Hinic Vladimira, Seth-Smith Helena, Stöckle Marcel, Goldenberger Daniel, Egli Adrian
Division of Clinical Microbiology, University Hospital Basel, Switzerland.
University Hospital Basel, 4031, Basel, SWITZERLAND / Applied Microbiology Research, Department of Biomedicine, University of Basel, Switzerland.
Swiss Med Wkly. 2018 Aug 22;148:w14645. doi: 10.4414/smw.2018.14645. eCollection 2018 Aug 13.
Shigella sonnei causes foodborne infections, but has recently also been described as a sexually transmitted infection (STI), with increased levels of antimicrobial resistance. We describe three cases of sexually acquired Shigella sonnei infection - the first report of this emerging infection in Switzerland. We used in-house whole genome sequencing (WGS) to investigate possible transmission routes and epidemiological correlations between the three cases. The genomic analysis demonstrated that two of three case isolates were very closely related, with only two single nucleotide polymorphism differences between them, despite being isolated from two unrelated patients at time-points six months apart, and the infections having been acquired at different geographic locations within Europe. All three isolates were found to fall within two of the clusters (1 and 7) defined within UK men who have sex with men (MSM) isolate populations, but with higher divergence, suggesting a more diverse pool circulating within Europe. Phenotypic testing confirmed the genotypic findings, with all three isolates azithromycin resistant, and two out of three resistant to quinolones. This report underlines the importance of the implementation of new sequencing technologies in the investigation of epidemiological aspects of this STI circulating in the population of MSM. In such cases, therapy should always be guided by antimicrobial susceptibility testing owing to increasing resistances. Greater awareness of this emerging sexually transmitted infection is needed.
宋内志贺菌可引起食源性感染，但最近也被描述为一种性传播感染（STI），且抗菌药物耐药性水平有所上升。我们描述了3例性传播的宋内志贺菌感染病例——这是瑞士关于这种新出现感染的首例报告。我们使用内部全基因组测序（WGS）来调查这3例病例之间可能的传播途径和流行病学关联。基因组分析表明，3例病例分离株中的2株密切相关，尽管它们是在相隔6个月的时间点从两名无关联的患者中分离出来的，且感染发生在欧洲不同地理位置，但它们之间仅有两个单核苷酸多态性差异。所有3株分离株均属于在英国男男性行为者（MSM）分离株群体中定义的两个簇（1和7），但差异更大，表明在欧洲有更多样化的菌株在传播。表型检测证实了基因型结果，所有3株分离株均对阿奇霉素耐药，3株中有2株对喹诺酮类耐药。本报告强调了在调查这种在男男性行为者群体中传播的性传播感染的流行病学方面采用新测序技术的重要性。在这种情况下，由于耐药性增加治疗应始终以抗菌药物敏感性试验为指导。需要提高对这种新出现的性传播感染的认识。
