A Study on the antibiotic resistence of Shigella

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ABSTRACT: The hospital morbidity caused by Shigella or dysentery ranges between 0.3 to 2.9%. Irrational use of antibiotics causes a persistent diarrhea and may lead to drug resistance. Objectives With various kinds of antibiotics available in Indonesia at the moment, this study aimed to anticipate the kinds of antibiotics appropriate for shigellosis and to evaluate the clinical spectrum of dysentery in children in Indonesia.
Method The study involved 50 children diagnosed with dysentery or dysentery-like syndrome, aged 1 to 12 years, who came to four different hospitals in Jakarta, from November 2001 to April 2002. Parents were asked for their consent. Interviewers recorded details of the children’s history of illness and the physical examinations. Stool culture and resistance tests were done.
Results Fifty dysentery cases, comprising 30 males and 20 females, 98% aged from 1 to 5 years, came to the four hospitals during the study period. Only 24 cases had positive Shigella cultures, of which 87% were Shigella flexneri and 17% were Shigella sonnei. The clinical manifestations of shigellosis were bloody stools (83%), mucus in the stool (75%), and watery diarrhea (96%). Fever and tenesmus were absent in 67% and 92% of subjects, respectively. Almost 87% of shigellosis cases were resistant to cotrimoxazole; all were sensitive to colistin and most were sensitive to nalidixic acid.
Conclusion This data suggests that colistin and nalidixic acid are drugs of choice for dysentery syndrome. The clinical manifestation of dysentery is not always accompanied by bloody stools but mostly incorporates watery diarrhea and mucus in the stool.
Keywords: dysentery, shigellosis, children, antibiotics, an-tibiotic resistance, antibiotic sensitivity
Author: Pramita G Dwipoerwantoro, MD; Sri P Pulungan, MD; Nuraini I Susanti, MD; Hartaniah Sadikin, MD; Agus Frimansyah, MD, PhD
Journal Code: jpkedokterangg050061

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Jp Kedokteran gg 2005