Epidemiología clínica y molecular de las infecciones por Shigella spp en niños de la Región Metropolitana durante el verano 2004-2005

• Christopher Hamilton-West M ^[1] ; Valeria Prado J ^[1] ; Juan Carlos Hormazábal O ^[2] ; Rosanna Lagos Z ^[3] ; Dona Benadof F ^[4] ; Carmen Mendoza N ^[5] ; Andrea Elgueta N ^[6] ; Cecilia Tapia P ^[7] ; Marcela C¡fuentes D ^[8] ; Isabel Alvarez A ^[9] ; Mariluz Hernández E ^[1]
  1. [1] Universidad de Chile

     Universidad de Chile

     Santiago, Chile

     
  2. [2] Instituto de Salud Pública, (ISP)
  3. [3] Centro para Vacunas en Desarrollo Chile
  4. [4] Roberto del Río
  5. [5] Exequiel González Cortés
  6. [6] Félix Bulnes
  7. [7] San Juan de Dios
  8. [8] San Borja Arriarán
  9. [9] Luis Calvo Mackenna

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• Localización: Revista Médica de Chile, ISSN-e 0034-9887, Vol. 135, Nº. 11, 2007, págs. 1388-1396
• Idioma: español
• Títulos paralelos:
  • Shigella spp Infections In children living In the Metropolitan RegionChile, during summer of 2004-2005
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• Resumen

  • Background: Shigella spp is a frequent cause of diarrhea in children. Antimicrobials decrease the duration of diarrhea and pathogen excretion. However, the increasing resistance limits their therapeutic value. Aim: To study Shigella serotype distribution in the Metropolitan Region in Chile, and its relationship with severity of disease, antimicrobial resistance pattern and clonality. Material and methods: During summer 2004-2005, stool samples from children with diarrhea were collected in Cary Blair transpon medium and cultured. Shigella isolates were serotyped using monoclonal and polyclonal commercial antibodies. In vitro activity of ampicillin, amoxicillin/clavulanic acid, chloramphenicol, cotrimoxazol, nalidixic acid, ciprofloxacin, ceftriaxone and azythromycin was determined by minimal inhibitory concentration (MIC). Clonality was studied by pulsed-field gel electrophoresis (PFGE) using Xbal as restriction enzyme. Results: One hundred thirty nine Shigella strains were isolated (77 S sonnei and 62 S flexneri). S sonnei and S flexneri 2a serotypes were responsible for 95% of episodes. Children aged 2-4 years, showed a greater incidence of Shigella infections and 77% of episodes were treated on an ambulatory basis. High resistance levels were observed for ampicillin, cotrimoxazole, amoxicillin-clavulanic acid and chloramphenicol (67%, 60%, 56% and 45%, respectively). We found 11 resistance patterns and 61,2% of strains were multiresistant. There were multiple clones without a strict relationship with resistance patterns. Conclusions: Shigella infections in Metropolitan Region in Chile are associated to a restricted number of serotypes, representing a clonal expansion associated to different antimicrobial resistant patterns