• ISSN 16748301
  • CN 32-1810/R
Volume 27 Issue 2
Mar.  2013
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Citation:

Prevalence and trends of aminoglycoside resistance in Shigella worldwide, 1999-2010

  • Received Date: 2012-11-12

    Fund Project: This research was funded by National Natural Science Foundation of China (No. 81000754), a grant from the Key Laboratory for Laboratory Medicine of Jiangsu Province of China (No. XK201114) and a project funded by the Priority Academic Program Development of Jiangsu Higher Education Institutions

  • Shigellosis causes diarrheal disease in humans in both developed and developing countries, and multi-drug resistance in Shigella is an emerging problem. Understanding changing resistance patterns is important in de-termining appropriate antibiotic treatments. This meta-analysis systematically evaluated aminoglycoside resist-ance in Shigella. A systematic review was constructed based on MEDLINE and EMBASE databases. Random-effect models or fixed-effect models were used based on P value considering the possibility of heterogeneity between studies for meta-analysis. Data manipulation and statistical analyses were performed using software STATA 11.0. By means of meta-analysis, we found a lower resistance to three kinds of aminoglycosides in the Europe-America areas during the 12 year study period than that of the Asia-Africa areas. Kanamycin resist-ance was observed to be the most common drug resistance among Shigella isolates with a prevalence of 6.88% (95%CI: 6.36%-7.43%). Comparison of data from Europe-America and Asia-Africa areas revealed that Shigella flexneri resistance was greater than the resistance calculated for Shigella sonnei. Importantly, S higella sonnei has played a significant role in aminoglycoside-resistance in recent years. Similarly, data showed that resistance to these drugs in children was higher than the corresponding data of adults. In conclusion, aminoglycoside-resistant Shigella is not an unusual phenomenon worldwide. Distribution in Shigella resistance differs sharply based on geographic areas, periods of time and subtypes. The results from the present study highlight the need for con-tinuous surveillance of resistance and control of antibiotic usage.
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Prevalence and trends of aminoglycoside resistance in Shigella worldwide, 1999-2010

  • 1. Department of Laboratory Medicine, the First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu 210029, China
  • 2.  National Key Clinical, Department of Laboratory Medicine, Nanjing, Jiangsu 210029, China
  • 3. Department of Acute Infectious Disease Prevention and Control, Jiangsu Provincial Center for Disease Prevention and Control, Nanjing, Jiangsu 210029, China
  • 4. Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 210029, China
Fund Project:  This research was funded by National Natural Science Foundation of China (No. 81000754), a grant from the Key Laboratory for Laboratory Medicine of Jiangsu Province of China (No. XK201114) and a project funded by the Priority Academic Program Development of Jiangsu Higher Education Institutions

Abstract: Shigellosis causes diarrheal disease in humans in both developed and developing countries, and multi-drug resistance in Shigella is an emerging problem. Understanding changing resistance patterns is important in de-termining appropriate antibiotic treatments. This meta-analysis systematically evaluated aminoglycoside resist-ance in Shigella. A systematic review was constructed based on MEDLINE and EMBASE databases. Random-effect models or fixed-effect models were used based on P value considering the possibility of heterogeneity between studies for meta-analysis. Data manipulation and statistical analyses were performed using software STATA 11.0. By means of meta-analysis, we found a lower resistance to three kinds of aminoglycosides in the Europe-America areas during the 12 year study period than that of the Asia-Africa areas. Kanamycin resist-ance was observed to be the most common drug resistance among Shigella isolates with a prevalence of 6.88% (95%CI: 6.36%-7.43%). Comparison of data from Europe-America and Asia-Africa areas revealed that Shigella flexneri resistance was greater than the resistance calculated for Shigella sonnei. Importantly, S higella sonnei has played a significant role in aminoglycoside-resistance in recent years. Similarly, data showed that resistance to these drugs in children was higher than the corresponding data of adults. In conclusion, aminoglycoside-resistant Shigella is not an unusual phenomenon worldwide. Distribution in Shigella resistance differs sharply based on geographic areas, periods of time and subtypes. The results from the present study highlight the need for con-tinuous surveillance of resistance and control of antibiotic usage.

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