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Toro CS, Salazar JC, Montero DA, Ugalde JA, Díaz J, Cádiz LA, Henríquez T, García C, Díaz P, Camponovo R, Hermosilla G, Ulloa MT. Antimicrobial Resistance Dynamics in Chilean Shigella sonnei Strains Within Two Decades: Role of Shigella Resistance Locus Pathogenicity Island and Class 1 and Class 2 Integrons. Front Microbiol 2022; 12:794470. [PMID: 35185820 PMCID: PMC8854971 DOI: 10.3389/fmicb.2021.794470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 12/22/2021] [Indexed: 11/13/2022] Open
Abstract
Shigellosis is an enteric infectious disease in which antibiotic treatment is effective, shortening the duration of symptoms and reducing the excretion of the pathogen into the environment. Shigella spp., the etiologic agent, are considered emerging pathogens with a high public health impact due to the increase and global spread of multidrug-resistant (MDR) strains. Since Shigella resistance phenotype varies worldwide, we present an overview of the resistance phenotypes and associated genetic determinants present in 349 Chilean S. sonnei strains isolated during the periods 1995–1997, 2002–2004, 2008–2009, and 2010–2013. We detected a great variability in antibiotic susceptibility patterns, finding 300 (86%) MDR strains. Mobile genetic elements (MGE), such as plasmids, integrons, and genomic islands, have been associated with the MDR phenotypes. The Shigella resistance locus pathogenicity island (SRL PAI), which encodes for ampicillin, streptomycin, chloramphenicol, and tetracycline resistance genes, was detected by PCR in 100% of the strains isolated in 2008–2009 but was less frequent in isolates from other periods. The presence or absence of SRL PAI was also differentiated by pulsed-field gel electrophoresis. An atypical class 1 integron which harbors the blaOXA–1-aadA1-IS1 organization was detected as part of SRL PAI. The dfrA14 gene conferring trimethoprim resistance was present in 98.8% of the 2008–2009 isolates, distinguishing them from the SRL-positive strains isolated before that. Thus, it seems an SRL-dfrA14 S. sonnei clone spread during the 2008–2009 period and declined thereafter. Besides these, SRL-negative strains harboring class 2 integrons with or without resistance to nalidixic acid were detected from 2011 onward, suggesting the circulation of another clone. Whole-genome sequencing of selected strains confirmed the results obtained by PCR and phenotypic analysis. It is highlighted that 70.8% of the MDR strains harbored one or more of the MGE evaluated, while 15.2% lacked both SRL PAI and integrons. These results underscore the temporal dynamics of antimicrobial resistance in S. sonnei strains circulating in Chile, mainly determined by the spread of MGE conferring MDR phenotypes. Since shigellosis is endemic in Chile, constant surveillance of antimicrobial resistance phenotypes and their genetic basis is a priority to contribute to public health policies.
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Affiliation(s)
- Cecilia S. Toro
- Programa de Microbiología y Micología, Facultad de Medicina, Instituto de Ciencias Biomédicas, Universidad de Chile, Santiago, Chile
- *Correspondence: Cecilia S. Toro,
| | - Juan Carlos Salazar
- Programa de Microbiología y Micología, Facultad de Medicina, Instituto de Ciencias Biomédicas, Universidad de Chile, Santiago, Chile
| | - David A. Montero
- Programa Disciplinario de Inmunología, Facultad de Medicina, Instituto de Ciencias Biomédicas, Universidad de Chile, Santiago, Chile
| | - Juan Antonio Ugalde
- C+, Research Center in Technologies for Society, School of Engineering, Universidad del Desarrollo, Santiago, Chile
- Millennium Initiative for Collaborative Research on Bacterial Resistance, Santiago, Chile
| | - Janepsy Díaz
- Departamento de Estudios Científicos, Instituto de Salud Pública de Chile, Santiago, Chile
| | - Leandro A. Cádiz
- Programa de Microbiología y Micología, Facultad de Medicina, Instituto de Ciencias Biomédicas, Universidad de Chile, Santiago, Chile
| | - Tania Henríquez
- Programa de Microbiología y Micología, Facultad de Medicina, Instituto de Ciencias Biomédicas, Universidad de Chile, Santiago, Chile
| | - Camila García
- Escuela de Tecnología Médica, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Patricia Díaz
- Programa de Microbiología y Micología, Facultad de Medicina, Instituto de Ciencias Biomédicas, Universidad de Chile, Santiago, Chile
| | | | - Germán Hermosilla
- Programa de Microbiología y Micología, Facultad de Medicina, Instituto de Ciencias Biomédicas, Universidad de Chile, Santiago, Chile
| | - María Teresa Ulloa
- Programa de Microbiología y Micología, Facultad de Medicina, Instituto de Ciencias Biomédicas, Universidad de Chile, Santiago, Chile
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Shigella Outer Membrane Vesicles as Promising Targets for Vaccination. Int J Mol Sci 2022; 23:ijms23020994. [PMID: 35055181 PMCID: PMC8781765 DOI: 10.3390/ijms23020994] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 01/11/2022] [Accepted: 01/14/2022] [Indexed: 12/17/2022] Open
Abstract
The clinical symptoms of shigellosis, a gastrointestinal infection caused by Shigella spp. range from watery diarrhea to fulminant dysentery. Endemic infections, particularly among children in developing countries, represent the majority of clinical cases. The situation is aggravated due to the high mortality rate of shigellosis, the rapid dissemination of multi-resistant Shigella strains and the induction of only serotype-specific immunity. Thus, infection prevention due to vaccination, encompassing as many of the circulating serotypes as possible, has become a topic of interest. However, vaccines have turned out to be ineffective so far. Outer membrane vesicles (OMVs) are promising novel targets for vaccination. OMVs are constitutively secreted by Gram-negative bacteria including Shigella during growth. They are composed of soluble luminal portions and an insoluble membrane and can contain toxins, bioactive periplasmic and cytoplasmic (lipo-) proteins, (phospho-) lipids, nucleic acids and/or lipopolysaccharides. Thus, OMVs play an important role in bacterial cell–cell communication, growth, survival and pathogenesis. Furthermore, they modulate the secretion and transport of biomolecules, the stress response, antibiotic resistance and immune responses of the host. Thus, OMVs serve as novel secretion machinery. Here, we discuss the current literature and highlight the properties of OMVs as potent vaccine candidates because of their immunomodulatory, antigenic and adjuvant properties.
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Phiri AF, Abia ALK, Amoako DG, Mkakosya R, Sundsfjord A, Essack SY, Simonsen GS. Burden, Antibiotic Resistance, and Clonality of Shigella spp. Implicated in Community-Acquired Acute Diarrhoea in Lilongwe, Malawi. Trop Med Infect Dis 2021; 6:tropicalmed6020063. [PMID: 33925030 PMCID: PMC8167763 DOI: 10.3390/tropicalmed6020063] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 03/31/2021] [Accepted: 04/01/2021] [Indexed: 11/17/2022] Open
Abstract
Although numerous studies have investigated diarrhoea aetiology in many sub-Saharan African countries, recent data on Shigella species’ involvement in community-acquired acute diarrhoea (CA-AD) in Malawi are scarce. This study investigated the incidence, antibiotic susceptibility profile, genotypic characteristics, and clonal relationships of Shigella flexneri among 243 patients presenting with acute diarrhoea at a District Hospital in Lilongwe, Malawi. Shigella spp. were isolated and identified using standard microbiological and serological methods and confirmed by identifying the ipaH gene using real-time polymerase chain reaction. The isolates’ antibiotic susceptibility to 20 antibiotics was determined using the VITEK 2 system according to EUCAST guidelines. Genes conferring resistance to sulfamethoxazole (sul1, sul2 and sul3), trimethoprim (dfrA1, dfrA12 and dfrA17) and ampicillin (oxa-1 and oxa-2), and virulence genes (ipaBCD, sat, ial, virA, sen, set1A and set1B) were detected by real-time PCR. Clonal relatedness was assessed using ERIC-PCR. Thirty-four Shigella flexneri isolates were isolated (an overall incidence of 14.0%). All the isolates were fully resistant to sulfamethoxazole/trimethoprim (100%) and ampicillin (100%) but susceptible to the other antibiotics tested. The sul1 (79%), sul2 (79%), sul3 (47%), dfrA12 (71%) and dfrA17 (56%) sulfonamide and trimethoprim resistance genes were identified; Oxa-1, oxa-2 and dfrA1 were not detected. The virulence genes ipaBCD (85%), sat (85%), ial (82%), virA (76%), sen (71%), stx (71%), set1A (26%) and set1B (18%) were detected. ERIC-PCR profiling revealed that the Shigella isolates were genetically distinct and clonally unrelated, indicating the potential involvement of genetically distinct S. flexneri in CA-AD in Malawi. The high percentage resistance to ampicillin and sulfamethoxazole/trimethoprim and the presence of several virulence determinants in these isolates emphasises a need for continuous molecular surveillance studies to inform preventive measures and management of Shigella-associated diarrhoeal infections in Malawi.
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Affiliation(s)
- Abel F.N.D. Phiri
- Antimicrobial Research Unit, College of Health Sciences, University of KwaZulu-Natal, Durban 4000, South Africa; (A.F.N.D.P.); (D.G.A.); (S.Y.E.)
- National Microbiology Reference Laboratory, Ministry of Health, Lilongwe 3, Malawi
| | - Akebe Luther King Abia
- Antimicrobial Research Unit, College of Health Sciences, University of KwaZulu-Natal, Durban 4000, South Africa; (A.F.N.D.P.); (D.G.A.); (S.Y.E.)
