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O'Flanagan H, Siddiq M, Llewellyn C, Richardson D. Antimicrobial resistance in sexually transmitted Shigella in men who have sex with men: A systematic review. Int J STD AIDS 2023; 34:374-384. [PMID: 36786731 DOI: 10.1177/09564624231154942] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
BACKGROUND Outbreaks of sexually transmitted Shigella flexneri and Shigella sonnei in men who have sex with men (MSM) are a major public health issue. While most cases can be managed conservatively, a minority require antimicrobial treatment. Recent reports have highlighted increasing antimicrobial resistant (AMR) strains of Shigella spp. in men who have sex with men. We aimed to systematically review antimicrobial resistance (and decreased antimicrobial sensitivity) in sexually transmitted shigella in men who have sex with men, focussing on macrolides, quinolones, and third generation cephalosporins. METHODS We systematically searched 4 bibliographical databases (EMBASE, medline, EMCARE and CINAHL) from January 2011 to November 2021. We used a 2-stage process to assess eligibility: the primary author conducted an initial screen and then 3 authors conducted independent full-text reviews to determine the final eligible manuscripts. We only included manuscripts in English which included men who have sex with men with sexually transmitted shigella where data on antimicrobial resistance was available. RESULTS Thirty-nine manuscripts met the inclusion criteria. A majority of the manuscripts (N = 34) described reduced susceptibility or antimicrobial resistant to macrolides, quinolones and third generation cephalosporins in circulating strains of shigella within sexual networks of men who have sex with men. Extensively drug resistant outbreaks of shigella in men who have sex with men have been reported containing genetic markers of ceftriaxone resistance (e.g. BlaCTX-M27) where isolates also contained markers of reduced susceptibility, and antimicrobial resistant to macrolides and quinolones. CONCLUSION There is little role for macrolides, quinolones or third generation cephalosporins in the management of sexually transmitted shigella in men who have sex with men. More research is needed to develop novel strategies for shigella control in men who have sex with men, as antimicrobial options are diminishing.
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Affiliation(s)
| | | | | | - Daniel Richardson
- 12190Brighton and Sussex Medical School, Brighton, UK.,8721University Hospitals Sussex NHS Foundation Trust, Brighton, UK
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2
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Lόpez-Vélez R, Lebens M, Bundy L, Barriga J, Steffen R. Bacterial travellers' diarrhoea: A narrative review of literature published over the past 10 years. Travel Med Infect Dis 2022; 47:102293. [PMID: 35247581 DOI: 10.1016/j.tmaid.2022.102293] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 02/24/2022] [Accepted: 02/28/2022] [Indexed: 02/04/2023]
Abstract
Travellers' diarrhoea (TD) is the most frequent illness experienced by international travellers to lower-income countries with bacterial agents considered to account for 80-90% of cases. In this review, we summarise evidence published on bacterial TD over the past 10 years, focusing on the epidemiology and aetiology of TD. Diarrhoeagenic Escherichia coli (DEC) continue to be the most commonly implicated bacteria in TD, although Enteropathogenic E. coli (EPEC) and Enteroaggregative E. coli (EAEC) now appear to be predominant where Enterotoxigenic E. coli (ETEC) was previously considered most prevalent globally. Where fluroquinolone resistance had primarily been documented for Campylobacter in Southeast Asia, widespread resistance has been observed in most regions of the world for multiple enteropathogens, including Shigella, Salmonella, ETEC and EAEC. Implementation of novel molecular methods for pathogen detection has led to identification of bacterial pathogens, including Clostridium difficile (with and without the use of prior antibiotics), Arcobacter species and Bacteroides fragilis, as aetiological agents in TD. The widespread resistance to first-line antibiotics in multiple bacterial enteropathogens warrants continued surveillance and re-evaluation of current treatment practices. Further investigations are required to determine the prevalence and geographical distribution of bacterial enteropathogens that have been more recently implicated in TD.
