Intercontinental dissemination of azithromycin-resistant shigellosis through sexual transmission: a cross-sectional study

Baker, Kate S.; Dallman, Timothy J.; Ashton, Philip; Day, Martin; Hughes, Gwenda; Crook, Paul; Gilbart, V L; Zittermann, Sandra; Allen, Vanessa; Howden, Benjamin P; Tomita, Takehiro; Valcanis, Mary; Harris, Simon R.; Connor, Thomas R.; Sintchenko, Vitali; Howard, Peter; Brown, Jonathon D.; Petty, Nicola K.; Gouali, Malika; Thanh, Duy Pham; Keddy, Karen H.; Smith, Anthony M.; Talukder, Kaisar A.; Faruque, Shah M.; Parkhill, Julian; Baker, Stephen; Weill, François‐Xavier; Jenkins, Claire; Thomson, Nicholas R.

doi:10.1016/s1473-3099(15)00002-x

Cited by 219 publications

(278 citation statements)

References 31 publications

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“…Nonetheless, to date no clinical resistance breakpoint has been established for the members of the Enterobacteriaceae family by either CLSI or EUCAST (CLSI, 2013;EUCAST, 2015). However, the isolation of highly azithromycin-resistant Enterobacteriaceae is increasing worldwide and the emergence of azithromycin-resistance has been observed among different members of this family in different geographical areas (Baker et al, 2015;Boumghar-Bourtchai et al, 2008;Bowen et al, 2015;Le Hello et al, 2013;Ochoa et al, 2009;Sj€ olund Karlsson et al, 2013;Vlieghe et al, 2012).…”

Section: Mechanisms Of Resistancementioning

confidence: 99%

“…This may be related to the presence of specific alleles which might have different inactivation levels, with the presence of unidentified macrolideresistance mechanisms or with the gene expression levels. In this latter line, different TMMR or multiple copies of the same TMMR may be present in the same or in different genetic structures within a microorganism (Baker et al, 2015;Katayama et al, 1998;Poirel et al, 2011;Soge et al, 2006). Moreover the final copy numbers of a specific gene also depend on its precise location (e.g.…”

Section: Mechanisms Of Resistancementioning

confidence: 99%

“…Together with its ability to inactivate azithromycin this finding may have a direct impact on the usefulness of azithromycin against pathogenic Enterobacteriaceae and has been increasingly described in Shigella spp. including some recent azithromycin-resistant Shigella sonnei outbreaks (Boumghar-Bourtchai et al, 2008;Gaudreau et al, 2014;Heiman et al, 2014;Howie et al, 2010;Sj€ olund Karlsson et al, 2013) and intercontinental spreaded Shigella flexneri 3a clone (Baker et al, 2015). The mph(A) gene has also been detected in a few isolates of the highly antibiotic-resistant Salmonella enterica serovar Kentucky, which is currently spreading from North Africa to different European countries (Le Hello et al, 2013).…”

Section: Phosphotransferasesmentioning

confidence: 99%

See 2 more Smart Citations

Macrolide resistance mechanisms inEnterobacteriaceae: Focus on azithromycin

Gomes

Martínez-Puchol

Palma

et al. 2016

Critical Reviews in Microbiology

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120

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Section: Mechanisms Of Resistancementioning

confidence: 99%

Section: Mechanisms Of Resistancementioning

confidence: 99%

Section: Phosphotransferasesmentioning

confidence: 99%

See 1 more Smart Citation

Macrolide resistance mechanisms inEnterobacteriaceae: Focus on azithromycin

Gomes

Martínez-Puchol

Palma

et al. 2016

Critical Reviews in Microbiology

119

120

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“…Strains from Israel and strains from nearly all previously reported OJC outbreaks elsewhere formed a distinct OJC-associated sublineage that emerged ≈30 years ago. Unlike other described emergent Shigella sublineages (17,28), the OJC-associated lineage lacked a defining association with AMR.…”

Section: Discussionmentioning

confidence: 70%

“…Analysis of sequencing data was similar to that previously described (28). Multiple sequence alignment for phylogenetic analysis was generated by mapping to reference isolate S. sonnei Ss046 (GenBank accession no.…”

Section: Methodsmentioning

confidence: 99%

Travel- and Community-Based Transmission of Multidrug-ResistantShigellasonneiLineage among International Orthodox Jewish Communities

Baker¹,

Dallman²,

Behar³

et al. 2016

Emerg. Infect. Dis.

