High level resistance to trimethoprim, cotrimoxazole and other antimicrobial agents among clinical isolates of Shigella species in Ontario, Canada--an update.

A total of 598 isolates of Shigella species (24 S. dysenteriae, 254 S. flexneri, 30 S. boydii, 290 S. sonnei) submitted to the Ontario Public Health Laboratories in 1990 were tested for their susceptibility to 14 antimicrobial agents by the agar dilution method. Overall 79.6% of isolates were resistant to one or more antimicrobial agents and 52.0% were resistant to four or more. Trimethoprim resistance ranged from 26.7% among isolates of S. boydii to 39.4% among S. flexneri strains. The majority of the 224 TMP resistant isolates (88.8%) demonstrated high level resistance (MIC > 1000 mg/l) to trimethoprim. Resistance to cotrimoxazole increased from 3% in 1978 to between 26.7 and 37.6% in 1990. MICs for 90% of isolates (MIC90s) for ampicillin, ticarcillin and piperacillin were 128 to > 256 mg/l, > 256 for tetracycline and chloramphenicol, and > 2.0/38.0 for cotrimoxazole. These results from the Canadian Province of Ontario emphasize the need for prudent use of antimicrobial agents in the treatment of shigellosis.