scholarly journals Persistent Transmission of Shigellosis in England Is Associated with a Recently Emerged Multidrug-Resistant Strain of Shigella sonnei

2020 ◽  
Vol 58 (4) ◽  
Author(s):  
Megan Bardsley ◽  
Claire Jenkins ◽  
Holly D. Mitchell ◽  
Amy F. W. Mikhail ◽  
Kate S. Baker ◽  
...  
Keyword(s):  
Public Health ◽  
Phylogenetic Analysis ◽  
Sexual Transmission ◽  
Multidrug Resistant ◽  
Shigella Sonnei ◽  
Health Concern ◽  
Adult Males ◽  
Content Type ◽  
Sex With Men ◽  
Travel Abroad

ABSTRACT Whole-genome sequencing has enhanced surveillance and facilitated detailed monitoring of the transmission of Shigella species in England. We undertook an epidemiological and phylogenetic analysis of isolates from all cases of shigellosis referred to Public Health England between 2015 and 2018 to explore recent strain characteristics and the transmission dynamics of Shigella species. Of the 4,950 confirmed cases of shigellosis identified during this period, the highest proportion of isolates was Shigella sonnei (54.4%), followed by S. flexneri (39.2%), S. boydii (4.1%), and S. dysenteriae (2.2%). Most cases were adults (82.9%) and male (59.5%), and 34.9% cases reported recent travel outside the United Kingdom. Throughout the study period, diagnoses of S. flexneri and S. sonnei infections were most common in men with no history of recent travel abroad. The species prevalence was not static, with cases of S. flexneri infection in men decreasing between 2015 and 2016 and the number of cases of S. sonnei infection increasing from 2017. Phylogenetic analysis showed this recent increase in S. sonnei infections was attributed to a novel clade that emerged from a Central Asia sublineage exhibiting resistance to ciprofloxacin and azithromycin. Despite changes in species prevalence, diagnoses of Shigella infections in England are persistently most common in adult males without a reported travel history, consistent with sexual transmission among men who have sex with men. The trend toward increasing rates of ciprofloxacin resistance in S. sonnei, in addition to plasmid-mediated azithromycin resistance, is of significant public health concern with respect to the transmission of multidrug-resistant gastrointestinal pathogens and the risk of treatment failures.

scholarly journals Persistent transmission of shigellosis in England is associated with a recently emerged multi-drug resistant strain ofShigella sonnei

2019 ◽  
Author(s):  
Megan Bardsley ◽  
Claire Jenkins ◽  
Holly D Mitchell ◽  
Amy FW Mikhail ◽  
Kate S Baker ◽  
...  
Keyword(s):  
Public Health ◽  
Phylogenetic Analysis ◽  
Sexual Transmission ◽  
Health Concern ◽  
Drug Resistant ◽  
Adult Males ◽  
Significant Public Health ◽  
Sex With Men ◽  
The Uk ◽  
Travel Abroad

AbstractBackgroundWhole genome sequencing has enhanced surveillance and facilitated detailed monitoring of transmission ofShigellaspecies in England.MethodsWe undertook an epidemiological and phylogenetic analysis of isolates from all cases of shigellosis referred to Public Health England between 2015 to 2018 to explore recent strain characteristics and transmission dynamics ofShigellaspecies.ResultsOf the 4950 confirmed cases of shigellosis identified during this period, the highest proportion of isolates wereS. sonnei(54.4%), followed byS. flexneri(39.2%),S. boydii(4.1%) andS. dysenteriae(2.2%). Most cases were adults (82.9%) and male (59.5%), and 34.9% cases reported recent travel outside the UK. Throughout the study period diagnoses ofS. flexneriandS. sonneiwere most common in men with no history of recent travel abroad. Species prevalence was not static with cases ofS. flexneriin men decreasing from 2015-2016, and the number of cases ofS. sonneiincreasing from 2017. Phylogenetic analysis showed this recent increase inS. sonneiwas attributed to a novel clade exhibiting resistance to ciprofloxacin and azithromycin, which had emerged from a Central Asia sub-lineage.ConclusionsDespite changes in species prevalence,Shigelladiagnoses in England are persistently the most common in adult males without reported travel history, consistent with sexual transmission amongst men who have sex with men. The trend in increasing ciprofloxacin resistance, in addition to plasmid-mediated azithromycin resistance, inS. sonneiis of significant public health concern with respect to transmission of multi-drug resistant gastrointestinal pathogens and the risk of treatment failures.SummaryShigelladiagnoses in England are most prevalent amongst men who have sex with men.S. sonneiexhibiting resistance to both azithromycin and ciprofloxacin has replaced azithromycin-resistantS. flexnerias the most commonly isolated species in this setting.

