Abstract
The purpose of the study – to determine the antimicrobial resistance of Shigella sonnei and Shigella flexneri isolated in Smolensk Region and to develop recommendations for empiric therapy of shigellosis. A total of 88 strains of S.flexneri and 69 strains of S.sonnei isolated in Smolensk and Smolensk Region during 1998–1999, were tested to 9 antimicrobials: ampicillin (AM), ampicillin/sulbactam (AMS), cefotaxime (CTX), tetracycline (TE), chloramphenicol (CL), nalidixic acid (NLA), norfloxacin (NOR), ciprofloxacin (CIP), trimethoprim/sulfamethoxazole (SXT) by agar dilution method. High rates of resistance were found in both S.flexneri and S.sonnei, to: SXT (96,6 and 94,2% respectively), TE (97,7 and 92,8% respectively), CL (93,2 and 50,7% respectively), AM (95,5% and 26,1% respectively) and AMS (95,5 and 23,2%). No resistance to NLA, NOR, CIP and CTX was detected. High rates of multiresistance (defined as resistance to 3 and more antimicrobials) was found: 96,9 and 63,8% in S.flexneri and in S.sonnei, respectively. Among S.flexneri 87,5% of strains were characterized by the AM/AMS/CL/TE/SXT phenotype of resistance and 37,7% of S.sonnei strains had SXT/CL/TE one. CL, TE and SXT lost his efficacy against Shigella spp. and can not be recommended for the empirical therapy of shigellosis in Smolensk Region. Quinolones and cephalosporins III remain highly active and can serve as drugs of choice for the treatment of shigellosis.
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