Identification Of Serotypes And Assessment Of Multiple Drug Resistance In 360 Shigella Isolates

Three hundred and sixty urban and rural Shigellae isolatesrnwere analysed in respect to serogrouping, serotyping, biochemotypingrnand drug resistance. S. flexneri (50.55%) was most common, followedrnby £. dysenteriae (32.78%), ~. b~£ii (11.39%) and £. sonnei (5.28%).rnIsolation rates of £. ftysenteriae, £. flexneri and fl. sonnei wererneomparablo in rural and urban areas, except for fl. boydii which isrnmore common in urban areas (significant at P=0.05).rnOut of the thirty-two known Shigella serotypes, twenty-twornwere identified in this study (i.e. fl. dysenteria~ 1,2, 3, 4, 6, 7;rn,2. flexneri I, 2, 3, 4, 6; E.. boydii 1, 2, 3, 4, 5, 8, 9, 10, 12, 111;rnand E.. sonnei). Urban isolates were represented by 22 serotypesrncompared to only 11 in rural areas. E.. dysenteriae serotypo 1rn(Shiga's bacillus) Was more common in rural areas (34.48%) than inrnurban areas (17.22%), and this difference is· significant (P=O,05).rnNinteen patterns of drug resistance were observed, with TSurn(21.11%), TCACbSSu (19.72%) and TSSu (12.50%) being comparativelyrnmore common. There 'Iere nine patterns of drug resistance inrn8erogroup A, 12 patterns in ll, 8 patterns in C, and 5 patterns in D.rnTCACbSSu pattern (53.39%) in serogroup A, TSu (41.76%) in B, andrnTSSu (26.31%) in D Vlere observed. lIitnin serogroup A, 81.82% ofrnfl' dysenteriae serotype 1 was associated with the TCACbSSu pattern.rnThere were Ii patterns of resistance in urban areas compared to 10rnin rural areas. The prominence of TCACbSSu pattern in rural areasrnwas related to the Iligh isolation rate of fl. dysenteriae type 1 inrnthese places. In rural areas, 14.94% of Shigella isolates werernclassified as sensitive to all drugs tested, compared to 26.37% inrnurban areas and this difference is significant (P=0.05).rnIdentification of rare biochemotypes included: a) three strainsrnof mannitol negative ~. flexneri type 6, b) a strain of gasrnproductng ~. boydii type 14, nnd c) a strain of 'invasive'rn~. ££1i (0:164) serologically cross reacting in ~. dysenteriaernserotype 3· antiserum.rnBased on the present study, it is recommended that: a) a furtherrnstudy of Shigella be persued, b) a Shigella reference center bernestablished, c) an improvement of sanitation be stressed,rnd) chemotherapy be discourae;ed and e) a national policy for drugrnsale be enacted.

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