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 ::  Abstract
 ::  Introduction
 ::  Methods
 ::  Results
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 ::  Acknowledgment
 ::  References
 ::  Article Tables

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Year : 1995  |  Volume : 41  |  Issue : 4  |  Page : 104-6

Serogroup prevalence of Shigellae in Bombay.


Dept of Microbiology, LTM Medical College, Sion, Bombay.

Correspondence Address:
M Sonawala
Dept of Microbiology, LTM Medical College, Sion, Bombay.

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Source of Support: None, Conflict of Interest: None


PMID: 0010707731

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 :: Abstract 

Prevalence of Shigellae serotypes in Bombay was studied from June 1988 to May 1991. A total of 2758 faecal specimens were collected from paediatric patients (< 12 yrs) with acute gastroenteritis. A total of 90 Shigella were isolated giving the isolation rate of 3.2%. Shigella flexneri was the predominant serogroup (73.3%) followed by Shigella dysenteriae (16.6%). All the isolates were sensitive to nalidixic acid. Eighty percent of the Shigellae were multidrug resistant. Present data were compared with the study carried out during the period of 1983-87 from the same institute. A change in the serogroup prevalence was noted wherein Shigella flexneri dominated over Shigella dysenteriae since 1985. Increase in resistance to ampicillin and cotrimoxazole was seen in Shigella flexneri strains as compared to previous years.


Keywords: Anti-Infective Agents, Quinolone, pharmacology,Child, Child, Preschool, Drug Resistance, Microbial, Drug Resistance, Multiple, Dysentery, Bacillary, drug therapy,epidemiology,microbiology,Female, Human, India, epidemiology,Infant, Male, Microbial Sensitivity Tests, Nalidixic Acid, pharmacology,Serotyping, Shigella, classification,drug effects,isolation &purification,


How to cite this article:
Sonawala M, Saraswathi K, Deodhar L P. Serogroup prevalence of Shigellae in Bombay. J Postgrad Med 1995;41:104

How to cite this URL:
Sonawala M, Saraswathi K, Deodhar L P. Serogroup prevalence of Shigellae in Bombay. J Postgrad Med [serial online] 1995 [cited 2019 Sep 23];41:104. Available from: http://www.jpgmonline.com/text.asp?1995/41/4/104/512





  ::   Introduction Top


Dysentery has been one of the major epidemic diseases in the history of mankind and one of the commonest killing diseases in the Pediatric age group all over the world. Outbreaks of Shigellosis have been reported from different parts of India[1],[2]. However, reports regarding prevalence of various serogroups of Shigella in Bombay are very few. The present investigation was therefore undertaken - (i) to study the incidence and serogroup prevalence of Shigella isolated from cases of dysentery during a three year period. (June 1988-May 199l): (ii) to determine their drug resistance pattern, and (iii) to compare the results of the present study with that of previous years as regards the prevalent serogroup and antimicrobial sensitivity pattern of Shigella isolates.


  ::   Methods Top


A total of 2.758 faecal specimens collected from Pediatric (< 12 yrs) patients with diarrhoea/dysentery were studied for enteric pathogens. Samples of faeces were collected in sterile wide mouth bottles and rectal swabs were transported in Cary-Biair transport medium and were processed within 2 hours of collection. The samples were examined macroscopically for the presence of mucus and blood and microscopically for pus cells, RBCs, macrophages cysts and ova of parasites.

Bacteriological examination

The samples were inoculated directly on the MacConkey agar, deoxycholate citrate agar (DCA) and enrichment was done in Selenite F broth and incubated at 37?C overnight. After the enrichment. subcultures were done on above mentioned culture media and further incubated at 37?C overnight. All the 2,758 samples were also processed for other enter-opathogens using standard laboratory procedures[3]. For  Yersinia More Details species, samples were incubated on Yersinia selective agar at 20-25?C overnight. For Campylobacter jejuni Scientific Name Search  Campy-BAP medium was used and samples were incubated under microaerophilic conditions at 37?C - 42?C overnight.

Colonies morphologically resembling Shigella species were further identified by biochemical reactions and confirmed by slide agglutination test using polyvalent and monovalent antisera from Burroughs Wellcome, England.

