaca mulatta , Macaca nemestrina , Antibacterianos/uso terapêutico , Enrofloxacina/uso terapêutico , Azitromicina/uso terapêutico
18.
Curr Microbiol ; 79(4): 118, 2022 Feb 27.
Artigo em Inglês | MEDLINE | ID: mdl-35220467

RESUMO

The rapid emergence of resistance to third-generation cephalosporins in Shigella flexneri is crucial in pediatric shigellosis management. Limited studies have been conducted on molecular pattern of antibiotic resistance of S. flexneri in diarrhea endemic areas of Pakistan. The aim of the study was to analyze the antimicrobial resistance of S. flexneri isolated from pediatric diarrheal patients in Peshawar, Pakistan. A total of 199 S. flexneri isolates (clinical, n = 1 55 and non-clinical, n = 44) were investigated for drug resistance and mutational analysis of selected drug resistance genes. All isolates were found to be highly resistant to amoxicillin/clavulanic acid (88%), followed by trimethoprim-sulfamethoxazole (77%), chloramphenicol (43%), and quinolones (41.6%). About 34.5% S. flexneri isolates were found to be resistant to third-generation cephalosporin. None of the isolates was resistant to imipenem, piperacillin-tazobactam, and amikacin. Interestingly high frequency of third-generation cephalosporin resistance was observed in S. flexneri isolated from non-clinical samples (49%) when compared to clinical samples (30.5%). Furthermore, the most prevalent phenotypic-resistant patterns among third-generation cephalosporin-resistant isolates were AMC,CAZ,CPD,CFM,CRO,SXT (13%) followed by OFX,AMC,CAZ,CPD,CFM,CRO,SXT,NA,CIP (10%). The most frequently detected resistance genes were trimethoprim-sulfamethoxazole (sul2 = 84%), beta-lactamase genes (blaOXA = 87%), quinolones (qnrS = 77%), and chloramphenicol (cat = 64%). No mutation was detected in any drug-resistant genes. We are reporting for the first time the sequence of the blaTEM gene in S. flexneri. Furthermore, high third-generation cephalosporin resistance was observed in the patients who practiced self-medication as compared to those who took medication according to physician prescription. This study shows the high emergence of third-generation cephalosporin-resistant S. flexneri isolates, which is a potential threat to the community in the country. This finding will be helpful to develop a suitable antibiotic prescription regime to treat shigellosis.


Assuntos
Disenteria Bacilar , Shigella , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Resistência às Cefalosporinas/genética , Criança , Farmacorresistência Bacteriana/genética , Disenteria Bacilar/tratamento farmacológico , Disenteria Bacilar/epidemiologia , Humanos , Testes de Sensibilidade Microbiana , Paquistão/epidemiologia , Shigella flexneri
19.
Foodborne Pathog Dis ; 19(8): 522-528, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35917515

RESUMO

Multiple drug-resistant (MDR) Shigella isolates have been reported worldwide. Between May 2017 and September 2018, 55 Shigella flexneri 2a isolates were collected from 3322 stool samples of 0-10-year-old outpatients with diarrhea at the Children's Hospital of Urumqi, China. All isolates were characterized using serotyping, antimicrobial susceptibility testing, and whole-genome sequencing. A total of 54 of 55 (98.2%) isolates exhibited MDR phenotypes and had accumulated multiple resistance determinants, particularly of fluoroquinolones and cephalosporins preferred for shigellosis treatment: point mutations in quinolone resistance-determining regions (QRDRs) of topoisomerases (GyrA (S83L, D87N) and ParC (S80I) [n = 9]; GyrA (S83L) and ParC (S80I) [n = 45]) and acquisition of qnrS1 (n = 3) and blaCTX-M (n = 8). Over 70% of isolates acquired two point mutations of GyrA (S83L) and ParC (S80I) in QRDRs and 11 highly resistant isolates accumulated three point mutations in QRDRs or acquired qnrS1. Four S. flexneri 2a isolates from three single-nucleotide polymorphism clusters exhibited coresistance to ciprofloxacin, cefotaxime, or azithromycin (AZM), which are used as first- and second-line shigellosis treatment antimicrobials in clinics. Our data indicated that fluoroquinolones should be terminated in shigellosis treatment for outpatients in Urumqi. The transferable antimicrobial resistance determinants have been identified for third-generation cephalosporins and AZM. Novel strategies are urgently required for developing empirical medication to reduce the antimicrobial selective pressure and prevent dissemination of MDR S. flexneri 2a isolates.


Assuntos
Anti-Infecciosos , Disenteria Bacilar , Quinolonas , Shigella , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Anti-Infecciosos/farmacologia , Cefalosporinas/farmacologia , Cefalosporinas/uso terapêutico , China/epidemiologia , Farmacorresistência Bacteriana/genética , Disenteria Bacilar/tratamento farmacológico , Disenteria Bacilar/epidemiologia , Fluoroquinolonas/farmacologia , Fluoroquinolonas/uso terapêutico , Humanos , Testes de Sensibilidade Microbiana , Pacientes Ambulatoriais , Quinolonas/farmacologia , Shigella/genética , Shigella flexneri/genética
20.
Molecules ; 27(6)2022 Mar 17.
Artigo em Inglês | MEDLINE | ID: mdl-35335300

RESUMO

Shigella species account for the second-leading cause of deaths due to diarrheal diseases among children of less than 5 years of age. The emergence of multi-drug-resistant Shigella isolates and the lack of availability of Shigella vaccines have led to the pertinence in the efforts made for the development of new therapeutic strategies against shigellosis. Consequently, designing small-interfering RNA (siRNA) candidates against such infectious agents represents a novel approach to propose new therapeutic candidates to curb the rampant rise of anti-microbial resistance in such pathogens. In this study, we analyzed 264 conserved sequences from 15 different conserved virulence genes of Shigella sp., through extensive rational validation using a plethora of first-generation and second-generation computational algorithms for siRNA designing. Fifty-eight siRNA candidates were obtained by using the first-generation algorithms, out of which only 38 siRNA candidates complied with the second-generation rules of siRNA designing. Further computational validation showed that 16 siRNA candidates were found to have a substantial functional efficiency, out of which 11 siRNA candidates were found to be non-immunogenic. Finally, three siRNA candidates exhibited a sterically feasible three-dimensional structure as exhibited by parameters of nucleic acid geometry such as: the probability of wrong sugar puckers, bad backbone confirmations, bad bonds, and bad angles being within the accepted threshold for stable tertiary structure. Although the findings of our study require further wet-lab validation and optimization for therapeutic use in the treatment of shigellosis, the computationally validated siRNA candidates are expected to suppress the expression of the virulence genes, namely: IpgD (siRNA 9) and OspB (siRNA 15 and siRNA 17) and thus act as a prospective tool in the RNA interference (RNAi) pathway. However, the findings of our study require further wet-lab validation and optimization for regular therapeutic use for treatment of shigellosis.


Assuntos
Disenteria Bacilar , Shigella , Criança , Diarreia/tratamento farmacológico , Disenteria Bacilar/tratamento farmacológico , Disenteria Bacilar/genética , Humanos , Interferência de RNA , RNA Interferente Pequeno/metabolismo , Shigella/genética
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