Antimicrobial susceptibility of Shigella flexneri and S. dysenteriae isolated from stool specimens of patients with bloody diarrhoea in Mwanza, Tanzania.
2008
This study was conducted to determine frequency and pattern of
antimicrobial susceptibility of Shigella species isolated from stool
specimens collected from patients presenting with bloody diarrhoea in
Mwanza City, Tanzania. The study was carried out from October 2004 to
October 2005 and involved patients attending Sekou Toure Regional
Hospital and Butimba Health Centre. Bacteriological cultures were done
at the National Institute for Medical Research laboratory. A total of
489 patients (median age= 20 years) participated in the study and were
able to provide stool specimens. Shigella species were isolated from
14% (69/489) of the stool specimens collected. Of the sixty nine
strains of Shigella isolated, 62 (90%) were S. flexneri and 7 (10%)
were S. dysenteriae. All Shigella strains isolated showed high
resistance to ampicillin, tetracycline, trimethoprim-sulphamethoxazole
and chloramphenicol, drugs commonly used for management of shigellosis
in Tanzania. However all isolates were fully susceptible to
ciprofloxacin, nalidixic acid, erythromycin, cefuroxime and gentamycin.
S. flexneri showed resistance to amoxy-clavulanicacid and azithromycin
in 5% and 2% of isolates, respectively. None of the S. dysenteriae
isolates were resistant to these two drugs. Entamoeba histolytica
, Giardia lamblia and Schistosoma mansoni
were microscopically detected in 16.5%, 4.4% and 5.3 % of patients,
respectively These findings suggest that there is a need to carry out
extensive susceptibility studies in different parts of the country with
view of re-appraising the current guidelines for management of bloody
diarrhoea in Tanzania.
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