Diarrhea in an infant due to Shigella flexneri 1 carrying multiple cephalosporinase-encoding genes.
Gut Pathog
; 13(1): 18, 2021 Mar 20.
Article
em En
| MEDLINE
| ID: mdl-33743818
ABSTRACT
BACKGROUND:
Infections caused by multidrug-resistant shigellae resistant to broad-spectrum cephalosporins are becoming more prevalent in the Middle East. We report a case of severe diarrhea due to a multiresistant Shigella flexneri 1 strain carrying four different ß-lactamase genes. CASE PRESENTATION A one-year-old Syrian infant presented with severe acute diarrhea, vomiting and dehydration. She did not respond to empirical treatment with amoxicillin-clavulanic acid followed by cefotaxime. Later, stool culture revealed S. flexneri 1 resistant to both these drugs. The patient was successfully treated with meropenem to which S. flexneri 1 was susceptible. The isolate was resistant to eight classes of antibiotics, and the whole genome sequence (WGS) identified four ß-lactamase genes (blaCTX-M-15, blaEC-8, blaOXA-1, and blaTEM-1) along with genes mediating resistance to seven other antibiotic classes. The WGS also identified several virulence genes including senA that encodes ShET-2 which induces watery diarrhea. Phylogenetically, the isolate was closely related to isolates from South Asia.CONCLUSIONS:
This report highlights the emergence of extremely resistant Shigella that has acquired multiple resistance genes to cephalosporins rendering these drugs ineffective.
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Bases de dados:
MEDLINE
Idioma:
En
Revista:
Gut Pathog
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Kuait