The re-emergence of sexually transmissible multidrug resistant Shigella flexneri 3a, England, United Kingdom.
Lewis C E MasonHannah CharlesKatie ThorleyCharlotte E ChongP Malaka De SilvaClaire JenkinsKate S BakerPublished in: npj antimicrobials and resistance (2024)
Shigellosis is an enteric infection that transmits through the faecal-oral route, which can occur during sex between men who have sex with men (MSM). Between 2009 and 2014, an epidemic of sexually transmissible Shigella flexneri 3a occurred in England that subsequently declined. However, from 2019 to 2021, despite SARS-CoV-2 restrictions, S. flexneri 3a continued to re-emerge. We explored possible drivers of re-emergence by comparing host demography and pathogen genomics. Cases were primarily among 35-64 year old men in London. Genomic analyses of 502 bacterial isolates showed that the majority (58%) of re-emerging MSM strains were a clonal replacement of the original, with reduced antimicrobial resistance, conservation of plasmid col156_1, and two SNPs with 19 predicted effects. The absence of major changes in the pathogen or host demographics suggest that other factors may have driven the re-emergence of S. flexneri 3a and highlight the need for further work in the area.
Keyphrases
- men who have sex with men
- antimicrobial resistance
- hiv testing
- hiv positive
- sars cov
- multidrug resistant
- escherichia coli
- candida albicans
- genome wide
- crispr cas
- drug resistant
- acinetobacter baumannii
- respiratory syndrome coronavirus
- gram negative
- single cell
- copy number
- gene expression
- hepatitis c virus
- dna methylation
- coronavirus disease
- south africa
- genetic diversity