Resistencia de Shigella spp. a los antimicrobianos en Córdoba, Argentina, durante el período 1990-1997

Abstract

This study analyzed the evolution of antimicrobial resistance in 771 isolates of Shigella spp. obtained from a total of 9,195 feces cultures done between 1990 and 1997 in a children's hospital in Córdoba, Argentina. S. flexneri, which was responsible for 73% of the Shigella infections, was the species with the greatest resistance. The frequency of S. flexneri resistance to the three antibiotics most used (ampicillin, trimethoprim-sulfamethoxazole, and chloramphenicol) increased from 10% in 1990 to 58% in 1997 (P < 0.001). Considering each of the drugs individually, the resistance to ampicillin increased from 60% to 100% (P < 0.001), the resistance to chloramphenicol from 13% to 71% (P < 0.001), and the resistance to trimethoprim-sulfamethoxazole from 79% to 84% (P = 0.22). For S. sonnei, the increase in resistance to ampicillin (from 36% in 1990 to 54% in 1997) was not statistically significant (P = 0.20), nor was the reduction in resistance to trimethoprim-sulfamethoxazole, which went from 82% in 1990 to 55% in 1997 (P = 0.08). Only two S. sonnei isolates were found that were resistant to chloramphenicol, one in 1995 and another in 1997; two S. sonnei isolates were found with resistance to all three antibiotics. We consider it essential to carry out susceptibility tests of each Shigella clinical isolate, to detect changes in the resistance profile and thus modify empiric treatment.