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Affiliation(s)
- Rogelio Lόpez-Vélez
- National Referral Unit for Tropical Diseases, Infectious Diseases Department, Ramón y Cajal University Hospital, IRYCIS, 28034, Madrid, Spain.
| | - Michael Lebens
- Department of Microbiology and Immunology, University of Gothenburg, Box 435, SE-40530, Gothenburg, Sweden.
| | - Leah Bundy
- Elements Communications Ltd, Westerham, TN16 1RQ, UK.
| | - Juan Barriga
- Department of Medical Affairs Europe, Emergent BioSolutions, 1455, Madrid, Spain.
| | - Robert Steffen
- Epidemiology, Biostatistics and Prevention Institute, World Health Organization Collaborating Centre for Travelers' Health, University of Zurich, Hirschengraben 84, CH-8001, Zurich, Switzerland; Epidemiology, Human Genetics and Environmental Sciences Division, University of Texas School of Public Health, Houston, TX 77030, Texas, USA.
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3
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Nowicki D, Krause K, Karczewska M, Szalewska-Pałasz A. Evaluation of the Anti-Shigellosis Activity of Dietary Isothiocyanates in Galleria mellonella Larvae. Nutrients 2021; 13:nu13113967. [PMID: 34836222 PMCID: PMC8625812 DOI: 10.3390/nu13113967] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/03/2021] [Accepted: 11/05/2021] [Indexed: 11/16/2022] Open
Abstract
Cruciferous vegetables, widely present in daily diets, are a rich source of organosulfur compounds with proven health benefits, especially chemopreventive or antioxidative effects. Isothiocyanate derivatives (ITCs) exhibit a broad spectrum of biological and pharmacological activity and recently, their antibacterial properties have been of particular importance. Here, we have focused on the anti-shigellosis activity of sulforaphane (SFN) and phenethyl ITC (PEITC). The genus Shigella causes gastroenteritis in humans, which constitutes a threat to public health. Production of a potent Stx toxin by S. dysenteriae type 1 results not only in more severe symptoms but also in serious sequela, including the hemolytic uremic syndrome. Here, we present evidence that two aliphatic and aromatic ITCs derivatives, SFN and PEITC, have an effective antibacterial potency against S. dysenteriae, also negatively regulating the stx gene expression. The molecular mechanism of this effect involves induction of the global stress-induced stringent response. ITCs also inhibit bacterial virulence against the Vero and HeLa cells. We present evidence for the therapeutic effect of sulforaphane and phenethyl ITC against a S. dysenteriae infection in the Galleria mellonella larvae model. Thus, our results indicate that isothiocyanates can be effectively used to combat dangerous bacterial infections.
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4
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Kim JH, Sung J, Kwon HJ, Cheong HK. Effects of El Niño/La Niña on the Number of Imported Shigellosis Cases in the Republic of Korea, 2004-2017. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 18:ijerph18010211. [PMID: 33396622 PMCID: PMC7795629 DOI: 10.3390/ijerph18010211] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 12/17/2020] [Accepted: 12/25/2020] [Indexed: 12/27/2022]
Abstract
Shigellosis is a major diarrheal disease in low- and middle-income countries. Although the incidence of such diseases in South and Southeast Asia has been associated with climate fluctuations linked to the El Niño-Southern Oscillation (ENSO), the impact of ENSO on shigellosis infections remains unknown. Data reported to being infected with shigellosis while traveling abroad from 2004 to 2017 were obtained from the Korea Centers for Disease Control and Prevention. We investigated the relationship between the Oceanic Niño Index (ONI) and Indian Ocean Dipole Mode Index and the relative risk of shigellosis in outbound travelers using distributed lag linear and non-linear models. From 2004 to 2017, 87.1% of imported shigellosis was infected in South and Southeast Asian countries. The relative risk of imported shigellosis infection in outbound travelers increased as the ONI decreased. In the association with the five-month cumulative ONI, the relative risk of infection continuously increased as the La Niña index gained strength. Climate fluctuations associated with the La Niña phenomenon in South and Southeast Asian countries can lead to issues in sanitation and water safety. Our findings suggest that the decreasing trend in the ONI is associated with an increased incidence of shigellosis in these countries.
