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Kong M, Liu C, Xu Y, Wang J, Jin D. Concordance between Genotypic and Phenotypic Drug-Resistant Profiles of Shigella Isolates from Taiyuan City, Shanxi Province, China, 2005 to 2016. Microbiol Spectr 2023; 11:e0011923. [PMID: 37249442 PMCID: PMC10269460 DOI: 10.1128/spectrum.00119-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 05/10/2023] [Indexed: 05/31/2023] Open
Abstract
Antimicrobial resistance in Shigella spp. is a global public health concern. In this study, the AMR phenotypic profiles of 10 kinds of antibiotics were compared with the genotypic profiles using genomic analysis of 218 Shigella isolates from Taiyuan City, Shanxi Province, China, 2005 to 2016. Core genome Multilocus Sequence Typing (cgMLST) based on the EnteroBase Escherichia/Shigella scheme was used to obtain the genetic relatedness of Shigella isolates. Multiple-drug resistance was observed in 96.79% Shigella spp., and the resistance to antimicrobial agents varied between S. flexneri and S. sonnei. The genotypic results correlated well with the phenotypic profiles with concordance rates of 96.42% and 94.50% in S. flexneri and S. sonnei isolates, respectively, from Taiyuan City, Shanxi Province. The sensitivity and specificity of the genotypic antimicrobial susceptibility testing (AST) were 97.56% and 95.34% for S. flexneri, and 95.65% and 93.31% for S. sonnei isolates, respectively. A discrepancy of genotypic and phenotypic AST results existed in some cephalosporin- and azithromycin-resistant Shigella isolates; there were no clear resistance patterns to predict ciprofloxacin resistance. There were major discrepancies between genotypic and phenotypic AST in the genotypically resistant but phenotypically susceptible isolates. The drug-resistance patterns and essential drug-resistance genes to predict the phenotypic drug-resistant profiles were the discrepancies between S. flexneri and S. sonnei isolates. Phylogenetic analysis showed that isolates of the same cluster but with different antibiotic-resistance gene patterns occurred because of the loss or gain of antibiotic-resistance genes located in the plasmids and multidrug-resistance islands. IMPORTANCE Antimicrobial resistance in Shigella spp. has become a global public health concern. In this study, we identified the antimicrobial susceptibility testing (AST) characteristics based on genomic sequences of 218 Shigella isolates and analyzed the correlation between genotypic and phenotypic antibiotic resistance profiles of Shigella spp., especially for fluoroquinolone, macrolides, and third-generation cephalosporins. Our results show that the genotypic results correlated with the phenotypic profiles with concordance rates of 96.42% and 94.50% in S. flexneri and S. sonnei isolates, respectively. The drug-resistance patterns and essential drug-resistance genes to predict the phenotypic drug-resistant profiles of S. flexneri and S. sonnei isolates in Taiyuan city were distinct. The discrepancy between genotypic and phenotypic AST was considerable in the genotypically resistant but phenotypically susceptible isolates. The information on drug resistance and resistance genes in this study can offer more details on the prevalence of drug resistance of Shigella spp.
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Affiliation(s)
- Mimi Kong
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan City, Shanxi Province, China
| | - Chunmei Liu
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan City, Shanxi Province, China
| | - Yang Xu
- Department of Microbiology Test, Taiyuan Center for Disease Control and Prevention, Taiyuan City, Shanxi Province, China
| | - Jitao Wang
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan City, Shanxi Province, China
- Department of Microbiology Test, Taiyuan Center for Disease Control and Prevention, Taiyuan City, Shanxi Province, China
| | - Dong Jin
- Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan City, Shanxi Province, China
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Changping, Beijing, China
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2
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Meron-Sudai S, Asato V, Adler A, Bialik A, Goren S, Ariel-Cohen O, Reizis A, Mulard LA, Phalipon A, Cohen D. A Shigella flexneri 2a synthetic glycan-based vaccine induces a long-lasting immune response in adults. NPJ Vaccines 2023; 8:35. [PMID: 36894570 PMCID: PMC9998260 DOI: 10.1038/s41541-023-00624-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 02/09/2023] [Indexed: 03/11/2023] Open
Abstract
Shigella is a leading cause of moderate to severe diarrhea worldwide and of diarrhea-associated deaths in children under 5 years of age in low-and middle-income countries. A vaccine against shigellosis is in high demand. SF2a-TT15, a synthetic carbohydrate-based conjugate vaccine candidate against Shigella flexneri 2a (SF2a) was found safe and strongly immunogenic in adult volunteers. Here, SF2a-TT15 at 10 µg oligosaccharide (OS) vaccine dose is shown to induce a sustained immune response in magnitude and functionality in the majority of volunteers followed up 2 and 3 years post-vaccination. High levels of either one of the humoral parameters as well as the number of specific-IgG memory B-cells determined 3 months after vaccination were good predictors of the durability of the immune response. This study is the first to examine the long-term durability of antibody functionality and memory B-cell response induced by a Shigella vaccine candidate.
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Affiliation(s)
- Shiri Meron-Sudai
- School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, 69978, Israel
| | - Valeria Asato
- School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, 69978, Israel
| | - Amos Adler
- School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, 69978, Israel.,Clinical Microbiology Laboratory, Tel-Aviv Sourasky Medical Center, 6 Weizmann Street, Tel Aviv, 6423906, Israel
| | - Anya Bialik
- School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, 69978, Israel
| | - Sophy Goren
- School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, 69978, Israel
| | - Ortal Ariel-Cohen
- School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, 69978, Israel
| | - Arava Reizis
- School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, 69978, Israel
| | - Laurence A Mulard
- Institut Pasteur, Université Paris Cité, CNRS UMR3523, Unité de Chimie des Biomolécules, F-75015, Paris, France
| | - Armelle Phalipon
- Institut Pasteur, Innovation Lab. Vaccines, F-75015, Paris, France
| | - Dani Cohen
- School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Tel Aviv, 69978, Israel.
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3
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Miti S, Chilyabanyama ON, Chisenga CC, Chibuye M, Bosomprah S, Mumba C, Chitondo S, Siziya S, Cohen D, Chilengi R, Simuyandi M. Sensitivity and predictive value of dysentery in diagnosing shigellosis among under five children in Zambia. PLoS One 2023; 18:e0279012. [PMID: 36827347 PMCID: PMC9955635 DOI: 10.1371/journal.pone.0279012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 11/28/2022] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND Shigella is a leading cause of bacterial diarrhea morbidity and mortality affecting mainly children under five in the developing world. In Zambia, Shigella has a high prevalence of 34.7% in children with diarrhea and an attributable fraction of 6.7% in Zambian children with moderate to severe diarrhea. Zambian diarrhea management guidelines and the health ministry reporting tool Health Management Information System (HMIS) heavily rely on the WHO clinical classification of dysentery to potentially identify and estimate the burden of Shigella in children. This reliance on clinical dysentery as a proxy to shigellosis in under five children may be resulting in gross under-estimation of shigella disease burden in Zambia. METHODS We used existing laboratory and clinical data to examine the sensitivity and predictive value of dysentery to correctly identify Shigella infection in under five children with PCR confirmed Shigella infection in Lusaka and Ndola districts, Zambia. RESULTS Clinical dysentery had a sensitivity of 8.5% (34/401) in identifying under five children with Shigella by stool PCR. Dysentery was able to correctly classify Shigella in 34 of 68 bloody stool samples giving a corresponding positive predictive value of 50%. Of the 1087 with non-bloody diarrhea, 720 did not have Shigella giving a negative predictive value of 66.2%. CONCLUSIONS Use of clinical dysentery as a screening symptom for Shigella infection in children under five presenting with moderate to severe diarrhea has low sensitivity and low positive predictive value respectively. Clinical dysentery as a screening symptom for Shigella contributes to gross under diagnosis and reporting of Shigella infection among under five children in Zambia. Further research is required to better inform practice on more accurate methods or tools to use in support of routine diagnosis, particularly in low middle-income settings where laboratory diagnosis remains a challenge.
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Affiliation(s)
- Sam Miti
- Arthur Davison Children’s Hospital, Ndola, Zambia,Center for Infectious Disease Research in Zambia, Lusaka, Zambia,School of Medicine, Copperbelt University, Ndola, Zambia,Tropical Diseases Research Center, Ndola, Zambia,* E-mail:
| | | | | | - Mwelwa Chibuye
- Center for Infectious Disease Research in Zambia, Lusaka, Zambia
| | - Samuel Bosomprah
- Center for Infectious Disease Research in Zambia, Lusaka, Zambia,Department of Biostatistics, School of Public Health, University of Ghana, Accra, Ghana
| | | | | | - Seter Siziya
- School of Medicine, Copperbelt University, Ndola, Zambia
| | - Dani Cohen
- School of Public Health, Tel Aviv University, Tel Aviv, Israel
| | - Roma Chilengi
- Center for Infectious Disease Research in Zambia, Lusaka, Zambia
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4
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Muzembo BA, Kitahara K, Mitra D, Ohno A, Khatiwada J, Dutta S, Miyoshi SI. Burden of Shigella in South Asia: a systematic review and meta-analysis. J Travel Med 2023; 30:6798401. [PMID: 36331282 DOI: 10.1093/jtm/taac132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/25/2022] [Accepted: 10/25/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Shigella remains one of the most common causes of diarrhoea in South Asia. Current estimates of the prevalence of Shigella are critical for guiding control measures. We estimated the prevalence of Shigella species and serogroups in South Asia. METHODS We performed a systematic review using PubMed, EMBASE, Google Scholar and Web of Science for peer-reviewed studies published between 2000 and 19 June 2022. We also manually searched the reference lists of the reviewed studies to identify additional studies. We included studies that detected the presence of Shigella in stool by culture or polymerase chain reaction (PCR). Studies associated with outbreaks were excluded. Two investigators independently reviewed the studies, extracted the data and performed quality assessment. A random-effects meta-analysis was performed to determine the pooled prevalence of Shigella. RESULTS Our search yielded 5707 studies, of which 91 studies from five South Asian countries were included in the systematic review, 79 in the meta-analysis of Shigella prevalence and 63 in the meta-analysis of Shigella serogroups prevalence. The pooled prevalence of Shigella was 7% [95% confidence interval (CI): 6-7%], with heterogeneity (I2 = 98.7; P < 0.01). The prevalence of Shigella was higher in children aged <5 years (10%; 95% CI: 8-11%), in rural areas (12%; 95% CI: 10-14%) and in studies using PCR (15%; 95% CI: 11-19%). Shigella flexneri (58%) was the most abundant serogroup, followed by Shigella sonnei (19%), Shigella boydii (10%) and Shigella dysenteriae (9%). Shigella flexneri 2a was the most frequently isolated serotype (36%), followed by serotype 3a (12%), serotype 6 (12%) and serotype 1b (6%). The prevalence of non-typeable Shigella was 10.0%. CONCLUSIONS Although the prevalence of Shigella in South Asia remains generally high, it varies by age group and geographical area, with data lacking in some countries. Effective Shigella vaccines would be advantageous for both endemic communities and travellers.
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Affiliation(s)
- Basilua Andre Muzembo
- Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Kei Kitahara
- Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
- Collaborative Research Centre of Okayama University for Infectious Diseases at ICMR-NICED, Kolkata, India
| | - Debmalya Mitra
- Collaborative Research Centre of Okayama University for Infectious Diseases at ICMR-NICED, Kolkata, India
| | - Ayumu Ohno
- Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
- Collaborative Research Centre of Okayama University for Infectious Diseases at ICMR-NICED, Kolkata, India
| | | | - Shanta Dutta
- Division of Bacteriology, ICMR-National Institute of Cholera and Enteric Diseases, Kolkata, India
| | - Shin-Ichi Miyoshi
- Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
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Qin C, Li L, Tian G, Ding M, Zhu S, Song W, Hu J, Seeberger PH, Yin J. Chemical Synthesis and Antigenicity Evaluation of Shigella dysenteriae Serotype 10 O-Antigen Tetrasaccharide Containing a ( S)-4,6- O-Pyruvyl Ketal. J Am Chem Soc 2022; 144:21068-21079. [DOI: 10.1021/jacs.2c05953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Chunjun Qin
- Key Laboratory of Carbohydrate Chemistry and Biotechnology, Ministry of Education, School of Biotechnology, Jiangnan University, Lihu Avenue 1800, Wuxi, Jiangsu 214122, P. R. China
- Department of Biomolecular Systems, Max Planck Institute of Colloids and Interfaces, Am Mühlenberg 1, Potsdam 14476, Germany
| | - Lingxin Li
- Key Laboratory of Carbohydrate Chemistry and Biotechnology, Ministry of Education, School of Biotechnology, Jiangnan University, Lihu Avenue 1800, Wuxi, Jiangsu 214122, P. R. China
| | - Guangzong Tian
- Key Laboratory of Carbohydrate Chemistry and Biotechnology, Ministry of Education, School of Biotechnology, Jiangnan University, Lihu Avenue 1800, Wuxi, Jiangsu 214122, P. R. China
- Department of Biomolecular Systems, Max Planck Institute of Colloids and Interfaces, Am Mühlenberg 1, Potsdam 14476, Germany
| | - Meiru Ding
- Key Laboratory of Carbohydrate Chemistry and Biotechnology, Ministry of Education, School of Biotechnology, Jiangnan University, Lihu Avenue 1800, Wuxi, Jiangsu 214122, P. R. China
| | - Shengyong Zhu
- Key Laboratory of Carbohydrate Chemistry and Biotechnology, Ministry of Education, School of Biotechnology, Jiangnan University, Lihu Avenue 1800, Wuxi, Jiangsu 214122, P. R. China
| | - Wuqiong Song
- Key Laboratory of Carbohydrate Chemistry and Biotechnology, Ministry of Education, School of Biotechnology, Jiangnan University, Lihu Avenue 1800, Wuxi, Jiangsu 214122, P. R. China
| | - Jing Hu
- Key Laboratory of Carbohydrate Chemistry and Biotechnology, Ministry of Education, School of Biotechnology, Jiangnan University, Lihu Avenue 1800, Wuxi, Jiangsu 214122, P. R. China
- Wuxi School of Medicine, Jiangnan University, Lihu Avenue 1800, Wuxi, Jiangsu 214122, P. R. China
| | - Peter H. Seeberger
- Department of Biomolecular Systems, Max Planck Institute of Colloids and Interfaces, Am Mühlenberg 1, Potsdam 14476, Germany
| | - Jian Yin
- Key Laboratory of Carbohydrate Chemistry and Biotechnology, Ministry of Education, School of Biotechnology, Jiangnan University, Lihu Avenue 1800, Wuxi, Jiangsu 214122, P. R. China
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Wang Y, He Z, Ablimit P, Ji S, Jin D. Development of multiplex cross displacement amplification combined with lateral flow biosensor assay for detection of virulent shigella sonnei. Front Cell Infect Microbiol 2022; 12:1012105. [PMID: 36339345 PMCID: PMC9627043 DOI: 10.3389/fcimb.2022.1012105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 10/04/2022] [Indexed: 11/13/2022] Open
Abstract
Shigella sonnei is the most common Shigella spp. in developed areas and the second most common in undeveloped regions. In this study, a multiple cross displacement amplification (MCDA) assay was used in combination with a lateral flow biosensor (LFB) assay to detect virulent S. sonnei strains containing the ipaH and wbgX genes. The multiplex MCDA-LFB assay detected wbgX at ≥1 pg/μL and ipaH at ≥10 fg/μL within 30 min in pure cultures maintained at 63°C. This assay was sensitive for ~37 CFU of virulent S. sonnei and ~3.7 CFU of Shigella spp. and enteroinvasive E. coli in stimulated fecal samples and had 100% specificity among 59 reference strains. The MCDA-LFB assay was also able to differentiate between virulent S. sonnei and other Shigella spp. and enteroinvasive E. coli among 99 clinical isolates. In summary, a multiplex MCDA-LFB assay was developed for rapid, convenient, point-of-care, and accurate identification of virulent S. sonnei within 30 min and at a constant temperature without the need for expensive lab equipment.
