AI Article Synopsis
- * A study of shigellosis clusters from 2011-2015 found significant antimicrobial resistance, particularly among clusters associated with men who have sex with men (MSM), where resistance was observed in all related clusters.
- * The findings suggest that clinicians should culture feces and consider patients' sexual histories when diagnosing shigellosis, and public health efforts should focus on prevention strategies specifically targeted at MSM.
Article Abstract
Shigella spp. cause ≈500,000 illnesses in the United States annually, and resistance to ciprofloxacin, ceftriaxone, and azithromycin is emerging. We investigated associations between transmission route and antimicrobial resistance among US shigellosis clusters reported during 2011-2015. Of 32 clusters, 9 were caused by shigellae resistant to ciprofloxacin (3 clusters), ceftriaxone (2 clusters), or azithromycin (7 clusters); 3 clusters were resistant to >1 of these drugs. We observed resistance to any of these drugs in all 7 clusters among men who have sex with men (MSM) but in only 2 of the other 25 clusters (p<0.001). Azithromycin resistance was more common among MSM-associated clusters than other clusters (86% vs. 4% of clusters; p<0.001). For adults with suspected shigellosis, clinicians should culture feces; obtain sex histories; discuss shigellosis prevention; and choose treatment, when needed, according to antimicrobial drug susceptibility. Public health interviews for enteric illnesses should encompass sex practices; health messaging for MSM must include shigellosis prevention.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4994375 | PMC |
| http://dx.doi.org/10.3201/eid2209.160624 | DOI Listing |
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