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Affiliation(s)
- Jong-Hun Kim
- Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon 16419, Korea; (J.-H.K.); (J.S.)
| | - Jisun Sung
- Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon 16419, Korea; (J.-H.K.); (J.S.)
| | - Ho-Jang Kwon
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan 31116, Korea;
| | - Hae-Kwan Cheong
- Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon 16419, Korea; (J.-H.K.); (J.S.)
- Correspondence: ; Tel.: +82-31-299-6300
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5
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Rui J, Chen Q, Chen Q, Hu Q, Hannah MN, Zhao Z, Wang Y, Liu X, Lei Z, Yu S, Chiang YC, Zhao B, Su Y, Zhao B, Chen T. Feasibility of containing shigellosis in Hubei Province, China: a modelling study. BMC Infect Dis 2020; 20:643. [PMID: 32873241 PMCID: PMC7461149 DOI: 10.1186/s12879-020-05353-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 08/17/2020] [Indexed: 12/14/2022] Open
Abstract
Background The transmission features and the feasibility of containing shigellosis remain unclear among a population-based study in China. Methods A population–based Susceptible – Exposed – Infectious / Asymptomatic – Recovered (SEIAR) model was built including decreasing the infectious period (DIP) or isolation of shigellosis cases. We analyzed the distribution of the reported shigellosis cases in Hubei Province, China from January 2005 to December 2017, and divided the time series into several stages according to the heterogeneity of reported incidence during the period. In each stage, an epidemic season was selected for the modelling and assessing the effectiveness of DIP and case isolation. Results A total of 130,770 shigellosis cases were reported in Hubei Province. The median of Reff was 1.13 (range: 0.86–1.21), 1.10 (range: 0.91–1.13), 1.09 (range: 0.92–1.92), and 1.03 (range: 0.94–1.22) in 2005–2006 season, 2010–2011 season, 2013–2014 season, and 2016–2017 season, respectively. The reported incidence decreased significantly (trend χ2 = 8260.41, P < 0.001) among four stages. The incidence of shigellosis decreased sharply when DIP implemented in three scenarios (γ = 0.1, 0.1429, 0.3333) and when proportion of case isolation increased. Conclusions Year heterogeneity of reported shigellosis incidence exists in Hubei Province. It is feasible to contain the transmission by implementing DIP and case isolation.
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Affiliation(s)
- Jia Rui
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, 4221-117 South Xiang'an Road, Xiang'an District, Xiamen City, Fujian Province, People's Republic of China
| | - Qi Chen
- Hubei Provincial Center for Disease Control and Prevention, Wuhan City, Hubei Province, People's Republic of China
| | - Qiuping Chen
- Medical Insurance Office, Xiang'an Hospital of Xiamen University, Xiamen City, Fujian Province, People's Republic of China
| | - Qingqing Hu
- Division of Public Health, School of Medicine, University of Utah, 201 Presidents Circle, Salt Lake City, UT, 84112, USA
| | - Mikah Ngwanguong Hannah
- Medical College, Xiamen University, Xiamen City, Fujian Province, People's Republic of China
| | - Zeyu Zhao
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, 4221-117 South Xiang'an Road, Xiang'an District, Xiamen City, Fujian Province, People's Republic of China
| | - Yao Wang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, 4221-117 South Xiang'an Road, Xiang'an District, Xiamen City, Fujian Province, People's Republic of China
| | - Xingchun Liu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, 4221-117 South Xiang'an Road, Xiang'an District, Xiamen City, Fujian Province, People's Republic of China
| | - Zhao Lei
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, 4221-117 South Xiang'an Road, Xiang'an District, Xiamen City, Fujian Province, People's Republic of China
| | - Shanshan Yu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, 4221-117 South Xiang'an Road, Xiang'an District, Xiamen City, Fujian Province, People's Republic of China
| | - Yi-Chen Chiang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, 4221-117 South Xiang'an Road, Xiang'an District, Xiamen City, Fujian Province, People's Republic of China
| | - Benhua Zhao
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, 4221-117 South Xiang'an Road, Xiang'an District, Xiamen City, Fujian Province, People's Republic of China
| | - Yanhua Su
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, 4221-117 South Xiang'an Road, Xiang'an District, Xiamen City, Fujian Province, People's Republic of China
| | - Bin Zhao
- Laboratory Department, Xiang'an Hospital of Xiamen University, State Key Laboratory of Molecular Vaccinology and Molecular Diagnosis, Xiamen City, Fujian Province, People's Republic of China
| | - Tianmu Chen
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, 4221-117 South Xiang'an Road, Xiang'an District, Xiamen City, Fujian Province, People's Republic of China.