scholarly journals Prolonged Outbreak of Multidrug-Resistant Shigella sonnei Harboring blaCTX-M-27 in Victoria, Australia

2020 ◽  
Vol 64 (12) ◽  
Author(s):  
Danielle J. Ingle ◽  
Patiyan Andersson ◽  
Mary Valcanis ◽  
Jessica Barnden ◽  
Anders Gonçalves da Silva ◽  
...  
Keyword(s):  
Public Health ◽  
Epidemiological Data ◽  
Multidrug Resistant ◽  
Shigella Sonnei ◽  
Health Concern ◽  
Content Type ◽  
Extended Spectrum Beta Lactamase ◽  
Extended Spectrum ◽  
Significant Public Health ◽  
Sex With Men

ABSTRACT In Australia, cases of shigellosis usually occur in returned travelers from regions of shigellosis endemicity or in men who have sex with men. Resistance to multiple antibiotics has significantly increased in Shigella sonnei isolates and represents a significant public health concern. We investigate an outbreak of multidrug-resistant S. sonnei in Victoria, Australia. We undertook whole-genome sequencing of 54 extended-spectrum-beta-lactamase (ESBL)-producing S. sonnei isolates received at the Microbiological Diagnostic Unit Public Health Laboratory between January 2019 and March 2020. The population structure and antimicrobial resistance profiles were identified by genomic analyses, with 73 previously characterized Australian S. sonnei isolates providing context. Epidemiological data, including age and sex of the shigellosis cases, were also collected. There was a significant increase in cases of ESBL S. sonnei from July 2019. Most of the ESBL S. sonnei isolates (65%) fell within a single cluster that was predominantly comprised of male cases that were characterized by the presence of the blaCTX-M-27 gene conferring resistance to extended-spectrum cephalosporins. These isolates were also multidrug resistant, including resistance to azithromycin and co-trimoxazole and reduced susceptibility to ciprofloxacin. Our data uncovered a prolonged clonal outbreak of ESBL S. sonnei infection that was likely first introduced by returned travelers and has subsequently been circulating locally in Australia. The emergence of a local outbreak of ESBL S. sonnei with a multidrug-resistant profile, including reduced susceptibility to ciprofloxacin, represents a significant public health threat.

scholarly journals Lack of Antimicrobial Resistance in Yersinia pestis Isolates from 17 Countries in the Americas, Africa, and Asia

2011 ◽  
Vol 56 (1) ◽  
pp. 555-558 ◽  
Author(s):  
Sandra K. Urich ◽  
Linda Chalcraft ◽  
Martin E. Schriefer ◽  
Brook M. Yockey ◽  
Jeannine M. Petersen
Keyword(s):  
Public Health ◽  
Multidrug Resistance ◽  
Antimicrobial Resistance ◽  
Yersinia Pestis ◽  
Causative Agent ◽  
Multidrug Resistant ◽  
Antimicrobial Treatment ◽  
Health Concern ◽  
Public Health Concern ◽  
Content Type

ABSTRACTYersinia pestisis the causative agent of plague, a fulminant disease that is often fatal without antimicrobial treatment. Plasmid (IncA/C)-mediated multidrug resistance inY. pestiswas reported in 1995 in Madagascar and has generated considerable public health concern, most recently because of the identification of IncA/C multidrug-resistant plasmids in other zoonotic pathogens. Here, we demonstrate no resistance in 392Y. pestisisolates from 17 countries to eight antimicrobials used for treatment or prophylaxis of plague.

