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Volume 26, Number 4—April 2020
Synopsis

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

Dana EikmeierComments to Author , Pamela Talley, Anna Bowen, Fe Leano, Ginette Dobbins, Selina Jawahir, Annastasia Gross, Dawn Huspeni, Allison La Pointe, Stephanie Meyer, and Kirk Smith
Author affiliations: Minnesota Department of Health, St. Paul, Minnesota, USA (D. Eikmeier, F. Leano, G. Dobbins, S. Jawahir, A. Gross, D. Huspeni, A. La Pointe, S. Meyer, K. Smith); Centers for Disease Control and Prevention, Atlanta, Georgia, USA (P. Talley, A. Bowen)

Main Article

Table 2

Antimicrobial drug class resistance for Shigella isolates, by patient sex, age, and international travel status, Minnesota, USA, 2012–2015*

Characteristic Total, n = 691 Known international travel, n = 69 Men, n = 194† Children and women, n = 428‡ OR (95% CI)§ p value
Antimicrobial drug class (drug)
Aminoglycoside (GEN, STR) 660 (96) 61 (88) 191 (98) 408 (95) 3.1 (0.9–10.6) 0.07
Cephem (CRO, CEF) 13 (2) 2 (3) 3 (2) 8 (2) 0.8 (0.2–3.1) 1.0
Folate-pathway inhibitor (SUL, SXT) 416 (60) 56 (81) 148 (76) 212 (50) 3.3 (2.2–4.8) <0.001
Macrolide (AZT) 46 (7) 3 (4) 42 (22) 1 (0) 118.0 (16.1–864.7) <0.001
Penicillin (AMP) 162 (23) 27 (39) 74 (38) 61 (14) 3.7 (2.5–5.5) <0.001
Phenicol (CHL) 76 (11) 22 (32) 26 (13) 28 (7) 2.2 (1.3–3.9) 0.01
Quinolone (CIP, NAL) 52 (8) 23 (33) 23 (12) 6 (1) 9.5 (3.8–23.6) <0.001
Tetracycline (TET)
257 (37)
60 (87)
124 (64)
73 (17)
8.6 (5.9–12.7)
<0.001
Class resistance
No resistance detected 6 (1) 2 (3) 0 (0) 4 (1) NA 0.32
≥3 classes 266 (38) 60 (87) 130 (67) 76 (18) 9.4 (6.4–13.9) <0.001
Clinical resistance¶ 486 (70) 66 (96) 173 (89) 247 (58) 6.0 (3.7–9.9) <0.001

*Values are no. (%) resistant except as indicated. Adults are persons >18 years of age; children are persons <18 years of age. AMP, ampicillin; AZT, azithromycin; CHL, chloramphenicol; CEF, cephalothin; CIP, ciprofloxacin; CRO, ceftriaxone; GEN gentamicin; NA, not applicable; NAL, nalidixic acid; OR, odds ratio; STR, streptomycin; SUL, sulfisoxazole; SXT, trimethoprim/sulfamethoxazole; TET, tetracycline.
†Total excludes 23 known international travelers.
‡Total excludes 46 known international travelers.
§Comparison of men with children and women. Reference group is children and women.
¶Resistance to >1 of the following antimicrobial drug classes: cephem, folate-pathway inhibitor, macrolide, penicillin, quinolone.

Main Article

Page created: March 17, 2020
Page updated: March 17, 2020
Page reviewed: March 17, 2020
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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