High Rates of Bacteremia and Fluoroquinolone Resistance During an Outbreak of Shigellosis Among People Experiencing Homelessness and Opioid Use Disorder in Philadelphia, Pennsylvania - Summary - MDSpire
Advertisement
High Rates of Bacteremia and Fluoroquinolone Resistance During an Outbreak of Shigellosis Among People Experiencing Homelessness and Opioid Use Disorder in Philadelphia, Pennsylvania
To evaluate the incidence of bacteremia and antibiotic resistance specifically among hospitalized patients during a Shigella flexneri outbreak in Philadelphia.
Key Findings:
67 patients hospitalized with confirmed shigellosis; 31.3% (21 patients) had bacteremia, indicating a significant health risk.
High prevalence of housing insecurity (67%) and opioid use disorder (68.7%) among patients, highlighting vulnerable populations.
All cultured isolates were resistant to ampicillin; significant resistance to fluoroquinolones was observed, raising concerns for treatment options.
Interpretation:
The outbreak revealed a concerning rate of bacteremia and extensive antibiotic resistance, underscoring the vulnerability of populations with housing insecurity and OUD, and the urgent need for targeted public health interventions.
Limitations:
The study was limited to a single health system, which may not represent broader trends in the community or other regions.
Some patients did not have stool cultures obtained, potentially underestimating the incidence of shigellosis and affecting the overall understanding of the outbreak.
Conclusion:
The outbreak underscores the need for effective treatment options, as trimethoprim-sulfamethoxazole was the only reliable antibiotic available due to high resistance rates, necessitating urgent public health responses.
