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Volume 41, Number 2, April 2008
| | Antimicrobial susceptibility of Shigella isolates in eight Asian countries, 2001-2004 |
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Chen-Yen Kuo1, Lin-Hui Su1, Jennifer Perera2, Celia Carlos3, Ban Hock Tan4, Gamini Kumarasinghe4, Thomas So5, Pham Hung Van6, Anan Chongthaleong7, Jae-Hoon Song8, Cheng-Hsun Chiu1
1Department of Pediatrics, Chang Gung Children’s Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan; 2Department of Microbiology, University of Colombo, Colombo, Sri Lanka; 3Research Institute for Tropical Medicine, Department of Health, Manila, The Philippines; 4Department of Internal Medicine, Singapore General Hospital, National University of Singapore, Singapore; 5Department of Medicine, Princess Margaret Hospital, Hong Kong; 6Department of Microbiology, University of Medicine and Pharmacy, Ho Chi Minh City, Vietnam; 7Department of Microbiology, Chulalongkorn University, Bangkok, Thailand; and 8Division of Infectious Diseases, Samsung Medical Center, Seoul, Korea
Received: April 24, 2007 Revised: June 6, 2007 Accepted: August 26, 2007
Corresponding author: Dr. Cheng-Hsun Chiu, Department of Pediatrics, Chang Gung Children’s Hospital, Kweishan, Taoyuan 333, Taiwan. E-mail:
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Background and Purpose: Shigellosis is a major health problem in developing countries, causing 91 million episodes and 414,000 deaths in Asia annually. Because of increasing trends towards drug resistance, this study was undertaken to monitor local resistance patterns of Shigella isolates from 8 Asian countries.
Methods: Ninety eight Shigella isolates collected from 8 centers in 8 Asian countries from July 2001 to July 2004 were analyzed in terms of serogroup distribution and antimicrobial susceptibility.
Results: The most common serogroup of Shigella isolates was Shigella flexneri (49/98, 50%), followed by Shigella sonnei (44/98, 45%). The highest resistance rate was found for trimethoprim-sulfamethoxazole (81%), followed by tetracycline (74%) and ampicillin (53%). Overall, 76 Shigella isolates (78%) were multidrug-resistant strains; S. flexneri had a higher multidrug resistance rate than S. sonnei (74% vs 23%). Increasing ciprofloxacin and ceftriaxone resistance was observed; approximately 10% and 5% of isolates were resistant to ciprofloxacin and ceftriaxone, respectively. Five ceftriaxone-non-susceptible strains (from Taiwan [3], Hong Kong [1] and The Philippines [1]) and 10 ciprofloxacin-non-susceptible strains (from Hong Kong [2], The Philippines [1], Korea [2], Vietnam [4] and Sri Lanka [1]) were isolated.
Conclusions: High rates of multidrug resistance and steady increases in ceftriaxone and ciprofloxacin resistance of Shigella are serious pubic health concerns in Asian countries. Continuous monitoring of resistance patterns among Shigella isolates is necessary.
Key words: Asia; Microbial sensitivity tests; Shigella
J Microbiol Immunol Infect. 2008;41:107-111.
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