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6
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Li LH, Chen TL, Chiu HW, Hsu CH, Wang CC, Tai TT, Ju TC, Chen FH, Chernikov OV, Tsai WC, Hua KF. Critical Role for the NLRP3 Inflammasome in Mediating IL-1β Production in Shigella sonnei-Infected Macrophages. Front Immunol 2020; 11:1115. [PMID: 32582195 PMCID: PMC7283925 DOI: 10.3389/fimmu.2020.01115] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Accepted: 05/07/2020] [Indexed: 12/24/2022] Open
Abstract
Shigella is one of the leading bacterial causes of diarrhea worldwide, affecting more than 165 million people annually. Among the serotypes of Shigella, Shigella sonnei is physiologically unique and endemic in human immunodeficiency virus-infected men who have sex with men. The NOD-, LRR-, and pyrin domain-containing protein 3 (NLRP3) inflammasome, a protein complex composed of NLRP3, apoptosis-associated speck-like protein, and caspase-1, recognizes, and responds to pathogen infection and diverse sterile host-derived or environmental danger signals to induce IL-1β and IL-18 production. Although the Shigella flexneri-mediated activation of the NLRP3 inflammasome has been reported, the effect of S. sonnei on NLRP3 inflammasome activation remains unclear. We found that S. sonnei induced IL-1β production through NLRP3-dependent pathways in lipopolysaccharide-primed macrophages. A mechanistic study revealed that S. sonnei induced IL-1β production through P2X7 receptor-mediated potassium efflux, reactive oxygen species generation, lysosomal acidification, and mitochondrial damage. In addition, the phagocytosis of viable S. sonnei was important for IL-1β production. Furthermore, we demonstrated that NLRP3 negatively regulated phagocytosis and the bactericidal activity of macrophages against S. sonnei. These findings provide mechanistic insight into the activation of the NLRP3 inflammasome by S. sonnei in macrophages.
