International spread of drug-resistant Shigella sonnei

In a recent study published in Nature Communications Journal, researchers examined international spread of widespread drug resistance outbreak Shigella sonnei (S. Sonney) strain transmitted through men who have sex with men (MSM) in the United Kingdom (UK).

study: Evolution and international spread of widespread drug-resistant Shigella sonnei. Image Credit: TatianaShepeleva/Shutterstock.com

Background

S. SonneyThe causative agent of dysentery, a gastrointestinal (GI) infection, exhibited multidrug resistance (MDR) in the 1960s.

The World Health Organization (WHO) recommends ciprofloxacin (an antibiotic) for empiric treatment of dysentery because it causes high levels of morbidity and mortality in low- to middle-income countries (LMICs).

rear S. Sonney Because it has acquired resistance to ciprofloxacin, WHO has raised the urgency for new antibiotics against this organism.

XDR S. Sonney Strains should be tested with all commonly recommended experience, including first-line antibiotics such as ciprofloxacin, azithromycin, and extended-spectrum β-lactam antibiotics such as ceftriaxone, trimethoprim-sulfamethoxazole, and ampicillin. Resistant to toxic and alternative antibiotics. This subtype previously caused periodic outbreaks in some countries, but did not spread as widely as its MDR predecessor.

From 2015 to 2019, from 2019 when the COVID-19 pandemic began, S. Sonney It was resistant to both azithromycin and ciprofloxacin, which is transmitted through MSM in the UK. but, S. Sonney It reappeared in late 2021, causing an outbreak that likely involved multiple countries.

About research

In the current study, researchers used genomic epidemiology to study evolutionary trajectories. S. Sonney and the basis of its XDR genotype.

In addition, they investigated the extent of prevalence of all representatives. S. Sonney A subclade containing single nucleotide polymorphism (SNP) addresses assigned by the United Kingdom Health Security Agency (UKHSA) in the United Kingdom, France, Belgium, Australia, and the United States (USA).

A strain with SNP address 1.1.1.1.377 became an XDR, and researchers examined occurrence at the 10-SNP threshold. For consistency with previous reports, they called his 1.1.1.1.377 SNP linkage cluster t10.377.

result

Researchers analyzed 3,304 strains from five countries and their genomic epidemiological analysis revealed a global link to the recent UK XDR outbreak.

Analysis of eight isolates from the UK revealed that all had identical plasmids with bla_CTX-M-27 A gene called p893816. Isolates from France and Australia also matched this plasmid from the UK.

A recent study showed that this plasmid inhibited the host SOS response to very low inhibitory concentrations of ciprofloxacin. p893816 was present in most of her BAPS 5 isolates, whose 2018 progenitor carried a low fitness cost resistance plasmid. S. flexneri 3a Separated from Australia.

It is likely that this plasmid will continue to spread to other microbial species via horizontal gene transfer (HGT). Shigella Serotypes among MSM.

out of 2,895 S. Sonney The t10.377 cluster comprised 483 of the isolates analyzed in this study S. Sonney Separate. The team analyzed these 483 isolates, along with 475 of his CipR.MSM5 isolates originating from France, Australia, the United States, and Belgium. They constructed a SNP-based phylogeny and further divided this population into BAPS clusters.

This analysis suggests that MSM-related evolutionary patterns S. Sonney It was organized temporally (rather than geographically). Furthermore, the CipR.MSM5 genotype and his BAPS 5 cluster revealed that he likely emerged in 2014 and 2018, respectively.

Monophyletic phylogeny of S. Sonney carry a bra_CTX-M-27 The gene has circulated intercontinentally across regions historically considered to be at low risk for shigellosis. Moreover, these isolates correlated with phenotypic ceftriaxone resistance.

Conclusion

Both MDR and XDR Shigella Strains have evolved to become a problem within the MSM community due to their likely overuse of antibiotics to treat sexually transmitted diseases (STDs).

For example, MSM uses azithromycin to treat sexually transmitted infections, and MSM-related Shigella get speed(A) and you know(B) Antimicrobial resistance (AMR) gene.

In high-risk MSM communities, Shigella strains acquire genes by horizontal gene transfer (HGT) from the commensal gut microbiota to refine the AMR repertoire.

Therefore, the MDR S. SonneyFor example, the BAPS5 lineage has caused outbreaks throughout the global MSM community.This is a global public health concern, increasing the risk of treatment failure and the emergence of pan-drug resistance S. Sonney KK.

The results of this study highlight the threat of horizontal AMR gene transfer and sexually transmitted enteric infections (STEI) in MSM and beyond. Therefore, it is important to continuously share relevant genomic surveillance data globally.