Annals of Laboratory Medicine

Korean Society for Laboratory Medicine (대한진단검사의학회)
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Quinolone-resistant Shigella flexneri Isolated in a Patient Who Travelled to India

  • Jeon, You La (Department of Medicine, Graduate School, Kyung Hee University) ;
  • Nam, You-sun (Department of Biomedical Science, Kyung Hee University Graduate School) ;
  • Lim, Gayoung (Department of Laboratory Medicine, School of Medicine, Kyung Hee University) ;
  • Cho, Sun Young (Department of Laboratory Medicine, School of Medicine, Kyung Hee University) ;
  • Kim, Yun-Tae (Department of Molecular Biology, Seoul Medical Science Institute/Seoul Clinical Laboratories) ;
  • Jang, Ji-Hyun (Department of Molecular Biology, Seoul Medical Science Institute/Seoul Clinical Laboratories) ;
  • Kim, Junyoung (Division of Enteric Bacterial Infections, Center for Infectious Disease, National Institute of Health,) ;
  • Park, Misun (Division of Enteric Bacterial Infections, Center for Infectious Disease, National Institute of Health,) ;
  • Lee, Hee Joo (Department of Laboratory Medicine, School of Medicine, Kyung Hee University)
  • Published : 2012.09.01
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Abstract

We report a recent case in which ciprofloxacin-resistant Shigella flexneri was isolated from a 23-yr-old female patient with a history of travel to India. Prior to her admission to our internal medicine department, she experienced symptoms of high fever and generalized weakness from continuous watery diarrhea that developed midway during the trip. S. flexneri was isolated from the stool culture. Despite initial treatment with ciprofloxacin, the stool cultures continued to show S. flexneri growth. In the susceptibility test for antibiotics of the quinolone family, the isolate showed resistance to ciprofloxacin (minimum inhibitory concentration [MIC], $8{\mu}g/mL$), norfloxacin (MIC, $32{\mu}g/mL$), ofloxacin (MIC, $8{\mu}g/mL$), nalidixic acid (MIC, $256{\mu}g/mL$), and intermediate resistance to levofloxacin (MIC, $4{\mu}g/mL$). In molecular studies for quinolone resistance related genes, plasmid borne-quinolone resistance genes such as qnrA, qnrB, qnrS, aac(6')-Ib-cr, qepA, and oqxAB were not detected. Two mutations were observed in gyrA ($248C{\rightarrow}T$, $259G{\rightarrow}A$ ) and 1 mutation in parC ($239G{\rightarrow}T$). The molecular characteristics of the isolated S. flexneri showed that the isolate was more similar to the strains isolated from the dysentery outbreak in India than those isolated from Korea.

Keywords

References

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