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Patient had traveled to China: shigella isolate is first U.S. strain found resistant to ciprofloxacin.

BETHESDA, MD. -- A Centers for Disease Control and Prevention monitoring program has detected the first U.S. case of shigella infection that is resistant to the fluoroquinolone ciprofloxacin, Nicole L. Baker reported at an annual conference on antimicrobial resistance sponsored by the National Foundation for Infectious Diseases.

Antibiotic therapy is not essential for most shigella infections, but it can shorten the duration of the illness and decrease the length of time that the patient is a carrier. And in severe shigella infections, antibiotics can be life saving, said Ms. Baker, an epidemiologist in the CDC's foodborne and diarrheal diseases branch in Atlanta.

As part of the National Antimicrobial Resistance Monitoring System, 17 state and local health departments around the country submitted every 10th shigella isolate they collected between 1999 and 2001 to the CDC for susceptibility testing.

Of the 1,170 isolates that were analyzed, 93% were resistant to at least one antimicrobial agent, including ampicillin (79% of isolates), streptomycin (56%), sulfamethoxazole (56%), tetracycline (53%), and combined trimethoprim and sulfamethoxazole (51%). Overall, 12% of the isolates were resistant to five or more antimicrobials.

Of the 17 isolates (1%) that were resistant to nalidixic acid, a nonfluorinated quinolone, I also was resistant to the fluoroquinolone ciprofloxacin. This infection developed in a child who resided in New York City but had a recent history of travel to China.

This first case to be recognized in an American "is reason for concern," even though shigella resistance to quinolones has been uncommon in the United States to date, Ms. Baker said in a poster presentation at the conference.
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Title Annotation:Gastroenterology
Author:Moon, Mary Ann
Publication:Internal Medicine News
Date:May 1, 2004
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