Clinical Infection, Microbiology, and Immunology, University of Liverpool, Liverpool, UK.
2Independent Consultant, Johannesburg, South Africa.
Nat Commun. 2023 Nov 24;14(1):7715. doi: 10.1038/s41467-023-43345-5.
Shigellosis, a leading cause of diarrhoeal mortality and morbidity globally, predominantly affects children under five years of age living in low- and middle-income countries. While whole genome sequence analysis (WGSA) has been effectively used to further our understanding of shigellosis epidemiology, antimicrobial resistance, and transmission, it has been under-utilised in sub-Saharan Africa. In this study, we applied WGSA to large sub-sample of surveillance isolates from South Africa, collected from 2011 to 2015, focussing on Shigella flexneri 2a and Shigella sonnei. We find each serotype is epidemiologically distinct. The four identified S. flexneri 2a clusters having distinct geographical distributions, and antimicrobial resistance (AMR) and virulence profiles, while the four sub-Clades of S. sonnei varied in virulence plasmid retention. Our results support serotype specific lifestyles as a driver for epidemiological differences, show AMR is not required for epidemiological success in S. flexneri, and that the HIV epidemic may have promoted Shigella population expansion.
志贺菌病是全球导致腹泻死亡和发病的主要原因，主要影响生活在中低收入国家的 5 岁以下儿童。全基因组序列分析（WGSA）已被有效地用于深入了解志贺菌病的流行病学、抗微生物药物耐药性和传播，但在撒哈拉以南非洲地区的应用不足。在这项研究中，我们应用 WGSA 对南非 2011 年至 2015 年期间收集的大量监测分离株的小样本进行了分析，重点关注福氏志贺菌 2a 和宋内志贺菌。我们发现每种血清型在流行病学上都是不同的。确定的四个福氏志贺菌 2a 群具有不同的地理分布和抗微生物药物耐药性（AMR）和毒力特征，而宋内志贺菌的四个亚系在毒力质粒保留方面存在差异。我们的研究结果支持血清型特异性生活方式是导致流行病学差异的驱动因素，表明 AMR 不是福氏志贺菌在流行病学上取得成功的必要条件，并且 HIV 流行可能促进了志贺菌种群的扩张。