Antibiotic Sensitivity tests: Drug susceptibility patterns of all Shigella isolates were determined by the disc diffusion technique of Kirby Bauer[4] Commercially manufactured discs (Bio-Pasteur) of antimicrobial agents and their concentration in mcg/ml were as follows: gentamicin (G) - 10, kanamycin (K) - 30, ampicillin (A) - 10, chloramphenicol (C) - 30, streptomycin (S) - 10, tetracycline (T) (- 30. nalidixic acid (NA) - 30 and cotrimoxazole (CoT) - 25. A control strain of E coli (ATCC - 225922) was included in each test. The minimum inhibitory concentration (MIC) of A, S, C, T and CoT was determined using agar dilution methods[5].


  ::   Results Top


Various enteropathogens isolated during the present study are shown in [Table - 1].

Isolation rate of Shigella species was 3.2% and was almost similar to that of  Salmonella More Details species (3.4%). Of 90 Shigella strains isolated, 66 were of  Shigella flexneri Scientific Name Search 73.3%) followed by  Shigella dysenteriae Scientific Name Search e 1 (16.6%), Shigella boydi (8.8%), and  Shigella sonnei Scientific Name Search 1 %). [Table - 2] shows the serogroup distribution of these 90 isolates.

Shigella flexneri was the predominant serogroup isolated and maximum number of Shigella was isolated during June 1989 to May 1990. Among Shigella group B, Shigella flexneri 2a was more common (83%) followed by Shigella flexneri 4a (15%) and Shigella flexneri 6 (2%). Eighty per cent of the Shigella isolated were from the children below the age of 5 and remaining 20% from 5-12 yrs of age.

Comparison of antimicrobial sensitivity pattern of Shigella isolated from 1983 to 1991 is shown in [Table - 3].

In the present study 100% sensitivity was seen with nalidixic acid followed by gentamicin (98.8%) and kanamycin (77.7%). The MIC of different drugs did not vary much from species to species or between strains. MIC of resistant Shigella isolated from 1988-91 is shown in [Table - 4].

In 1983 - 84, a similar study[6] was carried out in the same institute and the predominant serogroup was Shigella dysenteriae I (78%) followed by Shigella flexneri (21.9%).  Shigella boydii Scientific Name Search  Shigella sonnei strains were not detected during that period. The isolates were sensitive to Gentamicin. kanamycin, Ampicillin and Cotrimoxasole. From 1985 onwards (unpublished observations) a change in the serogroup prevalence was observed and majority of Shigella isolates belonged to Shigella flexneri (75%) followed by Shigella dysenteriae I (18%) till the year 1987. The resistance pattern observed in Shigella dysenteriae I strains isolated during the present study and those isolated in previous years was found to be similar. However, marked increase in the resistance in Shigella flexneri strains was seen with Ampicillin and Cotrimoxazole compared to the study carried out in previous years.


  ::   Discussion Top


Shigella still account for a significant proportion of bacillary dysentery in many tropical and subtropical countries[7].

A total of 90 Shigella were isolated from 2758 samples processed giving an isolation rate of 3.2%. Shigella flexneri accounted for the majority of the total Shigella isolated in the present study (73.3%) followed by Shigella dysenteriae I (1.6%). Our findings of serogroup prevalence among Shigella species are similar to other investigators[8],[9],[10].

Shigellosis was more common in first five years of life as 80% of Shigella were isolated from this age group. Same are the findings of other workers[11],[12].

All Shigella isolated were sensitive to nalidixic acid. Most of the isolates of Shigella dysenteriae I and Shigella flexneri were resistant to multiple antibiotics. The common resistance pattern observed were ACST and ACSTCoT Similar resistance pattern has been observed by Dudeja et al[13], and Shahid et al[14].

The results of the present study were compared with that of our previous publications[6]. Shigella dysenteriae I was the predominant serogroup isolated in previous years. However, 1985 onwards. Shigella flexneri predominated. In the present findings also, Shigella flexneri has dominated over other Shigella serogroups. In the previous study the incidence of Shigellosis was 2.0 to 2.5% which has increased to 3.2% during 1988-1991. This may be attributed to an outbreak of Shigellosis due to multi-drug resistant strains of Shigella flexneri.