- Correspondence:
| | - Daniel Gyamfi Amoako
- Antimicrobial Research Unit, College of Health Sciences, University of KwaZulu-Natal, Durban 4000, South Africa; (A.F.N.D.P.); (D.G.A.); (S.Y.E.)
| | - Rajab Mkakosya
- Department of Pathology, College of Medicine, University of Malawi, Blantyre 3, Malawi;
| | - Arnfinn Sundsfjord
- Department of Microbiology and Infection Control, University Hospital of North Norway, 9038 Tromsø, Norway; (A.S.); (G.S.S.)
- Faculty of Health Sciences, UiT—The Arctic University of Norway, N-9037 Tromsø, Norway
| | - Sabiha Y. Essack
- Antimicrobial Research Unit, College of Health Sciences, University of KwaZulu-Natal, Durban 4000, South Africa; (A.F.N.D.P.); (D.G.A.); (S.Y.E.)
| | - Gunnar Skov Simonsen
- Department of Microbiology and Infection Control, University Hospital of North Norway, 9038 Tromsø, Norway; (A.S.); (G.S.S.)
- Faculty of Health Sciences, UiT—The Arctic University of Norway, N-9037 Tromsø, Norway
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Ranjbar R, Farahani A. Shigella: Antibiotic-Resistance Mechanisms And New Horizons For Treatment. Infect Drug Resist 2019; 12:3137-3167. [PMID: 31632102 PMCID: PMC6789722 DOI: 10.2147/idr.s219755] [Citation(s) in RCA: 75] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 08/28/2019] [Indexed: 12/17/2022] Open
Abstract
Shigella spp. are a common cause of diarrheal disease and have remained an important pathogen responsible for increased rates of morbidity and mortality caused by dysentery each year around the globe. Antibiotic treatment of Shigella infections plays an essential role in reducing prevalence and death rates of the disease. However, treatment of these infections remains a challenge, due to the global rise in broad-spectrum resistance to many antibiotics. Drug resistance in Shigella spp. can result from many mechanisms, such as decrease in cellular permeability, extrusion of drugs by active efflux pumps, and overexpression of drug-modifying and -inactivating enzymes or target modification by mutation. Therefore, there is an increasing need for identification and evolution of alternative therapeutic strategies presenting innovative avenues against Shigella infections, as well as paying further attention to this infection. The current review focuses on various antibiotic-resistance mechanisms of Shigella spp. with a particular emphasis on epidemiology and new mechanisms of resistance and their acquisition, and also discusses the status of novel strategies for treatment of Shigella infection and vaccine candidates currently under evaluation in preclinical or clinical phases.
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Affiliation(s)
- Reza Ranjbar
- Molecular Biology Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Abbas Farahani
- Molecular Biology Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
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Wang Y, Ma Q, Hao R, Zhang Q, Yao S, Han J, Ren B, Fan T, Chen L, Xu X, Qiu S, Yang H. Antimicrobial resistance and genetic characterization of Shigella spp. in Shanxi Province, China, during 2006-2016. BMC Microbiol 2019; 19:116. [PMID: 31142259 PMCID: PMC6542020 DOI: 10.1186/s12866-019-1495-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Accepted: 05/20/2019] [Indexed: 11/11/2022] Open
Abstract
Background Shigella spp., facultative anaerobic bacilli of the family Enterobacteriaceae, are one of the most common causes of diarrheal diseases in human worldwide which have become a significant public health burden. So, we aimed to analyze the antimicrobial phenotypes and to elucidate the molecular mechanisms underlying resistance to cephalosporins and fluoroquinolones in Shigella isolates from patients with diarrhea in Shanxi Province. Results During 2006–2016, we isolated a total of 474 Shigella strains (including 337 S. flexneri and 137 S. sonnei). The isolates showed high rates of resistance to traditional antimicrobials, and 26, 18.1 and 3.0% of them exhibited resistance to cephalosporins, fluoroquinolones and co-resistance to cephalosporins and fluoroquinolones, respectively. Notably, 91.1% of these isolates, including 22 isolates that showed an ACTSuT profile, exhibited multidrug resistance (MDR). The resistance rates to cephalosporins in S. sonnei isolates were higher than those in S. flexneri. Conversely, the resistance rates to fluoroquinolones were considerably higher in S. flexneri isolates. Among the 123 cephalosporins-resistant isolates, the most common extended-spectrum beta-lactamase gene was blaTEM-1, followed by blaCTX-M, blaOXA-1, and blaSHV-12. Six subtypes of blaCTX-M were identified, blaCTX-M-14 (n = 36) and blaCTX-M-55 (n = 26) were found to be dominant. Of all the 86 isolates with resistance to fluoroquinolones and having at least one mutation (Ser83Leu, His211Tyr, or Asp87Gly) in the the quinolone resistance-determining regions of gyrA, 79 also had mutation of parC (Ser80Ile), whereas 7 contained plasmid-mediated quinolone resistance genes including qnrA, qnrB, qnrS, and aac(60)-Ib-cr. Furthermore, pulsed-field gel electrophoresis analysis (PFGE) showed a considerable genetic diversity in S. flexneri isolates. However, the S. sonnei isolates had a high genetic similarity. Conclusions Coexistence of diverse resistance genes causing the emergence and transmission of MDR might render the treatment of shigellosis difficult. Therefore, continuous surveillance might be needed to understand the actual disease burden and provide guidance for shigellosis. Electronic supplementary material The online version of this article (10.1186/s12866-019-1495-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yang Wang
- Shanxi Province Center for Disease Control and Prevention, Taiyuan, China
| | - Qiuxia Ma
- Oceanus Plus Medical Development Co., Ltd, Shanghai, China.,Institute of Disease Control and Prevention, PLA, Beijing, China
| | - Ruie Hao
- Shanxi Province Center for Disease Control and Prevention, Taiyuan, China
| | - Qiuxiang Zhang
- Shanxi Province Center for Disease Control and Prevention, Taiyuan, China
| | - Suxia Yao
- Shanxi Province Center for Disease Control and Prevention, Taiyuan, China
| | - Jiting Han
- Shanxi Province Center for Disease Control and Prevention, Taiyuan, China
| | - Binzhi Ren
- Shanxi Province Center for Disease Control and Prevention, Taiyuan, China
| | - Ting Fan
- Shanxi Province Center for Disease Control and Prevention, Taiyuan, China
| | - Limin Chen
- Shanxi Province Center for Disease Control and Prevention, Taiyuan, China
| | - Xuebin Xu
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Shaofu Qiu
- Institute of Disease Control and Prevention, PLA, Beijing, China.
| | - Hongxia Yang
- Shanxi Province Center for Disease Control and Prevention, Taiyuan, China.
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Community profiling of the intestinal microbial community of juvenile Hammerhead Sharks (Sphyrna lewini) from the Rewa Delta, Fiji. Sci Rep 2019; 9:7182. [PMID: 31073209 PMCID: PMC6509141 DOI: 10.1038/s41598-019-43522-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 04/10/2019] [Indexed: 01/18/2023] Open
Abstract
Fourteen juvenile scalloped hammerhead sharks (Sphyrna lewini; SHS) were captured between November and December 2014 in the Rewa Delta in Fiji, and assessed for intestinal microflora characterisation using 16S rRNA amplicon sequencing by Illumina Miseq. The microbial population revealed a fluctuating dominance between the Enterobacteriaceae and Vibrionaceae families, namely Citrobacter and Photobacterium spp. Other related marine operational taxonomic units were closely related to Afipia felis, Chloroflexus aggregans, Psychrobacter oceani, Pontibacter actiniarum and Shigella sonnei. Two sharks had distinctive profiles that were dominated by known pathogens, namely Aeromonas salmonicida and Klebsiella pneumonia. The presence of a Methanosaeta species, and of Shigella and Psychrobacter, would suggest sewage contamination because of a spill that occurred on the 6th of December 2014. This study successfully establishes a baseline for future research.
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Song YJ, Cheong HK, Ki M, Shin JY, Hwang SS, Park M, Ki M, Lim J. The Epidemiological Influence of Climatic Factors on Shigellosis Incidence Rates in Korea. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15102209. [PMID: 30309010 PMCID: PMC6210993 DOI: 10.3390/ijerph15102209] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 10/06/2018] [Accepted: 10/06/2018] [Indexed: 12/03/2022]
Abstract
Research has shown the effects of climatic factors on shigellosis; however, no previous study has evaluated climatic effects in regions with a winter seasonality of shigellosis incidence. We examined the effects of temperature and precipitation on shigellosis incidence in Korea from 2002–2010. The incidence of shigellosis was calculated based on data from the Korean Center for Disease Control and Prevention (KCDC, Cheongju, Korea), and a generalized additive model (GAM) was used to analyze the associations between the incidence and climatic factors. The annual incidence rate of shigellosis was 7.9 cases/million persons from 2002–2010. During 2007–2010, high incidence rates and winter seasonality were observed among those aged ≥65 years, but not among lower age groups. Based on the GAM model, the incidence of shigellosis is expected to increase by 13.6% and 2.9% with a temperature increase of 1 °C and a lag of two weeks and with a mean precipitation increase of 1 mm and a lag of five weeks after adjustment for seasonality, respectively. This study suggests that the incidence of shigellosis will increase with global climate change despite the winter seasonality of shigellosis in Korea. Public health action is needed to prevent the increase of shigellosis incidence associated with climate variations.
