Laboratory-based surveillance of Shigella spp from human clinical cases in Colombia, 1997 to 2018.

Abstract

Introduction: Shigellosis is endemic in low and middle-income countries, causing approximately 125 million diarrhea episodes annually, leading to around 160.000 deaths. One third of these deaths are associated with children. Objective: describe characteristics and antimicrobial resistance profiles of Shigella species recovered in Colombia from 1997 to 2018. Materials and methods: we obtained isolates from laboratories in twenty-nine Colombian states. Serotyping was performed with specific antiserum and antimicrobial resistance via Kirby-Bauer and minimal inhibitory concentration for ten antibiotics according to Clinical and Laboratory Standards Institute recommendations. Results: In total 5251 isolates of Shigella spp. were studies. Most isolates were obtained from stool 96.4%. Also, 2511(47.8%) were from children under five years of age. Two most frequent species were founded S. sonnei (55.1%) and S. flexneri (41.7%). The highest rate of resistance was found for tetracycline (88.1%), followed by trimethoprim-sulfamethoxazole (SXT, 79.3%) and ampicillin (65.5%). 50.8% of isolates were resistant to chloramphenicol, 43.6% to amoxicillin/clavulanic acid whilst resistance to cefotaxime, ceftazidime, gentamicin, and ciprofloxacin did not reach 1%. In S. sonnei, the most frequent resistance profile corresponded to SXT (92%), whereas for S. flexneri the most frequent antibiotic profiles were multidrug resistant. Conclusions. In Colombia the population under five years is affected by all Shigella species. These findings should be considered to guide funders and public health officials to make evidence-based decisions for protection and prevention measures. The antimicrobial resistant characteristics found in this study underlie the importance of combating the dissemination of the most frequently isolated species S. sonnei and S. flexneri.