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Affiliation(s)
- Lan-Hui Li
- Department of Laboratory Medicine, Linsen, Chinese Medicine and Kunming Branch, Taipei City Hospital, Taipei, Taiwan.,Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Tzu-Ling Chen
- Department of Laboratory Medicine, Linsen, Chinese Medicine and Kunming Branch, Taipei City Hospital, Taipei, Taiwan.,Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Hsiao-Wen Chiu
- Department of Biotechnology and Animal Science, National Ilan University, Ilan, Taiwan
| | - Chung-Hua Hsu
- Department of Laboratory Medicine, Linsen, Chinese Medicine and Kunming Branch, Taipei City Hospital, Taipei, Taiwan.,Institute of Traditional Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Chien-Chun Wang
- Infectious Disease Division, Linsen, Chinese Medicine and Kunming Branch, Taipei City Hospital, Taipei, Taiwan
| | - Tzu-Ting Tai
- Department of Biotechnology and Animal Science, National Ilan University, Ilan, Taiwan
| | - Tz-Chuen Ju
- Department of Animal Science and Biotechnology, Tunghai University, Taichung, Taiwan
| | - Fang-Hsin Chen
- Department of Medical Imaging and Radiological Sciences, Chang Gung University, Taoyuan, Taiwan
| | - Oleg V Chernikov
- G.B. Elyakov Pacific Institute of Bioorganic Chemistry FEB RAS, Vladivostok, Russia
| | - Wen-Chiuan Tsai
- Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Kuo-Feng Hua
- Department of Pathology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Department of Biotechnology and Animal Science, National Ilan University, Ilan, Taiwan.,Department of Medical Research, China Medical University Hospital, China Medical University, Taichung, Taiwan
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7
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Bourque DL, Solomon DA, Sax PE. Health Considerations for HIV-Infected International Travelers. Curr Infect Dis Rep 2019; 21:16. [PMID: 30980287 DOI: 10.1007/s11908-019-0672-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
PURPOSE OF THE REVIEW International travel continues to steadily increase, including leisure travel, travel to one's country of origin to visit friends and relatives, travel for service work, and business travel. Travelers with HIV may have an increased risk for travel-associated infections. The pre-travel medical consultation is an important means of assessing one's risk for travel-related health issues. The aim of this review is to provide an update on key health considerations for the HIV-infected traveler. RECENT FINDINGS Like all travelers, the HIV-infected traveler should adhere to behavioral precautions, including safety measures with food and water consumption, safe sexual practices, and arthropod bite avoidance. HIV is a risk factor for venous thromboembolism and patients should be educated regarding this risk. Most pre-travel vaccines are safe and immunogenic in HIV-infected individuals, though live vaccines should be avoided in patients with low CD4 counts. Malaria chemoprophylaxis is strongly recommended in patients with HIV traveling to endemic areas and no significant interactions exist between the commonly used prophylactic anti-malarial agents and anti-retroviral therapy (ART). Travelers with HIV, particularly those who are not on ART or who have low CD4 cell counts, may have increased risk for tuberculosis, malaria, enteric infections, visceral leishmaniasis, American trypanosomiasis, and endemic mycoses such as histoplasmosis, talaromycosis, and coccidioidomycosis. The immune status of the HIV-infected traveler should be assessed prior to travel along with the duration, itinerary, and activities planned during travel in order to carefully consider individual risk for travel-related health issues.
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Affiliation(s)
- Daniel L Bourque
- Division of Infectious Diseases and Travel Medicine, Mount Auburn Hospital, Cambridge, MA, USA. .,Harvard Medical School, Boston, MA, USA.
| | - Daniel A Solomon
- Harvard Medical School, Boston, MA, USA. .,Division of Infectious Diseases, Brigham and Women's Hospital, Boston, MA, USA.
| | - Paul E Sax
- Harvard Medical School, Boston, MA, USA. .,Division of Infectious Diseases, Brigham and Women's Hospital, Boston, MA, USA.