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Affiliation(s)
- Yonglu Wang
- Ma’anshan Center for Disease Control and Prevention, Ma’anshan, China
- Pishan County Center for Disease Control and Prevention, Hotan Prefecture, China
| | - Ziqiang He
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Patigul Ablimit
- Pishan County Center for Disease Control and Prevention, Hotan Prefecture, China
| | - Shunshi Ji
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Dong Jin
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- *Correspondence: Dong Jin,
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Ko KKK, Chu JJK, Lim KM, Yingtaweesittikul H, Huang W, Tan SYL, Goh KCM, Tan SH, Ng TY, Maiwald M, Chia JWZ, Cao DY, Tan YE, Sim JHC, Koh TH, Nagarajan N, Suphavilai C. Clonal serotype 1c multidrug-resistant Shigella flexneri detected in multiple institutions by sentinel-site sequencing. Front Med (Lausanne) 2022; 9:964640. [PMID: 35979220 PMCID: PMC9376355 DOI: 10.3389/fmed.2022.964640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Accepted: 07/08/2022] [Indexed: 11/18/2022] Open
Abstract
Shigella flexneri is a major diarrhoeal pathogen, and the emergence of multidrug-resistant S. flexneri is of public health concern. We report the detection of a clonal cluster of multidrug-resistant serotype 1c (7a) S. flexneri in Singapore in April 2022. Long-read whole-genome sequence analysis found five S. flexneri isolates to be clonal and harboring the extended-spectrum β-lactamases blaCTX−M−15 and blaTEM−1. The isolates were phenotypically resistant to ceftriaxone and had intermediate susceptibility to ciprofloxacin. The S. flexneri clonal cluster was first detected in a tertiary hospital diagnostic laboratory (sentinel-site), to which the S. flexneri isolates were sent from other hospitals for routine serogrouping. Long-read whole-genome sequence analysis was performed in the sentinel-site near real-time in view of the unusually high number of S. flexneri isolates received within a short time frame. This study demonstrates that near real-time sentinel-site sequence-based surveillance of convenience samples can detect possible clonal outbreak clusters and may provide alerts useful for public health mitigations at the earliest possible opportunity.
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Affiliation(s)
- Karrie K. K. Ko
- Department of Microbiology, Singapore General Hospital, Singapore, Singapore
- Department of Molecular Pathology, Singapore General Hospital, Singapore, Singapore
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
- *Correspondence: Karrie K. K. Ko ;
| | - Joash Jun Keat Chu
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore, Singapore
| | - Kar Mun Lim
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore, Singapore
| | | | - Wenjie Huang
- Department of Microbiology, Singapore General Hospital, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Shireen Yan Ling Tan
- Department of Microbiology, Singapore General Hospital, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Kenneth Choon Meng Goh
- Department of Microbiology, Singapore General Hospital, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Si Huei Tan
- Department of Laboratory Medicine, Changi General Hospital, Singapore, Singapore
| | - Tong Yong Ng
- Department of Pathology, Sengkang General Hospital, Singapore, Singapore
| | - Matthias Maiwald
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
- Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore, Singapore
| | | | | | - Yen Ee Tan
- Department of Microbiology, Singapore General Hospital, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - James Heng Chiak Sim
- Department of Microbiology, Singapore General Hospital, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Tse Hsien Koh
- Department of Microbiology, Singapore General Hospital, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Niranjan Nagarajan
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore, Singapore
| | - Chayaporn Suphavilai
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore, Singapore
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8
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Basak P, Maitra P, Khan U, Saha K, Bhattacharya SS, Dutta M, Bhattacharya S. Capsaicin Inhibits Shigella flexneri Intracellular Growth by Inducing Autophagy. Front Pharmacol 2022; 13:903438. [PMID: 35873583 PMCID: PMC9298657 DOI: 10.3389/fphar.2022.903438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 05/16/2022] [Indexed: 11/13/2022] Open
Abstract
Antibiotic treatment plays an essential role in preventing Shigella infection. However, incidences of global rise in antibiotic resistance create a major challenge to treat bacterial infection. In this context, there is an urgent need for newer approaches to reduce S. flexneri burden. This study largely focuses on the role of the herbal compound capsaicin (Caps) in inhibiting S. flexneri growth and evaluating the molecular mechanism behind bacterial clearance. Here, we show for the first time that Caps inhibits intracellular S. flexneri growth by inducing autophagy. Activation of autophagy by Caps is mediated through transcription factor TFEB, a master regulator of autophagosome biogenesis. Caps induced the nuclear localization of TFEB. Activation of TFEB further induces the gene transcription of autophagosomal genes. Our findings revealed that the inhibition of autophagy by silencing TFEB and Atg5 induces bacterial growth. Hence, Caps-induced autophagy is one of the key factors responsible for bacterial clearance. Moreover, Caps restricted the intracellular proliferation of S. flexneri-resistant strain. The efficacy of Caps in reducing S. flexneri growth was confirmed by an animal model. This study showed for the first time that S. flexneri infection can be inhibited by inducing autophagy. Overall observations suggest that Caps activates TFEB to induce autophagy and thereby combat S. flexneri infection.
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Affiliation(s)
- Priyanka Basak
- Division of Biochemistry, National Institute of Cholera and Enteric Diseases, Kolkata, India
| | - Priyanka Maitra
- Division of Biochemistry, National Institute of Cholera and Enteric Diseases, Kolkata, India
| | - Uzma Khan
- Division of Biochemistry, National Institute of Cholera and Enteric Diseases, Kolkata, India
| | - Kalyani Saha
- Division of Biochemistry, National Institute of Cholera and Enteric Diseases, Kolkata, India
| | | | - Moumita Dutta
- Division of Electron Microscopy, National Institute of Cholera and Enteric Diseases, Kolkata, India
| | - Sushmita Bhattacharya
- Division of Biochemistry, National Institute of Cholera and Enteric Diseases, Kolkata, India
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9
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Khezzani B, Baymakova M, Khechekhouche EA, Ghezal K, Meziou Z, Brahim AB. Incidence rates of dysentery among humans in Lemghaier province, Algeria. Germs 2022; 12:195-202. [PMID: 36504607 PMCID: PMC9719374 DOI: 10.18683/germs.2022.1322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 04/10/2022] [Accepted: 04/12/2022] [Indexed: 12/15/2022]
Abstract
Introduction Dysentery is an infectious clinical syndrome which can cause high morbidity and mortality, especially in developing countries. This research highlights the epidemiological features of dysentery in Lemghaier province, Algeria. Methods A retrospective study of the incidence rates of dysentery in Lemghaier province, Algeria and overall for the whole country for the period from January 2001 to December 2018 was carried out. On a local level data were provided by the Directorate of Health and Population of El-Oued province, Algeria. At the national level data were provided by the National Public Health Institute, Algeria. Results An overall number of 1,786 cases of dysentery were notified, with an incidence rate of 58.5 cases per 100,000 population (mean±SD: 58.54±47.20; 95% CI: 36.73-80.35). The high incidence rate was reported in autumn and summer, respectively, with 23.4 and 20.1 cases per 100,000 population. The high incidence rate observed in the persons aged 20-44 years with 76.4 cases per 100,000 population. Females were more likely to have dysentery than males, respectively, with 63.6 against 53.7 cases per 100,000 population. The highest incidence rate was reported in Lemghaier municipality (capital of the province) with 176.9 cases per 100,000 population. Conclusions The results from this research showed high incidence rates of dysentery in Lemghaier province, Algeria. Тhis fact is a serious reason for national public health organizations to take adequate and timely measures to reduce the incidence rates of dysentery in this part of the country.
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Affiliation(s)
- Bachir Khezzani
- PhD, Faculty of Natural Sciences, El-Oued University, P.O. Box: 789, El-Oued, Algeria and Laboratory of Biology, Environment and Health, Faculty of Natural Sciences, El-Oued University, P.O. Box: 789, El-Oued, Algeria
| | - Magdalena Baymakova
- MD, PhD, Department of Infectious Diseases, Military Medical Academy, P.O. Box: 1606, Sofia, Bulgaria,Corresponding author: Magdalena Baymakova,
| | - El Amine Khechekhouche
- PhD, Faculty of Natural Sciences, El-Oued University, P.O. Box: 789, El-Oued, Algeria and Laboratory of Biology, Environment and Health, Faculty of Natural Sciences, El-Oued University, P.O. Box: 789, El-Oued, Algeria
| | - Khadidja Ghezal
- MSc Student, Faculty of Natural Sciences, El-Oued University, P.O. Box: 789, El-Oued, Algeria, and Laboratory of Biology, Environment and Health, Faculty of Natural Sciences, El-Oued University, P.O. Box: 789, El-Oued, Algeria
| | - Zineb Meziou
- MSc Student, Faculty of Natural Sciences, El-Oued University, P.O. Box: 789, El-Oued, Algeria and Laboratory of Biology, Environment and Health, Faculty of Natural Sciences, El-Oued University, P.O. Box: 789, El-Oued, Algeria
| | - Aida Bousbia Brahim
- PhD Student, Faculty of Natural Sciences, El-Oued University, P.O. Box: 789, El-Oued, Algeria and Laboratory of Biology, Environment and Health, Faculty of Natural Sciences, El-Oued University, P.O. Box: 789, El-Oued, Algeria
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Gharpure R, Friedman CR, Fialkowski V, Collins JP, Strysko J, Marsh ZA, Chen JC, Meservey EH, Adediran AA, Schroeder MN, Wadhwa A, Fullerton KE, Francois Watkins L. Azithromycin and Ciprofloxacin Treatment Outcomes During an Outbreak of Multidrug-Resistant Shigella sonnei Infections in a Retirement Community-Vermont, 2018. Clin Infect Dis 2022; 74:455-460. [PMID: 33993224 PMCID: PMC8963682 DOI: 10.1093/cid/ciab450] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND In 2018, the Centers for Disease Control and Prevention and the Vermont Department of Health investigated an outbreak of multidrug-resistant Shigella sonnei infections in a retirement community that offered a continuum of care from independent living through skilled nursing care. The investigation identified 24 culture-confirmed cases. Isolates were resistant to trimethoprim-sulfamethoxazole, ampicillin, and ceftriaxone, and had decreased susceptibility to azithromycin and ciprofloxacin. METHODS To evaluate clinical and microbiologic response, we reviewed inpatient and outpatient medical records for treatment outcomes among the 24 patients with culture-confirmed S. sonnei infection. We defined clinical failure as diarrhea (≥3 loose stools per day) for ≥1 day after treatment finished, and microbiologic failure as a stool culture that yielded S. sonnei after treatment finished. We used broth microdilution to perform antimicrobial susceptibility testing, and whole genome sequencing to identify resistance mechanisms. RESULTS Isolates contained macrolide resistance genes mph(A) and erm(B) and had azithromycin minimum inhibitory concentrations above the Clinical and Laboratory Standards Institute epidemiological cutoff value of ≤16 µg/mL. Among 24 patients with culture-confirmed Shigella infection, 4 were treated with azithromycin; all had clinical treatment failure and 2 also had microbiologic treatment failure. Isolates were susceptible to ciprofloxacin but contained a gyrA mutation; 2 patients failed treatment with ciprofloxacin. CONCLUSIONS These azithromycin treatment failures demonstrate the importance of clinical breakpoints to aid clinicians in identifying alternative treatment options for resistant strains. Additionally, these treatment failures highlight a need for comprehensive susceptibility testing and systematic outcome studies, particularly given the emergence of multidrug-resistant Shigella among an expanding range of patient populations.
