2019, Number 1
<< Back Next >>
Rev Cubana Med Trop 2019; 71 (1)
Dysentery by CTX-M Type ESBL Producing Shigella flexneri
Garrido DI, Fuseau HM, Moises GS, Gutierrez M, Calvopiña L, Vivas G
Language: English
References: 18
Page: 1-11
PDF size: 322.54 Kb.
ABSTRACT
According to the World Health Organization, diarrheal infections cause 525 000 deaths of
children under five years of age every year, and shigellosis is a relevant cause of dysentery
which increases the morbidity and mortality in pediatric patients. Therefore, emerging of
antimicrobial resistant strains of Shigella is a concerning problem worldwide. We report the
case of a 7-year-old patient with acute dysentery caused by CTX-M Type ESBL Producing
Shigella flexneri, being the first case in the Hospital of Specialties of the Armed Forces N°1,
Quito, Ecuador. The antibiogram demonstrated sensibility to ampicillin-sulbactam. As a
result, after five days of microbiologically directed treatment, the patient improved his
condition without relapse. Proper clinical diagnoses and accurate laboratory studies like
stool culture and antibiogram are crucial to giving an appropriate therapy in infections
caused by Shigella and other enteric bacilli.
REFERENCES
World Health Organization (WHO). Enfermedades diarreicas [cited 2018 Jan 30]. Available from: http://www.who.int/mediacentre/factsheets/fs330/es/
Ministerio de Salud Pública (MSP). Información estadística y geográfica de salud. Información estadística de producción de salud-Producción 2016 [cited 2018 Jan 30]. Available from: http://www.salud.gob.ec/informacion-estadistica-de-produccion-de-salud/
Revelas A. Acute gastroenteritis among children in the developing world. South Afr J Epidemiol Infect. 2012;27(4):156-62.
Nic Fhogartaigh C, Dance DAB. Bacterial gastroenteritis. Medicine. 2013;41(12):693-9.
León-Ramírez S. Shigelosis (disentería bacilar). Salud en Tabasco. 2002:8(1):22-5.
Nüesch-Inderbinen M, Heini N, Zurfluh K, Althaus D, Hächler H, Stephan R. Shigella Antimicrobial Drug Resistance Mechanisms, 2004-2014. Emerg Infect Dis. 2016;22(6):1083- 5. doi:10.3201/eid2206.152088
Yang C, Li P, Zhang X, Ma Q, Cui X, Li H, et al. Molecular characterization and analysis of high-level multidrugresistance of Shigella flexneri serotype 4s strains from China. Sci Rep. 2016;629124. doi: 10.1038/srep29124
Gopal A, Chidambaram IS, Devaraj N, Devaraj H. Shigella dysenteriae infection activates proinflammatory response through β-catenin/NF-κB signaling pathway. PLoS One. 2017;12(4):e0174943.
François M, Le Cabec V, Dupont M-A, Sansonetti PJ, Maridonneau-Parini I. Induction of Necrosis in Human Neutrophils by Shigella flexneri Requires Type III Secretion, IpaB and IpaC Invasins, and Actin Polymerization. Tuomanen EI, ed. Infection and Immunity. 2000;68(3):1289-96.
Zurita J, Ortega-Paredes D, Barba P. First Description of Shigella sonnei Harboring blaCTX-M-55 Outside Asia. J Microbiol Biotechnol. 2016;26(12):2224-7.
Gonzales-Escalante E, Sevilla-Andrade R, León-Sandoval S. CTX-M-Type Extended- Spectrum β-lactamase in Shigella flexneri isolates from pediatric patients with acute diarrhea. Rev Peru Med Exp Salud Pública. 2013;30(3):527-8.
Radice M, González C, Power P, Vidal MC, Gutkind G. Third-generation cephalosporin resistance in Shigella sonnei, Argentina. Emerg Infect Dis. 2001;7(3):442-3.
Prasad-Parajuli N, Joshi G, Dev-Pardhe B, Shakya J, Bhetwal A, Shakya S.et al. Shigellosis Caused by CTX-M Type ESBL Producing Shigella flexneri in Two Siblings of Rural Nepal: First Case Report from the Country. Case Rep Infect Dis. 2017;2017. doi:10.1155/2017/1862320
Iredell J, Brown J, Tagg K. Antibiotic resistance in Enterobacteriaceae: mechanisms and clinical implications. BMJ. 2016 [cited 2018 Jan 30];352:h6420. doi: https://doi.org/10.1136/bmj.h6420
Rashid H, Rahman M. Possible transfer of plasmid mediated third generation cephalosporin resistance between Escherichia coli and Shigella sonnei in the human gut. Infect Genet Evol. 2015;30:15-8
Niu C, Yang J, Liu H, Cui Y, Xu H, Wang R, et al. Role of the virulence plasmid in acid resistance of Shigella flexneri. Sci Rep. 2017;25(7):46465.
Garrido D, Garrido S, Gutierrez M, Calvopiña L, Harrison AS, Fuseau M, et al. Clinical characterization and antimicrobial resistance of Escherichia coli in pediatric patients with urinary tract infection at a third level hospital in Quito, Ecuador. Bol Med Hosp Infant Mex. 2017;74(4):265-71.
Christopher PR, David KV, John SM, Sankarapandian V. Antibiotic therapy for Shigella dysentery. Cochrane Database Syst Rev. 2010;8:CD006784.