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High level resistance to trimethoprim, cotrimoxazole and other antimicrobial agents among clinical isolates of Shigella species in Ontario, Canada – an update

Published online by Cambridge University Press:  15 May 2009

N. Harnett
Affiliation:
Clinical Bacteriology Section, Central Public Health Laboratory, Box 9000, Terminal ‘A’, Toronto, Ontario, Canada, M5W 1R5
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Summary

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A total of 598 isolates of Shigella species (24 S. dysenteriae, 254 S. flexneri, 30 S. boydii, 290 S. sonnei) submitted to the Ontario Public Health Laboratories in 1990 were tested for their susceptibility to 14 antimicrobial agents by the agar dilution method. Overall 79·6% of isolates were resistant to one or more antimicrobial agents and 52·0% were resistant to four or more. Trimethoprim resistance ranged from 26·7% among isolates of S. boydii to 39·4% among S. flexneri strains. The majority of the 224 TMP resistant isolates (88·8%) demonstrated high level resistance (MIC > 1000 mg/1) to trimethoprim. Resistance to cotrimoxazole increased from 3% in 1978 to between 26·7 and 37·6% in 1990. MICs for 90% of isolates (MIC90S) for ampicillin, ticarcillin and piperacillin were 128 to > 256 mg/1, > 256 for tetracycline and chloramphenicol, and > 2·0/38·0 for cotrimoxazole. These results from the Canadian Province of Ontario emphasize the need for prudent use of antimicrobial agents in the treatment of shigellosis.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1992

References

REFERENCES

1.Mata, LJ, Gangarosa, EJ, Caceres, A, Perera, DR, Mejicanos, ML. Epidemic Shiga bacillus dysentery in Central America. 1. Etiologic investigation in Guatemala, 1969. J Infect Dis 1970; 122: 170–80.CrossRefGoogle Scholar
2.Olukoya, DK, Oni, O. Plasmid profile analysis and antimicrobial susceptibility patterns of shigella isolates from Nigeria. Epidemiol Infect 1990; 105: 5964.CrossRefGoogle ScholarPubMed
3.Palchauduri, S, Kumar, R, Sen, D, et al. Molecular epidemiology of plasmid patterns in Shigella dysenteriae type 1 obtained from an outbreak in West Bengal (India). FEMS Lett 1985; 30: 187–91.CrossRefGoogle Scholar
4.Gross, RJ, Threlfall, EJ, Ward, LR, Rowe, B. Drug resistance in Shigella dysenteriae, S. flexneri and S. boydii in England and Wales: increasing incidence of resistance to trimethoprim. Br Med J 1984; 288: 748–86.CrossRefGoogle ScholarPubMed
5.Heikkila, E, Siitonen, A, Jahkola, M, Fling, M, Sundstrom, L, Huovinen, P. Increase of trimethoprim resistance among Shigella species, 1975–1988: analysis of resistance mechanisms. J Infect Dis 1990; 161: 1242–8.CrossRefGoogle ScholarPubMed
6.Ling, J, Kam, KM, Lam, AW, French, GL. Susceptibilities of Hong Kong isolates of multiply-resistant Shigella spp. to 25 antimicrobial agents including ampicillin plus sulbactam and new 4-quinolones. Antimicrob Agents Chemother 1988; 32: 20–3.CrossRefGoogle ScholarPubMed
7.Bratoeva, MP, John, JF Jr. Dissemination of trimethoprim-resistant clones of Shigella sonnei in Bulgaria. J Infect Dis 1989; 159: 648–53.CrossRefGoogle ScholarPubMed
8.Litwin, CM, Ryan, KJ, Chipowsky, S, Storm, A, McCombie, S. Molecular epidemiology of Shigella sonnei in Puma County, Arizona: evidence for a Mexico-related plasmid. J Infect Dis 1990; 161: 797800.CrossRefGoogle Scholar
9.Bannatyne, R, Toma, S, Cheung, R, Hu, G. Resistance to trimethoprim and other antibiotics in Shigella isolated in the province of Ontario. Can J Microbiol 1980; 26: 1256–8.CrossRefGoogle ScholarPubMed
10.Harnett, N, McLeod, S, AuYong, Y, Krishnan, C. Increasing incidence of resistance among Shigellae to trimethoprim. Lancet 1991; 337: 622.CrossRefGoogle ScholarPubMed
11.Cowan, ST, Steel, KJ. Identification of medical bacteria, 2nd edn. Cambridge: Cambridge University Press, 1974.Google Scholar
12.Edwards, PR, Ewing, WH. Identification of Enterobacteriaceae. Minneapolis: Burgess Publishing, 1972.Google Scholar
13.National Committee for Clinical Laboratory Standards. Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically, 2nd edn. M7-A2. National Committee for Clinical Laboratory Standards, Villanova, Pa., 1990.Google Scholar
14.Steers, E, Foltz, L, Graves, BS. An inocula replicating apparatus for routine testing of bacterial susceptibility to antibiotics. Antibiot Chemother 1959; 9: 307–11.Google Scholar
15.Tauxe, RV, Puhr, ND, Wells, JG, Hargrett-Bean, N, Blake, PA. Antimicrobial resistance of Shigella isolates in the USA: the importance of international travellers. J Infect Dis 1990; 162: 1107–11.CrossRefGoogle Scholar
16.Griffin, PM, Tauxe, RV, Redd, SC, Puhr, ND, Hargrett-Bean, N, Blake, PA. Emergence of highly trimethoprim-sulfamethoxazole-resistant Shigella in a native American population: an epidemiologic study. Am J Epidemiol 1989; 129: 1042–51.CrossRefGoogle Scholar
17.Harnett, N. Transferable high-level trimethoprim resistance among isolates of Escherichia coli from urinary tract infections in Ontario, Canada. Epidemiol Infect 1992; 109; 473481.Google Scholar
18.McCormack, JG. Nalidixic acid for shigellosis. Lancet, 1983; ii: 1091.Google Scholar
19.Rogerie, F, Ott, D, Vandepitte, J, Verbist, L, Lemmens, P, Habiyaremye, I. Comparison of norfloxacin and nalidixic acid for treatment of dysentery caused by Shigella dysenteriae type 1 in adults. Antimicrob Agents Chemother 1986; 29: 883–6.CrossRefGoogle ScholarPubMed
20.Munshi, MH, Haider, K, Rahaman, MM, Sask, DA, Ahmed, ZV, Morhsed, MG. Plasmid-mediated resistance to nalidixic acid in Shigella dysenteriae type 1. Lancet 1987; ii: 419–21.CrossRefGoogle Scholar
21.Panhotra, BR, Desai, B, Sharma, PL. Nalidixic acid resistant Shigella dysenteriae 1. Lancet 1985; i: 763.CrossRefGoogle Scholar
22.Bannatyne, RM, Toma, S, Cheung, R. Nalidixic acid analogues and Shigella. Lancet 1984; ii: 172–3.Google Scholar
23.Dupont, HL. Use of quinolones in the treatment of gastrointestinal infections. Eur J Clin Microbiol Infect Dis 1991; 10: 325–9.Google Scholar