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 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 and Kate S. Baker ()
Additional contact information
Lewis C. E. Mason: NIHR HPRU in Gastrointestinal Infections at University of Liverpool
David R. Greig: UK Health Security Agency
Lauren A. Cowley: University of Bath
Sally R. Partridge: The Westmead Institute for Medical Research
Elena Martinez: University of Sydney
Grace A. Blackwell: University of Sydney
Charlotte E. Chong: Veterinary and Ecological Sciences
P. Malaka Silva: Veterinary and Ecological Sciences
Rebecca J. Bengtsson: Veterinary and Ecological Sciences
Jenny L. Draper: University of Sydney
Andrew N. Ginn: University of Sydney
Indy Sandaradura: Western Sydney Local Health District
Eby M. Sim: The Westmead Institute for Medical Research
Jonathan R. Iredell: The Westmead Institute for Medical Research
Vitali Sintchenko: The Westmead Institute for Medical Research
Danielle J. Ingle: The University of Melbourne at The Peter Doherty Institute for Infection and Immunity
Benjamin P. Howden: The University of Melbourne at The Peter Doherty Institute for Infection and Immunity
Sophie Lefèvre: Université Paris Cité, Unité des Bactéries pathogènes entériques, Centre National de Référence des Escherichia coli, Shigella et Salmonella
Elisabeth Njamkepo: Université Paris Cité, Unité des Bactéries pathogènes entériques, Centre National de Référence des Escherichia coli, Shigella et Salmonella
François-Xavier Weill: Université Paris Cité, Unité des Bactéries pathogènes entériques, Centre National de Référence des Escherichia coli, Shigella et Salmonella
Pieter-Jan Ceyssens: Division of Human Bacterial Diseases, Sciensano
Claire Jenkins: UK Health Security Agency
Kate S. Baker: NIHR HPRU in Gastrointestinal Infections at University of Liverpool

Nature Communications, 2023, vol. 14, issue 1, 1-12

Abstract: 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.

Date: 2023
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DOI: 10.1038/s41467-023-37672-w

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