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Effect of Bismuth Subsalicylate vs Placebo on Use of Antibiotics Among Adult Outpatients With Diarrhea in Pakistan

et al. 2019

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IMPORTANCE Many of the 4.5 billion annual episodes of diarrhea are treated unnecessarily with antibiotics; prevalence of antibiotic resistance among diarrheal pathogens is increasing. Knowledgebased antibiotic stewardship interventions typically yield little change in antibiotic use. OBJECTIVE To compare antibiotic use among adult outpatients with diarrhea given bismuth subsalicylate (BSS) or placebo. DESIGN, SETTING, AND PARTICIPANTS This randomized clinical trial took place from April to October 2014. Participants were patients aged 15 to 65 years with acute, nonbloody diarrhea from 22 outpatient clinics in Karachi, Pakistan. Participants were interviewed about symptoms and health care utilization during the 5 days after enrollment. Group assignment was concealed from participants, field staff, and the statistician. Primary analysis occurred from August to September 2015. INTERVENTIONS Participants were randomly assigned (1:1) to receive BSS or placebo for 48 hours or less. MAIN OUTCOMES AND MEASURES Use of systemic antibiotics within 5 days of enrollment. Secondary outcomes included measures of duration and severity of illness. RESULTS Among eligible patients, 39 declined to participate, 440 enrolled, and 1 enrolled participant was lost to follow-up, for a total of 439 patients included in the analysis. Median (interquartile range) participant age was 32 (23-45) years and 187 (43%) were male. Two hundred twenty patients were randomized to BSS and 220 were randomized to placebo. Overall, 54 participants (12%) used systemic antibiotics (16% in the placebo group and 9% in the BSS group); all antibiotic use followed consultation with a physician. Use of any antibiotic was significantly lower in the BSS group (20 of 220 vs 34 of 219 patients; odds ratio [OR], 0.54; 95% CI, 0.30-0.98), as was use of fluoroquinolones (8 of 220 vs 20 of 219 patients; OR, 0.38; 95% CI, 0.16-0.88). Rates of care seeking and hospitalization were similar between groups and no difference was detected in timing of diarrhea resolution. However, those in the BSS group less commonly received intravenous rehydration (14 of 220 vs 27 of 219 patients; OR, 0.48; 95% CI, 0.25-0.95) and missed less work (median [interquartile range], 0 [0-1] vs 1 [0-1] day; P = .04) during follow-up. CONCLUSIONS AND RELEVANCE This study found less antibiotic use among participants given BSS for acute diarrhea in a setting where antibiotics are commonly used to treat diarrhea. Encouraging health care professionals in such settings to recommend BSS as frontline treatment for adults with (continued) Key Points Question Among adults with diarrhea, does use of bismuth subsalicylate reduce antibiotic consumption? Findings In this placebo-controlled randomized trial that included 439 adults in Pakistan, antibiotic use occurred among 16% of participants who received placebo and 9% of those who received bismuth subsalicylate, a significant difference. Meaning The findings suggest that recommending bismuth subsalicylate as a frontline treatment for adults with diarrhea, inclu...

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Intercontinental dissemination of azithromycin-resistant shigellosis through sexual transmission: a cross-sectional study

Abstract: Wellcome Trust (grant number 098051).

Cited by 219 publications

References 31 publications

Macrolide resistance mechanisms inEnterobacteriaceae: Focus on azithromycin

Macrolide resistance mechanisms inEnterobacteriaceae: Focus on azithromycin

Travel- and Community-Based Transmission of Multidrug-ResistantShigellasonneiLineage among International Orthodox Jewish Communities

Effect of Bismuth Subsalicylate vs Placebo on Use of Antibiotics Among Adult Outpatients With Diarrhea in Pakistan

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