What is the overlap between HIV and shigellosis epidemics in England: further evidence of MSM transmission?

Mohan, Keerthi; Hibbert, Matthew Peter; Rooney, Graeme; Canvin, Malcolm; Childs, Tristan; Jenkins, Claire; Simms, Ian; Kirwan, Peter; Delpech, Valérie; Yin, Zhihua; Hughes, Gwenda; Field, Nigel

doi:10.1136/sextrans-2016-052962

Cited by 30 publications

(35 citation statements)

References 14 publications

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“…These clusters also contained isolates from men that reported no sexual contact with other men or isolates from women. This could possibly be due to spillover to the non-MSM population, or (8,11). Our study confirmed this phenomenon for the Dutch situation, as 30% to 100% of patients infected with isolates within MSM-associated clusters reported also an HIV infection, and only three patients that reported HIV were infected with isolates outside the MSM clusters.…”

Section: Mlst and Cgmlst Analysis And Genomic Epidemiologysupporting

confidence: 83%

“…Our study confirmed this phenomenon for the Dutch situation, as 30% to 100% of patients infected with isolates within MSM-associated clusters reported also an HIV infection, and only three patients that reported HIV were infected with isolates outside the MSM clusters. It was thought that this coexistence of shigellosis amongst MSM and HIV has multiple causes, which can be divided into social causes, as for instance specific sexual practices or the use of social media that might cause serosorting based on HIV status, and biological causes, as for instance susceptibility to infectious diseases or increased shedding of bacteria (8,11).…”

Section: Mlst and Cgmlst Analysis And Genomic Epidemiologymentioning

confidence: 99%

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The importance of a multifactorial approach for (inter)national surveillance of Shigella spp. and entero-invasive Escherichia coli

Beld¹,

Reubsaet²,

Pijnacker³

et al. 2019

Preprint

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Background: Shigella spp. and entero-invasive Escherichia coli (EIEC) can cause mild diarrhea to dysentery. In the Netherlands, although shigellosis is a notifiable disease, there is no laboratory surveillance for Shigella spp. and EIEC in place. Consequently, the population structure for circulating Shigella spp. and EIEC isolates is not known. This study describes the phenotypic and serological characteristics, the phenotypic and genetic antimicrobial resistance profiles, the virulence gene profiles, the classic multi-locus sequence types (MSLT) and core genome MLST (cgMLST) types, and the epidemiology of Shigella spp. and EIEC isolates collected during a cross-sectional study in the Netherlands in 2016 and 2017. Results: S. sonnei, S. flexneri and EIEC were predominantly detected in the Netherlands. A substantial part of the characterized isolates was resistant to antimicrobials advised for treatment, i.e., 73% was phenotypically resistant to co-trimoxazol and 19% to ciprofloxacin. Antimicrobial resistance was particularly observed in isolates from male patients who had sex with men or from patients that had travelled to Asia. Furthermore, isolates related to international clusters were also circulating in the Netherlands. Travel-related isolates formed clusters with isolates from patients without travel history, indicating their emergence into the Dutch population. Conclusions: In conclusion, laboratory surveillance using whole genome sequencing for genetic characterization of isolates complements the current epidemiological surveillance, as the latter is not sufficient to detect all (inter)national clusters, emphasizing the importance of multifactorial public health approaches.

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Section: Mlst and Cgmlst Analysis And Genomic Epidemiologysupporting

confidence: 83%

Section: Mlst and Cgmlst Analysis And Genomic Epidemiologymentioning

confidence: 99%

The importance of a multifactorial approach for (inter)national surveillance of Shigella spp. and entero-invasive Escherichia coli

Beld¹,

Reubsaet²,

Pijnacker³

et al. 2019

Preprint

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“…However, resistance profiles differed across groups at risk for shigellosis; 42 of the 43 domestically acquired DSA-Shigella cases in Minnesota occurred among men, 60% of whom were also infected with HIV. This trend has been observed in other jurisdictions and has implications for clinical testing, public health surveillance, case management, and prevention efforts (27)(28)(29).…”

Section: Discussionmentioning

confidence: 63%

Decreased Susceptibility to Azithromycin in ClinicalShigellaIsolates Associated with HIV and Sexually Transmitted Bacterial Diseases, Minnesota, USA, 2012–2015

Eikmeier¹,

Talley²,

Bowen³

et al. 2020

Emerg. Infect. Dis.

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S higella is an enteric bacterial pathogen that causes diarrhea (sometimes bloody), fever, and cramps (1). An estimated 500,000 Shigella infections occur annually in the United States (2). Shigella transmission is fecal-oral; it is easily spread person-to-person because of a low infectious dose. Outbreaks are most frequently documented in childcare settings but have also been reported among men who have sex with men (MSM) (3-7). Shigella infections are typically selflimiting, but treatment is recommended for patients with severe illness or underlying immunocompromising conditions (1,8). Antimicrobial drug treatment might shorten illness duration and is often used in childcare-associated outbreaks to prevent secondary transmission (1,8). When Shigella antimicrobial drug susceptibilities are unknown (e.g., when empiric therapy is started before culture and sensitivity results are available) or if the isolate is resistant to ampicillin and trimethoprim/sulfamethoxazole, oral treatment options include ciprofloxacin or azithromycin (1). However, fluoroquinolones, including ciprofloxacin, are generally avoided for treatment in children because of the risk for musculoskeletal damage (9). The emergence of Shigella with decreased susceptibility to azithromycin (DSA) has been reported in Asia, Europe, North America, and Oceania (10-17). Local outbreaks and intercontinental sexual transmission of DSA-Shigella have been observed among MSM (10,15,18-20). Co-infection with other enteric pathogens and sexually transmitted diseases (STDs) have also been reported among MSM (20-24). In 2016, the Clinical and Laboratory Standards Institute (CLSI) defined epidemiologic cutoff values for azithromycin resistance in S. sonnei or S. flexneri for the first time (25). Previously, the National Antimicrobial Resistance Monitoring System (NARMS) had documented DSA (azithromycin MIC >16 µg/ mL) among Shigella isolates; during 2011-2015, DSA prevalence increased from 0.9% to 6.1% among S. sonnei isolates and from 12.1% to 32.9% among S. flexneri

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“…HIV infection has been described as an independent risk factor [37,41]. In England, approximately 20% of all Shigella cases among men without a reported travel history may be HIV-positive [61]. The burden of illness in MSM can be substantial, particularly with S. flexneri which is more virulent and pathogenic [62], resulting in hospital admissions and significant complications such as bacteraemia or acute kidney injury, even among HIV-positive patients with high CD4 counts [59,63].…”

Section: Recent Outbreaks Of Steis Hepatitis Amentioning

confidence: 99%

Recent epidemiology of sexually transmissible enteric infections in men who have sex with men

Mitchell

Hughes

2018

Current Opinion in Infectious Diseases

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The roles of asymptomatic and/or persistent infection and other contextual factors in STEI transmission are not well described. STEI-associated AMR is increasing and has potential to spread rapidly in MSM, warranting further public health attention. A better understanding of the factors associated with sexual transmission will enable the development of more effective control measures. A holistic approach that promotes health and wellbeing as well as infection prevention and management is needed.

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What is the overlap between HIV and shigellosis epidemics in England: further evidence of MSM transmission?

Abstract: Background

Cited by 30 publications

References 14 publications

The importance of a multifactorial approach for (inter)national surveillance of Shigella spp. and entero-invasive Escherichia coli

The importance of a multifactorial approach for (inter)national surveillance of Shigella spp. and entero-invasive Escherichia coli

Decreased Susceptibility to Azithromycin in ClinicalShigellaIsolates Associated with HIV and Sexually Transmitted Bacterial Diseases, Minnesota, USA, 2012–2015

Recent epidemiology of sexually transmissible enteric infections in men who have sex with men

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