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- W4283017653 abstract "<h3>Introduction</h3> Shigellosis, traditionally a food and waterborne infection, causes significant morbidity globally. It is now a leading cause of sexually transmitted gastroenteritis among gay, bisexual and other men who have sex with men (MSM). We describe an ongoing international outbreak of extensively-drug resistant (XDR) Shigella sonnei, first detected in the UK. <h3>Methods</h3> Routine laboratory surveillance identified an exceedance of S. sonnei Clade 5 in England since September 2021. We used whole genome sequencing with single nucleotide polymorphism (SNP) typing for identification of genomic clusters and AMR determinants, analysing cases across the UK. Case enhancement using questionnaires collected demographic, epidemiological, and clinical data. Findings Seventy-two cases (97% male, median age 34 years) belonging to a 10 SNP single linkage cluster of S. sonnei Clade 5 were identified between 04 September 2021 and 09 February 2022. Most (78%) were HIV-negative MSM taking HIV pre-exposure prophylaxis (PrEP), reporting sexual contacts in the UK and Europe within the incubation period. Isolates were predominantly XDR, with 92% of strains harbouring blaCTX-M-27, a plasmid-mediated gene for production of extended spectrum beta-lactamases (ESBLs). Of 33 enhanced cases, 58% received antibiotics, 24% were hospitalised. Possible treatment failures were identified in 37% of enhanced cases receiving antibiotics (n=7). <h3>Discussion</h3> We highlight the rapid dissemination of XDR ESBL-producing S. sonnei in international sexual networks of MSM. We recommend global strengthening of Shigella screening where clinically indicated, AMR surveillance and integrated health promotion messaging among MSM using PrEP to reduce transmission and improve public health." @default.
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- W4283017653 date "2022-06-01" @default.
- W4283017653 modified "2023-09-26" @default.
- W4283017653 title "O24 Sexually transmitted shigellosis: an international outbreak of extensively-drug resistant Shigella sonnei, United Kingdom, 2021–22" @default.
- W4283017653 doi "https://doi.org/10.1136/sextrans-bashh-2022.24" @default.
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