Rising cases of drug-resistant Shigella in Kerala highlight urgent concerns over antimicrobial resistance. Discover the implications for public health.
Kerala is witnessing an increase in Shigella infection, raising concerns about antimicrobial resistance (AMR) and the possibility of infections becoming harder to treat. The state health authorities have reported Shigella cases across multiple districts, with outbreaks declared in several areas.
The concern is particularly important because antimicrobial-resistant bacteria may not respond effectively to medicines that are commonly used to treat bacterial infections. Kerala has also been strengthening its AMR surveillance and antibiotic-literacy initiatives to address the growing threat of drug resistance.
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Kerala’s Fight Against Antimicrobial Resistance
Kerala’s KARS-NET (Kerala Antimicrobial Resistance Surveillance Network), one of the strongest AMR surveillance systems in the country, has been tracking the AMR profile of Shigellosis since 2023. Its data says that the resistance profile of primary antibiotics used to treat the infection is growing.
According to KARS-NET, Ciprofloxacin, which is recommended by the national guidelines for Shigella dysentery treatment, has a resistance profile of 96%. Therefore, it can no longer be relied upon for Shigellosis treatment.
R. Aravind, head of infectious disease, Government Medical College, Thiruvananthapuram, who is also the convener of KARS-Net, said, “Till now, community-acquired AMR had not been a problem in the State. If you, as a citizen, have never been worried about AMR, you should be now, because it is showing up right at your doorstep. Our arsenal of effective and affordable antibiotics for common infections in the community is shrinking.”
Ceftriaxone is the next available drug that has developed pathogenic resistance. It is a third-generation cephalosporin antibiotic, which has gone up to 36%.
He added, “Clinicians have been using Ceftriaxone for treating Shigellosis in patients who get admitted to the hospital. But the clinical implication of growing resistance of Shigella to this drug is immense.”
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What Is Shigellosis?
Shigellosis is an intestinal infection caused by bacteria belonging to the Shigella group. It mainly affects the digestive system and can cause symptoms such as diarrhoea, fever and abdominal cramps.
The infection can spread when food or water becomes contaminated with Shigella bacteria. Person-to-person transmission can also occur, particularly when hand hygiene is poor.
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What Is Antimicrobial Resistance?
Antimicrobial resistance (AMR) occurs when microorganisms develop the ability to survive medicines that are designed to kill them or stop their growth.
When Shigella becomes resistant to commonly used antibiotics, treatment can become more difficult. This may limit the number of medicines available to doctors and can increase the risk of complications.
What Are the Symptoms of Shigellosis?
Common symptoms may include:
• Diarrhoea
• Fever
• Stomach cramps
• Abdominal pain
• Nausea
• Sometimes bloody diarrhoea
The severity can vary from person to person. Children, older adults and people with weakened immunity may be more vulnerable to complications from gastrointestinal infections.
How Does Shigella Spread?
Shigella can spread through the faecal-oral route, meaning bacteria from an infected person’s stool can reach another person’s mouth.
Transmission can occur through:
• Contaminated food or water
• Poor hand hygiene
• Close contact with an infected person
• Contaminated surfaces
Even a small amount of Shigella bacteria can potentially cause infection, making hygiene particularly important.
Why Is Drug-Resistant Shigella a Concern?
Antibiotics are sometimes required for severe Shigella infections or people at higher risk of complications. However, if the bacteria are resistant to commonly used antibiotics, treatment options become more limited.
This is why doctors may need to consider the patient’s condition and, where appropriate, laboratory testing to determine which medicines are likely to work.
Antibiotics should not be taken without medical advice, as inappropriate antibiotic use can contribute to antimicrobial resistance.
How Can Shigella Infection Be Prevented?
Simple hygiene measures can reduce the risk of infection:
• Wash hands thoroughly with soap and water.
• Drink safe and clean water.
• Eat properly cooked food.
• Maintain good food-handling hygiene.
• Avoid preparing food for others while experiencing diarrhoea.
• Keep contaminated surfaces clean.
Follow public-health advice during local outbreaks.
Conclusion
The rise in Shigella infections in Kerala highlights the importance of infection prevention, safe hygiene practices, and responsible antibiotic use. With antimicrobial resistance making some bacterial infections increasingly difficult to treat, timely diagnosis and appropriate medical management remain important.
Reference:
- Six More Shigella Cases Confirmed in the State – (https://health.kerala.gov.in/pressreleasedetail/eyJpdiI6IlIzbXkydW1EeEN2bWtjSFBFUUJlNmc9PSIsInZhbHVlIjoiM21hWnkwZGRLanU3OTMycXVZbHZSUT09IiwibWFjIjoiMWM0ZGVmNzNiNDQyNWNiNTcyODcwMjBiMTQ5NmNhOTQxMGZkOTM3NzA0OWJjOTY3OTVmZTAyNjg3NTc3MTM2YyIsInRhZyI6IiJ9 )
- Six More Shigella Cases Confirmed in the State – (https://www.cdc.gov/shigella/about/index.html)
- Antimicrobial resistance – (https://www.who.int/health-topics/antimicrobial-resistance)
Source-Medindia