ABSTRACT
Objective To understand genetic distribution, drug resistance, molecular typing and the epidemiological relativeness between strains of the Shigella boydii virulence. Methods Nine Shigella boydii strains were isolated form stool samples of patients with diarrhea from the Enteric Disease Clinic of the Second Hospital of Tianjin Medical University in June-October 2015. The strains were identified by biochemical test and serum agglutination test. Antibiotics susceptibility test was carried out using the Kirby-Bauer method. Polymerase chain reaction was used for detecting virulence genes. Pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) technique were used to determine the epidemiological relationship between nine Shigella boydii strains. Results There were three subtypes in nine isolated Shigella boydii samples, including one, three and five isolates inⅠ,Ⅱ,Ⅳsubtypes respectively. All of the 9 isolates were multi-drug resistant. The resistant rate of these strains for ampicillin was 100%(9/9), and then the resistant rates of these strains for ceftazidime, streptomycin, gentamicin, trimethoprim/sulfamethoxazole, cefotaxime, ceftriaxone, norfloxacin and levofloxacin were 1/9, 4/9, 4/9, 4/9, 5/9, 5/9, 6/9, 6/9 and 6/9, respectively. All of these strains were sensitive to amikacin, cefperazone-sulbactam and imipenem. The ipaH was carried by all the testing strains, and none of the strains carried the sen, set1A, set1B, ial, virA, icsA and SigA. The detective rates of pic, sepA and sat were 4/9, 5/9 and 7/9 strains, respectively. Nine shigella boydii strains were divided into 8 PFGE types. The similarity between the spectrums of PFGE was 63.21%-100%. Multilocus sequence typing showed that six isolates were belonged to ST648, two isolates were ST131 and one isolate was ST10. Conclusion Nine isolates of Shigella boydii (divided into three subtyping) isolated from our hospital are multi-drug resistant and they have distant relationships, belonging to the dissemination of case.
ABSTRACT
Shigella bacteremia is rare, occurring mainly in children. Shigella species often cause diarrhea or gastrointestinal inflammation in humans and are rarely associated with bacteremia. This report describes an unusual case of Shigella boydii bacteremia in an 84-year-old patient visiting our hospital after experiencing nausea, vomiting, and febrile sensation for 2 days. Peripheral blood cultures revealed S. boydii and 16S rDNA sequence analysis produced the same result. However, the organism was not isolated from the patient's stool. She was started on ciprofloxacin, to which this organism is sensitive, and was subsequently discharged with instructions to complete a 14-day course of ciprofloxacin. Shigellosis is usually a self-limiting enteric disease. However, in contrast to its isolation from both blood and stool, isolation of the organism from blood only is associated with a high mortality rate. As is frequently pointed out, blood cultures should be obtained from elderly or immunocompromised patients with acute febrile gastroenteritis to detect infection caused by enteric pathogens, including Shigella.
Subject(s)
Aged , Aged, 80 and over , Child , Humans , Bacteremia , Ciprofloxacin , Diarrhea , DNA, Ribosomal , Dysentery, Bacillary , Gastroenteritis , Immunocompromised Host , Inflammation , Mortality , Nausea , Sensation , Sequence Analysis , Shigella boydii , Shigella , VomitingABSTRACT
E relatado pela primeira vez no Brasil o isolamento de uma cepa de Shigella boydii 9, rápida fermentadora da lactose (AU).