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Affiliation(s)
- Radhika Gharpure
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA;,Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Cindy R. Friedman
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Jennifer P. Collins
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA;,Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jonathan Strysko
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA;,Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Zachary A. Marsh
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jessica C. Chen
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Azizat A. Adediran
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Morgan N. Schroeder
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Ashutosh Wadhwa
- Division of Healthcare Quality and Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA;,Laboratory Leadership Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Kathleen E. Fullerton
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Louise Francois Watkins
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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11
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Chang Q, Wang K, Zhang H, Li C, Wang Y, Jing H, Li S, Guo Y, Cui Z, Zhang W. Effects of daily mean temperature and other meteorological variables on bacillary dysentery in Beijing-Tianjin-Hebei region, China. Environ Health Prev Med 2022; 27:13. [PMID: 35314583 PMCID: PMC9251629 DOI: 10.1265/ehpm.21-00005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Background Although previous studies have shown that meteorological factors such as temperature are related to the incidence of bacillary dysentery (BD), researches about the non-linear and interaction effect among meteorological variables remain limited. The objective of this study was to analyze the effects of temperature and other meteorological variables on BD in Beijing-Tianjin-Hebei region, which is a high-risk area for BD distribution. Methods Our study was based on the daily-scale data of BD cases and meteorological variables from 2014 to 2019, using generalized additive model (GAM) to explore the relationship between meteorological variables and BD cases and distributed lag non-linear model (DLNM) to analyze the lag and cumulative effects. The interaction effects and stratified analysis were developed by the GAM. Results A total of 147,001 cases were reported from 2014 to 2019. The relationship between temperature and BD was approximately liner above 0 °C, but the turning point of total temperature effect was 10 °C. Results of DLNM indicated that the effect of high temperature was significant on lag 5d and lag 6d, and the lag effect showed that each 5 °C rise caused a 3% [Relative risk (RR) = 1.03, 95% Confidence interval (CI): 1.02–1.05] increase in BD cases. The cumulative BD cases delayed by 7 days increased by 31% for each 5 °C rise in temperature above 10 °C (RR = 1.31, 95% CI: 1.30–1.33). The interaction effects and stratified analysis manifested that the incidence of BD was highest in hot and humid climates. Conclusions This study suggests that temperature can significantly affect the incidence of BD, and its effect can be enhanced by humidity and precipitation, which means that the hot and humid environment positively increases the incidence of BD. Supplementary information The online version contains supplementary material available at https://doi.org/10.1265/ehpm.21-00005.
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Affiliation(s)
- Qinxue Chang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University
| | - Keyun Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University
| | - Honglu Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University
| | - Changping Li
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University
| | - Yong Wang
- Chinese PLA Center for Disease Control and Prevention
| | - Huaiqi Jing
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University
| | - Zhuang Cui
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University
| | - Wenyi Zhang
- Chinese PLA Center for Disease Control and Prevention
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12
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Safety and Immunogenicity of a Shigella Bivalent Conjugate Vaccine (ZF0901) in 3-Month- to 5-Year-Old Children in China. Vaccines (Basel) 2021; 10:vaccines10010033. [PMID: 35062694 PMCID: PMC8780113 DOI: 10.3390/vaccines10010033] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 12/01/2021] [Accepted: 12/03/2021] [Indexed: 01/09/2023] Open
Abstract
No licensed Shigella vaccine is presently available globally. A double-blinded, randomized, placebo-controlled, age descending phase II clinical trial of a bivalent conjugate vaccine was studied in China. The vaccine ZF0901 consisted of O-specific polysaccharides purified and detoxified from lipopolysaccharide (LPS) of S. flexneri 2a and S. sonnei and covalently bonded to tetanus toxoid. A total of 224, 310, and 434 children, consented by parents or guardians, aged 3 to 6 and 6 to 12 months and 1 to 5 years old, respectively, were injected with half or full doses, with or without adjuvant or control Hib vaccine. There were no serious adverse reactions in all recipients of ZF0901 vaccine independent of age, dosage, number of injections, or the adjuvant status. Thirty days after the last injection, ZF0901 induced robust immune responses with significantly higher levels of type-specific serum antibodies (geometric mean concentrations (GMCs) of IgG anti-LPS) against both serotypes in all age groups compared with the pre-immune or the Hib control (p < 0.0001). Here, we demonstrated that ZF0901 bivalent Shigella conjugate vaccine is safe and immunogenic in infants and young children and is likely suitable for routine immunization.
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13
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Li S, Ji S, Zhu X, Chen H, Jin D. Development of a loop-mediated isothermal amplification assay for molecular serotyping of Shigella flexneri Serotypes 2 and Xv. J Appl Microbiol 2021; 132:2980-2989. [PMID: 34822198 DOI: 10.1111/jam.15383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 11/21/2021] [Accepted: 11/22/2021] [Indexed: 11/29/2022]
Abstract
AIMS This study developed and evaluated a loop-mediated isothermal amplification (LAMP) assay to simply, rapidly and accurately identify Shigella flexneri serotypes 2 and Xv. METHODS AND RESULTS The LAMP assay based on the O-antigen synthesis and modification genes of S. flexneri including gtrII, gtrX, opt and wzx was developed. Its specificity and sensitivity were evaluated with 19 serotypes of S. flexneri and 96 other Shigella species and bacterial pathogens commonly found in stool samples. This LAMP assay was completed within 20 min at 61°C and could detect boiled DNA samples at concentrations as low as 1 pg/μl. The S. flexneri serotype LAMP assay exhibited 100% specificity for detecting 19 S. flexneri serotypes, no 96 strains of Shigella spp. and other bacterial pathogens. This LAMP assay was used to identify S. flexneri serotypes 2 and Xv from 299 S. flexneri strains isolated in China and results were consistent with that of slide agglutination and multiplex polymerase chain reaction results for the same isolates. CONCLUSIONS This LAMP assay may facilitate rapid and reliable identifying S. flexneri serotypes 2 and Xv. SIGNIFICANCE AND IMPACT OF STUDY The present study was the first LAMP method for identifying serotypes of S. flexneri.
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Affiliation(s)
- Sha Li
- Central & Clinical Laboratory of Sanya People's Hospital, Sanya People's Hospital, Hainan, China
| | - Shunshi Ji
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiong Zhu
- Central & Clinical Laboratory of Sanya People's Hospital, Sanya People's Hospital, Hainan, China
| | - Hai Chen
- Central & Clinical Laboratory of Sanya People's Hospital, Sanya People's Hospital, Hainan, China
| | - Dong Jin
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, China.,Shanghai Institute for Emerging and Re-emerging Infectious Diseases, Shanghai Public Health Clinical Center, Shanghai, China
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14
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Wang L, Xu C, Xiao G, Qiao J, Zhang C. Spatial heterogeneity of bacillary dysentery and the impact of temperature in the Beijing-Tianjin-Hebei region of China. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2021; 65:1919-1927. [PMID: 34050434 DOI: 10.1007/s00484-021-02148-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 12/29/2020] [Accepted: 05/15/2021] [Indexed: 06/12/2023]
Abstract
Previous studies indicate that the incidence of bacillary dysentery is closely related to meteorological factors. However, the impact of temperature and the spatial heterogeneity of the disease in regions of unbalanced socioeconomic development remains unclear. Therefore, this research collected data for 29,639 daily bacillary dysentery cases in children under 5 years of age, as well as the meteorological variables from China's Beijing-Tianjin-Hebei region, to analyze the spatial pattern of bacillary dysentery and reveal its nonlinear association with temperature. The SatScan method was employed first, to detect the spatial heterogeneity of the disease risk, and then the distributed lag nonlinear model (DLNM) was used to analyze the relationships between the daily minimum, mean, and maximum temperatures and bacillary dysentery in the stratified heterogeneous regions. The results indicated that bacillary dysentery incidence presented statistically significant spatial heterogeneity. The area of highest risk was found to be Beijing and its neighboring regions, which have high population densities. There was also a positive association between bacillary dysentery and temperature. Hotter temperatures were accompanied by higher relative risks. In the most likely spatial cluster region, the excess risk (ER) values for a 1°C rise in minimum, mean, and maximum temperatures above the median were 4.65%, 11.30%, and 19.21%, respectively. The effect of temperature on bacillary dysentery peaked at a lag of 3 to 4 days. The findings of this study will aid risk assessments and early warning systems for bacillary dysentery.
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Affiliation(s)
- Li Wang
- College of Environment and Planning, Henan University, Kaifeng, 475001, China
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Science and Natural Resource Research, Chinese Academy of Sciences, Beijing, 100101, China
- Key Laboratory of Geospatial Technology for the Middle and Lower Yellow River Regions (Henan University), Ministry of Education, Kaifeng, 475001, China
| | - Chengdong Xu
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Science and Natural Resource Research, Chinese Academy of Sciences, Beijing, 100101, China
- University of Chinese Academy of Sciences, Beijing, 100049, China
| | - Gexin Xiao
- National Institute of Hospital Administration, Beijing, 100044, China.
| | - Jiajun Qiao
- College of Environment and Planning, Henan University, Kaifeng, 475001, China
| | - Chaozheng Zhang
- China National Center for Food Safety Risk Assessment, Beijing, 100022, China
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15
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Peer V, Schwartz N, Green MS. Sex differences in shigellosis incidence rates: analysis of national data from nine countries using meta-analytic method. Eur J Public Health 2021; 30:974-981. [PMID: 32535632 DOI: 10.1093/eurpub/ckaa087] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Sex differences in the incidence of infectious diseases can provide insight to the biological mechanism of infection, disease susceptibility, severity and vaccine development. The consistency of age-specific sex differences in the incidence rates (IRs) of shigellosis is unclear. METHODS National data on cases of shigellosis by sex, age group and calendar year were obtained from nine countries, for a period of 6-25 years. The male to female incidence rate ratios (RR) were calculated by country, years and age group. For each age group, meta-analytic methods were used for computing pooled incidence RRs by country and years. Meta-regression was performed to estimate the contribution of age, country and time period to the differences in the male : female RRs. RESULTS In the age groups <1, 1-4, 5-9 and 10-14, there were excess IRs in males. The pooled incidence RRs (with 95% CI) were 1.21 (1.14-1.28), 1.17 (1.12-1.22), 1.04 (1.00-1.09) and 1.09 (1.01-1.18), respectively. In young adults, there was excess IR in females with RR = 0.80 (0.72-0.9). In middle aged and older adults, there was a slight excess in males with RR = 1.01 (0.89-1.15) and RR = 1.18 (1.09-1.28), respectively. In the meta-regression, age was the only variable that significantly contributed to the variation in the RRs. CONCLUSIONS The higher IRs in male infants and young children does not appear to be related to behavioral factors and genetic and hormonal factors could be important. In the older age groups, the higher rates in adult females may be due to behavioral factors.
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Affiliation(s)
- Victoria Peer
- School of Public Health, University of Haifa, Haifa, Israel
| | - Naama Schwartz
- School of Public Health, University of Haifa, Haifa, Israel
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16
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Taneja N, Tiewsoh JBA, Gupta S, Mohan B, Verma R, Shankar P, Narayan C, Yadav VK, Jayashree M, Singh S. Antimicrobial resistance in Shigella species: Our five years (2015-2019) experience in a tertiary care center in north India. Indian J Med Microbiol 2021; 39:489-494. [PMID: 34148675 DOI: 10.1016/j.ijmmb.2021.06.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 06/02/2021] [Accepted: 06/04/2021] [Indexed: 11/19/2022]
Abstract
PURPOSE Shigella is the second leading cause of diarrhoeal mortality especially in children <5 years of age in African and Asian countries. Rapid changes are occurring in the epidemiology of shigellosis and Shigella are increasingly becoming highly drug resistant. To determine the serogroup distribution and antimicrobial resistance of Shigella isolated at our tertiary care centre in North India. METHODS A retrospective study was conducted where demographic details along with antimicrobial susceptibility data of Shigella isolated from stool specimens from 1st January 2015 till 31st December 2019 were retrieved from records and analyzed by WHONET 2019 software. RESULTS Shigella species was isolated in 1.31% (n = 137) of a total of 10,456 stool samples. Males predominated (n = 82; 59.8%) and majority of cases were admitted (n = 94; 68.6%). Children ≤5 years of age (n = 47; 34.3%) were the most commonly affected. Adults in the 21-40 age group contributed 27% of cases (n = 37). Overall, Shigella flexneri (n = 87; 63.5%) was the most common serogroup followed by non-agglutinable Shigella (n = 28; 20.4%) while Shigella sonnei (n = 12, 8.8%) and Shigella boydii (n = 9, 6.6%) fluctuated over the years. Shigella dysenteriae reappeared in 2019 after a hiatus of ten years. Overall, 45.3% (n = 62) of isolates were multidrug resistant to CLSI recommended drugs and high resistance was noted for ampicillin/amoxicillin (68.1%), cotrimoxazole (75.8%) ciprofloxacin (61.5%) and ceftriaxone/cefotaxime (45.2%). CONCLUSIONS Shigella have become highly drug resistant to fluoroquinolones and cephalosporins. Community based studies are required to truly assess the burden of AMR in India.
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Affiliation(s)
- Neelam Taneja
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, 160012, India.
| | - Jutang Babat Ain Tiewsoh
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, 160012, India.
| | - Swati Gupta
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, 160012, India.
| | - Balvinder Mohan
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, 160012, India.
| | - Ritu Verma
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, 160012, India.
| | - Pinky Shankar
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, 160012, India.
| | - Chandradeo Narayan
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, 160012, India.
| | - Vivek Kumar Yadav
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, 160012, India.
| | - Muralidharan Jayashree
- Division of Pediatric Emergency and Intensive Care, Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, 160012, India.
| | - Surjit Singh
- Division of Pediatric Allergy & Immunology, Head of Department, Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education and Research, 160012, India.
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17
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Zhao Z, Chen Q, Wang Y, Chu M, Hu Q, Hannah MN, Rui J, Liu X, Yu Y, Zhao F, Ren Z, Yu S, An R, Pan L, Chiang YC, Zhao B, Su Y, Zhao B, Chen T. Relative transmissibility of shigellosis among different age groups: A modeling study in Hubei Province, China. PLoS Negl Trop Dis 2021; 15:e0009501. [PMID: 34111124 PMCID: PMC8219151 DOI: 10.1371/journal.pntd.0009501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 06/22/2021] [Accepted: 05/24/2021] [Indexed: 11/24/2022] Open
Abstract
Shigellosis is a heavy disease burden in China especially in children aged under 5 years. However, the age-related factors involved in transmission of shigellosis are unclear. An age-specific Susceptible-Exposed-Infectious/Asymptomatic-Recovered (SEIAR) model was applied to shigellosis surveillance data maintained by Hubei Province Centers for Disease Control and Prevention from 2005 to 2017. The individuals were divided into four age groups (≤ 5 years, 6-24 years, 25-59 years, and ≥ 60 years). The effective reproduction number (Reff), including infectivity (RI) and susceptibility (RS) was calculated to assess the transmissibility of different age groups. From 2005 to 2017, 130,768 shigellosis cases were reported in Hubei Province. The SEIAR model fitted well with the reported data (P < 0.001). The highest transmissibility (Reff) was from ≤ 5 years to the 25-59 years (mean: 0.76, 95% confidence interval [CI]: 0.34-1.17), followed by from the 6-24 years to the 25-59 years (mean: 0.69, 95% CI: 0.35-1.02), from the ≥ 60 years to the 25-59 years (mean: 0.58, 95% CI: 0.29-0.86), and from the 25-59 years to 25-59 years (mean: 0.50, 95% CI: 0.21-0.78). The highest infectivity was in ≤ 5 years (RI = 1.71), and was most commonly transmitted to the 25-59 years (45.11%). The highest susceptibility was in the 25-59 years (RS = 2.51), and their most common source was the ≤ 5 years (30.15%). Furthermore, "knock out" simulation predicted the greatest reduction in the number of cases occurred by when cutting off transmission routes among ≤ 5 years and from 25-59 years to ≤ 5 years. Transmission in ≤ 5 years occurred mainly within the group, but infections were most commonly introduced by individuals in the 25-59 years. Infectivity was highest in the ≤ 5 years and susceptibility was highest in the 25-59 years. Interventions to stop transmission should be directed at these age groups.
