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Volume 22, Number 11—November 2016
Dispatch

ESBL-Producing and Macrolide-Resistant Shigella sonnei Infections among Men Who Have Sex with Men, England, 2015

Piers MookComments to Author , Jacquelyn McCormick, Manpreet Bains, Lauren A. Cowley, Marie A. Chattaway, Claire Jenkins, Amy Mikhail, Gwenda Hughes, Richard Elson, Martin Day, Rohini Manuel, Jayshree Dave, Nigel Field1, Gauri Godbole1, Timothy J. Dallman2, and Paul Crook2
Author affiliations: Public Health England, London, UK (P. Mook, J. McCormick, M. Bains, L.A. Cowley, M.A. Chattaway, C. Jenkins, A. Mikhail, G. Hughes, R. Elson, M. Day, N. Field, G. Godbole, T. Dallman, P. Crook); Barts Health National Health Service Trust, London (R. Manuel, J. Dave); University College London, London (N. Field)

Main Article

Table 2

Reported exposure history for 9 case-patients with Shigella sonnei infection in the cluster with ESBL production and macrolide resistance, England, 2015*

Risk factor No. (%) exposed No. (%) unexposed No. unknown†
Exposure ever before onset
Self-identified as a man who has sex with men 7 (100) 0 2
Fisting 2 (29) 5 (71) 2
Sex under the influence of recreational drugs 4 (57) 3 (43) 2
Scat play 0 7 (100) 2
History of other sexually transmitted infections 7 (88) 1 (13) 1
Use of apps to meet partners 5 (71) 2 (29) 2
Awareness of Shigella infections 0 7 (100) 2
Previous Shigella diagnosis 0 8 (100) 1
Known to sexual health services
 7 (100)
 0
 2
Exposure during the 2 weeks before onset
Fisting 1 (14) 6 (86) 2
Sex under the influence of recreational drugs 3 (43) 4 (57) 2
Oral–anal contact 3 (43) 4 (57) 2
Condomless sex‡ 5 (71) 2 (29) 2
Attended sex parties or live sex premises 3 (43) 4 (57) 2
Use of sex toys with partner 1 (14) 6 (86) 2
Scat play 0 7 (100) 2

*ESBL, extended-spectrum β-lactamase; scat play, sexual arousal or activity linked to feces.
†Unknowns were not included in percentage calculations; 7 of 9 patients completed and 1 partially completed interviews about sexual behavior.
‡Any condomless sexual contact.

Main Article

1These authors contributed equally to this article.

2These senior authors contributed equally to this article.

Page created: October 19, 2016
Page updated: October 19, 2016
Page reviewed: October 19, 2016
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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