<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1683-9803</journal-id>
<journal-title><![CDATA[Pediatría (Asunción)]]></journal-title>
<abbrev-journal-title><![CDATA[Pediatr. (Asunción)]]></abbrev-journal-title>
<issn>1683-9803</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Paraguaya de Pediatría]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1683-98032026000100005</article-id>
<article-id pub-id-type="doi">10.31698/ped.53012026002</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Distribución de especies, serotipos y resistencia antimicrobiana de Shigella spp. en pacientes del área metropolitana de Paraguay (2019-2025)]]></article-title>
<article-title xml:lang="en"><![CDATA[Distribution of species, serotypes, and antimicrobial resistance of Shigella spp. in patients from the metropolitan area of Paraguay (2019-2025)]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pineda Fretez]]></surname>
<given-names><![CDATA[Amiliana Beatriz]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Alvarez]]></surname>
<given-names><![CDATA[Mercedes]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Orrego]]></surname>
<given-names><![CDATA[Verónica]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ortíz]]></surname>
<given-names><![CDATA[Helena]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Díaz]]></surname>
<given-names><![CDATA[Natalia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Abreu]]></surname>
<given-names><![CDATA[Karina Victoria]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Zubeldía]]></surname>
<given-names><![CDATA[Ana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Hamuy Ortega]]></surname>
<given-names><![CDATA[Rossana Valeria]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Martínez]]></surname>
<given-names><![CDATA[Maria Carolina Viera]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rojas]]></surname>
<given-names><![CDATA[Carolina]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Paez Samaniego]]></surname>
<given-names><![CDATA[Diana Verónica]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Arguello]]></surname>
<given-names><![CDATA[Rocío del Carmen]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[González Ortega]]></surname>
<given-names><![CDATA[Ruth Angelica]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Duarte]]></surname>
<given-names><![CDATA[Ruth]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pereira Martinez]]></surname>
<given-names><![CDATA[Jazmin Clarissa]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Medina Sanabria]]></surname>
<given-names><![CDATA[Betania Yamila]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Arza]]></surname>
<given-names><![CDATA[Fátima]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gauto Verón]]></surname>
<given-names><![CDATA[Mirna Leticia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Soilan]]></surname>
<given-names><![CDATA[Beatriz]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Arenas Chaparro]]></surname>
<given-names><![CDATA[Maria Rossana]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cuevas Casco]]></surname>
<given-names><![CDATA[Deili Nathalia]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Irala]]></surname>
<given-names><![CDATA[Juan]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Vera Ledesma]]></surname>
<given-names><![CDATA[Génesis Luján]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Weiler Gustafson]]></surname>
<given-names><![CDATA[Natalie]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Ministerio de Salud Pública y Bienestar Social Laboratorio Central de Salud Pública ]]></institution>
<addr-line><![CDATA[Asunción ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Laboratorio Meyer  ]]></institution>
<addr-line><![CDATA[Asunción ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Universidad Nacional de Asunción Facultad de Ciencias Médicas ]]></institution>
<addr-line><![CDATA[San Lorenzo ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Centro Médico La Costa  ]]></institution>
<addr-line><![CDATA[Asunción ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Hospital Regional de Luque  ]]></institution>
<addr-line><![CDATA[Luque ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af6">
<institution><![CDATA[,Instituto de Medicina Tropical  ]]></institution>
<addr-line><![CDATA[Asunción ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af7">
<institution><![CDATA[,Centro Médico Bautista  ]]></institution>
<addr-line><![CDATA[Asunción ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af8">
<institution><![CDATA[,Hospital General pediátrico Acosta Ñu  ]]></institution>
<addr-line><![CDATA[San Lorenzo ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="Af9">
<institution><![CDATA[,Hospital Nacional de Itauguá  ]]></institution>
<addr-line><![CDATA[Itauguá ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="A10">
<institution><![CDATA[,Instituto de Previsión Social Hospital CentraI ]]></institution>
<addr-line><![CDATA[Asunción ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="A11">
<institution><![CDATA[,Sanatorio Migone  ]]></institution>
<addr-line><![CDATA[Asunción ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="A12">
<institution><![CDATA[,Hospital Central Policial Rigoberto Caballero  ]]></institution>
<addr-line><![CDATA[Asunción ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="A13">
<institution><![CDATA[,Hospital de Barrio Obrero  ]]></institution>
<addr-line><![CDATA[Asunción ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="A14">
<institution><![CDATA[,Hospital Regional de Ciudad del Este  ]]></institution>
<addr-line><![CDATA[Asunción ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="A15">