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Tribble DR. Resistant pathogens as causes of traveller's diarrhea globally and impact(s) on treatment failure and recommendations. J Travel Med 2017; 24:S6-S12. [PMID: 28520997 PMCID: PMC5731445 DOI: 10.1093/jtm/taw090] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/23/2016] [Indexed: 01/15/2023]
Abstract
BACKGROUND : Diarrhea is a frequent clinical syndrome affecting international travellers. Bacterial etiologic agents have a long history of emergent antimicrobial resistance against commonly used antibiotics. Current approaches applying first-line antimicrobial therapy are being challenged by increasingly resistant organisms. This review summarizes recent epidemiological and clinical evidence of antibiotic resistance among enteropathogens causing traveller's diarrhea and the subsequent impact on current treatment recommendations. METHODS : The PubMed database was systemically searched for articles related to antibiotic susceptibility and diarrheal pathogens. RESULTS : Antibiotic resistance related to travellers' diarrhea has increased in recent years. Most notably, fluoroquinolone resistance has expanded from the Campylobacter -associated cases well documented in Southeast Asia in the 1990s to widespread occurrence, as well as increases among other common bacterial enteropathogens including, enterotoxigenic and enteroaggregative Escherichia coli , Shigella and non-typhoidal Salmonella . Multidrug resistance among enteropathogenic Enterobacteriacae and Campylobacter species create further challenges with the selection of empiric therapy. Treatment failures requiring early use of alternative agents, as well as delayed recovery comparable to placebo rates emphasize the impact of antimicrobial resistance on effective treatment. CONCLUSIONS : Although there are limitations in the available data, the increasing antibiotic resistance and adverse impact on clinical outcome require continued surveillance and reconsideration of practice guidelines.
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Affiliation(s)
- David R Tribble
- Infectious Disease Clinical Research Program, Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814-5119, USA
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Koley H, Ghosh P, Sinha R, Mitra S, Mukherjee P, Howlader DR, Chaki C, Nag D. Mice with Streptozotocin-Induced Hyperglycemia are Susceptible to Invasive Enteric Bacterial Infection. Jpn J Infect Dis 2017; 70:111-114. [DOI: 10.7883/yoken.jjid.2015.418] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Hemanta Koley
- Division of Bacteriology, National Institute of Cholera and Enteric Diseases
| | - Poushali Ghosh
- Division of Bacteriology, National Institute of Cholera and Enteric Diseases
| | - Ritam Sinha
- Division of Bacteriology, National Institute of Cholera and Enteric Diseases
| | - Soma Mitra
- Division of Bacteriology, National Institute of Cholera and Enteric Diseases
| | | | | | - Chandrima Chaki
- Division of Bacteriology, National Institute of Cholera and Enteric Diseases
| | - Dhrubajyoti Nag
- Division of Bacteriology, National Institute of Cholera and Enteric Diseases
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Shahsavan S, Owlia P, Rastegar Lari A, Bakhshi B, Nobakht M. Investigation of Efflux-Mediated Tetracycline Resistance in Shigella Isolates Using the Inhibitor and Real Time Polymerase Chain Reaction Method. IRANIAN JOURNAL OF PATHOLOGY 2017; 12:53-61. [PMID: 29760753 PMCID: PMC5938724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/02/2016] [Accepted: 01/27/2017] [Indexed: 11/05/2022]
Abstract
BACKGROUND Shigella spp. are gram negative bacteria, which are of global public health importance. The growing of multidrug-resistant Shigella isolates are a major problem around the world. METHODS Overall, 50 isolates of Shigella spp. from children diarrheic stools were studied. The isolates were identified and confirmed using biochemical, serological and molecular methods (ipaH, wbgZ and rfc genes). Antimicrobial susceptibility test was done according to the Clinical and Laboratory Standards Institute (CLSI) guidelines against minocycline, tetracycline, doxycycline, ampicillin, streptomycin, trimethoprim-sulfamethoxazole, nalidixic acid, norfloxacin, ciprofloxacin and levofloxacin. Also, the role of efflux pump in defense of Shigella against tetracycline was investigated by Minimum Inhibitory Concentration (MIC) with and without an efflux pump inhibitor. Detection of tetA, tetB, tetC and tetD genes in Shigella was evaluated by conventional Polymerase Chain Reaction (PCR) and real time PCR. RESULTS Molecular identification revealed a prevalence of 14% for Shigella flexneri and 86% for Shigella sonnei. Minimum Inhibitory Concentration (MIC) of 90% of resistant isolates was changed in the presence CCCP. Results of conventional PCR exhibited that 66% of isolates were positive for tetA, while according to real time PCR method, 90% of isolates carried tetA. Positive results for tetB were 12% and 18% by conventional and real time PCR methods, respectively. No positive results were detected for tetC and tetD. Also, tetB was detected only in S. flexneri while tetA was detected in both S. flexneri and S. sonnei. CONCLUSION It seems that efflux-mediated tetracycline resistance to tetracycline in S. flexneri can be related to tetB, however resistance in S. sonnei can be related to the expression of tetA.
