Patrones de sensibilidad in vitro y comportamiento clínico de Shigella

Abstract

Shigella is an important cause of diarrhea in children, with an increasing prevalence of antibiotic resistance during the past years making the choice of an empiric therapy in dysentery difficult. Between 1997 and 1999, 163 isolated Shigella strains were studied in vitro for susceptibility to antibiotics. S. sonnei represented 63% of the isolated strains. Antimicrobial resistance patterns have increased, specially for commonly used antimicrobials. The strains studied were 95% resistant to ampicillin, 84% to chloramphenicol, 43.6% to cotrimoxazole and 3.7% to furazolidone. There was no resistance to ciprofloxacin. Fifty seven children with shigellosis were admited into the hospital, 82.5% of them were older than two years. All the patients were feverish, 56% had dysentery and 8.8% had seizures. Six patient with a torpid evolution and therapeutic failure received ciprofloxacin with eventual clinical success. Ciprofloxacin represents an effective alternative empiric therapy in children with dysenteric diarrhea, which should be evaluated. The need of surveying the local prevalence of antimicrobial resistance to guide therapy in shigellosis is emphasized