Skip to main content

Advertisement

Log in

Molecular epidemiology of Shigella flexneri isolated from pediatrics in a diarrhea-endemic area of Khyber Pakhtunkhwa, Pakistan

  • Original Article
  • Published:
European Journal of Clinical Microbiology & Infectious Diseases Aims and scope Submit manuscript

Abstract

Shigella flexneri is considered as an important causative agent of Shigellosis causing diarrhea in the countries with a low socioeconomic status. No study has been carried out on the molecular prevalence of S. flexneri in Khyber Pakhtunkhwa, Pakistan. So this study was designed to evaluate the molecular prevalence of S. flexneri and their associated risk factors. A total of 2014 diarrheal stool samples were collected from January 2016 to May 2017 from pediatrics patients of Khyber Pakhtunkhwa followed by identification of S. flexneri through biochemical, serological, and molecular methods. The overall prevalence of Shigella species was found to be 7.9% (n = 160). The predominant Shigella specie was S. flexneri (n = 155, 96.8%) followed by S. boydii (n = 5, 3.1%). Interestingly, no sample was found positive for S. sonnei and S. dysenteriae. The majority of Shigellosis cases occurred from June to September. Potential risk factors related with Shigellosis were unhygienic latrine usage, bad hand washing, and consumption of unhygienic food and water, and pipe leakage in the sewage system. In this study, we have observed a high number of Shigellosis cases especially those caused by S. flexneri. It is suggested that effective health awareness programs should be organized by the regional health authorities to minimize the magnitude of pediatrics Shigellosis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Mardaneh J, Abbas S, Afrugh P (2013) Prevalence of Shigella species and antimicrobial resistance patterns of isolated strains from infected pediatrics in Tehran. Int J Enteric Pathog 1:28–31

    Article  Google Scholar 

  2. Saima SA, Abbas F et al (2018) Isolation & identification of Shigella species from food and water samples of Quetta, Pakistan. Pure Appl Biol 7:227–235

    CAS  Google Scholar 

  3. Ashkenazi S (2004) Shigella infections in children: new insights. Semin Pediatr Infect Dis 15:246–252

    Article  Google Scholar 

  4. Fan W, Qian H, Shang W et al (2017) Low distribution of genes encoding virulence factors in Shigella flexneri serotypes 1b clinical isolates from eastern Chinese populations. Gut Pathog 9:76

    Article  Google Scholar 

  5. Sharma A, Singh SK, Bajpai D (2010) Phenotypic and genotypic characterization of Shigella spp. with reference to its virulence genes and antibiogram analysis from river Narmada. Microbiol Res 165:33–42

    Article  CAS  Google Scholar 

  6. Wang S, Chen JHAW (2012) A rapid and specific PCR method for the detection of Shigella spp. in spiked samples. J Food Drug Anal 20:59–65

    Google Scholar 

  7. Khalil IA, Troeger C, Blacker BF et al (2018) Morbidity and mortality due to Shigella and enterotoxigenic Escherichia coli diarrhea: the global burden of disease study 1990–2016. Lancet Infect Dis 18:1229–1240

    Article  Google Scholar 

  8. Warren BR, Parish ME, Schneider KR (2006) Shigella as a foodborne pathogen and current methods for detection in food. Crit Rev Food Sci Nutr 46:551–567

    Article  CAS  Google Scholar 

  9. Muthuirulandi Sethuvel DP, Devanga Ragupathi NK, Anandan S, Veeraraghavan B (2017) Update on: Shigella new serogroups/serotypes and their antimicrobial resistance. Lett Appl Microbiol 64:8–18

    Article  CAS  Google Scholar 

  10. Rahimi E, Shirazi F, Khamesipour F (2017) Isolation and study of the antibiotic resistance properties of Shigella Species in meat and meat products. J Food Process Preserv 41:e12947

    Article  Google Scholar 

  11. Platts-Mills JA, McCormick BJJ, Kosek M et al (2014) Methods of analysis of enteropathogen infection in the MAL-ED cohort study. Clin Infect Dis 59:S233–S238