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Affiliation(s)
- Yeong-Jun Song
- Department of Preventive Medicine College of Medicine, Eulji University, Daejeon 34824, Korea.
| | - Hae-Kwan Cheong
- Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon 16419, Korea.
| | - Myung Ki
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul 02841, Korea.
| | - Ji-Yeon Shin
- Department of Preventive Medicine, School of Medicine, Kyungpook National University, Daegu 41944, Korea.
| | - Seung-Sik Hwang
- Department of Public Health Science, Graduate School of Public Health, Seoul National University, Seoul 08826, Korea.
| | - Mira Park
- Department of Preventive Medicine College of Medicine, Eulji University, Daejeon 34824, Korea.
| | - Moran Ki
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang 10408, Korea.
| | - Jiseun Lim
- Department of Preventive Medicine College of Medicine, Eulji University, Daejeon 34824, Korea.
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Spatiotemporal Characteristics of Bacillary Dysentery from 2005 to 2017 in Zhejiang Province, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15091826. [PMID: 30149494 PMCID: PMC6163953 DOI: 10.3390/ijerph15091826] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Revised: 08/10/2018] [Accepted: 08/17/2018] [Indexed: 11/24/2022]
Abstract
Background: This study aimed to analyze the epidemiological and spatiotemporal characteristics of bacillary dysentery in Zhejiang Province and to provide the basis for its monitoring, prevention and control. Methods: This study included cases registered in China Information System for Diseases Control and Prevention from 1 January 2005 to 31 December 2017 in Zhejiang. Descriptive methods were employed to investigate the long trend of this disease: gender distribution, high-risk population, seasonality, and circular distribution was explored to detect the peak period; incidence maps were made to show the incidence trend of disease at county level; spatial autocorrelation was explored and the regions with autocorrelation were detected; and spatiotemporal scan was conducted to map out the high-risk regions of disease and how long they lasted. Statistical significance was assumed at p value of <0.05. Results: A total of 105,577 cases of bacillary dysentery were included, the incidence declining sharply from 45.84/100,000 to 3.44/100,000 with an obvious seasonal peak from July to October. Males were more predisposed to the infection than females. Pre-education children had the highest proportion among all occupation categories. Incidence in all age groups were negatively correlated with the year (p < 0.001), and the incidences were negatively correlated with the age groups in 2005–2008 (p = 0.022, 0.025, 0.044, and 0.047, respectively). Local autocorrelation showed that counties in Hangzhou were high-risk regions of bacillary dysentery. The spatiotemporal scan indicated that all clusters occurred before 2011, and the most likely cluster for disease was found in Hangzhou, Jiaxing and Huzhou. Conclusions: The incidence of bacillary dysentery in Zhejiang from 2005 to 2017 featured spatiotemporal clustering, and remained high in some areas and among the young population. Findings in this study serve as a panorama of bacillary dysentery in Zhejiang and provide useful information for better interventions and public health planning.
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Baseer S, Ahmad S, Ranaghan KE, Azam SS. Towards a peptide-based vaccine against Shigella sonnei : A subtractive reverse vaccinology based approach. Biologicals 2017; 50:87-99. [DOI: 10.1016/j.biologicals.2017.08.004] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Revised: 07/11/2017] [Accepted: 08/08/2017] [Indexed: 02/06/2023] Open
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Miranda A, Ávila B, Díaz P, Rivas L, Bravo K, Astudillo J, Bueno C, Ulloa MT, Hermosilla G, Del Canto F, Salazar JC, Toro CS. Emergence of Plasmid-Borne dfrA14 Trimethoprim Resistance Gene in Shigella sonnei. Front Cell Infect Microbiol 2016; 6:77. [PMID: 27489797 PMCID: PMC4951496 DOI: 10.3389/fcimb.2016.00077] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2016] [Accepted: 07/05/2016] [Indexed: 11/24/2022] Open
Abstract
The most common mechanism of trimethoprim (TMP)-resistance is the acquisition of dihydrofolate reductase enzyme resistant to this drug. Previous molecular characterization of TMP-genes resistance in Chilean isolates of Shigella sonnei searching for dfrA1 and dfrA8, showed solely the presence of dfrA8 (formerly dhfrIIIc). However, these genetic markers were absent in S. sonnei strains further isolated during an outbreak in 2009. To identify the TMP-resistance gene in these strains, a genomic DNA library from a TMP-resistant (TMPR) S. sonnei representative strain for the outbreak was used to clone, select and identify a TMP-resistance marker. The TMPR clone was sequenced by primer walking, identifying the presence of the dfrA14 gene in the sul2-strA'-dfrA14-‘strA-strB gene arrangement, harbored in a native 6779-bp plasmid. The same plasmid was isolated by transforming with a ~4.2 MDa plasmid extracted from several TMPRS. sonnei strains into Escherichia coli. This plasmid, named pABC-3, was present only in dfrA14-positive strains and was homologous to a previously described pCERC-1, but different due to the absence of an 11-bp repetitive unit. The distribution of dfrA1, dfrA8, and dfrA14 TMP-resistance genes was determined in 126 TMPRS. sonnei isolates. Most of the strains (96%) carried only one of the three TMP-resistance genes assessed. Thus, all strains obtained during the 2009-outbreak harbored only dfrA14, whereas, dfrA8 was the most abundant gene marker before outbreak and, after the outbreak dfrA1 seems have appeared in circulating strains. According to PFGE, dfrA14-positive strains were clustered in a genetically related group including some dfrA1- and dfrA8-positive strains; meanwhile other genetic group included most of the dfrA8-positive strains. This distribution also correlated with the isolation period, showing a dynamics of trimethoprim genetic markers prevalent in Chilean S. sonnei strains. To our knowledge, dfrA14 gene associated to a small non-conjugative plasmid was detected for the first time in Shigella. Apparently, the strain causing the outbreak must have been introduced, changing drastically the genetic distribution of trimethoprim resistance in Chilean S. sonnei strains.
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Affiliation(s)
- Alfonso Miranda
- Programa de Microbiología y Micología, Facultad de Medicina, Instituto de Ciencias Biomédicas, Universidad de Chile Santiago, Chile
| | - Bárbara Ávila
- Programa de Microbiología y Micología, Facultad de Medicina, Instituto de Ciencias Biomédicas, Universidad de Chile Santiago, Chile
| | - Patricia Díaz
- Programa de Microbiología y Micología, Facultad de Medicina, Instituto de Ciencias Biomédicas, Universidad de Chile Santiago, Chile
| | - Lina Rivas
- Programa de Microbiología y Micología, Facultad de Medicina, Instituto de Ciencias Biomédicas, Universidad de Chile Santiago, Chile
| | - Karen Bravo
- Programa de Microbiología y Micología, Facultad de Medicina, Instituto de Ciencias Biomédicas, Universidad de Chile Santiago, Chile
| | - Javier Astudillo
- Programa de Microbiología y Micología, Facultad de Medicina, Instituto de Ciencias Biomédicas, Universidad de Chile Santiago, Chile
| | - Constanza Bueno
- Programa de Microbiología y Micología, Facultad de Medicina, Instituto de Ciencias Biomédicas, Universidad de Chile Santiago, Chile
| | - María T Ulloa
- Programa de Microbiología y Micología, Facultad de Medicina, Instituto de Ciencias Biomédicas, Universidad de Chile Santiago, Chile
| | - Germán Hermosilla
- Programa de Microbiología y Micología, Facultad de Medicina, Instituto de Ciencias Biomédicas, Universidad de Chile Santiago, Chile
| | - Felipe Del Canto
- Programa de Microbiología y Micología, Facultad de Medicina, Instituto de Ciencias Biomédicas, Universidad de Chile Santiago, Chile
| | - Juan C Salazar
- Programa de Microbiología y Micología, Facultad de Medicina, Instituto de Ciencias Biomédicas, Universidad de Chile Santiago, Chile
| | - Cecilia S Toro
- Programa de Microbiología y Micología, Facultad de Medicina, Instituto de Ciencias Biomédicas, Universidad de Chile Santiago, Chile
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Zhang H, Si Y, Wang X, Gong P. Patterns of Bacillary Dysentery in China, 2005-2010. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:164. [PMID: 26828503 PMCID: PMC4772184 DOI: 10.3390/ijerph13020164] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 01/19/2016] [Accepted: 01/21/2016] [Indexed: 02/06/2023]
Abstract
Although the incidence of bacillary dysentery in China has been declining progressively, a considerable disease burden still exists. Few studies have analyzed bacillary dysentery across China and knowledge gaps still exist in the aspects of geographic distribution and ecological drivers, seasonality and its association with meteorological factors, urban-rural disparity, prevalence and distribution of Shigella species. Here, we performed nationwide analyses to fill the above gaps. Geographically, we found that incidence increased along an east-west gradient which was inversely related to the economic conditions of China. Two large endemically high-risk regions in western China and their ecological drivers were identified for the first time. We characterized seasonality of bacillary dysentery incidence and assessed its association with meteorological factors, and saw that it exhibits north-south differences in peak duration, relative amplitude and key meteorological factors. Urban and rural incidences among China’s cities were compared, and disparity associated with urbanization level was invariant in most cities. Balanced decrease of urban and rural incidence was observed for all provinces except Hunan. S. flexneri and S. sonnei were identified as major causative species. Increasing prevalence of S. sonnei and geographic distribution of Shigella species were associated with economic status. Findings and inferences from this study draw broader pictures of bacillary dysentery in mainland China and could provide useful information for better interventions and public health planning.
