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.

An increase in shigellosis cases among men who have sex with men in the United Kingdom has been linked to an extensively drug-resistant strain of Shigella sonnei. In this genomic epidemiology study, the authors investigate the genetic basis, evolutionary history, and international dissemination of the outbreak strain.

Details

Title
The evolution and international spread of extensively drug resistant Shigella sonnei
Author
Mason, Lewis C. E. 1   VIAFID ORCID Logo  ; Greig, David R. 2 ; Cowley, Lauren A. 3 ; Partridge, Sally R. 4   VIAFID ORCID Logo  ; Martinez, Elena 5 ; Blackwell, Grace A. 5 ; Chong, Charlotte E. 6 ; De Silva, P. Malaka 6 ; Bengtsson, Rebecca J. 6 ; Draper, Jenny L. 5   VIAFID ORCID Logo  ; Ginn, Andrew N. 7 ; Sandaradura, Indy 8   VIAFID ORCID Logo  ; Sim, Eby M. 9 ; Iredell, Jonathan R. 4 ; Sintchenko, Vitali 10   VIAFID ORCID Logo  ; Ingle, Danielle J. 11   VIAFID ORCID Logo  ; Howden, Benjamin P. 11   VIAFID ORCID Logo  ; Lefèvre, Sophie 12   VIAFID ORCID Logo  ; Njamkepo, Elisabeth 12   VIAFID ORCID Logo  ; Weill, François-Xavier 12   VIAFID ORCID Logo  ; Ceyssens, Pieter-Jan 13 ; Jenkins, Claire 2 ; Baker, Kate S. 1   VIAFID ORCID Logo 

1  NIHR HPRU in Gastrointestinal Infections at University of Liverpool, Liverpool, UK (GRID:grid.10025.36) (ISNI:0000 0004 1936 8470); Veterinary and Ecological Sciences, Department of Clinical Infection, Microbiology, and Immunology; Institute for Infection, Liverpool, UK (GRID:grid.10025.36) 
2  UK Health Security Agency, Gastro and Food Safety (One Health) Division, London, UK (GRID:grid.515304.6) (ISNI:0000 0005 0421 4601) 
3  University of Bath, Milner Centre for Evolution, Bath, UK (GRID:grid.7340.0) (ISNI:0000 0001 2162 1699) 
4  The Westmead Institute for Medical Research, Centre for Infectious Diseases and Microbiology, Westmead, Australia (GRID:grid.476921.f); Western Sydney Local Health District, Westmead, Australia (GRID:grid.482212.f) (ISNI:0000 0004 0495 2383); University of Sydney, Faculty of Medicine and Health, Sydney, Australia (GRID:grid.1013.3) (ISNI:0000 0004 1936 834X); University of Sydney, Sydney Infectious Diseases Institute, Sydney, Australia (GRID:grid.1013.3) (ISNI:0000 0004 1936 834X) 
5  University of Sydney, Faculty of Medicine and Health, Sydney, Australia (GRID:grid.1013.3) (ISNI:0000 0004 1936 834X); New South Wales Health Pathology, Dee Why, Australia (GRID:grid.1013.3) 
6  Veterinary and Ecological Sciences, Department of Clinical Infection, Microbiology, and Immunology; Institute for Infection, Liverpool, UK (GRID:grid.1013.3) 
7  University of Sydney, Faculty of Medicine and Health, Sydney, Australia (GRID:grid.1013.3) (ISNI:0000 0004 1936 834X); University of Sydney, Sydney Infectious Diseases Institute, Sydney, Australia (GRID:grid.1013.3) (ISNI:0000 0004 1936 834X); New South Wales Health Pathology, Dee Why, Australia (GRID:grid.1013.3); Douglass Hanly Moir Pathology, Macquarie Park, Australia (GRID:grid.410690.a) (ISNI:0000 0004 0631 2320) 
8  Western Sydney Local Health District, Westmead, Australia (GRID:grid.482212.f) (ISNI:0000 0004 0495 2383); University of Sydney, Faculty of Medicine and Health, Sydney, Australia (GRID:grid.1013.3) (ISNI:0000 0004 1936 834X); New South Wales Health Pathology, Dee Why, Australia (GRID:grid.1013.3) 
9  The Westmead Institute for Medical Research, Centre for Infectious Diseases and Microbiology, Westmead, Australia (GRID:grid.476921.f); Western Sydney Local Health District, Westmead, Australia (GRID:grid.482212.f) (ISNI:0000 0004 0495 2383); University of Sydney, Sydney Infectious Diseases Institute, Sydney, Australia (GRID:grid.1013.3) (ISNI:0000 0004 1936 834X) 
10  The Westmead Institute for Medical Research, Centre for Infectious Diseases and Microbiology, Westmead, Australia (GRID:grid.476921.f); Western Sydney Local Health District, Westmead, Australia (GRID:grid.482212.f) (ISNI:0000 0004 0495 2383); University of Sydney, Faculty of Medicine and Health, Sydney, Australia (GRID:grid.1013.3) (ISNI:0000 0004 1936 834X); University of Sydney, Sydney Infectious Diseases Institute, Sydney, Australia (GRID:grid.1013.3) (ISNI:0000 0004 1936 834X); New South Wales Health Pathology, Dee Why, Australia (GRID:grid.1013.3); Westmead Hospital, Centre for Infectious Diseases and Microbiology – Public Health, Institute for Clinical Pathology and Microbiology Research, Westmead, Australia (GRID:grid.413252.3) (ISNI:0000 0001 0180 6477) 
11  The University of Melbourne at The Peter Doherty Institute for Infection and Immunity, Department of Microbiology and Immunology, Melbourne, Australia (GRID:grid.1008.9) (ISNI:0000 0001 2179 088X) 
12  Université Paris Cité, Unité des Bactéries pathogènes entériques, Centre National de Référence des Escherichia coli, Shigella et Salmonella, Institut Pasteur, Paris, France (GRID:grid.508487.6) (ISNI:0000 0004 7885 7602) 
13  Division of Human Bacterial Diseases, Sciensano, Ixelles, Belgium (GRID:grid.508031.f) 
Pages
1983
Publication year
2023
Publication date
2023
Publisher
Nature Publishing Group
e-ISSN
20411723
Source type
Scholarly Journal
Language of publication
English
DOI
https://doi.org/10.1038/s41467-023-37672-w
ProQuest document ID
2797987633
Copyright
© The Author(s) 2023. corrected publication 2023. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.