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 3
Reported symptoms and illness severity of patients with shigellosis, by azithromycin susceptibility status and CD4 count, Minnesota, USA, 2012–2015*
| Characteristic | DSA status, n = 691 |
CD4 count, cells/mm3, n = 878† |
||||||||
|---|---|---|---|---|---|---|---|---|---|---|
| DSA, n = 46‡ | Azithromycin susceptible, n = 64§ | OR (95% CI)¶ | p value | <200, n = 6 | 200–500, n = 21 | >500, n = 35 | Not known to be PLWH, n = 816 | p value | ||
| Bloody diarrhea | 13 (35) | 247 (45) | 0.7 (0.3–1.3) | 0.31 | 2 (50) | 6 (46) | 9 (33) | 319 (46) | 0.65 | |
| Fever | 23 (66) | 406 (74) | 0.7 (0.3–1.4) | 0.32 | 3 (75) | 9 (69) | 18 (69) | 525 (75) | 0.89 | |
| Hospitalized | 8 (17) | 136 (21) | 0.8 (0.4–1.7) | 0.71 | 3 (50) | 8 (38) | 13 (37) | 143 (18) | <0.001# | |
| Death | 0 | 1 (0) | NA | 1.00 | 0 | 0 | 0 | 1 (0) | 0.99 | |
| Median illness duration, d (range) | 11 (3–91) | 9 (1–125) | NA | 0.004 | 7 (3–15) | 11.5 (4–23) | 11 (3–32) | 8 (0–125) | 0.03** | |
*Values are no. (%) unless otherwise indicated. DSA, decreased susceptibility to azithromycin; OR, odds ratio; NA, not applicable; PLWH, person living with HIV.
†Total number of infections was 882. However, CD4 count was not available for 4 PLWH.
‡Species distribution: Shigella sonnei, 52%; S. flexneri, 46%; S. boydii, 2%.
§Species distribution: S. sonnei, 83%; S. flexneri, 16%; S. boydii, 0.6%; S. dysenteriae, 0.3%.
¶Reference group is azithromycin-susceptible patients.
#Patients not known to be PLWH had lower hospitalization rates.
**Patients not known to be PLWH had shorter median duration of illness than PLWH with CD4 counts >200 cells/mm3.