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Affiliation(s)
- Han Zhang
- Ministry of Education Key Laboratory for Earth System Modeling, Center for Earth System Science, Institute for Global Change Studies, Tsinghua University, Beijing 100084, China.
| | - Yali Si
- Ministry of Education Key Laboratory for Earth System Modeling, Center for Earth System Science, Institute for Global Change Studies, Tsinghua University, Beijing 100084, China.
- Joint Center for Global Change Studies, Beijing 100875, China.
| | - Xiaofeng Wang
- Center for Disease Surveillance and Information Services, Chinese Center for Disease Control and Prevention, Beijing 102206, China.
| | - Peng Gong
- Ministry of Education Key Laboratory for Earth System Modeling, Center for Earth System Science, Institute for Global Change Studies, Tsinghua University, Beijing 100084, China.
- Joint Center for Global Change Studies, Beijing 100875, China.
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12
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Chung The H, Rabaa MA, Thanh DP, Ruekit S, Wangchuk S, Dorji T, Tshering KP, Nguyen TNT, Vinh PV, Thanh TH, Minh CNN, Turner P, Sar P, Thwaites G, Holt KE, Thomson NR, Bodhidatta L, Jeffries Mason C, Baker S. Introduction and establishment of fluoroquinolone-resistant Shigella sonnei into Bhutan. Microb Genom 2015; 1:e000042. [PMID: 28348825 PMCID: PMC5320628 DOI: 10.1099/mgen.0.000042] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2015] [Accepted: 11/19/2015] [Indexed: 11/26/2022] Open
Abstract
Shigella sonnei is a major contributor to the global burden of diarrhoeal disease, generally associated with dysenteric diarrhoea in developed countries but also emerging in developing countries. The reason for the recent success of S. sonnei is unknown, but is likely catalysed by its ability to acquire resistance against multiple antimicrobials. Between 2011 and 2013, S. sonnei exhibiting resistance to fluoroquinolones, the first-line treatment recommended for shigellosis, emerged in Bhutan. Aiming to reconstruct the introduction and establishment of fluoroquinolone-resistant S. sonnei populations in Bhutan, we performed whole-genome sequencing on 71 S. sonnei samples isolated in Bhutan between 2011 and 2013.We found that these strains represented an expansion of a clade within the previously described lineage III, found specifically in Central Asia. Temporal phylogenetic reconstruction demonstrated that all of the sequenced Bhutanese S. sonnei diverged from a single ancestor that was introduced into Bhutan around 2006. Our data additionally predicted that fluoroquinolone resistance, conferred by mutations in gyrA and parC, arose prior to the introduction of the founder strain into Bhutan. Once established in Bhutan, these S. sonnei had access to a broad gene pool, as indicated by the acquisition of extended-spectrum β-lactamase-encoding plasmids and genes encoding type IV pili. The data presented here outline a model for the introduction and maintenance of fluoroquinolone-resistant S. sonnei in a new setting. Given the current circulation of fluoroquinolone-resistant S. sonnei in Asia, we speculate that this pattern of introduction is being recapitulated across the region and beyond.
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Affiliation(s)
- Hao Chung The
- The Hospital for Tropical Diseases, OUCRU, Ho Chi Minh City, Vietnam
| | - Maia A Rabaa
- The Hospital for Tropical Diseases, OUCRU, Ho Chi Minh City, Vietnam.,Centre for Tropical Medicine, Oxford University, Oxford, UK
| | - Duy Pham Thanh
- The Hospital for Tropical Diseases, OUCRU, Ho Chi Minh City, Vietnam
| | | | - Sonam Wangchuk
- Public Health Laboratory, Department of Public Health, Ministry of Health, Royal Government of Bhutan, Thimphu, Bhutan
| | - Tshering Dorji
- Public Health Laboratory, Department of Public Health, Ministry of Health, Royal Government of Bhutan, Thimphu, Bhutan
| | - Kinzang Pem Tshering
- Department of Pediatrics, Jigme Dorji Wangchuk Referral Hospital, Kawa Jangsa, Thimphu, Bhutan
| | | | - Phat Voong Vinh
- The Hospital for Tropical Diseases, OUCRU, Ho Chi Minh City, Vietnam
| | - Tuyen Ha Thanh
- The Hospital for Tropical Diseases, OUCRU, Ho Chi Minh City, Vietnam
| | | | - Paul Turner
- Centre for Tropical Medicine, Oxford University, Oxford, UK.,Cambodia-Oxford Medical Research Unit, Angkor Hospital for Children, Siem Reap, Cambodia
| | - Poda Sar
- Cambodia-Oxford Medical Research Unit, Angkor Hospital for Children, Siem Reap, Cambodia
| | - Guy Thwaites
- The Hospital for Tropical Diseases, OUCRU, Ho Chi Minh City, Vietnam.,Centre for Tropical Medicine, Oxford University, Oxford, UK
| | - Kathryn E Holt
- Department of Biochemistry and Molecular Biology, Bio21 Molecular Science and Biotechnology Institute, University of Melbourne, Parkville, Victoria 3010, Australia
| | - Nicholas R Thomson
- The Wellcome Trust Sanger Institute, Hinxton, Cambridgeshire, UK.,The London School of Hygiene and Tropical Medicine, London, UK
| | | | | | - Stephen Baker
- The Hospital for Tropical Diseases, OUCRU, Ho Chi Minh City, Vietnam.,Centre for Tropical Medicine, Oxford University, Oxford, UK.,The London School of Hygiene and Tropical Medicine, London, UK
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13
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Mahmoud RY, Stones DH, Li W, Emara M, El-Domany RA, Wang D, Wang Y, Krachler AM, Yu J. The Multivalent Adhesion Molecule SSO1327 plays a key role in Shigella sonnei pathogenesis. Mol Microbiol 2015; 99:658-73. [PMID: 26481305 DOI: 10.1111/mmi.13255] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2015] [Indexed: 12/30/2022]
Abstract
Shigella sonnei is a bacterial pathogen and causative agent of bacillary dysentery. It deploys a type III secretion system to inject effector proteins into host epithelial cells and macrophages, an essential step for tissue invasion and immune evasion. Although the arsenal of bacterial effectors and their cellular targets have been studied extensively, little is known about the prerequisites for deployment of type III secreted proteins during infection. Here, we describe a novel S. sonnei adhesin, SSO1327 which is a multivalent adhesion molecule (MAM) required for invasion of epithelial cells and macrophages and for infection in vivo. The S. sonnei MAM mediates intimate attachment to host cells, which is required for efficient translocation of type III effectors into host cells. SSO1327 is non-redundant to IcsA; its activity is independent of type III secretion. In contrast to the up-regulation of IcsA-dependent and independent attachment and invasion by deoxycholate in Shigella flexneri, deoxycholate negatively regulates IcsA and MAM in S. sonnei resulting in reduction in attachment and invasion and virulence attenuation in vivo. A strain deficient for SSO1327 is avirulent in vivo, but still elicits a host immune response.
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Affiliation(s)
- Rasha Y Mahmoud
- Strathclyde Institute of Pharmacy and Biomedical Sciences (SIPBS), University of Strathclyde, Glasgow, UK.,Department of Microbiology and Immunology, Faculty of Pharmacy, Helwan University, Cairo, Egypt
| | - Daniel Henry Stones
- Institute of Microbiology and Infection, School of Biosciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Wenqin Li
- Strathclyde Institute of Pharmacy and Biomedical Sciences (SIPBS), University of Strathclyde, Glasgow, UK
| | - Mohamed Emara
- Department of Microbiology and Immunology, Faculty of Pharmacy, Helwan University, Cairo, Egypt
| | - Ramadan A El-Domany
- Department of Microbiology and Immunology, Faculty of Pharmacy, Helwan University, Cairo, Egypt
| | - Depu Wang
- The center of Translational Medicine, The First Affiliated Hospital, Xi'an Jiao Tong University, Xi'an, China
| | - Yili Wang
- Institute for Cancer Research, School of Basic Medical Science, Health Science Center, Xi'an Jiao Tong University, Xi'an, China
| | - Anne Marie Krachler
- Institute of Microbiology and Infection, School of Biosciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - Jun Yu
- Strathclyde Institute of Pharmacy and Biomedical Sciences (SIPBS), University of Strathclyde, Glasgow, UK
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14
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Wang J, Qiu S, Xu X, Su W, Li P, Liang B, Ma Q, Yang C, Qi L, Li H, Yi S, Wu Z, Wang L, Hao R, Song H, Sun Y. Emergence of ONPG-negative Shigella sonnei in Shanghai, China. Diagn Microbiol Infect Dis 2015; 83:338-40. [PMID: 26403725 DOI: 10.1016/j.diagmicrobio.2015.08.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Revised: 08/08/2015] [Accepted: 08/17/2015] [Indexed: 11/30/2022]
Abstract
Shigella sonnei has become predominant species causing shigellosis in Shanghai. Two hundred ninety-three S. sonnei were isolated in sentinel hospitals of Shanghai in 2011. We found an emergence of 8 strains of S. sonnei with negative phenotype for o-nitrophenyl-β-d-galactopyranoside in late August, which showed distinct pulsed-field gel electrophoresis patterns from the other 285 S. sonnei and had genes deletion in lac and mhp operons.
