Genetic Mechanisms behind the Spread of Reduced Susceptibility to Azithromycin in Shigella Strains Isolated from Men Who Have Sex with Men in Québec, Canada

doi:10.1128/AAC.01679-18

. 2019 Jan 29;63(2):e01679-18.

doi: 10.1128/AAC.01679-18. Print 2019 Feb.

Genetic Mechanisms behind the Spread of Reduced Susceptibility to Azithromycin in Shigella Strains Isolated from Men Who Have Sex with Men in Québec, Canada

Khadidja Yousfi¹, Christiane Gaudreau^{2

3}, Pierre A Pilon^{1

4}, Brigitte Lefebvre¹, Matthew Walker⁵, Éric Fournier¹, Florence Doualla Bell¹, Christine Martineau^{1

2}, Jean Longtin¹, Sadjia Bekal^{6

2}

Affiliations

¹ Laboratoire de Santé Publique du Québec, Institut National de Santé Publique du Québec, Sainte-Anne-de-Bellevue, Canada.
² Université de Montréal, Québec, Canada.
³ Centre Hospitalier de l'Université, Montréal, Québec, Canada.
⁴ Direction Régionale de Santé Publique de Montréal, Québec, Canada.
⁵ National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Canada.
⁶ Laboratoire de Santé Publique du Québec, Institut National de Santé Publique du Québec, Sainte-Anne-de-Bellevue, Canada sadjia.bekal@inspq.qc.ca.

PMID: 30455248
PMCID: PMC6355565
DOI: 10.1128/AAC.01679-18

Genetic Mechanisms behind the Spread of Reduced Susceptibility to Azithromycin in Shigella Strains Isolated from Men Who Have Sex with Men in Québec, Canada

Khadidja Yousfi et al. Antimicrob Agents Chemother. 2019.

. 2019 Jan 29;63(2):e01679-18.

doi: 10.1128/AAC.01679-18. Print 2019 Feb.

Authors

Affiliations

¹ Laboratoire de Santé Publique du Québec, Institut National de Santé Publique du Québec, Sainte-Anne-de-Bellevue, Canada.
² Université de Montréal, Québec, Canada.
³ Centre Hospitalier de l'Université, Montréal, Québec, Canada.
⁴ Direction Régionale de Santé Publique de Montréal, Québec, Canada.
⁵ National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Canada.
⁶ Laboratoire de Santé Publique du Québec, Institut National de Santé Publique du Québec, Sainte-Anne-de-Bellevue, Canada sadjia.bekal@inspq.qc.ca.

PMID: 30455248
PMCID: PMC6355565
DOI: 10.1128/AAC.01679-18

Abstract

We analyzed 254 Shigella species isolates collected in Québec, Canada, during 2013 and 2014. Overall, 23.6% of isolates showed reduced susceptibility to azithromycin (RSA) encoded by mphA (11.6%), ermB (1.7%), or both genes (86.7%). Shigella strains with RSA were mostly isolated from men who have sex with men (68.8% or higher) from the Montreal region. A complete sequence analysis of six selected plasmids from Shigella sonnei and different serotypes of Shigella flexneri emphasized the role of IS26 in the dissemination of RSA.

Keywords: IS26 insertion sequence; Shigella spp.; plasmid diversity; reduced susceptibility to azithromycin.

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Figures

**FIG 1**
Antimicrobial resistance regions on plasmids of *Shigella* with determinants of reduced susceptibility to azithromycin. (a) Genes are represented by arrows and colored according to gene function. Shaded regions represent shared structures harboring *mphA* and *ermB*. Dashed line represents the nonsequenced parts. (b) Comparison of the plasmids was performed using Gview server. The sizes of the plasmids are: 82,860 bp (pSf1), 79,827 bp (pSf2), 72,298 bp (pSf3), 67,764 bp (pSf4), 89,529 bp (pSf5), and 94,328 bp (pSs1). Gene organization diagrams were drawn using Inkscape v0.91.

See this image and copyright information in PMC

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References

1. Committee on Infectious Diseases, American academy of Pediatrics. 2018. In Kimberlin DW, Brady MT, Jackson MA, Long SS. (ed) Red book: 2018 report of the Committee on Infectious Diseases, 31st ed American Academy of Pediatrics, Itasca, IL.
1. Baker KS, Dallman TJ, Ashton PM, Day M, Hughes G, Crook PD, Gilbart VL, Zittermann S, Allen VG, Howden BP, Tomita T, Valcanis M, Harris SR, Connor TR, Sintchenko V, Howard P, Brown JD, Petty NK, Gouali M, Thanh DP, Keddy KH, Smith AM, Talukder KA, Faruque SM, Parkhill J, Baker S, Weill FX, Jenkins C, Thomson NR. 2015. Intercontinental dissemination of azithromycin-resistant shigellosis through sexual transmission: a cross-sectional study. Lancet Infect Dis 15:913–921. doi:10.1016/S1473-3099(15)00002-X. - DOI - PubMed
1. Gaudreau C, Barkati S, Leduc JM, Pilon PA, Favreau J, Bekal S. 2014. Shigella spp. with reduced azithromycin susceptibility, Québec, Canada, 2012–2013. Emerg Infect Dis 20:854–856. doi:10.3201/eid2005.130966. - DOI - PMC - PubMed
1. Bowen A, Grass J, Bicknese A, Campbell D, Hurd J, Kirkcaldy RD. 2016. Elevated risk for antimicrobial drug resistant Shigella infection among men who have sex with men, United States, 2011–2015. Emerg Infect Dis 22:1613–1616. doi:10.3201/eid2209.160624. - DOI - PMC - PubMed
1. Gaudreau C, Bruneau A, Ismaïl J. 2005. Outbreak of Shigella flexneri and Shigella sonnei enterocolitis in men who have sex with men, Québec, 1999 to 2001. Can Commun Dis Rep 31:85–90. (In French.) - PubMed

