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High Rates of Antimicrobial Resistance and Virulence Gene Distribution Among Shigella spp. Isolated from Pediatric Patients in Tehran, Iran

Authors Karimi-Yazdi M, Ghalavand Z, Shabani M, Houri H, Sadredinamin M, Taheri M, Eslami G

Received 14 November 2019

Accepted for publication 29 January 2020

Published 13 February 2020 Volume 2020:13 Pages 485—492

DOI https://doi.org/10.2147/IDR.S238559

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Sahil Khanna


Mohammadmahdi Karimi-Yazdi,1 Zohreh Ghalavand,1 Mahdi Shabani,2 Hamidreza Houri,3 Mehrzad Sadredinamin,1 Marzieh Taheri,1 Gita Eslami1

1Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 2Department of Immunology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran; 3Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran

Correspondence: Gita Eslami
Department of Microbiology, Shahid Beheshti University of Medical Sciences, Koodakyar St., Tabnak Blv., Yaman Av., Chamran Highway, P. Box: 19857-17443, Tehran, Iran
Tel +98 21 23872556
Email g_eslami@yahoo.com

Background: Shigella continues to be important causes of acute pediatric diarrhea worldwide. Shigella produces numerous virulence factors involved in colonization and invasion into epithelial cells which eventually result in the disease. The present study was conducted to evaluate the prevalence of virulence genes and to investigate antibiotic resistance profiles among Shigella isolates obtained from pediatric patients in Iran.
Methods: A total of 141 Shigella isolates were collected between March 2017 and September 2018 from stool of children under 14 who were suspected to have shigellosis. Shigella isolates were identified using standard microbiological and serological tests and antimicrobial susceptibility testing was carried out via Kirby–Bauer disk diffusion method. In addition, the presence of seven virulence determinants including ipaH, ipaB, ipaC, ipaD, ipgD, sen, and virA were evaluated using PCR.
Results: S. sonnei (78.7%) was the most prevalent shigella spp. among children with shigellosis followed by S. flexneri (19.9%) and S. boydii (1.4%). Antimicrobial susceptibility testing revealed that most of the isolates were considered as multidrug-resistant (MDR) strains. Our findings also showed a high resistance rate against trimethoprim-sulfamethoxazole in Shigella isolates. The prevalence of ipaH, ipaC, sen, ipaD, virA, ipaB, and ipgD were 100%, 95.7%, 95.7%, 94.3%, 93.6%, 92.9%, and 80.8%, respectively.
Conclusion: The current study revealed that S. sonnei was the predominant species isolated from children with shigellosis in Iran. Our results also indicated a high distribution of type III secretion system effector protein-encoding genes and high multidrug-resistance among shigella spp. in Iran. Therefore, it is suggested that antimicrobial susceptibility testing be performed prior to antibiotic prescription.

Keywords: Shigella, virulence factors, type III secretion system, ipaH, ipaB, virA

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