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Affiliation(s)
- Jian Wang
- Institute of Disease Control and Prevention, Academy of Military Medical Sciences, Beijing, China
| | - Shaofu Qiu
- Institute of Disease Control and Prevention, Academy of Military Medical Sciences, Beijing, China
| | - Xuebin Xu
- Shanghai Municipal Centre for Disease Control and Prevention, Shanghai, China
| | - Wenli Su
- Institute of Disease Control and Prevention, Academy of Military Medical Sciences, Beijing, China
| | - Peng Li
- Institute of Disease Control and Prevention, Academy of Military Medical Sciences, Beijing, China
| | - Beibei Liang
- Institute of Disease Control and Prevention, Academy of Military Medical Sciences, Beijing, China
| | - Qiuxia Ma
- Institute of Disease Control and Prevention, Academy of Military Medical Sciences, Beijing, China
| | - Chaojie Yang
- Institute of Disease Control and Prevention, Academy of Military Medical Sciences, Beijing, China
| | - Lihua Qi
- Institute of Disease Control and Prevention, Academy of Military Medical Sciences, Beijing, China
| | - Hao Li
- Institute of Disease Control and Prevention, Academy of Military Medical Sciences, Beijing, China
| | - Shengjie Yi
- Institute of Disease Control and Prevention, Academy of Military Medical Sciences, Beijing, China
| | - Zhihao Wu
- Institute of Disease Control and Prevention, Academy of Military Medical Sciences, Beijing, China
| | - Ligui Wang
- Institute of Disease Control and Prevention, Academy of Military Medical Sciences, Beijing, China
| | - Rongzhang Hao
- Institute of Disease Control and Prevention, Academy of Military Medical Sciences, Beijing, China
| | - Hongbin Song
- Institute of Disease Control and Prevention, Academy of Military Medical Sciences, Beijing, China.
| | - Yansong Sun
- Department of Science and Technology, Academy of Military Medical Sciences, Beijing, China.
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15
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Alizadeh-Hesar M, Bakhshi B, Najar-Peerayeh S. Clonal dissemination of a single Shigella sonnei strain among Iranian children during Fall 2012 in Tehran, I.R. Iran. INFECTION GENETICS AND EVOLUTION 2015; 34:260-6. [DOI: 10.1016/j.meegid.2015.06.024] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Revised: 06/22/2015] [Accepted: 06/23/2015] [Indexed: 11/30/2022]
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16
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Rapid Genotyping of Shigella sonnei by Use of Multiplex High-Resolution Melting. J Clin Microbiol 2015; 53:2389-91. [PMID: 25926492 DOI: 10.1128/jcm.00874-15] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
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17
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Kim JS, Kim J, Jeon SE, Kim SJ, Kim NO, Hong S, Kang YH, Han S, Chung GT. Complete nucleotide sequence of the IncI1 plasmid pSH4469 encoding CTX-M-15 extended-spectrum β-lactamase in a clinical isolate of Shigella sonnei from an outbreak in the Republic of Korea. Int J Antimicrob Agents 2014; 44:533-7. [PMID: 25446906 DOI: 10.1016/j.ijantimicag.2014.08.007] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Revised: 04/24/2014] [Accepted: 08/01/2014] [Indexed: 10/24/2022]
Abstract
An outbreak of extended-spectrum β-lactamase (ESBL)-producing Shigella sonnei infections occurred in a school for disabled children in Gyeongbuk Province, Republic of Korea, in 2008. Five students were affected. Pulsed-field gel electrophoresis (PFGE) analysis revealed that all of the ESBL-producing S. sonnei isolates belonged to the same clone, and nucleotide sequence analysis of ESBL genes revealed that they harboured bla(CTX-M-15). This is the first identification of bla(CTX-M-15) in Shigella spp. in South Korea. In this study, a plasmid carrying the bla(CTX-M-15) gene, designated pSH4469, recovered from a S. sonnei isolate responsible for the outbreak was characterised. Replicon typing and plasmid multilocus sequence typing (pMLST) analysis of plasmids in the outbreak strain identified that the bla(CTX-M-15) gene was located on an IncI1 incompatibility group plasmid of sequence type 16 (ST16). The complete nucleotide sequence of pSH4469 revealed that this plasmid is 91109bp and harbours 119 putative genes, including another antibiotic resistance gene (bla(TEM-1b)) that is often associated with the ISEcp1-bla(CTX-M-15)-orf477delta transposable unit. The plasmid consists of a large backbone with considerable homology to the pEK204 plasmid isolated from Escherichia coli in the UK, except for insertion of an IS66 element found in pEK204. These data demonstrate that IncI1 plasmids are used as a successful platform for efficient horizontal gene transfer, thereby resulting in the dissemination of CTX-M-type β-lactamases among Enterobacteriaceae.
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Affiliation(s)
- Jin Seok Kim
- Division of Enteric Divisions, Center for Infectious Diseases, Korea National Institute of Health, Osongsaengmyeong2(i)-ro, Osong-eup, Cheongwon-gun, Chungcheongbuk-do, 363-951, Republic of Korea
| | - Junyoung Kim
- Division of Enteric Divisions, Center for Infectious Diseases, Korea National Institute of Health, Osongsaengmyeong2(i)-ro, Osong-eup, Cheongwon-gun, Chungcheongbuk-do, 363-951, Republic of Korea
| | - Se-Eun Jeon
- Division of Enteric Divisions, Center for Infectious Diseases, Korea National Institute of Health, Osongsaengmyeong2(i)-ro, Osong-eup, Cheongwon-gun, Chungcheongbuk-do, 363-951, Republic of Korea
| | - Soo Jin Kim
- Division of Enteric Divisions, Center for Infectious Diseases, Korea National Institute of Health, Osongsaengmyeong2(i)-ro, Osong-eup, Cheongwon-gun, Chungcheongbuk-do, 363-951, Republic of Korea
| | - Nan-Ok Kim
- Division of Enteric Divisions, Center for Infectious Diseases, Korea National Institute of Health, Osongsaengmyeong2(i)-ro, Osong-eup, Cheongwon-gun, Chungcheongbuk-do, 363-951, Republic of Korea
| | - Sahyun Hong
- Division of Enteric Divisions, Center for Infectious Diseases, Korea National Institute of Health, Osongsaengmyeong2(i)-ro, Osong-eup, Cheongwon-gun, Chungcheongbuk-do, 363-951, Republic of Korea
| | - Yeon-Ho Kang
- Division of Enteric Divisions, Center for Infectious Diseases, Korea National Institute of Health, Osongsaengmyeong2(i)-ro, Osong-eup, Cheongwon-gun, Chungcheongbuk-do, 363-951, Republic of Korea
| | - Soonyoung Han
- Division of Enteric Divisions, Center for Infectious Diseases, Korea National Institute of Health, Osongsaengmyeong2(i)-ro, Osong-eup, Cheongwon-gun, Chungcheongbuk-do, 363-951, Republic of Korea
| | - Gyung Tae Chung
- Division of Enteric Divisions, Center for Infectious Diseases, Korea National Institute of Health, Osongsaengmyeong2(i)-ro, Osong-eup, Cheongwon-gun, Chungcheongbuk-do, 363-951, Republic of Korea.
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18
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Zhang CL, Liu QZ, Wang J, Chu X, Shen LM, Guo YY. Epidemic and virulence characteristic of Shigella spp. with extended-spectrum cephalosporin resistance in Xiaoshan District, Hangzhou, China. BMC Infect Dis 2014; 14:260. [PMID: 24886028 PMCID: PMC4229937 DOI: 10.1186/1471-2334-14-260] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2013] [Accepted: 05/08/2014] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Shigellae have become increasingly resistant to the extended-spectrum cephalosporin (ESC) worldwide and pose a great challenge to anti-infection treatment options. The purpose of this study was to determine the resistance, cephalosporin resistance mechanisms, virulence characteristic and genotype of ESC-resistant Shigella. METHODS From 2008 to 2012, Shigella isolates collected from diarrhea patients were detected for antibiotics sensitivity by disk diffusion, cephalosporin resistance determinants and virulence genes using polymerase chain reaction (PCR) and genotyping through enterobacterial repetitive intergenic consensus sequence PCR (ERIC-PCR). RESULTS A total of 356 Shigella isolates were gathered, and 198 (55.6%, 58 S. flexneri and 140 S. sonnei) were resistant to ESC. All ESC-resistant isolates were susceptible to imipenem, and only 0.5% isolate was resistant to piperacillin/tazobactam. ESC-resistant S. flexneri showed high degrees of resistance to ampicillin (100%), ampicillin/sulbactam (96.6%), piperacillin (100%), trimethoprim/sulfamethoxazole (74.1%), ciprofloxacin (74.1%), levofloxacin (53.4%), ceftazidime (58.6%) and cefepime (58.6%). ESC-resistant S. sonnei exhibited high resistance rates to ampicillin (100%), piperacillin (100%) and trimethoprim/sulfamethoxazole (96.4%). Cephalosporin resistance genes were confirmed in 184 ESC-resistant isolates. bla(CTX-M) types (91.8%, mainly bla(CTX-M-14), bla(CTX-M-15) and bla(CTX-M-57)) were most prevalent, followed by bla(OXA-30) (26.3%). Over 99.0% ESC-resistant isolates harbored virulence genes ial, ipaH, virA and sen. However, set1 were more prevalent in ESC-resistant S. flexneri isolates than in S. sonnei isolates. ERIC-PCR results showed that 2 and 3 main genotypes were detected in ESC-resistant S. flexneri and S. sonnei, respectively. CONCLUSION Our findings indicated that a high prevalence of ESC-resistant Shigella mediated mainly by bla(CTX-M) with stronger resistance and virulence, and the existence of specific clones responsible for these Shigella infection in the region studied.
