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.

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