Journal
CLINICAL INFECTIOUS DISEASES
Volume 54, Issue -, Pages S458-S463Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/cid/cis230
Keywords
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Funding
- Centers for Disease Control and Prevention (CDC) [U60/CD303019]
- Food Safety Office
- US Department of Agriculture Food Safety and Inspection Service
- Food and Drug Administration
- Division of Foodborne, Waterborne
- Environmental Diseases of the National Center for Emerging and Zoonotic Infectious Diseases from the Centers for Disease Control and Prevention
- Association of Public Health Laboratories
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Background. Treatment of shigellosis with appropriate antimicrobial agents shortens duration of illness and bacterial shedding, but resistance to commonly used agents is increasing. Methods. We describe resistance patterns among Shigella isolates in the United States with use of linked data from the Foodborne Diseases Active Surveillance Network (FoodNet) and National Antimicrobial Resistance Monitoring System (NARMS). FoodNet sites send every 20th Shigella isolate to the NARMS laboratory for susceptibility testing. Results. During 2000-2010, the NARMS laboratory tested 1376 Shigella isolates from FoodNet sites. Of 1118 isolates (81%) linked to FoodNet, 826 (74%) were resistant to ampicillin, 649 (58%) to streptomycin, 402 (36%) to trimethoprim-sulfamethoxazole (TMP-SMX), 355 (32%) to sulfamethoxazole-sulfisoxazole, 312 (28%) to tetracycline, 19 (2%) to nalidixic acid, and 6 (0.5%) to ciprofloxacin. The proportion of Shigella isolates with resistance to TMP-SMX was 40% among white persons, 58% among Hispanic persons, and 75% among persons with a history of international travel. Resistance to at least TMP-SMX and ampicillin was present in 25% of isolate, and 5% were resistant to ampicillin, TMP-SMX, and chloramphenicol. Overall, 5% of isolates showed multidrug resistance to ampicillin, chloramphenicol, streptomycin, sulfamethoxazole-sulfisoxazole, and tetracycline, including 49 Shigella flexneri (33%) and 3 Shigella sonnei (0.3%) isolates. Male individuals were more likely than female individuals to be infected with a multidrug-resistant strain (7% versus 3%; P < .01). Conclusions. Antimicrobial resistance differed by race, ethnicity, age, travel, and species. Resistance to commonly used antibiotics is high; therefore, it is important to look at the susceptibility pattern before starting treatment.
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