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Affiliation(s)
| | - Qing-Zhong Liu
- Department of Clinical Laboratory, Shanghai First People's Hospital, School of Medicine, Shanghai Jiaotong University, 100 Haining Road, Shanghai 200080, People's Republic of China.
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19
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Ruekit S, Wangchuk S, Dorji T, Tshering KP, Pootong P, Nobthai P, Serichantalergs O, Poramathikul K, Bodhidatta L, Mason CJ. Molecular characterization and PCR-based replicon typing of multidrug resistant Shigella sonnei isolates from an outbreak in Thimphu, Bhutan. BMC Res Notes 2014; 7:95. [PMID: 24555739 PMCID: PMC3936901 DOI: 10.1186/1756-0500-7-95] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Accepted: 02/14/2014] [Indexed: 11/19/2022] Open
Abstract
Background Shigella species are an important cause of diarrhea in developing countries. These bacteria normally acquire their antibiotic resistance via several different mobile genetic elements including plasmids, transposons, and integrons involving gene cassettes. During a diarrhea surveillance study in Thimphu, Bhutan in June and July, 2011, Shigella sonnei were isolated more frequently than expected. This study describes the antibiotic resistance of these S. sonnei isolates. Methods A total of 29 S. sonnei isolates from Thimphu, Bhutan was characterized for antimicrobial susceptibility by disc diffusion assay and minimum inhibitory concentration (MIC) assay. All isolates were tested by pulsed-field gel electrophoresis (PFGE) with restriction enzyme XbaI and were tested for plasmid. The plasmid patterns and the PFGE patterns were analyzed by Bionumerics software. DNA sequencing was performed on amplified products for gyraseA gene and class 1 and class 2 integrons. S. sonnei isolates were classified for incompatibility of plasmids by PCR-based replicon typing (PBRT). Results These S. sonnei were resistant to multiple drugs like ciprofloxacin, nalidixic acid, trimethoprim-sulfamethoxazole, streptomycin, and tetracycline but susceptible to azithromycin. All isolates had class 2 integrons dfrA1, sat1 and aadA1 genes. Two point mutations in Gyrase A subunit at position Ser83Leu and Asp87Gly were detected in these quinolone resistant isolates. The plasmid and PFGE patterns of S. sonnei isolates suggested a clonal relationship of the isolates. All isolates carried common ColE plasmid. ColE plasmid co-resided with B/O plasmid (nine isolates) or I1 plasmid (one isolate). Conclusions The characteristics of 29 S. sonnei isolates from Thimphu, Bhutan in June and July, 2011 are identical in PFGE, plasmid and resistance pattern. This study suggests that these recent S. sonnei isolates are clonally related and multidrug-resistant.
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Affiliation(s)
- Sirigade Ruekit
- Department of Enteric Diseases, Armed Forces Research Institute of Medical Sciences (AFRIMS), Bangkok, Thailand.
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20
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Ud-Din AIMS, Wahid SUH, Latif HA, Shahnaij M, Akter M, Azmi IJ, Hasan TN, Ahmed D, Hossain MA, Faruque ASG, Faruque SM, Talukder KA. Changing trends in the prevalence of Shigella species: emergence of multi-drug resistant Shigella sonnei biotype g in Bangladesh. PLoS One 2013; 8:e82601. [PMID: 24367527 PMCID: PMC3867351 DOI: 10.1371/journal.pone.0082601] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Accepted: 10/26/2013] [Indexed: 11/18/2022] Open
Abstract
Shigellosis, caused by Shigella species, is a major public health problem in Bangladesh. To determine the prevalence and distribution of different Shigella species, we analyzed 10,827 Shigella isolates from patients between 2001 and 2011. S. flexneri was the predominant species isolated throughout the period. However, the prevalence of S. flexneri decreased from 65.7% in 2001 to 47% in 2011, whereas the prevalence of S. sonnei increased from 7.2% in 2001 to 25% in 2011. S. boydii and S. dysenteriae accounted for 17.3% and 7.7% of the isolates respectively throughout the period. Of 200 randomly selected S. sonnei isolates for extensive characterization, biotype g strains were predominant (95%) followed by biotype a (5%). Resistance to commonly used antibiotics including trimethoprim-sulfamethoxazole, nalidixic acid, ciprofloxacin, mecillinam and ampicillin was 89.5%, 86.5%, 17%, 10.5%, and 9.5%, respectively. All isolates were susceptible to ceftriaxone, cefotaxime, ceftazidime and imipenem. Ninety-eight percent of the strains had integrons belonging to class 1, 2 or both. The class 1 integron contained only dfrA5 gene, whereas among class 2 integron, 16% contained dhfrAI-sat1-aadA1-orfX gene cassettes and 84% harbored dhfrA1-sat2 gene cassettes. Plasmids of ∼5, ∼1.8 and ∼1.4 MDa in size were found in 92% of the strains, whereas only 33% of the strains carried the 120 MDa plasmid. PFGE analysis showed that strains having different integron patterns belonged to different clusters. These results show a changing trend in the prevalence of Shigella species with the emergence of multidrug resistant S. sonnei. Although S. flexneri continues to be the predominant species albeit with reduced prevalence, S. sonnei has emerged as the second most prevalent species replacing the earlier dominance by S. boydii and S. dysenteriae in Bangladesh.
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Affiliation(s)
- Abu I. M. S. Ud-Din
- Centre for Food and Water Borne Diseases, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Syeda U. H. Wahid
- Centre for Food and Water Borne Diseases, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Hasan A. Latif
- Centre for Food and Water Borne Diseases, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Mohammad Shahnaij
- Centre for Food and Water Borne Diseases, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Mahmuda Akter
- Centre for Food and Water Borne Diseases, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Ishrat J. Azmi
- Centre for Food and Water Borne Diseases, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Trisheeta N. Hasan
- Centre for Food and Water Borne Diseases, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Dilruba Ahmed
- Centre for Food and Water Borne Diseases, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Mohammad A. Hossain
- Centre for Food and Water Borne Diseases, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Abu S. G. Faruque
- Centre for Food and Water Borne Diseases, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Shah M. Faruque
- Centre for Food and Water Borne Diseases, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
| | - Kaisar A. Talukder
- Centre for Food and Water Borne Diseases, International Centre for Diarrhoeal Disease Research, Bangladesh, Dhaka, Bangladesh
- * E-mail:
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21
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Eftekhari N, Bakhshi B, Pourshafie MR, Zarbakhsh B, Rahbar M, Hajia M, Ghazvini K. Genetic diversity of Shigella spp. and their integron content. Foodborne Pathog Dis 2013; 10:237-42. [PMID: 23489046 DOI: 10.1089/fpd.2012.1250] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The aim of this study was to investigate the occurrence and resistance gene content of class 1 and 2 integrons among Shigella spp. and to study the genetic diversity of isolates using the pulsed-field gel electrophoresis (PFGE) method. METHODS AND RESULTS A total of 32 Shigella spp. were identified from 700 stool samples of patients with diarrhea from two provinces in Iran. S. sonnei (70.8%) and S. flexneri (62.5%) were the most frequent serogroups in Tehran and Razavi Khorasan provinces, respectively. Class 2 integrons were more frequent among Shigella spp. in comparison with class 1 integrons. Three different resistance gene arrays were identified among class 1 integrons. Dihydrofolate reductase (dfrA) gene cassette was detected in 78.9% of total integrons (class 1 and 2). PFGE analysis revealed clonal dissemination (62.5%) of a single clone with identical class 2 resistance gene content in Tehran province. Comparison of our Shigella pulsotypes with those published from other countries showed similar pulsotypes in India and Korea, with identical resistance profiles, which suggests dissemination of this (these) clone(s) in Asian countries. CONCLUSIONS Class 2 integrons were found to be predominant among our Shigella spp. This reflects the need to monitor the acquisition and dissemination of different resistant gene cassettes among integrons. Comparison of PFGE pattern through standard procedures promoted the molecular epidemiological surveys and identification of clonal isolates in Iran and other Asian countries.
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Affiliation(s)
- Nazanin Eftekhari
- Department of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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22
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Gu B, Ke X, Pan S, Cao Y, Zhuang L, Yu R, Qian H, Liu G, Tong M. Prevalence and trends of aminoglycoside resistance in Shigella worldwide, 1999-2010. J Biomed Res 2013; 27:103-15. [PMID: 23554801 PMCID: PMC3602868 DOI: 10.7555/jbr.27.20120125] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2012] [Revised: 12/09/2012] [Accepted: 01/17/2013] [Indexed: 12/02/2022] Open
Abstract
Shigellosis causes diarrheal disease in humans in both developed and developing countries, and multi-drug resistance in Shigella is an emerging problem. Understanding changing resistance patterns is important in determining appropriate antibiotic treatments. This meta-analysis systematically evaluated aminoglycoside resistance in Shigella. A systematic review was constructed based on MEDLINE and EMBASE databases. Random-effect models or fixed-effect models were used based on P value considering the possibility of heterogeneity between studies for meta-analysis. Data manipulation and statistical analyses were performed using software STATA 11.0. By means of meta-analysis, we found a lower resistance to three kinds of aminoglycosides in the Europe-America areas during the 12 year study period than that of the Asia-Africa areas. Kanamycin resistance was observed to be the most common drug resistance among Shigella isolates with a prevalence of 6.88% (95%CI: 6.36%-7.43%). Comparison of data from Europe-America and Asia-Africa areas revealed that Shigella flexneri resistance was greater than the resistance calculated for Shigella sonnei. Importantly, Shigella sonnei has played a significant role in aminoglycoside-resistance in recent years. Similarly, data showed that resistance to these drugs in children was higher than the corresponding data of adults. In conclusion, aminoglycoside-resistant Shigella is not an unusual phenomenon worldwide. Distribution in Shigella resistance differs sharply based on geographic areas, periods of time and subtypes. The results from the present study highlight the need for continuous surveillance of resistance and control of antibiotic usage.
