Emerging Ceftriaxone Resistance in Paediatric Shigella sonnei : A 10‐Year Retrospective Study

AIM: This study's aim is to evaluate temporal trends in antimicrobial resistance in Shigella sonnei, with a focus on the emergence of ceftriaxone-resistant strains among paediatric patients. METHODS: We conducted a 10-year retrospective study of all paediatric patients diagnosed with Shigella sonnei via stool culture in our emergency department. Clinical features, laboratory results, and length of hospital stay were reviewed to assess trends in ceftriaxone resistance and compare between resistant and sensitive groups. RESULTS: We analysed 180 paediatric Shigella sonnei cases. Of these, 177 (98.3%) were tested for ceftriaxone susceptibility: 156 (88.1%) were sensitive, and 21 (11.9%) resistant. Resistant strains emerged in 2022 (85.7%, 6/7), rising to 88.2% (15/17) in 2023, showing a strong correlation with calendar year (p < 0.001). Resistant cases showed lower neutrophil (p < 0.01) and sodium levels (p < 0.006). CONCLUSION: Ceftriaxone-resistant Shigella sonnei has risen sharply in Israel since 2022, mirroring global trends. This highlights the urgent need for strengthened antimicrobial resistance surveillance and to update current guidelines for the empiric treatment of childhood shigellosis.