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[1] Committee on Infectious Diseases, American academy of Pediatrics. 2018. In Kimberlin DW, Brady MT, Jackson MA, Long SS. (ed) Red book: 2018 report of the Committee on Infectious Diseases, 31st ed American Academy of Pediatrics, Itasca, IL.

[2] Committee on Infectious Diseases, American academy of Pediatrics. 2018. In Kimberlin DW, Brady MT, Jackson MA, Long SS. (ed) Red book: 2018 report of the Committee on Infectious Diseases, 31st ed American Academy of Pediatrics, Itasca, IL.

[3] Baker KS, Dallman TJ, Ashton PM, Day M, Hughes G, Crook PD, Gilbart VL, Zittermann S, Allen VG, Howden BP, Tomita T, Valcanis M, Harris SR, Connor TR, Sintchenko V, Howard P, Brown JD, Petty NK, Gouali M, Thanh DP, Keddy KH, Smith AM, Talukder KA, Faruque SM, Parkhill J, Baker S, Weill FX, Jenkins C, Thomson NR. 2015. Intercontinental dissemination of azithromycin-resistant shigellosis through sexual transmission: a cross-sectional study. Lancet Infect Dis 15:913–921. doi:10.1016/S1473-3099(15)00002-X. - DOI - PubMed

[4] Baker KS, Dallman TJ, Ashton PM, Day M, Hughes G, Crook PD, Gilbart VL, Zittermann S, Allen VG, Howden BP, Tomita T, Valcanis M, Harris SR, Connor TR, Sintchenko V, Howard P, Brown JD, Petty NK, Gouali M, Thanh DP, Keddy KH, Smith AM, Talukder KA, Faruque SM, Parkhill J, Baker S, Weill FX, Jenkins C, Thomson NR. 2015. Intercontinental dissemination of azithromycin-resistant shigellosis through sexual transmission: a cross-sectional study. Lancet Infect Dis 15:913–921. doi:10.1016/S1473-3099(15)00002-X. - DOI - PubMed

[5] Gaudreau C, Barkati S, Leduc JM, Pilon PA, Favreau J, Bekal S. 2014. Shigella spp. with reduced azithromycin susceptibility, Québec, Canada, 2012–2013. Emerg Infect Dis 20:854–856. doi:10.3201/eid2005.130966. - DOI - PMC - PubMed

[6] Gaudreau C, Barkati S, Leduc JM, Pilon PA, Favreau J, Bekal S. 2014. Shigella spp. with reduced azithromycin susceptibility, Québec, Canada, 2012–2013. Emerg Infect Dis 20:854–856. doi:10.3201/eid2005.130966. - DOI - PMC - PubMed

[7] Bowen A, Grass J, Bicknese A, Campbell D, Hurd J, Kirkcaldy RD. 2016. Elevated risk for antimicrobial drug resistant Shigella infection among men who have sex with men, United States, 2011–2015. Emerg Infect Dis 22:1613–1616. doi:10.3201/eid2209.160624. - DOI - PMC - PubMed

[8] Bowen A, Grass J, Bicknese A, Campbell D, Hurd J, Kirkcaldy RD. 2016. Elevated risk for antimicrobial drug resistant Shigella infection among men who have sex with men, United States, 2011–2015. Emerg Infect Dis 22:1613–1616. doi:10.3201/eid2209.160624. - DOI - PMC - PubMed

[9] Gaudreau C, Bruneau A, Ismaïl J. 2005. Outbreak of Shigella flexneri and Shigella sonnei enterocolitis in men who have sex with men, Québec, 1999 to 2001. Can Commun Dis Rep 31:85–90. (In French.) - PubMed

[10] Gaudreau C, Bruneau A, Ismaïl J. 2005. Outbreak of Shigella flexneri and Shigella sonnei enterocolitis in men who have sex with men, Québec, 1999 to 2001. Can Commun Dis Rep 31:85–90. (In French.) - PubMed

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Genetic Mechanisms behind the Spread of Reduced Susceptibility to Azithromycin in Shigella Strains Isolated from Men Who Have Sex with Men in Québec, Canada

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Genetic Mechanisms behind the Spread of Reduced Susceptibility to Azithromycin in Shigella Strains Isolated from Men Who Have Sex with Men in Québec, Canada

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