    Article  CAS  Google Scholar 

  12. Koneman EW, Allen SD, Janda WM, Schreckenberger PC, Winn WC (1997) Colour atlas and textbook of diagnostic microbiology (5th edition) Lippincott, NY, USA

  13. Carlos J, Junior R, Tamanini R et al (2016) Efficiency of boiling and four other methods for genomic DNA extraction of deteriorating spore-forming bacteria from milk. Semina: Ciencias Agrarias 37:3069–3078

    Google Scholar 

  14. James G (2010) Universal bacterial identification by PCR and DNA sequencing of 16S rRNA gene. In: Schuller M, Sloots PT, James SG, Halliday LC, Carter WJI (eds) PCR for clinical microbiology. Springer, Dordrecht, pp 209–214

    Chapter  Google Scholar 

  15. Wang XY, Du L, Von Seidlein L et al (2005) Occurrence of Shigellosis in the young and elderly in rural China: results of a 12-month population-based surveillance study. Am J Trop Med Hyg 73:416–422

    Article  Google Scholar 

  16. Opintan JA, Newman MJ (2007) Distribution of serogroups and serotypes of multiple drug resistant Shigella isolates. Ghana Med J 41:7–11

    Google Scholar 

  17. Nisar M, Ahmed MD, Hassan Mushtaq M et al (2014) Clinico-epidemiology of Shigellosis in children suffering from diarrhea in district Lahore, Pakistan. Int J Curr Microbiol App Sci 3:950–957

    Google Scholar 

  18. Orrett FA (2008) Prevalence of Shigella serogroups and their antimicrobial resistance patterns in southern Trinidad. J Health Popul Nutr 26:456–462

    PubMed  PubMed Central  Google Scholar 

  19. Ghaemi EO, Aslani MM, Moradi AV et al (2007) Epidemiology of Shigella-associated diarrhea in Gorgan, north of Iran. Saudi J Gastroenterol 13:129–132

    Article  Google Scholar 

  20. Khan AAI, Huq S, Malek MA et al (2004) Shigella serotypes among hospitalized patients in urban Bangladesh and their antimicrobial resistance. Epidemiol Infect 132:773–777

    Article  CAS  Google Scholar 

  21. Mache A (2001) Antibiotic resistance and sero-groups of Shigella among paediatric out-patients in Southwest Ethiopia. East Afr Med J 78:296–299

    Article  CAS  Google Scholar 

  22. Thompson CN, Duy PT, Baker S (2015) The rising dominance of Shigella sonnei: an intercontinental shift in the etiology of bacillary dysentery. PLoS Negl Trop Dis 9:e0003708

    Article  Google Scholar 

  23. Abdu A, Aboderin AO, Elusiyan JB et al (2013) Serogroup distribution of Shigella in Ile-Ife, southwest Nigeria. Trop Gastroenterol 34:164–169

    Article  Google Scholar 

  24. Yismaw G, Negeri C, Kassu A (2008) A five-year antimicrobial resistance pattern of Shigella isolated from stools in the Gondar university hospital, Northwest Ethiopia. Trop Dr 38:43–45

    Article  Google Scholar 

  25. Shapiro RL, Kumar L, Phillips-Howard P et al (2001) Antimicrobial resistant bacterial diarrhea in rural Western Kenya. J Infect Dis 183:1701–1704

    Article  CAS  Google Scholar 

  26. Brooks JT, Ochieng JB, Kumar L et al (2006) Surveillance for bacterial diarrhea and antimicrobi resistance in rural Western Kenya, 1997-2003. Clin Infect Dis 43:393–401

    Article  CAS  Google Scholar 

  27. Chang Z, Zhang J, Ran L et al (2016) The changing epidemiology of bacillary dysentery and characteristics of antimicrobial resistance of Shigella isolated in China from 2004–2014. BMC Infect Dis 16:685

    Article  Google Scholar 

  28. Cui X, Wang J, Yang C et al (2015) Prevalence and antimicrobial resistance of Shigella flexneri serotype 2 variant in China. Front Microbiol 6:435