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Affiliation(s)
- Shadi Shahsavan
- Antimicrobial Resistance research center, Iran University of Medical science, Tehran, Iran
| | - Parviz Owlia
- Molecular Microbiology Research Center, Shahed University, Tehran, IR Iran
| | - Abdolaziz Rastegar Lari
- Dept. of Microbiology, Faculty of Medicine, Iran University of Medical science, Tehran, Iran
| | - Bita Bakhshi
- Dept. of Microbiology, Faculty of Medicine, Tarbiat Modares University, Tehran, Iran
| | - Maliheh Nobakht
- Antimicrobial Resistance research center, Iran University of Medical science, Tehran, Iran,Dept. of Anatomy, Faculty of Medicine, Iran University of Medical science, Tehran, Iran,Corresponding Information: Dr. Maliheh Nobakht, Antimicrobial Resistance research center, Iran University of Medical science, Tehran, Iran. Tel: +982186704566
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11
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Shahsavan S, Nobakht M, Rastegar-Lari A, Owlia P, Bakhshi B. Multi-locus sequence type analysis of Shigellas pp. isolates from Tehran, Iran. IRANIAN JOURNAL OF MICROBIOLOGY 2016; 8:298-306. [PMID: 28149488 PMCID: PMC5277597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND OBJECTIVES Strains of Shigella spp. can cause shigellosis, or bacillary dysentery. that is a public health problem worldwide. The aim of this study was to describe the population structure and genetic relatedness of multidrug resistant S. sonnei and S. flexneri isolated during a one year period from children with diarrhea in Tehran, Iran. MATERIALS AND METHODS A total of 70 Shigella spp. were detected during the study period. Twenty MDR isolates of Shigella spp. were randomly selected and used in this study. Bacterial identification was performed by conventional biochemical and serological and confirmed by molecular method. After antimicrobial susceptibility testing, we used Multilocus sequence typing (MLST) for subtyping isolates. RESULTS We found 14 Shigella sonnei and 6 Shigella flexneri isolates. Results of MLST showed five sequence types (ST) (145, 152, 241, 245, 1502) and BURST analysis revealed the largest number of single locus variant (SLV) and highest frequency (FREQ) for ST152. ST 152 with nine members was predicted as the founder by BURST. Frequency for ST 1502 and ST 245 was four isolates and the least frequency was seen for ST 241 and 145 with one and two members, respectively. ST 145 and ST 245 were described as singletons in BURST. All isolates with ST145 and ST245 were identified as Shigella flexneri. CONCLUSION Annual Multi locus sequence typing of MDR Shigella would help us in better understanding of dominant species and comparing our results with the same studies in other countries especially our neighbor countries in source tracking purposes.
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Affiliation(s)
- Shadi Shahsavan
- Antimicrobial Resistance Research Center, Rasul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Maliheh Nobakht
- Antimicrobial Resistance Research Center, Rasul-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran,Department of Anatomy, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Abdolaziz Rastegar-Lari
- Department of Microbiology, Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Parviz Owlia
- Molecular Microbiology Research Center, Shahed University, Tehran, Iran
| | - Bita Bakhshi
- Department of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran,Corresponding author: Bita Bakhshi PhD, Department of Bacteriology, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran., Tel: +98-21-82884558, Fax: +98-21-82884555,
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Use of whole-genome sequencing for the public health surveillance of Shigella sonnei in England and Wales, 2015. J Med Microbiol 2016; 65:882-884. [DOI: 10.1099/jmm.0.000296] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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