<institution><![CDATA[,Instituto Nacional de Enfermedades Respiratorias y del Ambiente  ]]></institution>
<addr-line><![CDATA[Asunción ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="A16">
<institution><![CDATA[,Hospital General de San Lorenzo  ]]></institution>
<addr-line><![CDATA[San Lorenzo ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="A17">
<institution><![CDATA[,Sanatorio Italiano  ]]></institution>
<addr-line><![CDATA[Asunción ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="A18">
<institution><![CDATA[,Laboratorio ANALIZA  ]]></institution>
<addr-line><![CDATA[Asunción ]]></addr-line>
<country>Paraguay</country>
</aff>
<aff id="A19">
<institution><![CDATA[,Hospital Universitario  ]]></institution>
<addr-line><![CDATA[San Lorenzo ]]></addr-line>
<country>Paraguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>04</month>
<year>2026</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>04</month>
<year>2026</year>
</pub-date>
<volume>53</volume>
<numero>1</numero>
<fpage>5</fpage>
<lpage>14</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_arttext&amp;pid=S1683-98032026000100005&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_abstract&amp;pid=S1683-98032026000100005&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_pdf&amp;pid=S1683-98032026000100005&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN  Introducción:  La shigelosis es una infección aguda causada por bacterias del género Shigella, con alta prevalencia en poblaciones pediátricas. La vigilancia permite identificar serotipos y resistencia, mejorando el abordaje clínico y epidemiológico.  Objetivo:  Describir las características demográficas, la distribución de especies y serotipos, y los perfiles de resistencia antimicrobiana de Shigella spp. en aislamientos clínicos del área metropolitana de Paraguay durante el periodo 2019-2025.  Materiales y Métodos:  Se realizó un estudio observacional descriptivo transversal basado en 610 aislamientos clínicos de Shigella spp. recibidos por el Laboratorio Central de Salud Pública. Se determinaron características demográficas, especies, serotipos y perfiles de susceptibilidad antimicrobiana mediante métodos microbiológicos y serológicos estandarizados. Los datos fueron sistematizados y analizados mediante estadística descriptiva.  Resultados:  Predominaron los casos pediátricos. Se identificó a Shigella sonnei (67,2%) y Shigella flexneri. (32,8%). El serotipo 2a fue el más frecuente en S. flexneri (63,2%). La resistencia observada fue a trimetoprim-sulfametoxazol 62,6%, ampicilina 39,7% y azitromicina 13,4%. Resistencia intermedia a ciprofloxacina 19,4% y azitromicina 21,3%. S. sonnei presentó mayores niveles de resistencia a ácido nalidíxico, trimetoprim-sulfametoxazol y azitromicina, mientras que S. flexneri mostró una resistencia más alta a ampicilina. Cefotaxima mantuvo más del 99% de cepas sensibles.  Conclusiones: El estudio evidencia el predominio de S. sonnei y del serotipo 2a de S. flexneri, junto con patrones de resistencia que afectan antibióticos de uso habitual. La mayor afectación pediátrica subraya la necesidad de fortalecer la vigilancia, actualizar guías terapéuticas y optimizar estrategias de control para limitar la diseminación de cepas resistentes en Paraguay.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT  Introduction: Shigellosis is an acute infection caused by bacteria of the genus Shigella, with a high prevalence in pediatric populations. Surveillance allows for the identification of serotypes and resistance, improving the clinical and epidemiological approach.  Objective: To describe the demographic characteristics, species and serotype distribution, and the antimicrobial resistance profiles of Shigella spp. in clinical isolates from the metropolitan area of Paraguay during the 2019-2025 time period.  Materials and Methods: We conducted a descriptive, cross-sectional and observational study, based on 610 clinical isolates of Shigella spp. received by the Central Public Health Laboratory. Demographic characteristics, species, serotypes, and antimicrobial susceptibility profiles were determined using standardized microbiological and serological methods. Data were systematized and analyzed using descriptive statistics.  Results: Pediatric cases predominated. Shigella sonnei (67.2%) and Shigella flexneri (32.8%) were identified. Serotype 2a was the most frequent in S. flexneri (63.2%). Resistance was observed to trimethoprim-sulfamethoxazole (62.6%), ampicillin (39.7%), and azithromycin (13.4%). Intermediate resistance was observed to ciprofloxacin (19.4%) and azithromycin (21.3%). S. sonnei showed higher levels of resistance to nalidixic acid, trimethoprim-sulfamethoxazole, and azithromycin, while S. flexneri showed higher resistance to ampicillin. Cefotaxime maintained susceptibility in over 99% of strains.  Conclusions: The study demonstrates the predominance of S. sonnei and S. flexneri serotype 2a, along with resistance patterns affecting commonly used antibiotics. The higher incidence in children underscores the need to strengthen surveillance, update treatment guidelines, and optimize control strategies to limit the spread of resistant strains in Paraguay.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Shigella]]></kwd>
<kwd lng="es"><![CDATA[diarrea infecciosa]]></kwd>
<kwd lng="es"><![CDATA[vigilancia epidemiológica]]></kwd>
<kwd lng="es"><![CDATA[resistencia antimicrobiana]]></kwd>
<kwd lng="es"><![CDATA[Paraguay]]></kwd>
<kwd lng="en"><![CDATA[Shigella]]></kwd>
<kwd lng="en"><![CDATA[infectious diarrhea]]></kwd>
<kwd lng="en"><![CDATA[epidemiological surveillance]]></kwd>
<kwd lng="en"><![CDATA[antimicrobial resistance]]></kwd>
<kwd lng="en"><![CDATA[Paraguay]]></kwd>
</kwd-group>
</article-meta>
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