Shigella species epidemiology and antimicrobial susceptibility: the implications of emerging azithromycin resistance for guiding treatment, guidelines and breakpoints.
J Antimicrob Chemother
; 72(11): 3181-3186, 2017 Nov 01.
Article
in En
| MEDLINE
| ID: mdl-28961759
ABSTRACT
OBJECTIVES:
To examine antimicrobial susceptibility patterns and predictors of resistance among Shigella isolates in New South Wales (NSW), Australia during 2013-14 with emphasis on azithromycin.METHODS:
Cross-sectional analysis of all shigellosis cases (160) notified to public health authorities in NSW, Australia was performed.RESULTS:
Among 160 Shigella isolates tested, 139 (86.9%) were susceptible to azithromycin, 104 (65.0%) to ciprofloxacin and 38 (23.7%) to co-trimoxazole. Ciprofloxacin resistance was 1.9 times more common in infections acquired in Australia compared with those acquired overseas, while azithromycin resistance was 8.5 times more common in males.CONCLUSIONS:
We recommend ongoing reconsideration of guidelines for the treatment of shigellosis based on emerging resistance patterns. First-line therapy may need to be reconsidered based on local resistance rates due to common resistance to co-trimoxazole and ciprofloxacin. We recommend culture and susceptibility testing for suspected and proven shigellosis. Azithromycin susceptibility breakpoints for Shigella species may need to be species specific.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Shigella
/
Azithromycin
/
Drug Resistance, Multiple, Bacterial
/
Dysentery, Bacillary
/
Anti-Bacterial Agents
Type of study:
Guideline
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
Limits:
Adolescent
/
Adult
/
Aged
/
Child
/
Child, preschool
/
Female
/
Humans
/
Male
/
Middle aged
Country/Region as subject:
Oceania
Language:
En
Journal:
J Antimicrob Chemother
Year:
2017
Type:
Article
Affiliation country:
Australia