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Affiliation(s)
- Bing Gu
- Department of Laboratory Medicine, the First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu 210029, China; ; National Key Clinical, Department of Laboratory Medicine, Nanjing, Jiangsu 210029, China
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Chang Z, Lu S, Chen L, Jin Q, Yang J. Causative species and serotypes of shigellosis in mainland China: systematic review and meta-analysis. PLoS One 2012; 7:e52515. [PMID: 23285073 PMCID: PMC3527545 DOI: 10.1371/journal.pone.0052515] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2012] [Accepted: 11/14/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Shigella, the causative agent of shigellosis, is a major global public health concern, particularly in developing countries with poor sanitation. A comprehensive and current understanding of the prevalent species and serotypes of shigellosis is essential for both disease prevention and vaccine development. However, no current data are available on the causative species/serotypes of shigellosis in mainland China during the past decade. METHODS AND FINDINGS Relevant studies addressing the prevalent species of shigellosis in mainland China from January 2001 to December 2010 were identified from PubMed and the Chinese BioMedical Literature Database (in Chinese) until April 2012. A total of 131 eligible articles (136 studies) were included in this review. Meta-analyses showed that the prevalences of S. flexneri and S. sonnei were 76.2% (95% CI, 73.7%-78.5%) and 21.3% (95% CI, 19.0%-23.7%), respectively. Stratified analyses indicated a decrease in the prevalence of S. flexneri cases and an increase in the prevalence of S. sonnei cases concurrent with the rapid economic growth experienced by China in recent years. Moreover, significantly higher rates of S. sonnei were observed in the East, North and Northeast regions of China, as compared to the rest of the country. These phenomena imply the possible association between the prevalent species of Shigella and regional economic status; however, additional factors also exist and require further investigations. Moreover, the two major serotypes S. flexneri 2a and 4c accounted for 21.5% (95% CI, 16.7%-27.4%) and 12.9% (95% CI 9.8%-16.9%) of S. flexneri infections, respectively, in the past decade. However, these results were found to be frequently heterogeneous (p for Q tests <0.01). CONCLUSIONS This study provides an updated review of the causative agents of shigellosis in mainland China and focuses on the importance of strengthening prevention and research efforts on S. sonnei and the newly emerged S. flexneri serotype 4c.
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Affiliation(s)
- Zhili Chang
- MOH Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Shuting Lu
- Institute of Medical Information/Medical Library, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Lihong Chen
- MOH Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Qi Jin
- MOH Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Jian Yang
- MOH Key Laboratory of Systems Biology of Pathogens, Institute of Pathogen Biology, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
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Global phylogeny of Shigella sonnei strains from limited single nucleotide polymorphisms (SNPs) and development of a rapid and cost-effective SNP-typing scheme for strain identification by high-resolution melting analysis. J Clin Microbiol 2012; 51:303-5. [PMID: 23115259 DOI: 10.1128/jcm.02238-12] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The current Shigella sonnei pandemic involves geographically associated, multidrug-resistant clones. This study has demonstrated that S. sonnei phylogeny can be accurately defined with limited single nucleotide polymorphisms (SNPs). By typing 6 informative SNPs using a high-resolution melting (HRM) assay, major S. sonnei lineages/sublineages can be identified as defined by whole-genome variation.
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25
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Comparative analysis of Shigella sonnei biotype g isolated from paediatric populations in Egypt, 1999-2005. Epidemiol Infect 2012; 141:1614-24. [PMID: 22989417 DOI: 10.1017/s0950268812002002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Strain characteristics of 51 Shigella sonnei isolates obtained from children seeking medical care (MC) and 48 isolates recovered during a prospective diarrhoea birth cohort (BC) study were compared. Biochemical characterization and antibiotic susceptibility testing determined that all S. sonnei isolates were biotype g and multidrug-resistant. Plasmid profiling identified 15 closely related patterns and XbaI pulsed-field gel electrophoresis confirmed the high degree of genetic similarity between isolates. All S. sonnei isolates harboured ipaH and class II integrase genes and 84∙3 and 80% of the MC and BC isolates, respectively carried the sen gene. Neither the class I integrase nor the set gene was detected. Our results indicate that S. sonnei isolates associated with severe diarrhoea were indistinguishable from those associated with mild diarrhoea. Additional genetic tests with greater discrimination might offer an opportunity to determine genetic differences within the globally disseminating biotype g clone.
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Koh XP, Chiou CS, Ajam N, Watanabe H, Ahmad N, Thong KL. Characterization of Shigella sonnei in Malaysia, an increasingly prevalent etiologic agent of local shigellosis cases. BMC Infect Dis 2012; 12:122. [PMID: 22606962 PMCID: PMC3420240 DOI: 10.1186/1471-2334-12-122] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2011] [Accepted: 04/10/2012] [Indexed: 11/19/2022] Open
Abstract
Background Shigellosis is a major public health concern worldwide, especially in developing countries. It is an acute intestinal infection caused by bacteria of the genus Shigella, with a minimum infective dose as low as 10–100 bacterial cells. Increasing prevalence of Shigella sonnei as the etiologic agent of shigellosis in Malaysia has been reported. As there is limited information on the genetic background of S. sonnei in Malaysia, this study aimed to characterize Malaysian S. sonnei and to evaluate the prospect of using multilocus variable-number tandem-repeat (VNTR) analysis (MLVA) for subtyping of local S. sonnei. Methods Forty non-repeat clinical strains of S. sonnei isolated during the years 1997–2000, and 2007–2009 were studied. The strains were isolated from stools of patients in different hospitals from different regions in Malaysia. These epidemiologically unrelated strains were characterized using biotyping, antimicrobial susceptibility testing, pulsed-field gel electrophoresis (PFGE) and MLVA. Results The two biotypes identified in this study were biotype a (n = 29, 73%) and biotype g (n = 11, 27%). All the 40 strains were sensitive to kanamycin, ceftriaxone and ciprofloxacin. Highest resistance rate was observed for streptomycin (67.5%), followed by tetracycline (40%) and trimethoprim-sulfamethoxazole (37.5%). All the S. sonnei biotype g strains had a core resistance type of streptomycin - trimethoprim-sulfamethoxazole - tetracycline whereas the 29 biotype a strains were subtyped into eight resistotypes. All the strains were equally distinguishable by PFGE and MLVA. Overall, PFGE analysis indicated that S. sonnei biotype a strains were genetically more diverse than biotype g strains. Cluster analysis by MLVA was better in grouping the strains according to biotypes, was reflective of the epidemiological information and was equally discriminative as PFGE. Conclusions The S. sonnei strains circulating in Malaysia throughout the period studied were derived from different clones given their heterogeneous nature. MLVA based on seven selected VNTR loci was rapid, reproducible and highly discriminative and therefore may complement PFGE for routine subtyping of S. sonnei.
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Affiliation(s)
- Xiu Pei Koh
- Institute of Biological Science, University of Malaya, Kuala Lumpur 50603, Malaysia
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In vitro antibacterial and time-kill assessment of crude methanolic stem bark extract of Acacia mearnsii de wild against bacteria in shigellosis. Molecules 2012; 17:2103-18. [PMID: 22354188 PMCID: PMC6268967 DOI: 10.3390/molecules17022103] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2012] [Revised: 02/13/2012] [Accepted: 02/15/2012] [Indexed: 11/27/2022] Open
Abstract
Shigellosis is an important cause of worldwide morbidity and mortality among young children and old people for which treatment with antimicrobial agents is limited. Hence, the need for curative potentials obtainable from medicinal plants becomes inevitable. This study was carried out to assess the antibacterial potentials of crude methanolic extract of the stem bark of Acacia mearnsii against some selected bacteria of clinical importance in shigellosis. The bacteria were inhibited by the extract to produce concentration dependent inhibition zones. The extract exhibited a varied degree of antibacterial activity against all the tested isolates. The MIC values for Gram negative (0.0391–0.3125) mg/mL and those of Gram positive bacteria (0.0781–0.625) mg/mL indicated that the Gram negative bacteria were more inhibited by the extract than the Gram positive bacteria. Average log reduction in viable cell count in time-kill assay ranged between −2.456 Log10 to 2.230 Log10 cfu/mL after 4 h of interaction, and between −2.921 Log10 and 1.447 Log10 cfu/mL after 8 h interaction in 1× MIC and 2× MIC of the extract. The study provided scientific justification for the use of the crude methanolic extract from the stem bark of A. mearnsii in shigellosis. The degree of the antibacterial activity indicated that the crude extract is a potential source of bioactive compounds that could be useful for the development of new antimicrobial agents capable of decreasing the burden of drug resistance and cost of management of diseases of clinical and public health importance in South Africa.
