• 1.

    Liu L, Oza S, Hogan D, Perin J, Rudan I, Lawn JE, Cousens S, Mathers C, Black RE, 2015. Global, regional, and national causes of child mortality in 2000–13, with projections to inform post-2015 priorities: an updated systematic analysis. Lancet 385: 430440.

    • Search Google Scholar
    • Export Citation
  • 2.

    Kotloff KL et al. 2013. Burden and aetiology of diarrhoeal disease in infants and young children in developing countries (the Global Enteric Multicenter Study, GEMS): a prospective, case-control study. Lancet 382: 209222.

    • Search Google Scholar
    • Export Citation
  • 3.

    Breurec S et al. 2016. Etiology and epidemiology of diarrhea in hospitalized children from low income country: a matched case-control study in Central African Republic. PLoS Negl Trop Dis 10: e0004283.

    • Search Google Scholar
    • Export Citation
  • 4.

    Anderson M, Sansonetti PJ, Marteyn BS, 2016. Shigella diversity and changing landscape: insights for the twenty-first century. Front Cell Infect Microbiol 6: 45.

    • Search Google Scholar
    • Export Citation
  • 5.

    Livio S et al. 2014. Shigella isolates from the global enteric multicenter study inform vaccine development. Clin Infect Dis 59: 933941.

  • 6.

    Bercion R, Njuimo SP, Boudjeka PM, Manirakiza A, 2008. Distribution and antibiotic susceptibility of Shigella isolates in Bangui, Central African Republic. Trop Med Int Health 13: 468471.

    • Search Google Scholar
    • Export Citation
  • 7.

    Qiu S et al. 2015. Shift in serotype distribution of Shigella species in China, 2003–2013. Clin Microbiol Infect 21: 252 e5-8.

  • 8.

    Bangtrakulnonth A, Vieira AR, Lo Fo Wong DM, Pornreongwong S, Pulsrikarn C, Sawanpanyalert P, Hendriksen RS, Aarestrup FM, 2008. Shigella from humans in Thailand during 1993 to 2006: spatial-time trends in species and serotype distribution. Foodborne Pathog Dis 5: 773784.

    • Search Google Scholar
    • Export Citation
  • 9.

    Langendorf C, Le Hello S, Moumouni A, Gouali M, Mamaty AA, Grais RF, Weill FX, Page AL, 2015. Enteric bacterial pathogens in children with diarrhea in Niger: diversity and antimicrobial resistance. PLoS One 10: e0120275.

    • Search Google Scholar
    • Export Citation
  • 10.

    Rafai C, Frank T, Manirakiza A, Gaudeuille A, Mbecko JR, Nghario L, Serdouma E, Tekpa B, Garin B, Breurec S, 2015. Dissemination of IncF-type plasmids in multiresistant CTX-M-15-producing Enterobacteriaceae isolates from surgical-site infections in Bangui, Central African Republic. BMC Microbiol 15: 15.

    • Search Google Scholar
    • Export Citation
  • 11.

    Mao Y et al. 2013. Changing trends and serotype distribution of Shigella species in Beijing from 1994 to 2010. Gut Pathog 5: 21.

  • 12.

    Shakya G, Acharya J, Adhikari S, Rijal N, 2016. Shigellosis in Nepal: 13 years review of nationwide surveillance. J Health Popul Nutr 35: 36.

  • 13.

    Kahsay AG, Muthupandian S, 2016. A review on serodiversity and antimicrobial resistance patterns of Shigella species in Africa, Asia and South America, 2001–2014. BMC Res Notes 9: 422.

    • Search Google Scholar
    • Export Citation
  • 14.

    Thompson CN, Duy PT, Baker S, 2015. The rising dominance of Shigella sonnei: an intercontinental shift in the etiology of bacillary dysentery. PLoS Negl Trop Dis 9: e0003708.

    • Search Google Scholar
    • Export Citation
  • 15.

    Bercion R, Demartin M, Recio C, Massamba PM, Frank T, Escriba JM, Grimont F, Grimont PA, Weill FX, 2006. Molecular epidemiology of multidrug-resistant Shigella dysenteriae type 1 causing dysentery outbreaks in Central African Republic, 2003–2004. Trans R Soc Trop Med Hyg 100: 11511158.

    • Search Google Scholar
    • Export Citation
  • 16.

    Levine MM, 2006. Enteric infections and the vaccines to counter them: future directions. Vaccine 24: 38653873.

  • 17.

    Levine MM, Kotloff KL, Barry EM, Pasetti MF, Sztein MB, 2007. Clinical trials of Shigella vaccines: two steps forward and one step back on a long, hard road. Nat Rev Microbiol 5: 540553.

    • Search Google Scholar
    • Export Citation
  • 18.

