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Emergence of multidrug-resistant Shigella species harboring extended-spectrum beta-lactamase genes in pediatric patients with diarrhea from southwest of Iran

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Abstract

Owing to the scarce evidence about the multidrug-resistant (MDR) beta-lactamase-producing Shigella isolates in Iran, this study aimed to evaluate the occurrence of extended-spectrum beta-lactamases (ESBL) and AmpC β-lactamases in Shigella species collected in the southwest of Iran. This study was conducted on Shigella species isolated from stool samples of pediatric patients aged less than 15 years suffering from diarrhea. These isolates were identified by bacteriology tests, serotyping, and polymerase chain reaction (PCR). The antibiotic resistance was determined by disc diffusion. The production of ESBLs and AmpC was investigated by phenotypic confirmatory tests and PCR. In total, 79 Shigella isolates, including 46.8% (n = 37) of S. flexneri and 53.2% (n = 42) of S. sonnei, were isolated, respectively. The most effective antibiotic was imipenem with 93.7% of susceptibility followed by ampicillin (29.1%), and cotrimoxazole (30.4%).The resistance rates of ceftriaxone, ceftazidime, and cefotaxime were 41.8%, 34.2%, and 41.8%, respectively. Also, a total of 57 (72.2%) isolates showed MDR profiles. The phenotypic tests showed that 43.0% (34/79) of isolates can produce ESBLs, and no one was positive for ApmC. The frequency of blaTEM and blaCTX-M were 30.4% and 32.9%, respectively, while the blaPER, blaSHV, and AmpC genes were not detected. The ESBL-producing isolates had a significant (p-value ˂ 0.05) resistance rate against ceftriaxone, ceftazidime, cefotaxime, cefepime, erythromycin, and amikacin. The significant prevalence of MDR Shigella isolates harboring ESBL genes highlights the need for effective surveillance measures to prevent the more spread of drug resistance among species.

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Acknowledgements

This research was a part of the MSc. thesis of Maryam Moradi Bandbal, which was approved in the Infectious and Tropical Diseases Research Center, and was financially supported by a grant from Research Affairs, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. We would like to thank all staff of the Microbiology Ward of the laboratorie of Golestan, Razi, and Abuzar hospitals for their significant assistance in collecting the samples.

Funding

Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran (Grant no: OG-9825).

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Authors and Affiliations

  1. Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

    Ahmad Farajzadeh Sheikh, Maryam Moradi Bandbal & Morteza Saki

  2. Department of Microbiology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

    Ahmad Farajzadeh Sheikh, Maryam Moradi Bandbal & Morteza Saki

  3. Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

    Morteza Saki

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  1. Ahmad Farajzadeh Sheikh
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  2. Maryam Moradi Bandbal
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Correspondence to Maryam Moradi Bandbal.

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Ethics approval

The current study was conducted according to the Declaration of Helsinki and obtained approval from the Ethics Committee of Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran (IR.AJUMS.MEDICINE.REC.1398.014). Written informed consent was obtained from all patients or their parents/guardians.

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Farajzadeh Sheikh, A., Moradi Bandbal, M. & Saki, M. Emergence of multidrug-resistant Shigella species harboring extended-spectrum beta-lactamase genes in pediatric patients with diarrhea from southwest of Iran. Mol Biol Rep 47, 7097–7106 (2020). https://doi.org/10.1007/s11033-020-05776-x

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