Molecular Analysis of Antibiotic Resistance Development in Shigella flexneri isolated from Pediatric Diarrheal Patients

Abstract

Abstract Antibiotic resistance is a growing concern, particularly in developing countries, and Shigella flexneri is a leading cause of pediatric diarrheal infections. This study aimed to investigate the development of antibiotic resistance in Shigella flexneri isolated from pediatric diarrheal patients. We conducted a comprehensive investigation involving 29 Shigella isolates previously identified from 204 pediatric diarrheal patients. Antibiotic susceptibility testing was performed using antibiotics commonly used in pediatric cases. Conventional PCR assays were employed to detect antibiotic resistance genes (ARGs) int1, sul2, and gyrA. Gene expression levels were assessed through RT-PCR analysis. Additionally, plasmid profiling was conducted to elucidate the transmission of antibiotic-resistant genes among pediatric patients. Our findings reveal a concerning surge in multidrug-resistant S. flexneri strains among pediatric patients, with a particularly alarming 100% multidrug resistance observed in infants aged 1 day to 6 months. Multiple antibiotic resistance genes (ARGs) were identified in the studied isolates. Furthermore, RT-PCR analysis demonstrated a significant correlation between elevated ARG expression and antibiotic resistance. Plasmid profiling revealed a diverse plasmid population, including the novel plasmid pNV-Y394 harboring multiple antibiotic resistance genes. Collectively, these findings emphasize the critical importance of addressing antibiotic resistance in pediatric diarrheal cases, demanding immediate and decisive interventions.