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Volume 22, Number 9—September 2016
Research

Elevated Risk for Antimicrobial Drug–Resistant Shigella Infection among Men Who Have Sex with Men, United States, 2011–2015

Anna BowenComments to Author , Julian Grass, Amelia Bicknese, Davina Campbell, Jacqueline Hurd, and Robert D. Kirkcaldy
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA

Main Article

Table 1

Clusters of shigellosis with resistance to CIP, CRO, or AZM, United States, January 2011–December 2015*

Cluster
PFGE pattern†
Shigella sp.
Onset
No. cases‡
No. states with cases
Transmission route
Median patient age, y
Male sex, %
No. isolates tested by NARMS
No. isolates with resistance§
No. drug classes with resistance§ Ref
Penicillins,
AMP
β-lactam inhibitors,
AMC
Cephems
TETs, TET Aminoglycosides
Quinolones
Folate pathway inhibitors
Phenicols, CHL Macrolides, AZM
FOX
CEF
CRO
STR
GEN
NAL
CIP
SXZ
TMP/SXT
With resistance to AZM, CRO, or CIP
1 J16X01.3056, J16X01.7056 S. sonnei 2012 Apr 43 1 Food (bridge club) 87 57 4 0 0 0 0 0 4 4 0 0 0 4 4 0 4 4 (11)
2 J16X01.1244, J16X01.0728, J16X01.0038 S. sonnei 2014 Apr 128 16 MSM 38 83 14 11 0 3 3 3 11 14 0 0 0 12 12 0 10 6
3 J16X01.0618 S. sonnei 2014 Apr 7 6 MSM 36 100 4 3 0 0 0 0 4 4 0 0 0 4 4 0 3 5
4 J16X01.0232, J16X01.0775 S. sonnei 2014 May >300 34 Person-to-person 43 54 32 1 0 0 0 0 26 26 0 32 13 26 26 0 0 5 (9)
5 J16X01.3176, J16X01.3056 S. sonnei 2014 Jul 24 2 MSM 36 100 21 21 0 0 0 0 21 21 0 0 0 21 21 0 21 5 (8)
6 J16X01.0232, J16X01.0775 S. sonnei 2014 Sep 22 5 MSM 42 90 12 11 0 0 0 0 12 12 0 12 12 12 12 0 11 6 (9,10)
7 J16X01.0286, J16X01.3294 S. sonnei 2015 Mar 12 7 MSM 37 100 2 0 0 0 0 0 1 1 0 2 2 1 1 0 0 4
8 J16X01.1058, J16A26.0030 S. sonnei 2015 Apr 41 9 MSM 26 85 7 6 0 0 6 1 7 0 0 0 7 7 0 6 6
9
JZXN11.0302
S. flexneri 4a (IV:-)
2015 Aug
6
3
MSM
40
100
3
3
0
0
0
0
3
3
0

