Characteristics of Multidrug Resistant Shigella and Vibrio cholerae O1 Infections in Patients Treated at an Urban and a Rural Hospital in Bangladesh

We determined the frequency of multidrug resistant (MDR) infections with Shigella spp. and Vibrio cholerae O1 at an urban (Dhaka) and rural (Matlab) hospital in Bangladesh. We also compared sociodemographic and clinical features of patients with MDR infections to those with antibiotic-susceptible infections at both sites. Analyses were conducted using surveillance data from the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), for the years 2000–2012. Compared to patients with antibiotic-susceptible for Shigella infections, those in Dhaka with MDR shigellosis were more likely to experience diarrhea for >24 hours, while, in Matlab, they were more likely to stay inhospital >24 hours. For MDR shigellosis, Dhaka patients were more likely than those in Matlab to have dehydration, stool frequency >10/day, and diarrheal duration >24 hours. Patients with MDR Vibrio cholerae O1 infections in Dhaka were more likely than those in Matlab to experience dehydration and stool frequency >10/day. Thus, patients with MDR shigellosis and Vibrio cholerae O1 infection exhibited features suggesting more severe illness than those with antibiotic-susceptible infections. Moreover, Dhaka patients with MDR shigellosis and Vibrio cholerae O1 infections exhibited features indicating more severe illness than patients in Matlab.

[1]  Betsy Foxman,et al.  A Modeling Framework for the Evolution and Spread of Antibiotic Resistance: Literature Review and Model Categorization , 2013, American journal of epidemiology.

[2]  M. Sayeed,et al.  Ethnopharmacological survey of medicinal plants used by traditional healers in Bangladesh for gastrointestinal disorders. , 2013, Journal of ethnopharmacology.

[3]  M. A. Malek,et al.  Changing Emergence of Shigella Sero-Groups in Bangladesh: Observation from Four Different Diarrheal Disease Hospitals , 2013, PloS one.

[4]  F. Moussy,et al.  Review of Two Decades of Cholera Diagnostics – How Far Have We Really Come? , 2012, PLoS neglected tropical diseases.

[5]  A. Faruque,et al.  Severe, Acute Watery Diarrhea in an Adult , 2010, PLoS neglected tropical diseases.

[6]  J. Wells,et al.  Sporadic paediatric diarrhoeal illness in urban and rural sites in Nyanza Province, Kenya. , 2010, East African medical journal.

[7]  Anil Kumar Singh,et al.  Molecular characterization of multidrug-resistant Shigella species isolated from epidemic and endemic cases of shigellosis in India. , 2008, Journal of medical microbiology.

[8]  M. A. Malek,et al.  Emergence of Multidrug-resistant Strain of Vibrio cholerae O1 in Bangladesh and Reversal of Their Susceptibility to Tetracycline after Two Years , 2007, Journal of health, population, and nutrition.

[9]  Z. Bhutta,et al.  A Multicentre Study of Shigella Diarrhoea in Six Asian Countries: Disease Burden, Clinical Manifestations, and Microbiology , 2006, PLoS medicine.

[10]  Fred C Tenover,et al.  Mechanisms of antimicrobial resistance in bacteria. , 2006, The American journal of medicine.

[11]  A. Faruque,et al.  Enterotoxigenic Escherichia coli and Vibrio cholerae Diarrhea, Bangladesh, 2004 , 2005, Emerging infectious diseases.

[12]  T. Ramamurthy,et al.  Shigellosis : challenges & management issues. , 2004, The Indian journal of medical research.

[13]  K. Thong,et al.  Prevalence of multidrug-resistant Shigella isolated in Malaysia. , 2002, Journal of health, population, and nutrition.

[14]  M. Ferraro Performance standards for antimicrobial susceptibility testing , 2001 .

[15]  David A. Sack,et al.  Antimicrobial resistance in shigellosis, cholera and campylobacteriosis , 2001 .

[16]  D. Swerdlow,et al.  Global burden of Shigella infections: implications for vaccine development and implementation of control strategies. , 1999, Bulletin of the World Health Organization.

[17]  Z. Samra,et al.  Increasing antimicrobial resistance of Shigella isolates in Israel during the period 1984 to 1992 , 1995, Antimicrobial agents and chemotherapy.

[18]  R. Guerrant,et al.  High frequency of strains multiply resistant to ampicillin, trimethoprim-sulfamethoxazole, streptomycin, chloramphenicol, and tetracycline isolated from patients with shigellosis in northeastern Brazil during the period 1988 to 1993 , 1995, Antimicrobial agents and chemotherapy.

[19]  S. Pal,et al.  Multidrug resistant epidemic shigellosis in a village in west Bengal, 1984. , 1990, Indian Journal of Public Health.

[20]  B. Stoll,et al.  Surveillance of patients attending a diarrhoeal disease hospital in Bangladesh , 1982, British medical journal.