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Author Spotlight: Advancements in Understanding and Combatting Shigella Infections
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Author Spotlight: Advancements in Understanding and Combatting Shigella Infections

Published on: February 9, 2024

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The evolution and international spread of extensively drug resistant Shigella sonnei

Lewis C E Mason1,2, David R Greig3, Lauren A Cowley4

  • 1NIHR HPRU in Gastrointestinal Infections at University of Liverpool, Liverpool, UK.

Nature Communications
|April 8, 2023
PubMed

Insights

An outbreak of extensively drug-resistant Shigella sonnei, a sexually transmitted gastrointestinal illness, was analyzed. Genomic data revealed international spread linked to a low-cost resistance plasmid, emphasizing the need for open data sharing.

Area of Science:

  • Microbiology
  • Genomics
  • Epidemiology

Background:

  • Shigella sonnei causes shigellosis, a severe gastrointestinal illness.
  • Antimicrobial resistance, including to WHO-recommended drugs like azithromycin and ciprofloxacin, is common in S. sonnei.
  • An extensively drug-resistant S. sonnei outbreak linked to men who have sex with men (MSM) occurred in the UK.

Purpose of the Study:

  • To investigate the genetic basis of the UK outbreak strain.
  • To determine the evolutionary history and international dissemination of the outbreak strain.
  • To understand the role of antimicrobial resistance plasmids in the spread of S. sonnei.

Main Methods:

  • Genomic epidemiological analysis of 3,304 S. sonnei isolates.
  • Analysis included isolates from the United Kingdom, Australia, Belgium, France, and the United States.
  • Phylogenetic analysis to determine the most recent common ancestor and evolutionary relationships.

Main Results:

  • The outbreak strain demonstrated international connectivity, with a most recent common ancestor identified in 2018.
  • The strain carried a low-fitness cost antimicrobial resistance plasmid, previously seen in other Shigella species.
  • Genomic surveillance data highlighted the rapid international dissemination of resistant strains.

Conclusions:

  • Horizontally transmitted antimicrobial resistance poses a persistent threat in S. sonnei.
  • Genomic epidemiology is crucial for tracking and understanding the spread of resistant pathogens.
  • Early and open international sharing of genomic surveillance data is vital for public health.

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