    Article  Google Scholar 

  29. Abu-elyazeed RR, Wierzba TF, Frenck RW, Putnam SD, Rao MR, Savarino SJ, Kamal KA, Peruski JR, Abd-El messih IA, El-Alkamy S, Naficy AB (2004) Epidemiology of Shigella-associated diarrhea in rural Egyptian children. Am J Trop Med Hyg 71:367–372

    Article  Google Scholar 

  30. Molbak K (2000) The epidemiology of diarrhoeal diseases in early childhood. A review of community studies in Guinea-Bissau. Dan Med Bull 47:340–358

    CAS  PubMed  Google Scholar 

  31. Hossain MA, Albert MJ, Hasan KZ (1990) Epidemiology of Shigellosis in teknaf, a coastal area of Bangladesh: a 10-year survey. Epidemiol Infect 105:41–49

    Article  CAS  Google Scholar 

  32. Sousa ABM, Mendes EN, Collares GB et al (2013) Shigella in Brazilian children with acute diarrhea: prevalence, antimicrobial resistance and virulence genes. Mem Inst Oswaldo Cruz 108:30–35

    Article  Google Scholar 

  33. Anteneh ZA, Andargie K, Tarekegn M (2017) Prevalence and determinants of acute diarrhea among children younger than five years old in Jabithennan district, Northwest Ethiopia, 2014. BMC Public Health 17:99

    Article  Google Scholar 

  34. Mamo A, Hailu A (2014) Assessment of prevalence and related factors of diarrheal diseases among under-five year’s children in debrebirehan referral hospital, Debrebirehan town, North shoa zone, Amhara region, Ethiopia. OALib 01:1–14

    Article  Google Scholar 

  35. Thiam S, Diene AN, Fuhrimann S et al (2017) Prevalence of diarrhea and risk factors among children under five years old in Mbour, Senegal: a cross-sectional study. Infect Dis Poverty 6:109

    Article  Google Scholar 

  36. Godana W (2013) Environmental factors associated with acute diarrhea among children under five years of age in derashe district, Southern Ethiopia. Sci J Public Health 1:119

    Article  Google Scholar 

  37. Chompook P, Todd J, Wheeler JG et al (2006) Risk factors for Shigellosis in Thailand. Int J Infect Dis 10:425–433

    Article  Google Scholar 

  38. Swaddiwudhipong W, Karintraratana SKS (1995) A common-source outbreak of Shigellosis involving a piped public water supply in northern Thai communities. J Trop Med Hyg 98:145–150

    CAS  PubMed  Google Scholar 

  39. Egoz N, Shmilovitz M, Kretzer B et al (1991) An outbreak of Shigella sonnei infection due to contamination of a municipal water supply in northern Israel. J Inf Secur 22:87–93

    CAS  Google Scholar 

  40. Mengistie B, Berhane Y, Worku A (2013) Prevalence of diarrhea and associated risk factors among children under-five years of age in Eastern Ethiopia: a cross-sectional study. Open J Prev Med 03:446–453

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Contributions

Muhammad Qasim, Iqbal Nisa, Arnold Driessen, Jeroen Nijland, and Fazli Bari designed the study, carried out the experiments, analyzed the data, and drafted the manuscript. Muhammad Qasim, Iqbal Nisa, and Jeroen Nijland helped in data analysis and results interpretation. Muhammad Qasim, Arnold Driessen, Jeroen Nijland, Fazli Bari, Mohammad Haroon, Hazir Rehman, Nusrat Yasin, Taj Ali Khan, Mubbashir Hussain, and Waheed Ullah critically reviewed and commented on the manuscript.

Corresponding author

Correspondence to Muhammad Qasim.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000. In addition, the institutional research ethical committee approved the present study.

Informed consent

Informed consent was obtained from all patients/guardian for being included in the study.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Nisa, I., Qasim, M., Driessen, A. et al. Molecular epidemiology of Shigella flexneri isolated from pediatrics in a diarrhea-endemic area of Khyber Pakhtunkhwa, Pakistan. Eur J Clin Microbiol Infect Dis 39, 971–985 (2020). https://doi.org/10.1007/s10096-020-03811-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10096-020-03811-0

Keywords

Navigation