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Affiliation(s)
- Zeyu Zhao
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, 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
| | - Yao Wang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, People’s Republic of China
| | - Meijie Chu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, People’s Republic of China
| | - Qingqing Hu
- Division of Public Health, School of Medicine, University of Utah, Presidents Circle, Salt Lake City, Utah, United States of America
| | - Mikah Ngwanguong Hannah
- Medical College, Xiamen University, Xiamen City, Fujian Province, People’s Republic of China
| | - Jia Rui
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, 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, Xiamen City, Fujian Province, People’s Republic of China
| | - Yunhan Yu
- School of Statistics, Beijing Normal University, Beijing City, People’s Republic of China
| | - Fuwei Zhao
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, People’s Republic of China
| | - Zhengyun Ren
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, 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, Xiamen City, Fujian Province, People’s Republic of China
| | - Ran An
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, People’s Republic of China
| | - Lili Pan
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, 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, 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, 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, Xiamen City, Fujian Province, People’s Republic of China
| | - Bin Zhao
- Medical Insurance Office, Xiang’an Hospital of Xiamen University, 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, Xiamen City, Fujian Province, People’s Republic of China
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18
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Wang S, Liu Z, Tong M, Xiang J, Zhang Y, Gao Q, Zhang Y, Lu L, Jiang B, Bi P. Real-time forecasting and early warning of bacillary dysentery activity in four meteorological and geographic divisions in China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 761:144093. [PMID: 33360132 DOI: 10.1016/j.scitotenv.2020.144093] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 11/08/2020] [Accepted: 11/20/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Accurate and timely forecasts of bacillary dysentery (BD) incidence can be used to inform public health decision-making and response preparedness. However, our ability to detect BD dynamics and outbreaks remains limited in China. OBJECTIVES This study aims to explore the impacts of meteorological factors on BD transmission in four representative regions in China and to forecast weekly number of BD cases and outbreaks. METHODS Weekly BD and meteorological data from 2014 to 2016 were collected for Beijing (Northern China), Shenyang (Northeast China), Chongqing (Southwest China) and Shenzhen (Southern China). A boosted regression tree (BRT) model was conducted to assess the impacts of meteorological factors on BD transmission. Then a real-time forecast and early warning model based on BRT was developed to track the dynamics of BD and detect the outbreaks. The forecasting methodology was compared with generalized additive model (GAM) and seasonal autoregressive integrated moving average model (SARIMA) that have been used to model the BD case data previously. RESULTS Ambient temperature was the most important meteorological factor contributing to the transmission of BD (80.81%-92.60%). A positive effect of temperature was observed when weekly mean temperature exceeded 4 °C, -3 °C, 9 °C and 16 °C in Beijing (Northern China), Shenyang (Northeast China), Chongqing (Southwest China) and Shenzhen (Southern China), respectively. BD incidence (Beijing and Shenyang) in temperate cities was more sensitive to high temperature than that in subtropical cities (Chongqing and Shenzhen). The dynamics and outbreaks of BD can be accurately forecasted and detected by the BRT model. Compared to GAM and SARIMA, BRT model showed more accurate forecasting for 1-, 2-, 3-weeks ahead forecasts in Beijing, Shenyang and Shenzhen. CONCLUSIONS Temperature plays the most important role in weather-attributable BD transmission. The BRT model achieved a better performance in comparison with GAM and SARIMA in most study cities, which could be used as a more accurate tool for forecasting and outbreak alert of BD in China.
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Affiliation(s)
- Shuzi Wang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China; Shandong University Climate Change and Health Center, Jinan 250012, Shandong, China
| | - Zhidong Liu
- Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China; Shandong University Climate Change and Health Center, Jinan 250012, Shandong, China
| | - Michael Tong
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Jianjun Xiang
- School of Public Health, Fujian Medical University, Fuzhou 350121, Fujian, China; School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Ying Zhang
- School of Public Health, China Studies Centre, The University of Sydney, New South Wales, Australia
| | - Qi Gao
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China; Shandong University Climate Change and Health Center, Jinan 250012, Shandong, China
| | - Yiwen Zhang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China; Shandong University Climate Change and Health Center, Jinan 250012, Shandong, China
| | - Liang Lu
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China; Shandong University Climate Change and Health Center, Jinan 250012, Shandong, China
| | - Baofa Jiang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China; Shandong University Climate Change and Health Center, Jinan 250012, Shandong, China.
| | - Peng Bi
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
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Zhang X, Gu X, Wang L, Zhou Y, Huang Z, Xu C, Cheng C. Spatiotemporal variations in the incidence of bacillary dysentery and long-term effects associated with meteorological and socioeconomic factors in China from 2013 to 2017. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 755:142626. [PMID: 33039932 DOI: 10.1016/j.scitotenv.2020.142626] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 09/23/2020] [Accepted: 09/23/2020] [Indexed: 06/11/2023]
Abstract
Bacillary dysentery is a global public health problem that exhibits manifest spatiotemporal heterogeneity. However, long-term variations and regional determinant factors remain unclear. In this study, the Bayesian space-time hierarchy model was used to identify the long-term spatiotemporal heterogeneity of the incidence of bacillary dysentery and quantify the associations of meteorological factors with the incidence of bacillary dysentery in northern and southern China from 2013 to 2017. GeoDetector was used to quantify the determinant powers of socioeconomic factors in the two regions. The results showed that the incidence of bacillary dysentery peaked in summer (June to August), indicating temporal seasonality. Geographically, the hot spots (high-risk areas) were distributed in northwestern China (Xinjiang, Gansu, and Ningxia) and northern China (including Beijing, Tianjin, and Hebei), whereas the cold spots (low-risk areas) were concentrated in southeastern China (Jiangsu, Zhejiang, Fujian, and Guangdong). Moreover, significant regional differences were found among the meteorological and socioeconomic factors. Average temperature was the dominant meteorological factor in both northern and southern China. In northern and southern China, a 1 °C increase in the average temperature led to an increase of 1.01% and 4.26% in bacillary dysentery risk, respectively. The dominant socioeconomic factors in northern and southern China were per capita gross domestic product and the number of health technicians, with q statistic values of 0.81 and 0.49, respectively. These findings suggest that hot, moist, and overcrowded environments or poor health conditions increase the risk of bacillary dysentery. This study provides suggestions and serves as a basis for surveillance efforts. Further, the suggestions may aid in the control of bacillary dysentery and in the implementation of disease prevention policies.
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Affiliation(s)
- Xiangxue Zhang
- State Key Laboratory of Earth Surface Processes and Resource Ecology, Beijing Normal University, Beijing 100875, China; Faculty of Geographical Science, Beijing Normal University, Beijing 100875, China; State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China
| | - Xinchen Gu
- College of Water & Architectural Engineering, Shihezi University, Shihezi 832003, China
| | - Li Wang
- College of Environment and Planning, Henan University, KaiFeng 475001, China; Key Laboratory of Geospatial Technology for the Middle and Lower Yellow River Regions (Henan University), Ministry of Education, KaiFeng 475001, China
| | - Yuke Zhou
- Key Laboratory of Ecosystem Network Observation and Modeling, Institute of Geographic Sciences and Nature Resources Research, Chinese Academy of Sciences, Beijing 100101, China
| | - Zhentao Huang
- College of Oceanography and Space Informatics, China University of Petroleum, Qingdao 266580, China
| | - Chengdong Xu
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China.
| | - Changxiu Cheng
- State Key Laboratory of Earth Surface Processes and Resource Ecology, Beijing Normal University, Beijing 100875, China; Faculty of Geographical Science, Beijing Normal University, Beijing 100875, China.
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20
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Association of Serotype With Antimicrobial Resistance Patterns Among Shigella flexneri Isolates From Pakistan: The Importance of Serotype 2b. Pediatr Infect Dis J 2020; 39:e352-e358. [PMID: 33021590 DOI: 10.1097/inf.0000000000002791] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Shigella flexneri is an emerging threat in low socioeconomic countries including Pakistan. No previous data is available on the association between S. flexneri serotypes and antimicrobial resistance in Pakistan. OBJECTIVES The objective of the present study was to assess the association between serotypes and antimicrobial resistance patterns among S. flexneri isolated from clinical and nonclinical samples. METHODS A total of 199 S. flexneri isolates were subjected to molecular serotyping and antibiotic resistance. RESULTS The most prevalent S. flexneri serotype was 2b (38%) followed by 1b (24%), 7a (20%), 2a (11%), 1d (5%) and Y (2%). The phylogenetic reconstruction showed 12 clades among which the clades II, III, V, VIII, IX and XI have consisted of serotypes that were found both in human population and environment samples. A high level of multidrug resistance (MDR) was observed in serotype 2b (37.68%) followed by 1b (19.5%) and 7a (19.5%), 2a (11.5%), 1d (5%) and Y (2%). All isolates of serotype 2b showed high level of resistance to amoxicillin/clavulanic acid (100%) followed by quinolone (74.6%) and trimethoprim-sulfamethoxazole (54.6%). Interestingly, none of the serotype was resistant to piperacillin-tazobactam, imipenem and amikacin. The most frequently detected resistance genes among serotype 2b were blaOXA (100%) followed by qnrS (88%), cat (81%) and sul2 (63%). CONCLUSION The most frequent S. flexneri serotype was 2b while 1d and Y was first time reported in Pakistan. High frequency of MDR serotypes of S. flexneri is a serious threat in diarrhea endemic regions and thus require urgent strategies for its continuous monitoring and prevention.
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Liu Y, Shen W, Sun Y, Lv N, Sun K, Hu L, Ye Y, Gao Y, Li J. Virulence-Related Gene Distribution Among Shigella Isolates in Anhui, China: The Association with Antimicrobial Resistance. Infect Drug Resist 2020; 13:3637-3647. [PMID: 33116683 PMCID: PMC7585282 DOI: 10.2147/idr.s274862] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 09/26/2020] [Indexed: 12/27/2022] Open
Abstract
Objective The aim of this study was to investigate the antimicrobial resistance profiles and distribution of virulence-related genes (VRGs) among Shigella isolates in Anhui, China, and to identify the correlation between the VRGs and antimicrobial resistance. Materials and Methods A total of 525 non-duplicate Shigella isolates (449 S. flexneri, 68 S. sonnei, 3 S. boydii, and 5 S. dysenteriae) were collected in Anhui Province, China between September 2011 and September 2015. The antimicrobial resistance of the strains was determined by the agar dilution method according to CLSI guidelines. The presence of 16 VRGs, including ipaH, ipaA-D, ial, virB, virF, set, sen, icsA, icsB, sigA, sat, pic, and sepA, was evaluated using PCR amplification and sequencing. Results Shigella flexneri was the most abundant (85.5%), followed by S. sonnei (13.0%). The proportion of males with S. flexneri was higher than that of females (57% vs 43%; P<0.0001). The most common resistance pattern was the combination of ampicillin, nalidixic acid, and tetracycline for S. flexneri (90.2%) and S. sonnei (94.1%). Resistance to ciprofloxacin and levofloxacin was more common among S. flexneri than among S. sonnei (49.7% vs.19.1%, P<0.0001; 30.5% vs 10.3%, P=0.001, respectively). All the isolates were positive for the ipaH gene, while the set, sat, pic, and sepA genes were not detected among the S. sonnei isolates. Except for sigA and sen, resistance to chloramphenicol and ciprofloxacin was more common among VRG-positive S. flexneri than among VRG-negative S. flexneri (P<0.05). Furthermore, resistance to ceftriaxone and ceftazidime was more frequently detected among sat- and set-positive S. flexneri than among sat- and set-negative S. flexneri (P<0.05). However, gentamicin resistance was more prevalent among VRG-negative (ial, virF, set, sat, pic, and sepA) S. flexneri than among VRG-positive S. flexneri (P<0.05). Conclusion Shigella flexneri remains the predominant species in Anhui, China, and the resistance to fluoroquinolones was more widespread among S. flexneri than among S. sonnei. Shigella flexneri strains harboring specific VRGs were associated with antimicrobial resistance. To the best of our knowledge, this is the first report of the correlation between the VRGs and antimicrobial resistance in Anhui, China.