scholarly journals Multidrug Resistance Salmonella Genomic Island 1 in a Morganella morganii subsp. morganii Human Clinical Isolate from France

mSphere ◽  
2017 ◽  
Vol 2 (2) ◽  
Author(s):  
Eliette Schultz ◽  
Olivier Barraud ◽  
Jean-Yves Madec ◽  
Marisa Haenni ◽  
Axel Cloeckaert ◽  
...  
Keyword(s):  
Public Health ◽  
Multidrug Resistance ◽  
Resistance Genes ◽  
Salmonella Enterica ◽  
Genomic Island ◽  
Multidrug Resistant ◽  
Health Concern ◽  
Human Pathogens ◽  
Morganella Morganii ◽  
Content Type

ABSTRACT Since its initial identification in epidemic multidrug-resistant Salmonella enterica serovar Typhimurium DT104 strains, several SGI1 variants, SGI1 lineages, and SGI1-related elements (SGI2, PGI1, and AGI1) have been described in many bacterial genera (Salmonella, Proteus, Morganella, Vibrio, Shewanella, etc.). They constitute a family of multidrug resistance site-specific integrative elements acquired by horizontal gene transfer, SGI1 being the best-characterized element. The horizontal transfer of SGI1/PGI1 elements into other genera is of public health concern, notably with regard to the spread of critically important resistance genes such as ESBL and carbapenemase genes. The identification of SGI1 in Morganella morganii raises the issue of (i) the potential for SGI1 to emerge in other human pathogens and (ii) its bacterial host range. Further surveillance and research are needed to understand the epidemiology, the spread, and the importance of the members of this SGI1 family of integrative elements in contributing to antibiotic resistance development. Salmonella genomic island 1 (SGI1) is a multidrug resistance integrative mobilizable element that harbors a great diversity of antimicrobial resistance gene clusters described in numerous Salmonella enterica serovars and also in Proteus mirabilis. A serious threat to public health was revealed in the recent description in P. mirabilis of a SGI1-derivative multidrug resistance island named PGI1 (Proteus genomic island 1) carrying extended-spectrum-β-lactamase (ESBL) and metallo-β-lactamase resistance genes, bla VEB-6 and bla NDM-1, respectively. Here, we report the first description of Salmonella genomic island 1 (SGI1) in a multidrug-resistant clinical Morganella morganii subsp. morganii strain isolated from a patient in France in 2013. Complete-genome sequencing of the strain revealed SGI1 variant SGI1-L carrying resistance genes dfrA15, floR, tetA(G), bla PSE-1 (now referred to as bla CARB-2), and sul1, conferring resistance to trimethoprim, phenicols, tetracyclines, amoxicillin, and sulfonamides, respectively. The SGI1-L variant was integrated into the usual chromosome-specific integration site at the 3′ end of the trmE gene. Beyond Salmonella enterica and Proteus mirabilis, the SGI1 integrative mobilizable element may thus also disseminate its multidrug resistance phenotype in another genus belonging to the Proteae tribe of the family Enterobacteriaceae. IMPORTANCE Since its initial identification in epidemic multidrug-resistant Salmonella enterica serovar Typhimurium DT104 strains, several SGI1 variants, SGI1 lineages, and SGI1-related elements (SGI2, PGI1, and AGI1) have been described in many bacterial genera (Salmonella, Proteus, Morganella, Vibrio, Shewanella, etc.). They constitute a family of multidrug resistance site-specific integrative elements acquired by horizontal gene transfer, SGI1 being the best-characterized element. The horizontal transfer of SGI1/PGI1 elements into other genera is of public health concern, notably with regard to the spread of critically important resistance genes such as ESBL and carbapenemase genes. The identification of SGI1 in Morganella morganii raises the issue of (i) the potential for SGI1 to emerge in other human pathogens and (ii) its bacterial host range. Further surveillance and research are needed to understand the epidemiology, the spread, and the importance of the members of this SGI1 family of integrative elements in contributing to antibiotic resistance development.

scholarly journals Isolation of the human-associated bla CTX-M-15-harbouring Klebsiella pneumoniae ST307 from a tortoise in the UK

