Rapid emergence of extensively drug-resistant Shigella sonnei in France

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Lefèvre, Sophie | Njamkepo, Elisabeth | Feldman, Sarah | Ruckly, Corinne | Carle, Isabelle | Lejay-Collin, Monique | Fabre, Laëtitia | Yassine, Iman | Frézal, Lise | Pardos de la Gandara, Maria | Fontanet, Arnaud | Weill, François-Xavier

Edité par CCSD ; Nature Publishing Group -

International audience. Shigella sonnei, the main cause of bacillary dysentery in high-income countries,has become increasingly resistant to antibiotics. We monitored the anti-microbial susceptibility of 7121 S. sonnei isolates collected in France between2005 and 2021. We detected a dramatic increase in the proportion of isolatessimultaneously resistant to ciprofloxacin (CIP), third-generation cephalos-porins (3GCs) and azithromycin (AZM) from 2015. Our genomic analysis of164 such extensively drug-resistant (XDR) isolates identified 13 differentclusters within CIP-resistant sublineage 3.6.1, which was selected in South Asia∼15 years ago. AZM resistance was subsequently acquired, principally throughIncFII (pKSR100-like) plasmids. The last step in the development of theXDR phenotype involved various extended-spectrum beta-lactamase genes(blaCTX-M-3, blaCTX-M-15, blaCTX-M-27, blaCTX-M-55, and blaCTX-M-134) carried bydifferent plasmids (IncFII, IncI1, IncB/O/K/Z) or even integrated into thechromosome, and encoding resistance to 3GCs. This rapid emergence of XDRS. sonnei, including an international epidemic strain, is alarming, and goodlaboratory-based surveillance of shigellosis will be crucial for informeddecision-making and appropriate public health action.

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