    Noriega FR, Liao FM, Maneval DR, Ren S, Formal SB, Levine MM, 1999. Strategy for cross-protection among Shigella flexneri serotypes. Infect Immun 67: 782788.

    • Search Google Scholar
    • Export Citation
  • 19.

    von Seidlein L et al. 2006. A multicentre study of Shigella diarrhoea in six Asian countries: disease burden, clinical manifestations, and microbiology. PLoS Med 3: e353.

    • Search Google Scholar
    • Export Citation
  • 20.

    Farzam N, Ramon-Saraf R, Banet-Levi Y, Lerner-Geva L, Ashkenazi S, KublnKielb J, Vinogradov E, Robbins JB, Schneerson R, 2017. Vaccination with Shigella flexneri 2a conjugate induces type 2a and cross-reactive type 6 antibodies in humans but not in mice. Vaccine 35: 49904996.

    • Search Google Scholar
    • Export Citation
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 

 

 

Serotype Distribution and Antimicrobial Resistance of Shigella Species in Bangui, Central African Republic, from 2002 to 2013

View More View Less
  • 1 Laboratoire de Bactériologie, Institut Pasteur de Bangui, Bangui, Central African Republic;
  • | 2 Faculté de Médecine Hyacinthe Bastaraud, Université des Antilles, Pointe-à-Pitre, France;
  • | 3 Laboratoire de Microbiologie Clinique et Environnementale, Centre Hospitalier Universitaire de Pointe-à-Pitre/les Abymes, Pointe-à-Pitre, France;
  • | 4 Délégation à la Recherche Clinique et à l’Innovation, Centre Hospitalier Universitaire de Nantes, Nantes, France;
  • | 5 Unité des Bactéries Pathogènes Entériques, Centre National de Référence des Escherichia coli, Shigella et Salmonella, Institut Pasteur, Paris, France
Restricted access

Shigella is a major cause of severe diarrhea in children less than the age of 5 years in sub-Saharan Africa. The aim of this study was to describe the (sub-)serotype distribution and antimicrobial susceptibility of Shigella serogroups from Centrafrican patients with diarrhea between 2002 and 2013. We collected 443 Shigella isolates in total. The most common serogroups were Shigella flexneri (N = 243, 54.9%), followed by Shigella sonnei (N = 90, 20.3%) and Shigella dysenteriae (N = 72, 16.3%). The high diversity of (sub-)serotypes of S. flexneri and S. dysenteriae may impede the development of an efficient vaccine. Rates of resistance were high for ampicillin, chloramphenicol, tetracycline, and cotrimoxazole but low for many other antimicrobials, confirming recommendations for the use of third-generation cephalosporins (only one organism resistant) and fluoroquinolones (no resistance). However, the detection of one extended-spectrum beta-lactamase–producing Shigella organism highlights the need for continued monitoring of antimicrobial drug susceptibility.

Author Notes

Address correspondence to Sebastien Breurec, Centre Hospitalier Universitaire de Pointe-à-Pitre/les Abymes, Laboratoire de Microbiologie Clinique et Environnementale, Route de Chauvel, Pointe-à-Pitre, France, E-mail: sebastien.breurec@chu-guadeloupe.fr or François-Xavier Weill, Centre National de Référence des Escherichia coli, Shigella et Salmonella, Unité des Bactéries Pathogènes Entériques, Institut Pasteur, 28 rue du Docteur Roux, 75724 Paris Cedex 15, France, E-mail: francois-xavier.weill@pasteur.fr.

Financial support: The French National Reference Center for Escherichia coli, Shigella, and Salmonella is funded by the Institut Pasteur and Santé Publique France. The Unité des Bactéries Pathogènes Entériques belongs to the Integrative Biology of Emerging Infectious Diseases Laboratory of Excellence funded by the French Government as part of the Investissement d'Avenir program (grant no. ANR-10-LABX-62-IBEID).

Authors’ addresses: Sebastien Breurec, Faculté de Médecine, Universite des Antilles, Pointe-a-Pitre, France, E-mail: sbreurec@gmail.com. Clotaire Rafaï, Manuella Onambele, Thierry Frank, and Alain Farra, Laboratoire de Bactériologie, Institut Pasteur de Bangui, Bangui, République Centrafricaine, E-mails: clotairerafai@yahoo.fr, onambelemanu@yahoo.fr, thierryfrank@yahoo.fr, and farra_alain@yahoo.fr. Arnaud Legrand, DRCI, Centre Hospitalier Universitaire de Nantes, Nantes, France, E-mail: arnaud.legrand@chu-nantes.fr. François-Xavier Weill, Unité des Bactéries Pathogènes Entériques, Centre National de Référence des Escherichia coli, Shigella et Salmonella, Institut Pasteur, Paris, France, E-mail: fxweill@pasteur.fr.

Save