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
, Pamela Talley, Anna Bowen, Fe Leano, Ginette Dobbins, Selina Jawahir, Annastasia Gross, Dawn Huspeni, Allison La Pointe, Stephanie Meyer, and Kirk Smith
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.