2020 ◽  
Vol 2 (12) ◽  
Author(s):  
Geoffrey Foster ◽  
Manal AbuOun ◽  
Romain Pizzi ◽  
Bryn Tennant ◽  
Margaret McCall ◽  
...  
Keyword(s):  
Public Health ◽  
Klebsiella Pneumoniae ◽  
Type Species ◽  
Multidrug Resistant ◽  
Health Concern ◽  
Public Health Concern ◽  
Emerging Pathogen ◽  
Content Type ◽  
Link Type ◽  
The Uk

The ST307 multidrug-resistant CTX-M-15-producing Klebsiella pneumoniae is an emerging pathogen, which has become disseminated worldwide in humans but is rarely reported from other reservoirs. We report the first isolation of K. pneumoniae from an animal in Europe and also from a reptile, a captive tortoise, whose death it probably caused. Detection of this clone from an animal adds to evidence of niche expansion in non-human environments, where it may amplify, recycle and become of greater public health concern.

scholarly journals Emergence of novel strains of Shigella flexneri associated with sexual transmission in adult men in England, 2019–2020

2021 ◽  
Vol 70 (10) ◽  
Author(s):  
Timothy J Dallman ◽  
Hannah Charles ◽  
Mateo Prochazka ◽  
Katy Sinka ◽  
Gwenda Hughes ◽  
...  
Keyword(s):  
Type Species ◽  
Sexual Transmission ◽  
Shigella Flexneri ◽  
Multidrug Resistant ◽  
National Surveillance ◽  
Adult Males ◽  
Content Type ◽  
Sexually Transmitted ◽  
Adult Men ◽  
Link Type

National surveillance of shigellosis in England revealed an increase in sexually transmitted Shigella flexneri in adult males in 2019 that persisted throughout 2020. We observed a resurgence of azithromycin-resistant S. flexneri serotype 3a, and the emergence of two novel multidrug-resistant clades of S. flexneri 2a and S. flexneri 1b.

scholarly journals Genomic and Phenotypic Analyses Reveal the Emergence of an Atypical Salmonella enterica Serovar Senftenberg Variant in China

2016 ◽  
Vol 54 (8) ◽  
pp. 2014-2022 ◽  
Author(s):  
Moataz Abd El Ghany ◽  
Xiaolu Shi ◽  
Yinghui Li ◽  
Hifzur R. Ansari ◽  
Grant A. Hill-Cawthorne ◽  
...  
Keyword(s):  
Public Health ◽  
Salmonella Enterica ◽  
Multidrug Resistant ◽  
Health Concern ◽  
Phenotypic Analysis ◽  
Content Type ◽  
Recent Emergence ◽  
Contaminated Food ◽  
Cultured Human Cells ◽  
Human Infections

Human infections withSalmonella entericasubspeciesentericaserovar Senftenberg are often associated with exposure to poultry flocks, farm environments, or contaminated food. The recent emergence of multidrug-resistant isolates has raised public health concerns. In this study, comparative genomics and phenotypic analysis were used to characterize 14SalmonellaSenftenberg clinical isolates recovered from multiple outbreaks in Shenzhen and Shanghai, China, between 2002 and 2011. Single-nucleotide polymorphism analyses identified two phylogenetically distinct clades ofS. Senftenberg, designated SC1 and SC2, harboring variations inSalmonellapathogenicity island 1 (SPI-1) and SPI-2 and exhibiting distinct biochemical and phenotypic signatures. Although the two variants shared the same serotype, the SC2 isolates of sequence type 14 (ST14) harbored intact SPI-1 and -2 and hence were characterized by possessing efficient invasion capabilities. In contrast, the SC1 isolates had structural deletion patterns in both SPI-1 and -2 that correlated with an impaired capacity to invade cultured human cells and also the year of their isolation. These atypical SC1 isolates also lacked the capacity to produce hydrogen sulfide. These findings highlight the emergence of atypicalSalmonellaSenftenberg variants in China and provide genetic validation that variants lacking SPI-1 and regions of SPI-2, which leads to impaired invasion capacity, can still cause clinical disease. These data have identified an emerging public health concern and highlight the need to strengthen surveillance to detect the prevalence and transmission of nontyphoidalSalmonellaspecies.

