The Trend of Antibiotic Resistance in Shigellosis and the Diagnostic Value of Erythrocyte Sedimentation Rate for Its Differentiation from Viral Gastroenteritides in Aliasghar Children Hospital Tehran (1996-2006)

Background and objectives As a common infectious disease in childhood shigellosis has a variety of seasonal and microbiologic patterns and there is a concerning trend of resistance in various parts of the world and even a single country. Inappropriate empiric therapy for any acute episode of gastroenteritis which might be based on lab studies could potentially lead to even further resistance. In this report the erythrocyte sedimentation rate was studied in patients with acute gastroenteritis. Methods Medical records of 117 patients were reviewed in this study. The mean and standard deviation of some of the acute phase inflammatory indicators were compared in two groups of shigellosis and viral gastroenteritides using independent samples t test. Results The mean age of the patients was 49 months and almost half of them were male. Shigella sonnei was the commonest species isolated from these patients. Shigellosis was found to be more frequent during August to October. After 2001 resistance to ampicillin and cotrimoxazole was observed in 75% and 90% of isolates respectively. A few cases were resistant to third generation of cephalosporins (< 3%). In shigellosis the erythrocyte sedimentation rate was significantly higher than viral gastroenteritis. Conclusion Empiric use of cotrimoxazole is no longer recommended in children suspicious of contracting shigellosis in Tehran. To avoid unnecessary preh1ion of antibiotics for acute gastroenteritis a normal result of erythrocyte sedimentation rate might be helpful.