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Multidrug-Resistant Shigella sonnei Bacteremia among Persons Experiencing Homelessness, Vancouver, British Columbia,
Emerging Infectious Diseases
|July 24, 2023
Abstract:
Increased invasive bloodstream infections caused by multidrug resistant Shigella sonnei were noted in Vancouver, British Columbia, Canada, during 2021-2023. Whole-genome sequencing revealed clonal transmission of genotype 3.6.1.1.2 (CipR.MSM5) among persons experiencing homelessness. Improvements in identifying Shigella species, expanding treatment options for multidrug resistant infections, and developing public health partnerships are needed.
Insights
Multidrug-resistant Shigella sonnei bloodstream infections rose in Vancouver, linked to a specific genotype spreading among the homeless population. Enhanced surveillance and treatment strategies are crucial.
Area of Science:
- Infectious Diseases
- Genomics
- Public Health
Background:
- Invasive bloodstream infections (iBSIs) pose significant public health challenges.
- The emergence of multidrug-resistant (MDR) pathogens, such as Shigella sonnei, necessitates urgent investigation.
- Vancouver, British Columbia, Canada, observed an increase in iBSIs during 2021-2023.
Purpose of the Study:
- To investigate the cause of increased invasive bloodstream infections caused by multidrug-resistant Shigella sonnei in Vancouver.
- To identify the genetic characteristics and transmission patterns of the causative pathogen.
- To inform public health strategies for controlling MDR Shigella sonnei outbreaks.
Main Methods:
- Retrospective analysis of invasive bloodstream infection cases.
- Whole-genome sequencing (WGS) to characterize Shigella sonnei isolates.
- Genotyping and phylogenetic analysis to determine clonal transmission.
Main Results:
- An increase in invasive bloodstream infections due to multidrug-resistant Shigella sonnei was identified between 2021 and 2023.
- Whole-genome sequencing revealed clonal transmission of a specific genotype, 3.6.1.1.2 (CipR.MSM5).
- This transmission was predominantly observed among individuals experiencing homelessness.
Conclusions:
- A specific multidrug-resistant Shigella sonnei genotype (3.6.1.1.2) has emerged and is spreading clonally within the homeless population in Vancouver.
- There is a critical need for improved identification of Shigella species.
- Enhanced treatment options for MDR infections and strengthened public health partnerships are essential for future control efforts.
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