Molecular characterization of virulence and antimicrobial resistance profile of Shigella species isolated from children with moderate to severe diarrhea in northeastern Brazil

Publication date: Available online 10 November 2017
Source:Diagnostic Microbiology and Infectious Disease
Author(s): Pedro Henrique Quintela Soares de Medeiros, Aldo Ângelo Moreira Lima, Marjorie Moreira Guedes, Alexandre Havt, Mariana Duarte Bona, Luís Carlos Rey, Alberto Melo Soares, Richard Littleton Guerrant, Bernhard H. Weigl, Ila Fernanda Nunes Lima
Molecular characterization of virulence and antimicrobial resistance profiles were determined for Shigella species isolated from children with diarrhea in Fortaleza, Brazil. Fecal specimens were collected along with socioeconomic and clinical data from children with moderate to severe diarrhea requiring emergency care. Shigella spp. were isolated by standard microbiological techniques and we developed four multiplex polymerase chain reaction assays to detect 16 virulence-related genes (VRGs). Antimicrobial susceptibility tests were performed using disk diffusion assays. S. flexneri and S. sonnei were the predominant serogroups. S. flexneri was associated with low monthly incomes, more severe disease, higher number of VRGs, and presence of pic, set, and sepA genes. The SepA gene was associated with more intense abdominal pain. S. flexneri was correlated with resistance to ampicillin and chloramphenicol, while S. sonnei was associated with resistance to azithromycin. Strains harboring higher numbers of VRGs were associated with resistance to more antimicrobials. We highlight the correlation between presence of S. flexneri and sepA, and increased virulence and suggest a link to socioeconomic change in northeastern Brazil. Additionally, antimicrobial resistance was associated with serogroup-specificity in Shigella spp. and increased bacterial VRGs.



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