Jpn. J. Infect. Dis., 54, 2001

Laboratory and Epidemiology Communications

Changlng Pattems of Serotypes and Antimicrobial Susceptibilities ofShigella Species Isolated from Children in Calcutta, India
Swapan Kumar Niyogi*, Utpala Mitra and Phalguni Dutta
Division of Microbiology and Clinical Medicine, National Institute of Cholera & Enteric Diseases,

P33 CITRoad Schm.M, P 0 Beliaghata, Calcutta 700 010, India
Communicated by Haruo Watanabe(Accepted July 17, 2001)

isolated sporadically from 3% of diarrhea cases in Calcutta

Shigellosis occurs both in epidemic and endemic fbms inchildren and remains a major public health problem in develop‑(4). S. dysenteriae type 1, the most virulent and epidemic

lng countries. Over the past decades, Shigella spp. havebecome progressively resistant to most of the widely used

potential serotype, was not isolated in that period. ln 1984,
an epidemic of shigellosis caused primarily by S. dysenteriae

and inexpensive antimicrobials ( 1 ). Moreover, changes in thetype 1 broke out in the eastern parts of India affectlng

incidence of Shigella subgroups from time to time makes itthousands of people and caused many deaths in and arounddifficult to formulate a drug of choice for shigellosis (2). TheCalcutta (5). During the epidemic of bacillary dysentery

present study reports the distribution of Shigella subgroups(1984), isolation of Shigella spp. as well as S. dysenteriae

and the antimicrobial susceptibility pattem of Shigella spp.

type 1 was high･ Decreased isolation of S･ dysenteriae type I

isolated from children in Calcutta, India.

and increased isolation of S. jlexneri was observed during

From January 1998 to December 2000, a total of675 stool
samples were collected from children suffering from acuteposトendemic years (6). However, during 1990‑1992 5'.

dia血ea attending the Dia汀hoea Treatment Unit at Dr. B.C.

dysenteriae type 1 was isolated more from Calcutta (7).
During the period 1995‑1996 in a study conducted among

Roy Memorial Hospital f♭r Children, Calcutta, and werechildren, S. jlexneri was isolated as predominant serotype

cultured for Shigella spp. All isolates were conflrmed serologl‑(51%) followed by S. boydii (21%), S. sonnei (17%), and S.
dysenteriaetype I (10%), r?Spectively (8)･ During the 1984

cally by slide agglutination uslng COmmerCially available

specific antisera (Denka Seiken, Tokyo). Antimicrobial

epidemic highly encouraglng results through the use ofsusceptibility tests were perf♭med uslng an agar di軌sion

nalidixic acid in the treatment of multi‑resistant S. dysenteriae

technique method fbllowlng National Comittee f♭r Clinicaltype I infection was reported from Calcutta (9). However,Laboratory Standards guidelines (3).

within a sholl period the widespread use of the dmg resulted

The thirty‑four strains of Shigella spp. that were isolated

in the emergence of a nalidixic acid‑resistant S. dysenteriae

were distributed as follows: 22 (65%) were S.jlemeri, 7 (20%)
were S. sonnet and 5 (15%) were S. boydii. No S. dysenteriae

type 1 strain in several parts of the world including India

strains were isolated. The antimicrobial susceptibility pattem

our instltute during 1 990‑1 992 demonstrated a slgn泊cantlyof Shigella strains is shown in Table.

low resistance to nalidixic acid and furazolidone (7). During(1 0), ne芦ating the efficacy of the drug･ A study conducted inTemporal and spatial variations in the isolation of Shigella

1995‑ 1 996, however, increased resistance to nalidixic acidspp. have been reported in various parts of lndia from time toand furazolidone †as observed (8)･ In the present study, atime. Before 1 984, S. jlexneri was the predominant species

slgnificantly low resistance tO nalidixic acid was observed. The

Table. Percentage of antimicrobial resistant of isolated Shigella strains% resistance f♭rAntimicrobial agents

All Shigella isolates S.jlexneri S. sonnet(肝34)

