Distribución de especies, serotipos y resistencia antimicrobiana de Shigella spp. en pacientes del área metropolitana de Paraguay (2019-2025)

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Abstract
Introduction: Shigellosis is an acute infection caused by bacteria of the genus Shigella, with high prevalence in pediatric populations. Surveillance allows the identification of serotypes and resistance patterns, improving clinical and epidemiological management. Objective: To determine the distribution of species, serotypes, and antimicrobial resistance of Shigella spp. in the metropolitan area of Paraguay (2019–2025). Methods: A cross-sectional descriptive observational study was conducted on 610 clinical bacterial isolates received by the Central Public Health Laboratory of the Enteropathogen Network. Species, serotypes, and resistance profiles were identified following standardized protocols. Data were processed in Microsoft Excel® and analyzed using descriptive statistics. Results: Pediatric cases predominated (69.8%). Shigella sonnei (67.2%) and Shigella flexneri (32.8%) were identified. Among 155 strains of S. flexneri, the most frequent serotype was 2a (63.2%). Observed resistance was trimethoprim-sulfamethoxazole 62.6%, ampicillin 39.7%, and azithromycin 13.4%. Intermediate resistance was found to ciprofloxacin 19.4% and azithromycin 21.3%. Conclusions: The study demonstrated the prevalence of S. sonnei and serotype 2a of S. flexneri, along with resistance patterns that compromise commonly used antibiotics. These findings reinforce the need to maintain active laboratory surveillance, update therapeutic guidelines, and strengthen control strategies against resistant strains, with direct impact on public health and clinical management of shigellosis in Paraguay.