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AMR profiles of Shigella dysenteriae isolated from travelers returning to the UK.

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eMediNexus    07 August 2018

The purpose of a new study published in the Journal of Medical Microbiology was to detect evidence of emerging antimicrobial resistance (AMR) associated with travelers’ diarrhea. Here, AMR profiles of 754 strains of Shigella dysenteriae isolated from UK travelers reporting symptoms of gastrointestinal (GI) disease between 2004 and 2017 were reviewed. Out of 548 the travelers, 90.9 % (498) reported travel outside the UK within seven days of onset of their symptoms, whereas 9.1 % (50/498) reported no travel in that period. During the course of this study, whole genome sequencing (WGS) was implemented for GI disease surveillance and phenotypic AMR profiles were compared to those derived from WGS data. The results revealed that the phenotypic and genotypic AMR results correlated well, with 90.1 % (121/133) isolates having concordant results to 10 classes of antimicrobials. However, resistance were observed to the first-line drugs commonly used in the treatment of shigellosis throughout the study – 54.1% to ampicillin; 33.7 % to chloramphenicol; 76.0 % to sulphonamides; and 80.0% to trimethoprim. Additionally, it was noted that between 2004 and 2017, resistance to all classes of antimicrobials, except the phenicols, increased. Meanwhile, the proportion of isolates exhibiting reduced susceptibility to ciprofloxacin increased from 3.8 % to 75.7 % from in 2004-2017; this was markedly associated with cases reporting travel to Asia. Furthermore, of the 201 sequenced isolates, 3.0 % had either blaCTX-M-15 or blaCMY-4. From the findings, it was inferred that increasing multi-drug resistance, along with resistance to the fluroquinolones and third generation cephalosporins, in Shigella dysenteriae causing travelers’ diarrhea provides further evidence for the need to regulate the use of antimicrobial agents and continuous monitoring of emerging AMR.

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