Comparison of the sensitivity pattern of Shigella isolated during previous years and now has revealed that the change in pattern of Shigella serogroup is also associated with an increase in the resistance to Ampicillin and co-trimoxazole. Our findings arid those reported by Arora et al[1] show an increase in drug resistance with Ampicillin, chloramphenicol. streptomycin and tetracycline as against those reported by Kaliyug et al[9] and Panicker et al[15].

MIC studies have confirmed high level of drug resistance to commonly used antibiotics. The results of the MIC of resistant strains are comparable with that of Panicker et al[15] and Macaden et al[16]. However lower values have been reported to these antibiotics previously by Kaliyuga et al[9] and Gaikwad and Deodhar.

The present study indicates the emergence of resistant strains of Shigella flexneri to cotrimoxazole which is the drug of choice in the treatment of Shigellosis. An increased resistance to cotrimoxazole may be attributed to an indiscriminate use of this drug.

 
 :: References Top

1.   Back to cited text no. 1    
2.Arora DR. Midha NK Icchoujani RL. Chugh TD Drug resistant Shigellosis in North India Ind J Med Res 1982; 76:74 - 9.  Back to cited text no. 2    
3.Kale VV lyer L. Jain VIX. Shigellosis in infants and children J Postgrad Med 1982; 28:206-10  Back to cited text no. 3    
4.Finegold SM, Barron EJ. In Bailey and Scott's Diagnostic Microbiology, Chapter 27, 7th ed, St. Louis, Toronto The C V Mosby Company, 1986; 406  Back to cited text no. 4    
5.Bauer AW Kirby WMM, Sherris JC, Turk CXM Antibiotic susceptibility testing by a standardised single disc method Am J Clin Pathol 1966; 45:493-6.  Back to cited text no. 5    
6.Mastan JM. Antimicrobial susceptibility test. Laboratory testing in support of antimicrobial therapy In Sonnenwirth Ac, Jarratter L Eds. Gradwohl's Clinical Laboratory Methods and Diagnosis, 8th ed. St. Louis, Toronto, London 1980; 1937-70  Back to cited text no. 6    
7.Gaikwad S, Deodhar LP. Shigellosis - antibiotic resistance and transfer of R factors. J Postgrad Med 1985; 31:24-7  Back to cited text no. 7    
8.Woodruff AW In Medicine in Tropics Edinburgh and London, Churchill Livingstone 1974; 249.  Back to cited text no. 8    
9.Agrawal SK, Goel M, Das R, Kumar A Transmissible antibiotic resistance among Shigella species Ind J Med Res 1984; 80:402-8.  Back to cited text no. 9    
10.Kaliyuga P, Gupta U, Mahapatra LN Antimicrobial clwa resistance and R factors in Shigella Ind J Med Res 1978; 68:220-4.  Back to cited text no. 10    
11.Mutanda LN, Kavita JN, Wamola IA. Patterns of Shigella species and serotypes in East Africa East Afr Med J 1979; 56:381-4.  Back to cited text no. 11    
12.Arya D, Chikara NL, Agarwal KC, Ganguly NK, Shigellosis in Chandigarh Ind J Pathol Micobiol 1977; 20:15-21.  Back to cited text no. 12    
13.Macaden R, Bhat P. Changing pattern of Shigella serotypes in a Southern Indian population. J Diarrhoeal Dis Res 1986; 14:77-80.  Back to cited text no. 13    
14.Dudeja M. Kapoor H, Prakash K. Prevalent Shigella serotypes around Delhi, Ind J Med Microbiol 1987; 5:15-20.  Back to cited text no. 14    
15.Shahid NS, Rahaman MM, Haider K Banu H Rahaman N Changing pattern of resistant Shiga bacillus dysenteriae type I) and Shigella flexneri in Bangladesh J Inf Dis 1985; 152:1114-9.  Back to cited text no. 15    
16.Panicker CKJ, Vimia KM, Bhat P. Stephen S. Drug resistant Shigellosis in South India Ind J Med Res 1982; 68:413-7.  Back to cited text no. 16    
17.Macaden R, Gokul BN, Pereira P. Bhat P. Bacillary dysentery due to multi-drug resistant Shigella dysentenae type I Ind J Med Res 1980; 71:178-85.   Back to cited text no. 17    


    Tables

[Table - 1], [Table - 2], [Table - 3], [Table - 4]

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