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Affiliation(s)
- Yanyan Liu
- Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China.,Anhui Center for Surveillance of Bacterial Resistance, Hefei, Anhui, People's Republic of China.,Institute of Bacterial Resistance, Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Weihua Shen
- Department of Special Clinic, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Yating Sun
- Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Na Lv
- Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Kaili Sun
- Department of Infectious Diseases, The Chaohu Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Lifen Hu
- Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Ying Ye
- Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China.,Anhui Center for Surveillance of Bacterial Resistance, Hefei, Anhui, People's Republic of China.,Institute of Bacterial Resistance, Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Yufeng Gao
- Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China.,Anhui Center for Surveillance of Bacterial Resistance, Hefei, Anhui, People's Republic of China.,Institute of Bacterial Resistance, Anhui Medical University, Hefei, Anhui, People's Republic of China
| | - Jiabin Li
- Department of Infectious Diseases, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China.,Anhui Center for Surveillance of Bacterial Resistance, Hefei, Anhui, People's Republic of China.,Institute of Bacterial Resistance, Anhui Medical University, Hefei, Anhui, People's Republic of China.,Department of Infectious Diseases, The Chaohu Affiliated Hospital of Anhui Medical University, Hefei, Anhui, People's Republic of China
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Shigella sonnei: virulence and antibiotic resistance. Arch Microbiol 2020; 203:45-58. [PMID: 32929595 PMCID: PMC7489455 DOI: 10.1007/s00203-020-02034-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 08/27/2020] [Accepted: 09/02/2020] [Indexed: 12/21/2022]
Abstract
Shigella sonnei is the emerging pathogen globally, as it is the second common infectious species of shigellosis (bloody diarrhoea) in low- and middle-income countries (LMICs) and the leading one in developed world. The multifactorial processes and novel mechanisms have been identified in S. sonnei, that are collectively playing apart a substantial role in increasing its prevalence, while replacing the S. flexneri and other Gram-negative gut pathogens niche occupancy. Recently, studies suggest that due to improvement in sanitation S. sonnei has reduced cross-immunization from Plesiomonas shigelliodes (having same O-antigen as S. sonnei) and also found to outcompete the two major species of Enterobacteriaceae family (Shigella flexneri and Escherichia coli), due to encoding of type VI secretion system (T6SS). This review aimed to highlight S. sonnei as an emerging pathogen in the light of recent research with pondering aspects on its epidemiology, transmission, and pathogenic mechanisms. Additionally, this paper aimed to review S. sonnei disease pattern and related complications, symptoms, and laboratory diagnostic techniques. Furthermore, the available treatment reigns and antibiotic-resistance patterns of S. sonnei are also discussed, as the ciprofloxacin and fluoroquinolone-resistant S. sonnei has already intensified the global spread and burden of antimicrobial resistance. In last, prevention and controlling strategies are briefed to limit and tackle S. sonnei and possible future areas are also explored that needed more research to unravel the hidden mysteries surrounding S. sonnei.
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Darton TC, Thi Hong Chau T, Parry CM, Campbell JI, Minh Ngoc N, Le Chau Ngoc T, Thanh Tuyen H, Thuy Duong V, Thanh Hoang Nhat L, van Minh P, Kestelyn E, Thwaites GE, Huu Tung T, Baker S. The CIPAZ study protocol: an open label randomised controlled trial of azithromycin versus ciprofloxacin for the treatment of children hospitalised with dysentery in Ho Chi Minh City, Vietnam. Wellcome Open Res 2020. [DOI: 10.12688/wellcomeopenres.16093.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Diarrhoeal disease remains a common cause of illness and death in children <5 years of age. Faecal-oral infection by Shigella spp. causing bacillary dysentery is a leading cause of moderate-to-severe diarrhoea, particularly in low and middle-income countries. In Southeast Asia, S. sonnei predominates and infections are frequently resistant to first-line treatment with the fluoroquinolone, ciprofloxacin. While resistance to all antimicrobials is increasing, there may be theoretical and clinical benefits to prioritizing treatment of bacillary dysentery with the azalide, azithromycin. In this study we aim to measure the efficacy of treatment with azithromycin compared with ciprofloxacin, the current standard of care, for the treatment of children with bacillary dysentery. Methods and analysis: We will perform a multicentre, open-label, randomized controlled trial of two therapeutic options for the antimicrobial treatment of children hospitalised with dysentery. Children (6–60 months of age) presenting with symptoms and signs of dysentery at Children’s Hospital 2 in Ho Chi Minh City will be randomised (1:1) to treatment with either oral ciprofloxacin (15mg/kg/twice daily for 3 days, standard-of-care) or oral azithromycin (10mg/kg/daily for 3 days). The primary endpoint will be the proportion of treatment failure (defined by clinical and microbiological parameters) by day 28 (+3 days) and will be compared between study arms by logistic regression modelling using treatment allocation as the main variable. Ethics and dissemination: The study protocol (version 1.2 dated 27th December 2018) has been approved by the Oxford Tropical Research Ethics Committee (47–18) and the ethical review boards of Children's Hospital 2 (1341/NĐ2-CĐT). The study has also been approved by the Vietnamese Ministry of Health (5044/QĐ-BYT). Trial registration: Clinicaltrials.gov: NCT03854929 (February 26th 2019).
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Yu X, Zhang D, Song Q. Profiles of gyrA Mutations and Plasmid-Mediated Quinolone Resistance Genes in Shigella Isolates with Different Levels of Fluoroquinolone Susceptibility. Infect Drug Resist 2020; 13:2285-2290. [PMID: 32765004 PMCID: PMC7367718 DOI: 10.2147/idr.s257877] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 06/25/2020] [Indexed: 11/23/2022] Open
Abstract
Purpose Fluoroquinolone-resistant Shigella is considered a serious public health problem and has been put on the WHO global priority list of antibiotic-resistant bacteria. This study was aimed to investigate the fluoroquinolone resistance in Shigella and its relevant genetic mechanisms. Materials and Methods Shigella isolates that were isolated from diarrheal patient’s feces in Ningbo China from 2011 to 2018 were tested for susceptibility to ampicillin, gentamicin, tetracycline, nalidixic acid, ciprofloxacin, and cefotaxime. Genes related to quinolone resistance were amplified by PCR. Results A total of 118 Shigella isolates were collected, including 76 S. flexneri isolates, 40 S. sonnei isolates, and 2 S. boydii isolates. Ciprofloxacin susceptibility test identified 10 (9%) susceptible, 65 (55%) intermediate, and 43 (36%) resistant isolates. Of 76 S. flexneri isolates, 37 were ciprofloxacin resistant, a prevalence significantly higher than 6 of 40 S. sonnei isolates (P=0.01). The isolates collected during 2014–2018 displayed a significant increase in the prevalence of ciprofloxacin resistance (P=0.05) than those collected during 2011–2013. All the ciprofloxacin-intermediate and resistant isolates had mutations of gyrA(S83L) and parC (S80I), whereas only the ciprofloxacin-resistant isolates had gyrA (D87N) mutation and qnrB gene. Additionally, 30% of the ciprofloxacin-resistant isolates were positive for aac(6´)-Ib-cr gene. Conclusion This study shows the currently increasing prevalence of ciprofloxacin resistance. The reduced fluoroquinolone susceptibility is highly associated with gyrA (S83L) and parC (S80I) mutations, while the fluoroquinolone resistance is highly associated with gyrA (D87N) mutation, qnrB gene and perhaps aac(6´)-Ib-cr gene.
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Affiliation(s)
- Xuxia Yu
- Department of Hospital Infection, Ningbo City First Hospital, Ningbo, Zhejiang Province, People's Republic of China
| | - Danyang Zhang
- Department of Microbiology, Ningbo Municipal Centre for Disease Control and Prevention, Ningbo, Zhejiang Province, People's Republic of China
| | - Qifa Song
- Central Laboratory, Ningbo City First Hospital, Ningbo, Zhejiang Province, People's Republic of China
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Kunstmann S, Engström O, Wehle M, Widmalm G, Santer M, Barbirz S. Increasing the Affinity of an O-Antigen Polysaccharide Binding Site in Shigella flexneri Bacteriophage Sf6 Tailspike Protein. Chemistry 2020; 26:7263-7273. [PMID: 32189378 PMCID: PMC7463171 DOI: 10.1002/chem.202000495] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 03/09/2020] [Indexed: 12/30/2022]
Abstract
Broad and unspecific use of antibiotics accelerates spread of resistances. Sensitive and robust pathogen detection is thus important for a more targeted application. Bacteriophages contain a large repertoire of pathogen-binding proteins. These tailspike proteins (TSP) often bind surface glycans and represent a promising design platform for specific pathogen sensors. We analysed bacteriophage Sf6 TSP that recognizes the O-polysaccharide of dysentery-causing Shigella flexneri to develop variants with increased sensitivity for sensor applications. Ligand polyrhamnose backbone conformations were obtained from 2D 1 H,1 H-trNOESY NMR utilizing methine-methine and methine-methyl correlations. They agreed well with conformations obtained from molecular dynamics (MD), validating the method for further predictions. In a set of mutants, MD predicted ligand flexibilities that were in good correlation with binding strength as confirmed on immobilized S. flexneri O-polysaccharide (PS) with surface plasmon resonance. In silico approaches combined with rapid screening on PS surfaces hence provide valuable strategies for TSP-based pathogen sensor design.
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Affiliation(s)
- Sonja Kunstmann
- Physikalische BiochemieUniversität PotsdamKarl-Liebknecht-Str. 24–2514476PotsdamGermany
- Theory and BiosystemsMax Planck Institute of Colloids and InterfacesAm Mühlenberg 114476PotsdamGermany
- Current address: Department of Biotechnology and BiomedicineTechnical University of DenmarkSøltofts Plads2800 Kgs.LyngbyDenmark
| | - Olof Engström
- Department of Organic ChemistryArrhenius LaboratoryStockholm University10691StockholmSweden
| | - Marko Wehle
- Theory and BiosystemsMax Planck Institute of Colloids and InterfacesAm Mühlenberg 114476PotsdamGermany
| | - Göran Widmalm
- Department of Organic ChemistryArrhenius LaboratoryStockholm University10691StockholmSweden
| | - Mark Santer
- Theory and BiosystemsMax Planck Institute of Colloids and InterfacesAm Mühlenberg 114476PotsdamGermany
| | - Stefanie Barbirz
- Physikalische BiochemieUniversität PotsdamKarl-Liebknecht-Str. 24–2514476PotsdamGermany
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Liu Z, Tong MX, Xiang J, Dear K, Wang C, Ma W, Lu L, Liu Q, Jiang B, Bi P. Daily Temperature and Bacillary Dysentery: Estimated Effects, Attributable Risks, and Future Disease Burden in 316 Chinese Cities. ENVIRONMENTAL HEALTH PERSPECTIVES 2020; 128:57008. [PMID: 32452706 PMCID: PMC7266621 DOI: 10.1289/ehp5779] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 04/29/2020] [Accepted: 05/01/2020] [Indexed: 05/27/2023]
Abstract
BACKGROUND Bacillary dysentery (BD) remains a significant public health issue, especially in developing countries. Evidence assessing the risk of BD from temperature is limited, particularly from national studies including multiple locations with different climatic characteristics. OBJECTIVES We estimated the effect of temperature on BD across China, assessed heterogeneity and attributable risks across cities and regions, and projected the future risk of BD under climate change. METHODS Daily BD surveillance and meteorological data over 2014-2016 were collected from the Chinese Center for Disease Control and Prevention and the China Meteorology Administration, respectively. A two-stage statistical model was used to estimate city-specific temperature-BD relationships that were pooled to derive regional and national estimates. The risk of BD attributable to temperature was estimated, and the future burden of BD attributable to temperature was projected under different climate change scenarios. RESULTS A positive linear relationship for the pooled effect was estimated at the national level. Subgroup analyses indicate that the estimated effect of temperature on BD was similar by age (≤5y or >5y) and gender. At baseline, estimated attributable risks for BD due to average daily mean temperatures above the 50th percentile were highest for the Inner Mongolia (16%), Northeast China (14%), and Northern China (13%). Most of the individual cities in the same regions and most of the cities in the Northwest, Southern, and Southwest regions, had high attributable risks (≥5%). The Northern, Northeast, Inner Mongolia, Northwest, and Southern China regions were identified as high risk for future BD, with estimated increases by the 2090s compared with baseline of 20% (95% confidence interval: 11%, 27%), 15% (6%, 20%), 15% (-1%, 22%), 12% (1%, 19%), and 11% (5%, 15%), respectively, under Representative Concentration Pathway 8.5. CONCLUSIONS The positive association between temperature and BD in different climatic regions of China, and the projection for increased risk due to climate change, support efforts to mitigate future risks. https://doi.org/10.1289/EHP5779.
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Affiliation(s)
- Zhidong Liu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, People's Republic of China
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Michael Xiaoliang Tong
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Jianjun Xiang
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Keith Dear
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Changke Wang
- National Climate Center, China Meteorological Administration, Beijing, People's Republic of China
| | - Wei Ma
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, People's Republic of China
- Climate Change and Health Center, Shandong University, Jinan, Shandong Province, People's Republic of China
| | - Liang Lu
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Qiyong Liu
- Climate Change and Health Center, Shandong University, Jinan, Shandong Province, People's Republic of China
- State Key Laboratory of Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, People's Republic of China
| | - Baofa Jiang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong Province, People's Republic of China
- Climate Change and Health Center, Shandong University, Jinan, Shandong Province, People's Republic of China
| | - Peng Bi
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
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Zhao ZY, Chen Q, Zhao B, Hannah MN, Wang N, Wang YX, Xuan XF, Rui J, Chu MJ, Yu SS, Wang Y, Liu XC, An R, Pan LL, Chiang YC, Su YH, Zhao BH, Chen TM. Relative transmissibility of shigellosis among male and female individuals: a modeling study in Hubei Province, China. Infect Dis Poverty 2020; 9:39. [PMID: 32299485 PMCID: PMC7162736 DOI: 10.1186/s40249-020-00654-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 03/30/2020] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Developing countries exhibit a high disease burden from shigellosis. Owing to the different incidences in males and females, this study aims to analyze the features involved in the transmission of shigellosis among male (subscript m) and female (subscript f) individuals using a newly developed sex-based model. METHODS The data of reported shigellosis cases were collected from the China Information System for Disease Control and Prevention in Hubei Province from 2005 to 2017. A sex-based Susceptible-Exposed-Infectious/Asymptomatic-Recovered (SEIAR) model was applied to explore the dataset, and a sex-age-based SEIAR model was applied in 2010 to explore the sex- and age-specific transmissions. RESULTS From 2005 to 2017, 130 770 shigellosis cases (including 73 981 male and 56 789 female cases) were reported in Hubei Province. The SEIAR model exhibited a significant fitting effect with the shigellosis data (P < 0.001). The median values of the shigellosis transmission were 2.3225 × 108 for SARmm (secondary attack rate from male to male), 2.5729 × 108 for SARmf, 2.7630 × 10-8 for SARfm, and 2.1061 × 10-8 for SARff. The top five mean values of the transmission relative rate in 2010 (where the subscript 1 was defined as male and age ≤ 5 years, 2 was male and age 6 to 59 years, 3 was male and age ≥ 60 years, 4 was female and age ≤ 5 years, 5 was female and age 6 to 59 years, and 6 was male and age ≥ 60 years) were 5.76 × 10-8 for β61, 5.32 × 10-8 for β31, 4.01 × 10-8 for β34, 7.52 × 10-9 for β62, and 6.04 × 10-9 for β64. CONCLUSIONS The transmissibility of shigellosis differed among male and female individuals. The transmissibility between the genders was higher than that within the genders, particularly female-to-male transmission. The most important route in children (age ≤ 5 years) was transmission from the elderly (age ≥ 60 years). Therefore, the greatest interventions should be applied in females and the elderly.