scholarly journals In Vitro Efficacy of Gentamicin Alone and in Combination with Ceftriaxone, Ertapenem, and Azithromycin against Multidrug-Resistant Neisseria gonorrhoeae

2021 ◽  
Author(s):  
Xuechun Li ◽  
Wenjing Le ◽  
Xiangdi Lou ◽  
Biwei Wang ◽  
Caroline A. Genco ◽  
...  
Keyword(s):  
Public Health ◽  
Neisseria Gonorrhoeae ◽  
Treatment Options ◽  
Multidrug Resistant ◽  
Health Concern ◽  
Global Public Health ◽  
Public Health Concern ◽  
Content Type ◽  
New Treatment

Antimicrobial-resistant Neisseria gonorrhoeae is a major global public health concern. New treatment options are urgently needed to successfully treat multidrug-resistant (MDR) Neisseria gonorrhoeae infections.

scholarly journals Changing Antimicrobial Resistance Profiles among Neisseria gonorrhoeae Isolates in Italy, 2003 to 2012

2014 ◽  
Vol 58 (10) ◽  
pp. 5871-5876 ◽  
Author(s):  
Anna Carannante ◽  
Giovanna Renna ◽  
Ivano Dal Conte ◽  
Valeria Ghisetti ◽  
Alberto Matteelli ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Neisseria Gonorrhoeae ◽  
Antimicrobial Agents ◽  
Multidrug Resistant ◽  
Resistance Rate ◽  
Health Concern ◽  
Content Type ◽  
Resistance Patterns ◽  
Sex With Men ◽  
Sequence Types

ABSTRACTThe emergence ofNeisseria gonorrhoeaeisolates displaying resistance to antimicrobial agents is a major public health concern and a serious issue related to the occurrence of further untreatable gonorrhea infections. A retrospective analysis on 1,430N. gonorrhoeaeisolates, collected from 2003 through 2012, for antimicrobial susceptibility by Etest and molecular characterization byNeisseria gonorrhoeaemultiantigen sequence typing (NG-MAST) was carried out in Italy. Azithromycin-resistant gonococci decreased from 14% in 2007 to 2.2% in 2012. Similarly, isolates with high MICs to cefixime (>0.125 mg/liter) decreased from 11% in 2008 to 3.3% in 2012. The ciprofloxacin resistance rate remains quite stable, following an increasing trend up to 64% in 2012. The percentage of penicillinase-producingN. gonorrhoeae(PPNG) significantly declined from 77% in 2003 to 7% in 2012. A total of 81 multidrug-resistant (MDR) gonococci were identified, showing 11 different antimicrobial resistance patterns. These were isolated from men who have sex with men (MSM) and from heterosexual patients. Two sequence types (STs), ST661 and ST1407, were the most common. Genogroup 1407, which included cefixime-, ciprofloxacin-, and azithromycin-resistant isolates, was found. In conclusion, a change in the antimicrobial resistance profiles among gonococci was identified in Italy together with a percentage of MDR isolates.

scholarly journals Genetic Mechanisms behind the Spread of Reduced Susceptibility to Azithromycin in Shigella Strains Isolated from Men Who Have Sex with Men in Québec, Canada

2018 ◽  
Vol 63 (2) ◽  
pp. e01679-18 ◽  
Author(s):  
Khadidja Yousfi ◽  
Christiane Gaudreau ◽  
Pierre A. Pilon ◽  
Brigitte Lefebvre ◽  
Matthew Walker ◽  
...  
Keyword(s):  
Sequence Analysis ◽  
Shigella Flexneri ◽  
Complete Sequence ◽  
Shigella Sonnei ◽  
Content Type ◽  
Genetic Mechanisms ◽  
Sex With Men

ABSTRACT We analyzed 254 Shigella species isolates collected in Québec, Canada, during 2013 and 2014. Overall, 23.6% of isolates showed reduced susceptibility to azithromycin (RSA) encoded by mphA (11.6%), ermB (1.7%), or both genes (86.7%). Shigella strains with RSA were mostly isolated from men who have sex with men (68.8% or higher) from the Montreal region. A complete sequence analysis of six selected plasmids from Shigella sonnei and different serotypes of Shigella flexneri emphasized the role of IS26 in the dissemination of RSA.

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