Ampicillin

(炉22)

(〟‑7)

′0 0 7 0 295

7 4 0ノCefuroxime

43000000000

0 9 0 5 0 4 0ノ

ChloramphcnicoI4 0 ′05 07 0

Cipronoxacin
Co‑trimoxazole
Furazolidonc

88 3 ∠U

1Gentamicill

5Nalidixic acid
Nornoxacin
10Tctracycline*Corresponding author: Tel: +9 1 ‑331350‑0448, Fax: +9 1 ‑33‑350‑

5066, E‑mail: niced@ca12.vsnl.net.in

121

Jpn. ). Infect. Dis., 54, 2001
development of resistance to furazolidone steadily increased

De, S. P., Bhattacharya, S. K., Dutta, P., Dutta, D. andover the past few years (8) and we also observed a markedly

Pal, S. C. (1985): Etiological spectrum oracute dia血oea

high resistance to furazolidone･in hospitalized patients. Indian ∫. Med･ Res･, 82, 286‑

The shi氏in the prevalence of serogroups and the changlng

pattern in antimicrobial susceptibilities among Shigellaisolates poses a major difficulty ln the determination of an291.

5. Pal, S. C. (1984): Epidemic bacillary dysentery in West
Bengal (Letter). Lancet, ii, 1462.

approprlate drug fわr the treatment of shigellosis･ Continuous

6. Dutta, P., Dutta, D., Bhattacharya, S. K., Sen, D., Mitra, U･,

monitorlng Of antimicrobial susceptibilities of Shigella spp･Ghosh, A. 良., Lahiri, M. and Deb, 良. C. (1989): Clinicalthrough a surveillance system is thus essential for effective
therapy and control measures agalnSt Shigellosis･Authors thank Mr. S. K. Das for typlng the manuscrlPt.

and bacteriologlCal profiles of Shigellosis in Calcutta

before and after an epidemic (1984‑87). Indian J. Med･Res., 89, 132‑137.
7. Bhattachrya, M. K., Bhattacharya, S. K., Paul, M･, Dutta,D., Puttia, P., Kole, H., De, D., Ghosh, A. R., Das, P. andREFERENCES

1. Sack, R. B., Rahaman, M., Yunus, M. and Khan, E.
(1997): Antimicrobial resistance in organisms causing
diarrheal disease. Clin. Infect. Dis., 24 (Suppl. 1), SIO2‑S105.

2. Jesudason, M. V, Laitha, M. K. and Koshi, G. (1984):
Changes in incidence of Shigella subgroups and theirantibiotic susceptibility pattem in Vellore, South India.

J. Trop. Med. Hyg., 32, 153‑160･
3. National Committee for Clinical Laboratory Standards(1997): Perfわrmance standard fわr antimicrobial disk

susceptibility tests: approved standards. 6th ed･ NCCLS

document M2‑A6, Wayne, Pa.
4. Sen, D., Saha, M. 良., Nai一, G. 良., Das, P., Niyogi, S. K.,Nair, G. 良. (1994): Shigellosis in Calcutta during 1990‑

92 antibiotic susceptibility pattem and clinical features･J. Dia汀. Dis. Res., 12, 121‑124.

8. Dutta, S., Sinha Mahapatra, T., Dutta, P., Mitra, U･ andDasgupta, S. (1998): Serotypes and antimicrobial
susceptibility pattems of Shigella species isolated fromchildren in Calcutta, India. Eur. J. Clin. Micro. Inf. Dis.,17, 298‑299.

9･ Bose, R･, Nashipuri, J･ N･, Sen, P･ K･, Daaa, P･, Bhattacharya,

S. K., Datta, D., Sen, D. and Bhattacharya, M. K. (1984):
Epidemic of dysentery in West Bengal: clinicians'enlgma･Lancet, ii, 1 160.

10. Sen, D., Dutta, P., Deb, B. C. and Pal, S. C. (1988):
Nalidixic acid resistant Shigella dysenteriae type I in
Eastem India. Lancet, ii, 91 1.