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Affiliation(s)
- Ze-Yu Zhao
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, 4221-117 South Xiang'an Road, Xiang'an District, Xiamen, 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
| | - Bin Zhao
- Laboratory Department, Xiang'an Hospital of Xiamen University, State Key Laboratory of Molecular Vaccinology and Molecular Diagnosis, Xiamen, Fujian, People's Republic of China
| | - Mikah Ngwanguong Hannah
- Medical College, Xiamen University, Xiamen City, Fujian Province, People's Republic of China
| | - Ning Wang
- Respiratory Department, Shanghai General Hospital, Shanghai, People's Republic of China
| | - Yu-Xin Wang
- Department of Nephrology, The Second Affiliated Hospital of Xiamen Medical College, Xiamen, Fujian, People's Republic of China
| | - Xian-Fa Xuan
- Department of Nephrology, The Second Affiliated Hospital of Xiamen Medical College, Xiamen, Fujian, People's Republic of China
| | - Jia Rui
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, 4221-117 South Xiang'an Road, Xiang'an District, Xiamen, Fujian Province, People's Republic of China
| | - Mei-Jie Chu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, 4221-117 South Xiang'an Road, Xiang'an District, Xiamen, Fujian Province, People's Republic of China
| | - Shan-Shan Yu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, 4221-117 South Xiang'an Road, Xiang'an District, Xiamen, Fujian Province, People's Republic of China
| | - Yao Wang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, 4221-117 South Xiang'an Road, Xiang'an District, Xiamen, Fujian Province, People's Republic of China
| | - Xing-Chun Liu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, 4221-117 South Xiang'an Road, Xiang'an District, Xiamen, Fujian Province, People's Republic of China
| | - Ran An
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, 4221-117 South Xiang'an Road, Xiang'an District, Xiamen, Fujian Province, People's Republic of China
| | - Li-Li Pan
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, 4221-117 South Xiang'an Road, Xiang'an District, Xiamen, 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, Xiamen City, Fujian Province, 4221-117 South Xiang'an Road, Xiang'an District, Xiamen, Fujian Province, People's Republic of China
| | - Yan-Hua Su
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, 4221-117 South Xiang'an Road, Xiang'an District, Xiamen, Fujian Province, People's Republic of China.
| | - Ben-Hua Zhao
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, 4221-117 South Xiang'an Road, Xiang'an District, Xiamen, Fujian Province, People's Republic of China.
| | - Tian-Mu Chen
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen City, Fujian Province, 4221-117 South Xiang'an Road, Xiang'an District, Xiamen, Fujian Province, People's Republic of China.
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Zhang X, Xu C, Xiao G. Spatial heterogeneity of the association between temperature and hand, foot, and mouth disease risk in metropolitan and other areas. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 713:136623. [PMID: 31954246 DOI: 10.1016/j.scitotenv.2020.136623] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 01/08/2020] [Accepted: 01/08/2020] [Indexed: 05/26/2023]
Abstract
Interest in assessing the effects of temperature on hand, foot, and mouth disease (HFMD) has increased. However, little evidence is available on spatial heterogeneity in relationship to temperature and HFMD in metropolitan (capital city and municipal districts) and other areas where economic levels are significantly different. In this study, the Bayesian space-time hierarchy model was applied to identify the spatiotemporal heterogeneity of HFMD. GeoDetector was then used to quantify the determinant power of temperature to the disease in regions where the economic level has significant spatial heterogeneity. There was significant spatial heterogeneity in the influence of temperature on the incidence of HFMD in metropolitan and other areas. In metropolitan areas, where the disease risk is higher (hot spots), the HFMD incidence was higher alongside an increase in average temperature. However, in non-metropolitan areas, where the disease risk is lower (cold spots), there was an approximately S-shaped relationship between the temperature and the HFMD risk. More specifically, when the temperature was >25 °C, the HFMD incidence no longer increased monotonically with the increasing temperature. There was significant spatial heterogeneity in the effects of temperature on the HFMD incidence in metropolitan and non-metropolitan areas. This finding may serve as a suggestion and basis for the surveillance and control of this disease and it is conducive to the rational allocation of medical resources in different areas.
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Affiliation(s)
- XiangXue Zhang
- State Key Laboratory of Earth Surface Processes and Resource Ecology, Beijing Normal University, Beijing 100875, China; State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China
| | - ChengDong Xu
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China.
| | - GeXin Xiao
- China National Center for Food Safety Risk Assessment, Beijing 100022, China
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Yang J, Chen W, Xia P, Zhang W. Dynamic comparison of gut microbiota of mice infected with Shigella flexneri via two different infective routes. Exp Ther Med 2020; 19:2273-2281. [PMID: 32104294 PMCID: PMC7027338 DOI: 10.3892/etm.2020.8469] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 12/06/2019] [Indexed: 12/13/2022] Open
Abstract
Shigella is one of the main pathogens causing diarrheal disease, and is associated with high morbidity and mortality in developing countries. Previous clinical data and animal studies have shown that the outcomes of oral and peritoneal infections of Shigella differ, and that the latter is more serious. Furthermore, a variety of pathogenic bacteria are known to cause changes in intestinal flora after infection, and the influence of Shigella infection on intestinal flora remains poorly understood. In the present study, the 16S rRNA high-throughput sequencing method was used to compare the changes in gut microbiota profiles in feces of mice infected with Shigella via two routes. In addition, the present study investigated the association between the differences in infection performance and bacterial communities. The present results suggested that the intraperitoneal route induced a distinct decrease in α-diversity in the fecal microbiota when compared to the control at a later time, while the effect of the oral route on α-diversity was not obvious. Oral infection of Shigella had a rapid and significant effect on gut microbiota, mainly causing a decreased abundance of Lactobacillus and an increased abundance of Prevotella and Escherichia/Shigella in the early stage of infection. By contrast, the effect of intraperitoneal infection on the gut microbiota was relatively slow and small. The principal coordinate analysis results suggested that the dynamic profile of gut microbiota between the two infective routes was consistent with the infection process. Probiotics, such as Lactobacillus reuteri and Faecalitalea exhibited significantly reduced abundance after Shigella infection. Collectively, the present results suggested that gut microbiota may play a pivotal role in the pathogenesis of Shigella infection. Future studies should investigate the effect of Shigella infection on the interaction between pathogenic bacteria and intestinal flora. The present results suggested that the use of probiotics may facilitate the prevention and treatment of shigellosis.
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Affiliation(s)
- Jinsong Yang
- Fujian Provincial Key Laboratory of Environment Factors and Cancer, Key Laboratory of Environment and Health, School of Public Health, Fujian Medical University, Fuzhou, Fujian 350122, P.R. China
| | - Wei Chen
- Department for Viral Disease Control and Prevention, Fujian Center for Disease Control and Prevention, Fuzhou, Fujian 350001, P.R. China
| | - Pinchang Xia
- Department for Viral Disease Control and Prevention, Fujian Center for Disease Control and Prevention, Fuzhou, Fujian 350001, P.R. China
| | - Wenchang Zhang
- Fujian Provincial Key Laboratory of Environment Factors and Cancer, Key Laboratory of Environment and Health, School of Public Health, Fujian Medical University, Fuzhou, Fujian 350122, P.R. China
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Nisa I, Qasim M, Yasin N, Ullah R, Ali A. Shigella flexneri: an emerging pathogen. Folia Microbiol (Praha) 2020; 65:275-291. [PMID: 32026288 DOI: 10.1007/s12223-020-00773-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 01/16/2020] [Indexed: 12/19/2022]
Abstract
Shigella flexneri is a leading etiologic agent of diarrhea in low socioeconomic countries. Notably, various serotypes in S. flexneri are reported from different regions of the world. The precise approximations of illness and death owing to shigellosis are missing in low socioeconomic countries, although it is widespread in different regions. The inadequate statistics available reveal S. flexneri to be a significant food and waterborne pathogen. All over the world, different antibiotic-resistant strains of S. flexneri serotypes have been emerged especially multidrug-resistant strains. Recently, increased resistance was observed in cephalosporins (3rd generation), azithromycin, and fluoroquinolones. There is a need for a continuous surveillance study on antibiotic resistance that will be helpful in the update of the antibiogram. The shigellosis burden can be reduced by adopting preventive measures like delivery of safe drinking water, suitable sanitation, and development of an effective and inexpensive multivalent vaccine. This review attempts to provide the recent findings of S. flexneri related to epidemiology and the emergence of multidrug resistance.
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Affiliation(s)
- Iqbal Nisa
- Department of Microbiology, Kohat University of Science and Technology, Kohat, Pakistan.
| | - Muhammad Qasim
- Department of Microbiology, Kohat University of Science and Technology, Kohat, Pakistan
| | - Nusrat Yasin
- Department of Microbiology, Kohat University of Science and Technology, Kohat, Pakistan
| | - Rafi Ullah
- Bacteriology Laboratory Center of Microbiology and Bacteriology (CMB) Veterinary Research Institute, Peshawar, Pakistan
| | - Anwar Ali
- Bacteriology Laboratory Center of Microbiology and Bacteriology (CMB) Veterinary Research Institute, Peshawar, Pakistan
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31
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Nisa I, Qasim M, Driessen A, Nijland J, Bari F, Haroon M, Rahman H, Yasin N, Khan TA, Hussain M, Ullah W. Molecular epidemiology of Shigella flexneri isolated from pediatrics in a diarrhea-endemic area of Khyber Pakhtunkhwa, Pakistan. Eur J Clin Microbiol Infect Dis 2020; 39:971-985. [PMID: 31938959 DOI: 10.1007/s10096-020-03811-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 01/02/2020] [Indexed: 10/25/2022]
Abstract
Shigella flexneri is considered as an important causative agent of Shigellosis causing diarrhea in the countries with a low socioeconomic status. No study has been carried out on the molecular prevalence of S. flexneri in Khyber Pakhtunkhwa, Pakistan. So this study was designed to evaluate the molecular prevalence of S. flexneri and their associated risk factors. A total of 2014 diarrheal stool samples were collected from January 2016 to May 2017 from pediatrics patients of Khyber Pakhtunkhwa followed by identification of S. flexneri through biochemical, serological, and molecular methods. The overall prevalence of Shigella species was found to be 7.9% (n = 160). The predominant Shigella specie was S. flexneri (n = 155, 96.8%) followed by S. boydii (n = 5, 3.1%). Interestingly, no sample was found positive for S. sonnei and S. dysenteriae. The majority of Shigellosis cases occurred from June to September. Potential risk factors related with Shigellosis were unhygienic latrine usage, bad hand washing, and consumption of unhygienic food and water, and pipe leakage in the sewage system. In this study, we have observed a high number of Shigellosis cases especially those caused by S. flexneri. It is suggested that effective health awareness programs should be organized by the regional health authorities to minimize the magnitude of pediatrics Shigellosis.
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Affiliation(s)
- Iqbal Nisa
- Department of Microbiology, Kohat University of Science and Technology, Kohat, 26000, Pakistan
| | - Muhammad Qasim
- Department of Microbiology, Kohat University of Science and Technology, Kohat, 26000, Pakistan.
| | - Arnold Driessen
- Department of Molecular Microbiology, Groningen Biomolecular Sciences, and Biotechnology Institute, Faculty of Science and Engineering, Rijksuniversiteit Groningen, Groningen, The Netherlands
| | - Jeroen Nijland
- Department of Molecular Microbiology, Groningen Biomolecular Sciences, and Biotechnology Institute, Faculty of Science and Engineering, Rijksuniversiteit Groningen, Groningen, The Netherlands
| | - Fazli Bari
- Department of Pathology, Lady Reading Hospital, Peshawar, Pakistan.,Department of Microbiology, Nowshera Medical College, Nowshera, Pakistan
| | - Mohammad Haroon
- Department of Medicine, Khyber Teaching Hospital, Peshawar, Pakistan
| | - Hazir Rahman
- Department of Microbiology, Abdul Wali Khan University, Mardan, Pakistan
| | - Nusrat Yasin
- Department of Microbiology, Kohat University of Science and Technology, Kohat, 26000, Pakistan
| | - Taj Ali Khan
- Department of Microbiology, Kohat University of Science and Technology, Kohat, 26000, Pakistan
| | - Mubbashir Hussain
- Department of Microbiology, Kohat University of Science and Technology, Kohat, 26000, Pakistan
| | - Waheed Ullah
- Department of Microbiology, Kohat University of Science and Technology, Kohat, 26000, Pakistan
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Meng Q, Liu X, Xie J, Xiao D, Wang Y, Deng D. Epidemiological characteristics of bacillary dysentery from 2009 to 2016 and its incidence prediction model based on meteorological factors. Environ Health Prev Med 2019; 24:82. [PMID: 31883513 PMCID: PMC6935186 DOI: 10.1186/s12199-019-0829-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 11/12/2019] [Indexed: 12/19/2022] Open
Abstract
Background This study aimed to analyse the epidemiological characteristics of bacillary dysentery (BD) caused by Shigella in Chongqing, China, and to establish incidence prediction models based on the correlation between meteorological factors and BD, thus providing a scientific basis for the prevention and control of BD. Methods In this study, descriptive methods were employed to investigate the epidemiological distribution of BD. The Boruta algorithm was used to estimate the correlation between meteorological factors and BD incidence. The genetic algorithm (GA) combined with support vector regression (SVR) was used to establish the prediction models for BD incidence. Results In total, 68,855 cases of BD were included. The incidence declined from 36.312/100,000 to 23.613/100,000, with an obvious seasonal peak from May to October. Males were more predisposed to the infection than females (the ratio was 1.118:1). Children < 5 years old comprised the highest incidence (295.892/100,000) among all age categories, and pre-education children comprised the highest proportion (34,658 cases, 50.335%) among all occupational categories. Eight important meteorological factors, including the highest temperature, average temperature, average air pressure, precipitation and sunshine, were correlated with the monthly incidence of BD. The obtained mean absolute percent error (MAPE), mean squared error (MSE) and squared correlation coefficient (R2) of GA_SVR_MONTH values were 0.087, 0.101 and 0.922, respectively. Conclusion From 2009 to 2016, BD incidence in Chongqing was still high, especially in the main urban areas and among the male and pre-education children populations. Eight meteorological factors, including temperature, air pressure, precipitation and sunshine, were the most important correlative feature sets of BD incidence. Moreover, BD incidence prediction models based on meteorological factors had better prediction accuracies. The findings in this study could provide a panorama of BD in Chongqing and offer a useful approach for predicting the incidence of infectious disease. Furthermore, this information could be used to improve current interventions and public health planning.