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Barnoy S, Jeong KI, Helm RF, Suvarnapunya AE, Ranallo RT, Tzipori S, Venkatesan MM. Characterization of WRSs2 and WRSs3, new second-generation virG(icsA)-based Shigella sonnei vaccine candidates with the potential for reduced reactogenicity. Vaccine 2009; 28:1642-54. [PMID: 19932216 DOI: 10.1016/j.vaccine.2009.11.001] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2009] [Revised: 09/02/2009] [Accepted: 11/03/2009] [Indexed: 11/28/2022]
Abstract
Live, attenuated Shigella vaccine candidates, such as Shigella sonnei strain WRSS1, Shigella flexneri 2a strain SC602, and Shigella dysenteriae 1 strain WRSd1, are attenuated principally by the loss of the VirG(IcsA) protein. These candidates have proven to be safe and immunogenic in volunteer trials and in one study, efficacious against shigellosis. One drawback of these candidate vaccines has been the reactogenic symptoms of fever and diarrhea experienced by the volunteers, that increased in a dose-dependent manner. New, second-generation virG(icsA)-based S. sonnei vaccine candidates, WRSs2 and WRSs3, are expected to be less reactogenic while retaining the ability to generate protective levels of immunogenicity seen with WRSS1. Besides the loss of VirG(IcsA), WRSs2 and WRSs3 also lack plasmid-encoded enterotoxin ShET2-1 and its paralog ShET2-2. WRSs3 further lacks MsbB2 that reduces the endotoxicity of the lipid A portion of the bacterial LPS. Studies in cell cultures and in gnotobiotic piglets demonstrate that WRSs2 and WRSs3 have the potential to cause less diarrhea due to loss of ShET2-1 and ShET2-2 as well as alleviate febrile symptoms by loss of MsbB2. In guinea pigs, WRSs2 and WRSs3 were as safe, immunogenic and efficacious as WRSS1.
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Affiliation(s)
- S Barnoy
- Division of Bacterial & Rickettsial Diseases, Walter Reed Army Institute of Research 503, Robert Grant Avenue, Silver Spring, MD 208914, United States
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Surveillance of antibiotic susceptibility patterns among Shigella sonnei strains isolated in Belgium during the 18-year period 1990 to 2007. J Clin Microbiol 2009; 47:1379-85. [PMID: 19321731 DOI: 10.1128/jcm.02460-08] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
This study was conducted to determine the frequency and pattern of antimicrobial susceptibility of Shigella sonnei, the predominant species causing shigellosis in Belgium. Between 1990 and 2007, a total of 7,307 strains, mainly (98.2%) isolated from stools, were diagnosed by peripheral laboratories before being confirmed as Shigella strains by serotyping by the National Reference Center of Salmonella and Shigella. A significant increase in resistances to tetracycline, streptomycin, trimethoprim, sulfonamides, and cotrimoxazole (i.e., trimethoprim in combination with sulfonamides) was observed during this period. Since 1998, resistance to nalidixic acid also increased to reach a peak (12.8%) of resistant isolates in 2004. Concomitantly, multidrug resistance (MDR) in this species emerged in 2007, with 82% of total isolates being MDR. However, during this 18-year period, all isolates remained fully susceptible to ciprofloxacin and gentamicin. The work includes the molecular characterization of mechanisms of resistance to ampicillin, tetracycline, chloramphenicol, and cotrimoxazole and class 1 and class 2 integrons. S. sonnei acquired antimicrobial resistance to traditional antibiotics (ampicillin and tetracycline) by horizontal gene transfer, while the genetic stability of transposons was responsible for a high (89%) proportion of resistance to a commonly prescribed antibiotic (cotrimoxazole). Therefore, cotrimoxazole should no longer be considered appropriate as empirical therapy for treatment of shigellosis in Belgium when antibiotics are indicated. Rates of resistance to nalidixic acid should also be attentively monitored to detect any shift in fluoroquinolone resistance, because it represents the first line among antibiotics used in the treatment of shigellosis.
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Nagachinta S, Chen J. Integron-mediated antibiotic resistance in Shiga toxin-producing Escherichia coli. J Food Prot 2009; 72:21-7. [PMID: 19205459 DOI: 10.4315/0362-028x-72.1.21] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
This study was undertaken to characterize the integrons present in a group of Shiga toxin-producing Escherichia coli (STEC) isolates and the ability of these integrons to transfer antibiotic resistance genes from STEC to E. coli K-12 MG1655. A total of 177 STEC isolates were analyzed for antibiotic susceptibility and the presence of integrons. Class 1 integrons were detected in 14 STEC isolates, and a class 2 integron was identified in 1 STEC isolate. The STEC isolates positive for class 1 integrons were resistant to streptomycin (MICs > 128 microg/ml) and sulfisoxazole (MICs > 1,024 microg/ml), and the isolate positive for the class 2 integron was resistant to streptomycin (MIC of 128 microg/ml), trimethoprim (MIC > 256 microg/ml), and streptothricin (MIC > 32 microg/ml). Results of restriction digestion and nucleotide sequencing revealed that the cassette regions of the class 1 integrons had a uniform size of 1.1 kb and contained a nucleotide sequence identical to that of aadA1. The class 2 integron cassette region was 2.0 kb and carried nucleotide sequences homologous to those of aadA1, sat1, and dfrA1. Results of the conjugation experiments revealed that horizontal transfers of conjugative plasmids are responsible for the dissemination of class 1 integron-mediated antibiotic resistance genes from STEC to E. coli K-12 MG1655. Antibiotic resistance traits not mediated by integrons, such as resistance to tetracycline and oxytetracycline, were cotransferred with the integron-mediated antibiotic resistance genes. The study suggested a possible role of integron and conjugative plasmid in dissemination of genes conferring resistance to antibiotics from pathogenic to generic E. coli cells.
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Affiliation(s)
- Supakana Nagachinta
- Department of Food Science and Technology, The University of Georgia, 1109 Experiment Street, Griffin, Georgia 30223-1797, USA
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Choi SY, Jeon YS, Lee JH, Choi B, Moon SH, von Seidlein L, Clemens JD, Dougan G, Wain J, Yu J, Lee JC, Seol SY, Lee BK, Song JH, Song M, Czerkinsky C, Chun J, Kim DW. Multilocus sequence typing analysis of Shigella flexneri isolates collected in Asian countries. J Med Microbiol 2008; 56:1460-1466. [PMID: 17965345 PMCID: PMC2652033 DOI: 10.1099/jmm.0.47322-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The multilocus sequence typing scheme used previously for phylogenetic analysis of Escherichia coli was applied to 107 clinical isolates of Shigella flexneri. DNA sequencing of 3423 bp throughout seven housekeeping genes identified eight new allele types and ten new sequence types among the isolates. S. flexneri serotypes 1-5, X and Y were clustered together in a group containing many allelic variants while serotype 6 formed a distinct group, as previously established.
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Affiliation(s)
- Seon Young Choi
- School of Biological Sciences, Seoul National University, Seoul 151-742, Republic of Korea.,International Vaccine Institute, San 4-8 Bongcheon 7 dong, Kwanak gu, Seoul 151-818, Republic of Korea
| | - Yoon-Seong Jeon
- Interdisciplinary Program of Bioinformatics, Seoul National University, Seoul 151-742, Republic of Korea.,International Vaccine Institute, San 4-8 Bongcheon 7 dong, Kwanak gu, Seoul 151-818, Republic of Korea
| | - Je Hee Lee
- School of Biological Sciences, Seoul National University, Seoul 151-742, Republic of Korea.,International Vaccine Institute, San 4-8 Bongcheon 7 dong, Kwanak gu, Seoul 151-818, Republic of Korea
| | - Boram Choi
- International Vaccine Institute, San 4-8 Bongcheon 7 dong, Kwanak gu, Seoul 151-818, Republic of Korea
| | - Sun Hwa Moon
- International Vaccine Institute, San 4-8 Bongcheon 7 dong, Kwanak gu, Seoul 151-818, Republic of Korea
| | - Lorenz von Seidlein
- International Vaccine Institute, San 4-8 Bongcheon 7 dong, Kwanak gu, Seoul 151-818, Republic of Korea
| | - John D Clemens
- International Vaccine Institute, San 4-8 Bongcheon 7 dong, Kwanak gu, Seoul 151-818, Republic of Korea
| | - Gordon Dougan
- The Wellcome Trust Sanger Institute, Hinxton, Cambridgeshire CB10 1SA, UK
| | - John Wain
- The Wellcome Trust Sanger Institute, Hinxton, Cambridgeshire CB10 1SA, UK
| | - Jun Yu
- The Wellcome Trust Sanger Institute, Hinxton, Cambridgeshire CB10 1SA, UK
| | - Je Chul Lee
- School of Medicine, Kyungpook National University, Daegu 700-422, Republic of Korea
| | - Sung Yong Seol
- School of Medicine, Kyungpook National University, Daegu 700-422, Republic of Korea
| | - Bok Kwon Lee
- Laboratory of Enteric Infections, Department of Microbiology, National Institute of Health Korea, Republic of Korea
| | - Jae-Hoon Song
- Division of Infectious Disease, Samsung Medical Center, Seoul, Republic of Korea
| | - Manki Song
- International Vaccine Institute, San 4-8 Bongcheon 7 dong, Kwanak gu, Seoul 151-818, Republic of Korea
| | - Cecil Czerkinsky
- International Vaccine Institute, San 4-8 Bongcheon 7 dong, Kwanak gu, Seoul 151-818, Republic of Korea
| | - Jongsik Chun
- Interdisciplinary Program of Bioinformatics, Seoul National University, Seoul 151-742, Republic of Korea.,School of Biological Sciences, Seoul National University, Seoul 151-742, Republic of Korea.,International Vaccine Institute, San 4-8 Bongcheon 7 dong, Kwanak gu, Seoul 151-818, Republic of Korea
| | - Dong Wook Kim
- International Vaccine Institute, San 4-8 Bongcheon 7 dong, Kwanak gu, Seoul 151-818, Republic of Korea
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