The Centers for Disease Control (CDC) advised against the overprescription of antibiotics to treat shigella infections, after a Taiwanese last year was found to have a drug-resistant strain of the bacteria — the first such case in Asia.
Since June last year, 21 additional cases of shigellosis — caused by the salmonella-related family of intestinal bacteria known as shigella — have proved resistant to treatment with the antibiotic azithromycin, the centers said.
The patients, aged 22 to 44, had symptoms such as lower abdominal pain, high fever, diarrhea, vomiting, nausea and stools containing blood and mucus.
The WHO lists shigella among the seven types of bacteria that can acquire drug resistance, centers physician Philip Yi-chun Lo (羅一鈞) said, adding that penicillin was used to treat shigellosis before drug-resistant strains developed.
Since 2015, the US, Australia and several European countries have reported strains of macrolide antibiotic-resistant shigella, Lo said.
Last year’s discovery in Taiwan of a drug-resistant form of shigella was published in the February edition of US the journal Emerging Infectious Diseases.
Although the Taiwanese patients had no history of overseas travel, the shigella strain they were infected with is the same as that found in Europe and the US, leading to speculation that the original carrier brought it from overseas.
The centers said that treatment options for patients hospitalized with shigellosis are shrinking.
While they were treated with ciprofloxacin, co-trimoxazole and third-generation cephalosporin before, there are concerns that the bacteria is still mutating and might eventually become resistant to all available antibiotics, it said.
If antibiotics are overprescribed, this virulent strain of shigella could develop into a “super bacterium” that would be very difficult to treat and could lead to blood poisoning or pneumonia in pregnant, elderly or very young patients, which could be life-threatening, it said.
The centers said it receives reports of bacillary dysentery every year between June and October, and the ingestion of a minute quantity of bacteria can lead to such an infection.
Shigella bacteria are transmitted via the fecal-oral route, the centers said, adding that it is often spread directly through physical contact such as handshakes or indirectly after an infected person touches something that others later touch or consume.
The public should be conscious of personal and environmental hygeine, Lo said.
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