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Affiliation(s)
- Qiuyu Meng
- School of Public Health and Management, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, 400016, China
| | - Xun Liu
- Department of Healthcare-associated Infection Control, The Second Affiliated Hospital of Military Medical University, Chongqing, 400037, China
| | - Jiajia Xie
- School of Public Health and Management, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, 400016, China
| | - Dayong Xiao
- Institute for Prevention and Control of Endemic and Parasitic Diseases, Chongqing Center for Disease Control and Prevention, Chongqing, 400042, China
| | - Yi Wang
- School of Public Health and Management, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, 400016, China
| | - Dan Deng
- School of Public Health and Management, Research Center for Medicine and Social Development, Innovation Center for Social Risk Governance in Health, Chongqing Medical University, Chongqing, 400016, China.
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Mao Y, Zhang N, Zhu B, Liu J, He R. A descriptive analysis of the Spatio-temporal distribution of intestinal infectious diseases in China. BMC Infect Dis 2019; 19:766. [PMID: 31477044 PMCID: PMC6721277 DOI: 10.1186/s12879-019-4400-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Accepted: 08/23/2019] [Indexed: 01/02/2023] Open
Abstract
Background Intestinal infectious diseases (IIDs) have caused numerous deaths worldwide, particularly among children. In China, eight IIDs are listed as notifiable infectious diseases, including cholera, poliomyelitis, dysentery, typhoid and paratyphoid (TAP), viral Hepatitis A, viral Hepatitis E, hand-foot-mouth disease (HFMD) and other infectious diarrhoeal diseases (OIDDs). The aim of the study is to analyse the spatio-temporal distribution of IIDs from 2006 to 2016. Methods Data on the incidence of IIDs from 2006 to 2016 were collected from the public health science data centre issued by the Chinese Center for Disease Control and Prevention. This study applied seasonal decomposition analysis, spatial autocorrelation analysis and space-time scan analysis. Plots and maps were constructed to visualize the spatio-temporal distribution of IIDs. Results Regarding temporal analysis, the incidence of HFMD and Hepatitis E showed a distinct increasing trend, while the incidence of TAP, dysentery, and Hepatitis A presented decreasing trends over the last decade. The incidence of OIID remained steady. Summer is the season with the greatest number of cases of different IIDs. Regarding the spatial distribution, approximately all p values for the global Moran’s I from 2006 to 2016 were less than 0.05, indicating that the incidences of the epidemics were unevenly distributed throughout the country. The high-risk areas for HFMD and OIDD were located in the Beijing-Tianjin-Tangshan (BTT) region and south China. The high-risk areas for TAP were located in some parts of southwest China. A higher incidence rates for dysentery and Hepatitis A were observed in the BTT region and some west provincial units. The high-risk areas for Hepatitis E were the BTT region and the Yangtze River Delta area. Conclusions Based on our temporal and spatial analysis of IIDs, we identified the high-risk periods and clusters of regions for the diseases. HFMD and OIDD exhibited high incidence rates, which reflected the negligence of Class C diseases by the government. At the same time, the incidence rate of Hepatitis E gradually surpassed Hepatitis A. The authorities should pay more attention to Class C diseases and Hepatitis E. Regardless of the various distribution patterns of IIDs, disease-specific, location-specific, and disease-combined interventions should be established. Electronic supplementary material The online version of this article (10.1186/s12879-019-4400-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ying Mao
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, 710049, China.
| | - Ning Zhang
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, 710049, China
| | - Bin Zhu
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, 710049, China.,Department of Public Policy, City University of Hong Kong, Hong Kong, 999077, China
| | - Jinlin Liu
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, 710049, China
| | - Rongxin He
- School of Public Policy and Administration, Xi'an Jiaotong University, Xi'an, 710049, China
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Abstract
The consistent, sporadic transmission of shigellosis in Taiwan necessitates an exploration of risk factors for the occurrence of shigellosis. The purpose of this study was to study the epidemiologic characteristics and the relationship between climatic factors and the incidence of shigellosis in Taiwan. We collected data from cases of shigellosis reported to the Taiwan Centers for Disease Control (Taiwan CDC) from 2001 to 2016. Climatic data were obtained from the Taiwan Central Weather Bureau. The relationships between weather variability and the incidence of shigellosis in Taiwan were determined via Poisson regression analyses. During the 16-year study period, a total of 4171 clinical cases of shigellosis were reported to the Taiwan CDC. Among them, 1926 (46.2%) were classified as confirmed cases. The incidence of shigellosis showed significant seasonality, with the majority of cases occurring in summertime (for oscillation, P < .001). The number of shigellosis cases started to increase when temperatures reached 21°C (r = 0.88, P < .001). Similarly, the number of shigellosis cases began to increase at a relative humidity of 70-74% (r = 0.75, P < .005). The number of shigellosis cases was positively associated with the mean temperature and relative humidity in the period preceding the infection. In conclusion, the occurrence of shigellosis is significantly associated with increasing temperature and relative humidity in Taiwan. Therefore, these factors could be regarded as warning signals indicating the need to implement preventive measures.
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Affiliation(s)
- Chian-Ching Chen
- Department of Business Administration, National Taiwan University of Science and Technology
| | - Chuan-Yao Lin
- Research Center for Environmental Changes, Academia Sinica, Taipei
| | - Kow-Tong Chen
- Department of Occupational Medicine, Tainan Municipal Hospital (Managed by Show Chwan Medical Care Corporation)
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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Hao Y, Liao W, Ma W, Zhang J, Zhang N, Zhong S, Wang Z, Yang L, Huang C. Effects of ambient temperature on bacillary dysentery: A multi-city analysis in Anhui Province, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 671:1206-1213. [PMID: 31186130 DOI: 10.1016/j.scitotenv.2019.03.443] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 03/18/2019] [Accepted: 03/28/2019] [Indexed: 05/16/2023]
Abstract
BACKGROUND Rising ambient temperature is expected to increase incidence of bacillary dysentery (BD), but few studies have compared the temperature-BD effects of different age groups and cities in China, especially in a multi-city setting. OBJECTIVES We used city-specific data including BD cases and meteorological variables to determine the relationship between BD incidence and temperature at provincial level. METHODS Weekly BD disease surveillance data and meteorological variables were collected in all 16 prefecture-level cities in Anhui Province of China. Firstly, city-specific weekly mean temperature-BD incidence associations were estimated with Distributed Lag Nonlinear Model (DLNM). Secondly, city-specific estimates were pooled at province-level through multivariate meta-analysis. Also, we conducted subgroup analyses for ages (children <5 years old and population of other ages) and urbanization of cities (high and low level), respectively. RESULTS In Anhui, BD morbidity risk increased with increasing weekly mean temperature. Relative risks (RR) at the 90th percentile (27.5 °C) versus the 50th percentile (17 °C) of weekly mean temperature were 1.42 (95% confidence interval (CI): 1.16, 1.75) and 2.02 (95% CI: 1.76, 2.32) for children <5 and population of other ages, respectively. The relative risk of high temperature on other ages group was higher than that of children under five years old (p = 0.006). Children under 5 in high urbanized cities appeared to be more vulnerable to the effects of ambient high temperature (RR: 1.56, 95% CI: 1.20, 1.92) than in low urbanized cities (RR: 1.01, 95% CI: 0.70, 1.46), the difference between two intervals was statistically significant (p = 0.044). CONCLUSIONS This study suggests that high temperatures may be an important trigger of BD incidence, and especially lead to a substantial burden of BD for high urbanized cities in Anhui Province of China.
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Affiliation(s)
- Yanbin Hao
- Department of Health Policy and Management, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, Guangdong, China; Department of Preventive Medicine, Gannan Medical University, Ganzhou 341000, Jiangxi, China
| | - Wenmin Liao
- Department of Health Policy and Management, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, Guangdong, China
| | - Wanwan Ma
- Anhui Provincial Center for Disease Control and Prevention, Hefei 230601, Anhui, China
| | - Jin Zhang
- Anhui Provincial Center for Disease Control and Prevention, Hefei 230601, Anhui, China
| | - Na Zhang
- Department of Health Policy and Management, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, Guangdong, China
| | - Shuang Zhong
- Center for Chinese Public Administration Research, School of Government, Sun Yat-Sen University, Guangzhou 510080, Guangdong, China
| | - Zhe Wang
- Chinese Center for Disease Control and Prevention, 102206 Beijing, China.
| | - Lianping Yang
- Department of Health Policy and Management, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, Guangdong, China.
| | - Cunrui Huang
- Department of Health Policy and Management, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, Guangdong, China
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Yeoh HL, Hall V, Williamson DA, Gardiner BJ. Locally acquired extended-spectrum β-lactamase Shigella infection. Med J Aust 2019; 211:163-164.e1. [PMID: 31206167 DOI: 10.5694/mja2.50245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Zhang WX, Chen HY, Tu LH, Xi MF, Chen M, Zhang J. Fluoroquinolone Resistance Mechanisms in Shigella Isolates in Shanghai, China, Between 2010 and 2015. Microb Drug Resist 2018; 25:212-218. [PMID: 30307807 DOI: 10.1089/mdr.2018.0113] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES This study aimed to investigate the antimicrobial susceptibility of Shigella isolated in Shanghai, China and to determine the genetic basis of its resistance to fluoroquinolones. MATERIALS AND METHODS A total of 402 strains of Shigella, including 145 Shigella flexneri and 257 Shigella sonnei isolates, were analyzed. The Kirby-Bauer disk diffusion method was used to determine the susceptibility of the strains to 13 antimicrobials. Minimum inhibitory concentration of ciprofloxacin was determined by E-test. Mutations within the quinolone resistance-determining regions (QRDRs) of gyrA and parC and in the plasmid-mediated quinolone resistance (PMQR) genes, including qnrA, qnrB, qnrS, and aac (6')-Ib-cr, were detected by polymerase chain reaction. All the products were then sequenced. RESULTS Most of the Shigella isolates were found to be resistant to nalidixic acid (96.4%), streptomycin (96.4%), ampicillin (86.2%), tetracycline (79.8%), and sulfamethoxazole/trimethoprim (80.6%). S. flexneri isolates showed a significantly higher resistance to cefepime (33.6%), ciprofloxacin (54.2%), norfloxacin (34.1%), and levofloxacin (12.1%) compared with that observed for the S. sonnei strains (χ2 analysis, p < 0.05). Three mutations (Ser83, Asp87, and His211) in gyrA and one mutation (Ser80) in parC were detected. Of 257 S. sonnei isolates, 11.7% possessed gyrA mutations and 2% had parC mutations. Of 145 S. flexneri isolates, 98.6% possessed gyrA mutations and 97.9% had parC mutations. The plasmid-mediated resistance genes of qnrS and aac (6')-Ib-cr were detected among 17 strains (4.2%). CONCLUSIONS The mutation percentage within the QRDR of S. flexneri was as high as 98.6 in gyrA and 97.9 in parC. The significant abundance of mutations within QRDRs conferred high levels of fluoroquinolone resistance. Moreover, the PMQR genes, particularly qnrS, played an important role in the decreased susceptibility of Shigella to fluoroquinolones.
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Affiliation(s)
- Wen-Xia Zhang
- 1 Department of Clinical Laboratory, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine , Shanghai, China
| | - Hong-You Chen
- 2 Laboratory of Bacterial, Shanghai Center for Disease Control and Prevention , Shanghai, China
| | - Li-Hong Tu
- 2 Laboratory of Bacterial, Shanghai Center for Disease Control and Prevention , Shanghai, China
| | - Man-Fang Xi
- 2 Laboratory of Bacterial, Shanghai Center for Disease Control and Prevention , Shanghai, China
| | - Min Chen
- 2 Laboratory of Bacterial, Shanghai Center for Disease Control and Prevention , Shanghai, China
| | - Jue Zhang
- 1 Department of Clinical Laboratory, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine , Shanghai, China
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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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Prevalence and characterisation of third-generation cephalosporin-resistant Shigella flexneri isolates from Jiangsu Province, China, 2013-2015. J Glob Antimicrob Resist 2018; 15:283-287. [PMID: 30144637 DOI: 10.1016/j.jgar.2018.08.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 07/18/2018] [Accepted: 08/14/2018] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES The aim of this study was to assess the prevalence of Shigella flexneri resistance to third-generation cephalosporins (3GCs) and to characterise the underlying resistance mechanisms. METHODS A total of 282 S. flexneri strains isolated in 2013-2015 in Jiangsu Province, China, were identified, serotyped and analysed for their susceptibility to 3GCs. The blaTEM, blaSHV, blaOXA-1-like and blaCTX-M-type extended-spectrum β-lactamase (ESBL) genes were amplified and sequenced by PCR. RESULTS Of the 282 S. flexneri strains, 97 (34.4%) were resistant to cefotaxime, from which 68 (24.1%) were also resistant to ceftazidime. ESBL genes were detected in 73/97 isolates (75.3%), of which 66/73 (90.4%) showed resistance to 3GCs. Of the 73 ESBL-positive isolates, 32 (43.8%) were positive for CTX-M-1 group (17 for CTX-M-55, 4 for CTX-M-3, 1 for CTX-M-15, 3 for CTX-M-79 and 7 for CTX-M-123), 31 (42.5%) were positive for CTX-M-9 group (29 for CTX-M-14, 1 for CTX-M-24 and 1 for CTX-M-27), 25 (34.2%) were positive for TEM-types (21 for TEM-1 and 4 for TEM-1b) and 1 (1.4%) was positive for SHV-type (SHV-12); none were positive for CTX-M-2 group, CTX-M-8 group and OXA-type. CONCLUSION ESBLs play an important role in Shigella resistance to 3GCs. CTX-M-14 and CTX-M-55 appeared to be the dominant ESBLs in 13 cities of Jiangsu Province. Therefore, it is time to regularly monitor resistance of S. flexneri to 3GCs and to take appropriate measures to manage this problem.
