CDC recommendations for diagnosing and managing Shigella strains with possible reduced susceptibility to Ciprofloxacin

Details

• Corporate Authors:
  Centers for Disease Control and Prevention (U.S.)
• Description:
  April 18, 2017, 16:00 ET (4:00 PM ET)
  
  CDCHAN-00401
  
  This Health Advisory describes the identification of emerging Shigella strains with elevated minimum inhibitory concentration values for ciprofloxacin and outlines new recommendations for clinical diagnosis, management, and reporting, as well as new recommendations for laboratories and public health officials. Current interpretive criteria provided by the Clinical and Laboratory Standards Institute (CLSI) categorize these strains as susceptible to ciprofloxacin, which is a fluoroquinolone antibiotic and a key agent in the management of Shigella infections.
  
  However, recent data from the Centers for Disease Control and Prevention (CDC) and state and local public health partners show that these strains often have a quinolone resistance gene that may lead to clinically significant reduced susceptibility to fluoroquinolone antibiotics. Clinicians treating patients with multidrug-resistant shigellosis for whom antibiotic treatment is indicated should avoid prescribing fluoroquinolones if the ciprofloxacin MIC is 0.12 μg/mL or higher even if the laboratory report identifies the isolate as susceptible, and should work closely with their clinical microbiology laboratory and infectious disease specialists to determine appropriate antimicrobial therapy.
  
  Shigellosis is a nationally notifiable condition, and all cases of shigellosis should be reported to local health departments.
  
  
• Subjects:
  Ciprofloxacin Drug Resistance, Bacterial Dysentery, Bacillary Shigella
• Source:
  HAN ; 401
• Series:
  Health Alert Network
• Document Type:
  HAN Health Advisory
• Place as Subject:
  Florida ; Miami Beach (Fla.) ; Miami-Dade County (Fla.)
• Pages in Document:
  5 unnumbered pages
• Issue:
  401
• Collection(s):
  Health Alert Network (HAN)
• Main Document Checksum:
  urn:sha-512:f8a7aae8b90fa566d6802f85566ef9ff14096e1554701d8f046231a8afccef76dc4eec9bc1c651f1332e4aa3a61b98f5ccabbf95ece76fdabb3ea855a9bef04d
• Download URL:
  https://stacks.cdc.gov/view/cdc/45183/cdc_45183_DS1.pdf
• File Type:
  [PDF - 301.74 KB ]