Epidemiological Evidence of Multidrug-Resistant Shigella sonnei Colonization in India by Sentinel Surveillance in a Japanese Quarantine Station

We applied a previously reported method to clarify whether a multidrug-resistant Shigella colonizes in a south Asian country. At Kansai Airport Quarantine Station, stool samples were collected from overseas travelers who reported a history of diarrhea. Shigella strains were isolated, ranging from 53 to 106 (average, 82.4) isolates/year (2001-2005), and almost 80% of the isolates were Shigella sonnei. The most frequent country of origin was India. Strains from the country of the most frequent origin were studied by antimicrobial susceptibility testing. Resistance to tetracycline, sulfamethoxazole-trimethoprim and nalidixic acid was observed at the highest frequency: in 23 of the 25 strains isolated in 2001, 5 of the 13 strains isolated in 2002, and 16 of the 19 strains isolated in 2005. Strains showing the most prevalent multidrug-resistance pattern were analyzed by pulsed-field gel electrophoresis (PFGE). The PFGE profiles showed that 27 of the 44 strains isolated in 2001, 2002, and 2005 were identical in PFGE pattern, as determined using two restriction enzymes. We concluded that a multidrug-resistant Shigella sonnei colonizes in a south Asian country.