0
0

3
3
3
1
6

Without resistance to AZM, CRO, or CIP
10 J16X01.0408, J16A26.0071 S. sonnei 2011 Jul 16 1 Recreational water 9 44 1 0 0 0 0 0 1 1 0 0 0 1 1 0 0 3
11 J16X01.1290 S. sonnei 2011 Sep 61 1 Person-to-person 7 41 5 0 0 0 0 0 0 5 0 0 0 0 0 0 0 1
12 J16X01.0283, J16A26.0051 S. sonnei 2011 Nov 12 2 Food 49 92 1 0 0 0 0 0 0 1 0 0 0 0 1 0 0 2
13 J16X01.0559 S. sonnei 2012 Feb 33 1 Person-to-person NA NA 3 3 0 0 0 0 0 3 0 0 0 3 3 0 0 3
14 J16X01.0283, J16X01.0199 S. sonnei 2012 Mar 18 1 Person-to-person 9 25 1 1 0 0 0 0 0 1 0 0 0 0 0 0 0 2
15 J16X01.1986, J16X01.0199, J16X01.2995 S. sonnei 2012 Jul 100 1 Person-to-person 3 NA 3 0 0 0 0 0 0 3 0 0 0 0 0 0 0 1
16 J16X01.3073, J16X01.3072 S. sonnei 2012 Oct 29 1 Person-to-person 8 46 4 0 0 0 0 0 0 4 0 0 0 0 0 0 0 1
17 J16X01.2995 S. sonnei 2013 Mar 13 1 Person-to-person 4 33 5 1 0 0 0 0 0 5 0 0 0 1 1 0 0 3
18 J16X01.0408, J16X01.0981, J16X01.3218 S. sonnei 2013 Jul 58 4 Recreational water 8 48 6 0 0 0 0 0 5 6 0 0 0 5 5 0 0 3
19 J16X01.3157 S. sonnei 2014 Feb 263 3 Person-to-person 7 48 19 2 1 0 0 0 3 19 0 0 0 4 7 0 0 4
20 J16X01.1166 S. sonnei 2014 Mar 9 1 Food 31 56 2 0 0 0 0 0 2 2 0 0 0 2 2 0 0 3
21 J16X01.2624 S. sonnei 2014 Jul 8 3 Food 25 34 2 0 0 0 0 0 2 2 0 0 0 2 2 0 0 3
22 J16X01.0199, J16X01.0283 S. sonnei 2014 Jul 335 26 Person-to-person 8 45 21 1 0 0 0 0 6 21 0 0 0 7 14 0 0 3
23 J16X01.1166, J16X01.1148 S. sonnei 2014 Jul 474 31 Person-to-person 8 42 59 7 0 0 0 0 2 59 0 1 0 3 4 0 0 3
24 J16X01.2493, J16X01.0623 S. sonnei 2014 Sep 30 5 Food 28 31 5 0 0 0 0 0 3 5 0 0 0 3 4 0 0 3
25 J16X01.1254 S. sonnei 2014 Oct 13 5 Person-to-person 17 45 4 3 0 0 0 0 0 4 0 0 0 0 0 0 0 2
26 J16X01.0437, J16X01.0466 S. sonnei 2014 Nov 53 4 Person-to-person 9 51 5 0 0 0 0 0 1 3 0 0 0 1 3 0 0 3
27 J16X01.1244 S. sonnei 2014 Jun 6 1 Food 13 50 1 0 0 0 0 0 0 1 0 0 0 1 1 0 0 2
28 J16X01.1166, J16X01.1148, J16X01.2427 S. sonnei 2015 May 982 26 Person-to-person 7 44 42 16 0 0 0 0 3 42 0 0 0 3 5 0 0 3
29 J16X01.1278 S. sonnei 2015 Jun 34 3 Person-to-person 7 53 4 0 0 0 0 0 0 4 0 0 0 0 0 0 0 1
30 J16X01.2261 S. sonnei 2015 Jun 15 3 Person-to-person 4 38 3 0 0 0 0 0 0 3 0 0 0 0 0 0 0 1
31 J16X01.1298 S. sonnei 2015 Jul 15 4 Person-to-person 21 30 1 0 0 0 0 0 0 1 0 0 0 0 1 0 0 2
32 ≈27 patterns S. sonnei 2015 Oct 118 1 Person-to-person 26 50 7 0 0 0 0 0 3 7 0 0 0 3 4 0 0 3

*AMC, amoxicillin/clavulanic acid; AMP, ampicillin; AZM, azithromycin; CEF, ceftiofur; CHL, chloramphenicol; CIP, ciprofloxacin; CRO, ceftriaxone; FOX, cefoxitin; GEN, gentamycin; MSM, men who have sex with men; NAL, nalidixic acid; NARMS, National Antimicrobial Resistance Monitoring System for Enteric Bacteria; NA, not available; PFGE, pulsed-field gel electrophoresis; Ref, reference; STR, streptomycin; SXZ, sulfisoxazole; TET, tetracycline; TMP/SXT, trimethoprim/sulfamethoxazole. Blank cells indicate no previous reference, i.e., clusters that have not previously been published.
†PFGE was performed by PulseNet using enzyme XbaI for S. sonnei and NotI for S. flexneri (22).
‡Clusters 2, 6, and 8 had ongoing transmission as of December 2015.
§As defined by the Clinical and Laboratory Standards Institute; for AZM, resistance was defined as non–wild-type MICs (24).
¶Among 6 isolates tested.

Main Article

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Main Article

Page created: August 16, 2016
Page updated: August 16, 2016
Page reviewed: August 16, 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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