The evolution and international spread of extensively drug resistant Shigella sonnei

Lewis C E Mason; David R Greig; Lauren A Cowley; Sally R Partridge; Elena Martinez; Grace A Blackwell; Charlotte E Chong; P Malaka De Silva; Rebecca J Bengtsson; Jenny L Draper; Andrew N Ginn; Indy Sandaradura; Eby M Sim; Jonathan R Iredell; Vitali Sintchenko; Danielle J Ingle; Benjamin P Howden; Sophie Lefèvre; Elisabeth Njamkepo; François-Xavier Weill; Pieter-Jan Ceyssens; Claire Jenkins; Kate S Baker

doi:10.1038/s41467-023-37672-w

The evolution and international spread of extensively drug resistant Shigella sonnei

Nat Commun. 2023 Apr 8;14(1):1983. doi: 10.1038/s41467-023-37672-w.

Authors

Lewis C E Mason^{1

2}, David R Greig³, Lauren A Cowley⁴, Sally R Partridge^{5

6

7

8}, Elena Martinez^{7

9}, Grace A Blackwell^{7

9}, Charlotte E Chong², P Malaka De Silva², Rebecca J Bengtsson², Jenny L Draper^{7

9}, Andrew N Ginn^{7

8

9

10}, Indy Sandaradura^{6

7

9}, Eby M Sim^{5

6

8}, Jonathan R Iredell^{5

6

7

8}, Vitali Sintchenko^{5

6

7

8

9

11}, Danielle J Ingle¹², Benjamin P Howden¹², Sophie Lefèvre¹³, Elisabeth Njamkepo¹³, François-Xavier Weill¹³, Pieter-Jan Ceyssens¹⁴, Claire Jenkins³, Kate S Baker^{15

16}

Affiliations

¹ NIHR HPRU in Gastrointestinal Infections at University of Liverpool, Liverpool, UK.
² Department of Clinical Infection, Microbiology, and Immunology; Institute for Infection, Veterinary and Ecological Sciences, Liverpool, UK.
³ Gastro and Food Safety (One Health) Division, UK Health Security Agency, London, UK.
⁴ Milner Centre for Evolution, University of Bath, Bath, UK.
⁵ Centre for Infectious Diseases and Microbiology, The Westmead Institute for Medical Research, Westmead, NSW, Australia.
⁶ Western Sydney Local Health District, Westmead, NSW, Australia.
⁷ Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
⁸ Sydney Infectious Diseases Institute, University of Sydney, Sydney, NSW, Australia.
⁹ New South Wales Health Pathology, Dee Why, NSW, Australia.
¹⁰ Douglass Hanly Moir Pathology, Macquarie Park, NSW, Australia.
¹¹ Centre for Infectious Diseases and Microbiology - Public Health, Institute for Clinical Pathology and Microbiology Research, Westmead Hospital, Westmead, NSW, Australia.
¹² Department of Microbiology and Immunology, The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Melbourne, Australia.
¹³ Institut Pasteur, Université Paris Cité, Unité des Bactéries pathogènes entériques, Centre National de Référence des Escherichia coli, Shigella et Salmonella, Paris, F-75015, France.
¹⁴ Division of Human Bacterial Diseases, Sciensano, Ixelles, Belgium.
¹⁵ NIHR HPRU in Gastrointestinal Infections at University of Liverpool, Liverpool, UK. kbaker@liverpool.ac.uk.
¹⁶ Department of Clinical Infection, Microbiology, and Immunology; Institute for Infection, Veterinary and Ecological Sciences, Liverpool, UK. kbaker@liverpool.ac.uk.

Abstract

Shigella sonnei causes shigellosis, a severe gastrointestinal illness that is sexually transmissible among men who have sex with men (MSM). Multidrug resistance in S. sonnei is common including against World Health Organisation recommended treatment options, azithromycin, and ciprofloxacin. Recently, an MSM-associated outbreak of extended-spectrum β-lactamase producing, extensively drug resistant S. sonnei was reported in the United Kingdom. Here, we aimed to identify the genetic basis, evolutionary history, and international dissemination of the outbreak strain. Our genomic epidemiological analyses of 3,304 isolates from the United Kingdom, Australia, Belgium, France, and the United States of America revealed an internationally connected outbreak with a most recent common ancestor in 2018 carrying a low-fitness cost resistance plasmid, previously observed in travel associated sublineages of S. flexneri. Our results highlight the persistent threat of horizontally transmitted antimicrobial resistance and the value of continuing to work towards early and open international sharing of genomic surveillance data.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Anti-Bacterial Agents / pharmacology
Anti-Bacterial Agents / therapeutic use
Drug Resistance, Bacterial / genetics
Homosexuality, Male
Humans
Male
Microbial Sensitivity Tests
Sexual and Gender Minorities*
Shigella sonnei / genetics
Shigella*
Travel

Substances

Anti-Bacterial Agents

Abstract

Publication types

MeSH terms

Substances

Grants and funding