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Rapid emergence of extensively drug-resistant Shigella sonnei in France

Author

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  • 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)

  • Sarah Feldman

    (Université Paris Cité, Unité Epidémiologie des maladies émergentes
    Tel-Aviv Sourasky Medical Center)

  • Corinne Ruckly

    (Université Paris Cité, Unité des Bactéries pathogènes entériques, Centre National de Référence des Escherichia coli, Shigella et Salmonella)

  • Isabelle Carle

    (Université Paris Cité, Unité des Bactéries pathogènes entériques, Centre National de Référence des Escherichia coli, Shigella et Salmonella)

  • Monique Lejay-Collin

    (Université Paris Cité, Unité des Bactéries pathogènes entériques, Centre National de Référence des Escherichia coli, Shigella et Salmonella)

  • Laëtitia Fabre

    (Université Paris Cité, Unité des Bactéries pathogènes entériques, Centre National de Référence des Escherichia coli, Shigella et Salmonella)

  • Iman Yassine

    (Université Paris Cité, Unité des Bactéries pathogènes entériques, Centre National de Référence des Escherichia coli, Shigella et Salmonella)

  • Lise Frézal

    (Université Paris Cité, Unité des Bactéries pathogènes entériques, Centre National de Référence des Escherichia coli, Shigella et Salmonella)

  • Maria Pardos de la Gandara

    (Université Paris Cité, Unité des Bactéries pathogènes entériques, Centre National de Référence des Escherichia coli, Shigella et Salmonella)

  • Arnaud Fontanet

    (Université Paris Cité, Unité Epidémiologie des maladies émergentes)

  • François-Xavier Weill

    (Université Paris Cité, Unité des Bactéries pathogènes entériques, Centre National de Référence des Escherichia coli, Shigella et Salmonella)

Abstract

Shigella sonnei, the main cause of bacillary dysentery in high-income countries, has become increasingly resistant to antibiotics. We monitored the antimicrobial susceptibility of 7121 S. sonnei isolates collected in France between 2005 and 2021. We detected a dramatic increase in the proportion of isolates simultaneously resistant to ciprofloxacin (CIP), third-generation cephalosporins (3GCs) and azithromycin (AZM) from 2015. Our genomic analysis of 164 such extensively drug-resistant (XDR) isolates identified 13 different clusters within CIP-resistant sublineage 3.6.1, which was selected in South Asia ∼15 years ago. AZM resistance was subsequently acquired, principally through IncFII (pKSR100-like) plasmids. The last step in the development of the XDR phenotype involved various extended-spectrum beta-lactamase genes (blaCTX-M-3, blaCTX-M-15, blaCTX-M-27, blaCTX-M-55, and blaCTX-M-134) carried by different plasmids (IncFII, IncI1, IncB/O/K/Z) or even integrated into the chromosome, and encoding resistance to 3GCs. This rapid emergence of XDR S. sonnei, including an international epidemic strain, is alarming, and good laboratory-based surveillance of shigellosis will be crucial for informed decision-making and appropriate public health action.

Suggested Citation

  • Sophie Lefèvre & Elisabeth Njamkepo & Sarah Feldman & Corinne Ruckly & Isabelle Carle & Monique Lejay-Collin & Laëtitia Fabre & Iman Yassine & Lise Frézal & Maria Pardos de la Gandara & Arnaud Fontane, 2023. "Rapid emergence of extensively drug-resistant Shigella sonnei in France," Nature Communications, Nature, vol. 14(1), pages 1-10, December.
    • Handle: RePEc:nat:natcom:v:14:y:2023:i:1:d:10.1038_s41467-023-36222-8
    DOI: 10.1038/s41467-023-36222-8
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    References listed on IDEAS

    as
    1. Jane Hawkey & Kalani Paranagama & Kate S. Baker & Rebecca J. Bengtsson & François-Xavier Weill & Nicholas R. Thomson & Stephen Baker & Louise Cerdeira & Zamin Iqbal & Martin Hunt & Danielle J. Ingle &, 2021. "Global population structure and genotyping framework for genomic surveillance of the major dysentery pathogen, Shigella sonnei," Nature Communications, Nature, vol. 12(1), pages 1-12, December.
    2. Iman Yassine & Sophie Lefèvre & Elisabeth E. Hansen & Corinne Ruckly & Isabelle Carle & Monique Lejay-Collin & Laëtitia Fabre & Rayane Rafei & Dominique Clermont & Maria Pardos Gandara & Fouad Dabbous, 2022. "Population structure analysis and laboratory monitoring of Shigella by core-genome multilocus sequence typing," Nature Communications, Nature, vol. 13(1), pages 1-14, December.
    3. Kate S. Baker & Timothy J. Dallman & Nigel Field & Tristan Childs & Holly Mitchell & Martin Day & François-Xavier Weill & Sophie Lefèvre & Mathieu Tourdjman & Gwenda Hughes & Claire Jenkins & Nicholas, 2018. "Horizontal antimicrobial resistance transfer drives epidemics of multiple Shigella species," Nature Communications, Nature, vol. 9(1), pages 1-10, December.
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