Epidemic dysentery caused by Shigella dysenteriae type 1: a sentinel site surveillance of antimicrobial resistance patterns in Burundi. 1995

D Engels, and T Madaras, and S Nyandwi, and J Murray
Programme for the Control of Diarrhoeal Diseases, Belgian Technical Cooperation, Burundi.

Annual epidemics of bacillary dysentery have been a public health problem in Burundi for the last 14 years. Recent civil unrest, resulting in the displacement of large numbers of people into refugee settlements, has aggravated the situation. We report the results of a nationwide, health-centre based, sentinel site survey to check the drug resistance of Shigella dysenteriae type 1 (Sd1), the causal organism of such epidemics. Shigella spp. (of which 97% were Sd1) were isolated from 73% of the 126 specimens collected from six main sites around the country. There was no difference in culture results from fresh and frozen stool specimens. Overall Sd1 resistance to commonly available antibiotics (sulfamethoxazole + trimethoprim, ampicillin, tetracycline, and chloramphenicol) varied from 77% to 99% and was fairly uniformly distributed over the country. All Sd1 isolates were susceptible to newer drugs, such as ciprofloxacin and ceftriaxone. Resistance to nalidixic acid, the current first line of treatment for bacillary dysentery in Burundi, varied from 8% to 83% in the different sentinel sites; global resistance was 57%.

UI MeSH Term Description Entries
D009268 Nalidixic Acid A synthetic 1,8-naphthyridine antimicrobial agent with a limited bacteriocidal spectrum. It is an inhibitor of the A subunit of bacterial DNA GYRASE. Nalidixin,Nalidixate Sodium,Nalidixate Sodium Anhydrous,Nevigramon,Sodium Nalidixic Acid, Anhydrous,Sodium Nalidixic Acid, Monohydrate,Acid, Nalidixic,Anhydrous, Nalidixate Sodium,Sodium Anhydrous, Nalidixate,Sodium, Nalidixate
D012036 Refugees Persons fleeing to a place of safety, especially those who flee to a foreign country or power to escape danger, persecution, or economic distress in their own country or habitual residence. Asylum Seekers,Displaced Persons,Internally Displaced Persons,Political Asylum Seekers,Political Refugees,Asylum Seeker,Asylum Seeker, Political,Asylum Seekers, Political,Displaced Person,Displaced Person, Internally,Displaced Persons, Internally,Internally Displaced Person,Person, Displaced,Persons, Displaced,Political Asylum Seeker,Political Refugee,Refugee,Refugee, Political,Refugees, Political,Seeker, Asylum,Seekers, Asylum,Seekers, Political Asylum
D002063 Burundi A republic in eastern Africa bounded on the north by RWANDA and on the south by TANZANIA. Its capital is Bujumbura. Republic of Burundi,Urundi
D004352 Drug Resistance, Microbial The ability of microorganisms, especially bacteria, to resist or to become tolerant to chemotherapeutic agents, antimicrobial agents, or antibiotics. This resistance may be acquired through gene mutation or foreign DNA in transmissible plasmids (R FACTORS). Antibiotic Resistance,Antibiotic Resistance, Microbial,Antimicrobial Resistance, Drug,Antimicrobial Drug Resistance,Antimicrobial Drug Resistances,Antimicrobial Resistances, Drug,Drug Antimicrobial Resistance,Drug Antimicrobial Resistances,Drug Resistances, Microbial,Resistance, Antibiotic,Resistance, Drug Antimicrobial,Resistances, Drug Antimicrobial
D004405 Dysentery, Bacillary DYSENTERY caused by gram-negative rod-shaped enteric bacteria (ENTEROBACTERIACEAE), most often by the genus SHIGELLA. Shigella dysentery, Shigellosis, is classified into subgroups according to syndrome severity and the infectious species. Group A: SHIGELLA DYSENTERIAE (severest); Group B: SHIGELLA FLEXNERI; Group C: SHIGELLA BOYDII; and Group D: SHIGELLA SONNEI (mildest). Shigellosis,Dysentery, Shiga bacillus,Dysentery, Shigella boydii,Dysentery, Shigella dysenteriae,Dysentery, Shigella dysenteriae type 1,Dysentery, Shigella flexneri,Dysentery, Shigella sonnei,Shigella Dysentery,Shigella Infection,Bacillary Dysentery,Dysenteries, Shigella,Dysenteries, Shigella boydii,Dysenteries, Shigella dysenteriae,Dysenteries, Shigella flexneri,Dysenteries, Shigella sonnei,Dysentery, Shigella,Infection, Shigella,Infections, Shigella,Shiga bacillus Dysentery,Shigella Dysenteries,Shigella Infections,Shigella boydii Dysenteries,Shigella boydii Dysentery,Shigella dysenteriae Dysenteries,Shigella dysenteriae Dysentery,Shigella flexneri Dysenteries,Shigella flexneri Dysentery,Shigella sonnei Dysenteries,Shigella sonnei Dysentery
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000890 Anti-Infective Agents Substances that prevent infectious agents or organisms from spreading or kill infectious agents in order to prevent the spread of infection. Anti-Infective Agent,Anti-Microbial Agent,Antimicrobial Agent,Microbicide,Microbicides,Anti-Microbial Agents,Antiinfective Agents,Antimicrobial Agents,Agent, Anti-Infective,Agent, Anti-Microbial,Agent, Antimicrobial,Agents, Anti-Infective,Agents, Anti-Microbial,Agents, Antiinfective,Agents, Antimicrobial,Anti Infective Agent,Anti Infective Agents,Anti Microbial Agent,Anti Microbial Agents
D012762 Shigella dysenteriae A species of gram-negative, facultatively anaerobic, rod-shaped bacteria that is extremely pathogenic and causes severe dysentery. Infection with this organism often leads to ulceration of the intestinal epithelium. Bacillus dysenteriae,Bacillus dysentericus,Bacillus shigae,Eberthella dysenteriae,Shigella shigae
D018571 Sentinel Surveillance Monitoring of rate of occurrence of specific conditions to assess the stability or change in health levels of a population. It is also the study of disease rates in a specific cohort such as in a geographic area or population subgroup to estimate trends in a larger population. (From Last, Dictionary of Epidemiology, 2d ed) Sentinel Health Event,Biosurveillance Systems,Syndromic Surveillance,Biosurveillance System,Health Event, Sentinel,Surveillance, Sentinel,Surveillance, Syndromic

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