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Decreased Susceptibility to Azithromycin Among Clinical Shigella Isolates from China.
Microb Drug Resist 2017; 23(5):596-601MD

Abstract

The aim of this study was to detect the decreased susceptibility to azithromycin (DSA) and associated mechanisms in Shigella from China. Three hundred and ninety-two Shigella isolates, including 134 Shigella flexneri and 258 Shigella sonnei isolates, were examined for minimum inhibitory concentrations (MICs) and zone sizes to azithromycin by broth microdilution and disk diffusion methods, respectively. The MICs were compared with corresponding zone diameters to find whether there was uniformity between both tests. Twelve macrolide-resistant genes located on mobile elements were determined for the DSA isolates by PCR, and chromosomal efflux pump activity was analyzed using Phe-Arg-β-naphthylamide inhibition test and quantitative real-time PCR. Shigella isolates displayed MICs of 0.125-512 μg/ml and zone sizes of 6-26 mm against azithromycin. There were 80 (20.4%) isolates to be DSA. No significant difference was found between the DSA rates of S. flexneri and S. sonnei isolates (p = 0.052). There was an intimate relativity between MICs and zone diameters (p < 0.001). Only the plasmid-borne mphA conferring high-level DSA was detected in 55.0% (44/80) DSA-Shigella isolates. This study highlighted the prevalence of DSA-Shigella and mphA in the region studied. Clinical laboratories and clinicians should pay attention to the elevated azithromycin MICs in Shigella spp.

Authors+Show Affiliations

1 Department of Clinical Laboratory, Zhejiang Xiaoshan Hospital , Hangzhou, China .2 Department of Clinical Laboratory, Shanghai General Hospital, School of Medicine, Shanghai Jiaotong University , Shanghai, China .2 Department of Clinical Laboratory, Shanghai General Hospital, School of Medicine, Shanghai Jiaotong University , Shanghai, China .1 Department of Clinical Laboratory, Zhejiang Xiaoshan Hospital , Hangzhou, China .3 Department of Clinical Microbiology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine , Shanghai, China .2 Department of Clinical Laboratory, Shanghai General Hospital, School of Medicine, Shanghai Jiaotong University , Shanghai, China .

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27841958

Citation

Zhang, Chuanling, et al. "Decreased Susceptibility to Azithromycin Among Clinical Shigella Isolates From China." Microbial Drug Resistance (Larchmont, N.Y.), vol. 23, no. 5, 2017, pp. 596-601.
Zhang C, Zhang R, Yu Q, et al. Decreased Susceptibility to Azithromycin Among Clinical Shigella Isolates from China. Microb Drug Resist. 2017;23(5):596-601.
Zhang, C., Zhang, R., Yu, Q., Chu, X., Sun, J., & Liu, Q. (2017). Decreased Susceptibility to Azithromycin Among Clinical Shigella Isolates from China. Microbial Drug Resistance (Larchmont, N.Y.), 23(5), pp. 596-601. doi:10.1089/mdr.2016.0134.
Zhang C, et al. Decreased Susceptibility to Azithromycin Among Clinical Shigella Isolates From China. Microb Drug Resist. 2017;23(5):596-601. PubMed PMID: 27841958.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Decreased Susceptibility to Azithromycin Among Clinical Shigella Isolates from China. AU - Zhang,Chuanling, AU - Zhang,Rulin, AU - Yu,Qi, AU - Chu,Xu, AU - Sun,Jingyong, AU - Liu,Qingzhong, Y1 - 2016/11/14/ PY - 2016/11/15/pubmed PY - 2018/3/31/medline PY - 2016/11/15/entrez KW - Enterobacteriaceae KW - antimicrobial KW - microbial drug resistance KW - minimum inhibitory concentrations (MICs) KW - polymerase chain reaction (PCR) SP - 596 EP - 601 JF - Microbial drug resistance (Larchmont, N.Y.) JO - Microb. Drug Resist. VL - 23 IS - 5 N2 - The aim of this study was to detect the decreased susceptibility to azithromycin (DSA) and associated mechanisms in Shigella from China. Three hundred and ninety-two Shigella isolates, including 134 Shigella flexneri and 258 Shigella sonnei isolates, were examined for minimum inhibitory concentrations (MICs) and zone sizes to azithromycin by broth microdilution and disk diffusion methods, respectively. The MICs were compared with corresponding zone diameters to find whether there was uniformity between both tests. Twelve macrolide-resistant genes located on mobile elements were determined for the DSA isolates by PCR, and chromosomal efflux pump activity was analyzed using Phe-Arg-β-naphthylamide inhibition test and quantitative real-time PCR. Shigella isolates displayed MICs of 0.125-512 μg/ml and zone sizes of 6-26 mm against azithromycin. There were 80 (20.4%) isolates to be DSA. No significant difference was found between the DSA rates of S. flexneri and S. sonnei isolates (p = 0.052). There was an intimate relativity between MICs and zone diameters (p < 0.001). Only the plasmid-borne mphA conferring high-level DSA was detected in 55.0% (44/80) DSA-Shigella isolates. This study highlighted the prevalence of DSA-Shigella and mphA in the region studied. Clinical laboratories and clinicians should pay attention to the elevated azithromycin MICs in Shigella spp. SN - 1931-8448 UR - https://www.unboundmedicine.com/medline/citation/27841958/Decreased_Susceptibility_to_Azithromycin_Among_Clinical_Shigella_Isolates_from_China_ L2 - https://www.liebertpub.com/doi/full/10.1089/mdr.2016.0134?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -