Ahead of Print -Outbreak of Ciprofloxacin-Resistant Shigella sonnei Associated with Travel to Vietnam, South Korea - Volume 21, Number 7—July 2015 - Emerging Infectious Disease journal - CDC
Volume 21, Number 7—July 2015
Outbreak of Ciprofloxacin-Resistant Shigella sonnei Associated with Travel to Vietnam, South Korea
Shigella spp. are etiologic agents of gastrointestinal disease worldwide and are frequently associated with outbreaks because of their low infectious doses and person-to-person transmission (1,2). For the treatment of persons who have severe infections, fluoroquinolones are among the first-line agents for adults; additionally, oral extended-spectrum cephalosporins are used to treat young children. However, the current emergence and spread of drug resistance in Shigella strains could hinder empirical antimicrobial therapy, leading to treatment failure. S. sonnei is the most frequently isolated species among all cases of Shigella infection in industrialized countries (3), and it has become increasingly prevalent across Southeast Asia in recent decades (4). Recently, international travel to areas where the disease is highly endemic has accelerated the global spread of drug-resistant S. sonnei to nonendemic regions. Here, we describe a travel-associated outbreak of illness caused by a S. sonnei strain that was resistant to extended-spectrum cephalosporins and fluoroquinolones.
Dr Kim is a researcher at Center for Infectious Disease in the Korea National Institute of Health. His primary research interests include antimicrobial drug susceptibility and molecular epidemiology of enteric bacteria.
This work was supported by a grant from the Korea Centers for Disease Control and Prevention [4847-311-210].
- Kotloff KL, Winickoff JP, Ivanoff B, Clemens JD, Swerdlow DL, Sansonetti PJ, Global burden of Shigella infections: implications for vaccine development and implementation of control strategies. Bull World Health Organ. 1999;77:651–66 .
- Boveé L, Whelan J, Sonder GJ, van Dam AP, van den Hoek A. Risk factors for secondary transmission of Shigella infection within households: implications for current prevention policy. BMC Infect Dis. 2012;12:347.
- Gupta A, Polyak CS, Bishop RD, Sobel J, Mintz ED. Laboratory-confirmed shigellosis in the United States, 1989–2002: epidemiologic trends and patterns. Clin Infect Dis. 2004;38:1372–7.
- Vinh H, Nhu NT, Nga TV, Duy PT, Campbell JI, Hoang NV, A changing picture of shigellosis in southern Vietnam: shifting species dominance, antimicrobial susceptibility and clinical presentation. BMC Infect Dis. 2009;9:204.
- Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing. 22nd informational supplement (M100–S22). Wayne (PA): The Institute; 2012.
- Kim JS, Kim J, Jeon SE, Kim SJ, Kim NO, Hong S, Complete nucleotide sequence of the IncI1 plasmid pSH4469 encoding CTX-M-15 extended-spectrum beta-lactamase in a clinical isolate of Shigella sonnei from an outbreak in the Republic of Korea. Int J Antimicrob Agents. 2014;44:533–7.
- Carattoli A, Bertini A, Villa L, Falbo V, Hopkins KL, Threlfall EJ. Identification of plasmids by PCR-based replicon typing. J Microbiol Methods.2005;63:219–28.
- García-Fernández A, Chiaretto G, Bertini A, Villa L, Fortini D, Ricci A, Multilocus sequence typing of IncI1 plasmids carrying extended-spectrum beta-lactamases in Escherichia coli and Salmonella of human and animal origin. J Antimicrob Chemother. 2008;61:1229–33 .
- Holt KE, Thieu Nga TV, Thanh DP, Vinh H, Kim DW, Vu Tra MP, Tracking the establishment of local endemic populations of an emergent enteric pathogen. Proc Natl Acad Sci U S A. 2013;110:17522–7.
- Woodford N, Carattoli A, Karisik E, Underwood A, Ellington MJ, Livermore DM. Complete nucleotide sequences of plasmids pEK204, pEK499, and pEK516, encoding CTX-M enzymes in three major Escherichia coli lineages from the United Kingdom, all belonging to the international O25:H4–ST131 clone. Antimicrob Agents Chemother. 2009;53:4472–82.
- Folster JP, Pecic G, Bowen A, Rickert R, Carattoli A, Whichard JM. Decreased susceptibility to ciprofloxacin among Shigella isolates in the United States, 2006 to 2009. Antimicrob Agents Chemother. 2011;55:1758–60.
- Ciesielczuk H, Hornsey M, Choi V, Woodford N, Wareham DW. Development and evaluation of a multiplex PCR for eight plasmid-mediated quinolone-resistance determinants. J Med Microbiol. 2013;62:1823–7.
- Lartigue MF, Poirel L, Decousser JW, Nordmann P. Multidrug-resistant Shigella sonnei and Salmonella enterica serotype Typhimurium isolates producing CTX-M β-lactamases as causes of community-acquired infection in France. Clin Infect Dis. 2005;40:1069–70.
Suggested citation for this article: Kim JS, Kim JJ, Kim SJ, Jeon SE, Seo KY, Choi JK, et al. Outbreak of ciprofloxacin-resistant Shigella sonnei associated with travel to Vietnam, South Korea. Emerg Infect Dis. 2015 Jul [date cited]. http://dx.doi.org/10.3201/eid2107.150363