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Frenck RW, Baqar S, Alexander W, Dickey M, McNeal M, El-Khorazaty J, Baughman H, Hoeper A, Barnoy S, Suvarnapunya AE, Kaminski RW, Venkatesan MM. A Phase I trial to evaluate the safety and immunogenicity of WRSs2 and WRSs3; two live oral candidate vaccines against Shigella sonnei. Vaccine 2018; 36:4880-4889. [PMID: 30037478 PMCID: PMC10559265 DOI: 10.1016/j.vaccine.2018.06.063] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 06/26/2018] [Accepted: 06/28/2018] [Indexed: 10/28/2022]
Abstract
Effective vaccines are needed to combat diarrheal diseases due to Shigella. Two live oral S. sonnei vaccine candidates, WRSs2 and WRSs3, attenuated principally by the lack of spreading ability, as well as the loss of enterotoxin and acyl transferase genes, were tested for safety and immunogenicity. Healthy adults 18-45 years of age, assigned to 5 cohorts of 18 subjects each (WRSs2 (n = 8), WRSs3 (n = 8) or placebo (n = 2)) were housed in an inpatient facility and administered a single oral dose of study agent 5 min after ingestion of oral bicarbonate. Ascending dosages of vaccine (from 103 CFU to 107 CFU) were evaluated. On day 8, treatment with ciprofloxacin (500 mg BID for 3 days) was initiated and subjects were discharged home 2 days after completing antibiotics. Subjects returned for outpatient visits on day 14, 28 and 56 post-vaccination for monitoring and collection of stool and blood samples. Both WRSs2 and WRSs3 were generally well tolerated and safe over the entire dose range. Among the 80 vaccinees, 11 subjects developed diarrhea, 8 of which were mild and did not affect daily activities. At the 107 CFU dose, moderate diarrhea occurred in one WRSs2 subject while at the same dose of WRSs3, 2 subjects had moderate or severe diarrhea. Vaccinees mounted dose-dependent mucosal and systemic immune responses that appeared to correlate with fecal shedding. S. sonnei vaccine candidates WRSs2 and WRSs3 are safe and immunogenic over a wide dose range. Future steps will be to select the most promising candidate and move to human challenge models for efficacy of the vaccine.
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Affiliation(s)
- Robert W Frenck
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States.
| | - Shahida Baqar
- Division of Microbiology and Infectious Diseases, National Institute of Allergy and Infectious Diseases, Bethesda, MD, United States
| | - William Alexander
- Division of Microbiology and Infectious Diseases, National Institute of Allergy and Infectious Diseases, Bethesda, MD, United States
| | - Michelle Dickey
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Monica McNeal
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | | | | | - Amy Hoeper
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Shoshana Barnoy
- Department of Enteric Infections, Bacterial Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, United States
| | - Akamol E Suvarnapunya
- Department of Enteric Infections, Bacterial Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, United States
| | - Robert W Kaminski
- Department of Enteric Infections, Bacterial Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, United States
| | - Malabi M Venkatesan
- Department of Enteric Infections, Bacterial Diseases Branch, Walter Reed Army Institute of Research, Silver Spring, MD, United States
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Qian H, Liu G, Chen Y, Ma P, Kong X, Zhou L, Hong J, Bao C, Gu B. Increasing clinical resistance rate of Shigella sonnei to cefotaxime in Jiangsu Province, China, between 2012 and 2015. ANNALS OF TRANSLATIONAL MEDICINE 2018; 6:207. [PMID: 30023370 DOI: 10.21037/atm.2018.05.43] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Background The objective of this study is to evaluate the prevalence of Shigella sonnei (S. sonnei) and characterize the mechanism of its increasing resistance to cefotaxime, a third-generation cephalosporin agent between 2012 and 2015. Methods We investigated the drug resistance in 95 isolates of S. sonnei by K-B dilution method and isolates with the extended-spectrum beta-lactamases (ESBLs)-producing genes were detected by polymerase chain reaction (PCR) and sequencing. Results Over a 4-year period, the resistance rate of S. sonnei to cefotaxime increased from 31.6% to 64.3%, between 2012 and 2015. Molecular characterization of the ESBL genes, comprising 28 strains of CTX-M-1 group: blaCTX-M-55 (n=22), blaCTX-M-3 (n=3) and blaCTX-M-15 (n=3); 11 strains of CTX-M-9 group: blaCTX-M-14 (n=9) and blaCTX-M-65 (n=2), and 36 strains with blaTEM-1 gene. None of S. sonnei isolates carried blaCTX-M-2 group and SHV-type. Conclusions The antimicrobial resistance rate of S. sonnei to cefotaxime significantly increased. Accordingly, regular surveillance of the cephalosporin-resistant S. sonnei should be emphasized. Moreover, exploration of the mechanism underlying the resistance of S. sonnei to cefotaxime contributes to the prophylaxis of further emergence of drug resistance.
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Affiliation(s)
- Huimin Qian
- Department of Acute Infectious Disease Prevention and Control, Jiangsu Provincial Center for Disease Prevention and Control, Nanjing 210029, China
| | - Guoye Liu
- Medical Technology School, Xuzhou Medical University, Xuzhou 221004, China
| | - Yin Chen
- Medical Technology School, Xuzhou Medical University, Xuzhou 221004, China
| | - Ping Ma
- Medical Technology School, Xuzhou Medical University, Xuzhou 221004, China.,Department of Laboratory Medicine, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221002, China
| | - Xiaoxiao Kong
- Department of Acute Infectious Disease Prevention and Control, Jiangsu Provincial Center for Disease Prevention and Control, Nanjing 210029, China
| | - Lu Zhou
- Department of Acute Infectious Disease Prevention and Control, Jiangsu Provincial Center for Disease Prevention and Control, Nanjing 210029, China
| | - Jie Hong
- Department of Acute Infectious Disease Prevention and Control, Jiangsu Provincial Center for Disease Prevention and Control, Nanjing 210029, China
| | - Changjun Bao
- Department of Acute Infectious Disease Prevention and Control, Jiangsu Provincial Center for Disease Prevention and Control, Nanjing 210029, China
| | - Bing Gu
- Medical Technology School, Xuzhou Medical University, Xuzhou 221004, China.,Department of Laboratory Medicine, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221002, China
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Kotloff KL, Riddle MS, Platts-Mills JA, Pavlinac P, Zaidi AKM. Shigellosis. Lancet 2018; 391:801-812. [PMID: 29254859 DOI: 10.1016/s0140-6736(17)33296-8] [Citation(s) in RCA: 307] [Impact Index Per Article: 51.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 08/10/2017] [Accepted: 09/15/2017] [Indexed: 01/02/2023]
Abstract
Shigellosis is a clinical syndrome caused by invasion of the epithelium lining the terminal ileum, colon, and rectum by Shigella species. Although infections occur globally, and in people of all ages, endemic infections among children aged 1-4 years living in low-income and middle-income settings constitute most of the disease burden. The versatile manifestations of these highly contagious organisms range from acute watery diarrhoea to fulminant dysentery characterised by frequent scant bloody stools with fever, prostration, and abdominal cramps. A broad array of uncommon, but often severe, intestinal and extraintestinal complications can occur. Despite marked reductions in mortality during the past three decades, there are roughly 164 000 annual deaths attributable to shigellosis. Intercontinental dissemination of multiresistant shigella strains, facilitated by travellers and men who have sex with men, has prompted new recommendations for antibiotic therapy. Awareness of disease burden and the emerging threats posed by shigella have accelerated interest in development of shigella vaccines, many of which are being tested in clinical trials.
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Affiliation(s)
- Karen L Kotloff
- Departments of Pediatrics and Medicine, Center for Vaccine Development, Institute for Global Health, University of Maryland School of Medicine, Baltimore, MD, USA.
| | - Mark S Riddle
- Naval Medical Research Center, Silver Spring, MD, USA; Department of Preventive Medicine and Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - James A Platts-Mills
- Division of Infectious Diseases and International Health, University of Virginia, Charlottesville, VA, USA
| | - Patricia Pavlinac
- Department of Global Health, Global Center for Integrated Health of Women, Adolescents and Children (Global WACh), University of Washington, Seattle, WA, USA
| | - Anita K M Zaidi
- Enteric and Diarrheal Diseases Programme, Bill & Melinda Gates Foundation, Seattle, WA, USA
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Trends of foodborne diseases in China: lessons from laboratory-based surveillance since 2011. Front Med 2017; 12:48-57. [DOI: 10.1007/s11684-017-0608-6] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 10/27/2017] [Indexed: 01/22/2023]
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Xu C, Li Y, Wang J, Xiao G. Spatial-temporal detection of risk factors for bacillary dysentery in Beijing, Tianjin and Hebei, China. BMC Public Health 2017; 17:743. [PMID: 28946856 PMCID: PMC5613329 DOI: 10.1186/s12889-017-4762-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Accepted: 09/15/2017] [Indexed: 11/30/2022] Open
Abstract
Background Bacillary dysentery is the third leading notifiable disease and remains a major public health concern in China. The Beijing–Tianjin–Hebei urban region is the biggest urban agglomeration in northern China, and it is one of the areas in the country that is most heavily infected with bacillary dysentery. The objective of the study was to analyze the spatial-temporal pattern and to determine any contributory risk factors on the bacillary dysentery. Methods Bacillary dysentery case data from 1 January 2012 to 31 December 2012 in Beijing–Tianjin– Hebei were employed. GeoDetector method was used to determine the impact of potential risk factors, and to identify regions and seasons at high risk of the disease. Results There were 36,472 cases of bacillary dysentery in 2012 in the study region. The incidence of bacillary dysentery varies widely amongst different age groups; the higher incidence of bacillary dysentery mainly occurs in the population under the age of five. Bacillary dysentery presents apparent seasonal variance, with the highest incidence occurring from June to September. In terms of the potential meteorological risk factors, mean temperature, relative humidity, precipitation, mean wind speed and sunshine hours explain the time variant of bacillary dysentery at 83%, 31%, 25%, 17% and 13%, respectively. The interactive effect between temperature and humidity has an explanatory power of 87%, indicating that a hot and humid environment is more likely to lead to the occurrence of bacillary dysentery. Socio-economic factors affect the spatial distribution of bacillary dysentery. The top four factors are age group, per capita GDP, population density and rural population proportion, and their determinant powers are 61%, 27%, 25% and 21%, respectively. The interactive effect between age group and the other factors accounts for more than 60% of bacillary dysentery transmission. Conclusions Bacillary dysentery poses a higher risk in the population of children. It is affected by meteorological and socio-economic factors, and it is necessary to pay more attention to the meteorological period and situation, particularly in period with high temperature and humidity, as well as places in urban areas with high population density, and a low proportion of rural population.
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Affiliation(s)
- Chengdong Xu
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China.
| | - Yuanyuan Li
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China.,Chang'an University, Xi'an, China
| | - Jinfeng Wang
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographic Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing, China
| | - Gexin Xiao
- China National Center for Food Safety Risk Assessment, Beijing, China
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Zhao L, Xiong Y, Meng D, Guo J, Li Y, Liang L, Han R, Wang Y, Guo X, Wang R, Zhang L, Gao L, Wang J. An 11-year study of shigellosis and Shigella species in Taiyuan, China: Active surveillance, epidemic characteristics, and molecular serotyping. J Infect Public Health 2017; 10:794-798. [PMID: 28188118 DOI: 10.1016/j.jiph.2017.01.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Revised: 12/15/2016] [Accepted: 01/07/2017] [Indexed: 10/20/2022] Open
Abstract
A hospital-based surveillance of shigellosis was conducted in Taiyuan from 2005 to 2015. A total of 2655 stool cultures were collected from patients with diarrhea, 115 were identified as S. flexneri and 107 were S. sonnei. The highest infection rates were found among children under 5 years of age (34.2 %), and during the summer (61.0 %). Six serotypes were identified among S. flexneriisolates:1a, 2a, 2b, Xv, X and Y. Serotype 2a and Xv were the dominant serotypes in two periods, 2012-2015 and 2005-2008, respectively. High shigellosis rates over the past decade highlight shigellosis is still a major public health problem in Taiyuan.
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Affiliation(s)
- Lifeng Zhao
- Laboratory of Microbiology, Taiyuan Center for Disease Control and Prevention, Taiyuan, Shanxi Province 030012, China.
| | - Yanwen Xiong
- State Key Laboratory for Infectious Disease Prevention and Control, National Institute for Communicable Disease Control and Prevention, China CDC, Changping, Beijing 102206, China.
| | - Dequan Meng
- Laboratory of Microbiology, Taiyuan Center for Disease Control and Prevention, Taiyuan, Shanxi Province 030012, China.
| | - Jiane Guo
- Laboratory of Microbiology, Taiyuan Center for Disease Control and Prevention, Taiyuan, Shanxi Province 030012, China.
| | - Yiping Li
- Laboratory of Microbiology, Taiyuan Center for Disease Control and Prevention, Taiyuan, Shanxi Province 030012, China.
| | - Lirong Liang
- Laboratory of Microbiology, Taiyuan Center for Disease Control and Prevention, Taiyuan, Shanxi Province 030012, China.
| | - Rui Han
- Laboratory of Microbiology, Taiyuan Center for Disease Control and Prevention, Taiyuan, Shanxi Province 030012, China.
| | - Yanqin Wang
- Laboratory of Microbiology, Taiyuan Center for Disease Control and Prevention, Taiyuan, Shanxi Province 030012, China.
| | - Xiaofang Guo
- Laboratory of Microbiology, Taiyuan Center for Disease Control and Prevention, Taiyuan, Shanxi Province 030012, China.
| | - Rui Wang
- Laboratory of Microbiology, Taiyuan Center for Disease Control and Prevention, Taiyuan, Shanxi Province 030012, China.
| | - Ladi Zhang
- Laboratory of Microbiology, Taiyuan Center for Disease Control and Prevention, Taiyuan, Shanxi Province 030012, China.
| | - Li Gao
- Laboratory of Microbiology, Taiyuan Center for Disease Control and Prevention, Taiyuan, Shanxi Province 030012, China.
| | - Jitao Wang
- Laboratory of Microbiology, Taiyuan Center for Disease Control and Prevention, Taiyuan, Shanxi Province 030012, China.
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