Identification and Characterization of Shigella with Decreased Susceptibility to Azithromycin in the United States, 2005 to 2014

Details

• Alternative Title:
  J Glob Antimicrob Resist
• Personal Author:
  Campbell, Davina ; Bowen, Anna ; Bhatnagar, Amelia ; McCullough, Andre ; Grass, Julian ; Chen, Jessica ; Folster, Jason P.
• Description:
  Objectives
  
  To identify Shigella isolates in the U.S. with decreased susceptibility to azithromycin (DSA) and characterized the genetic mechanisms responsible for this resistance.
  
  Methods
  
  The National Antimicrobial Resistance Monitoring System (NARMS) at Centers for Disease Control and Prevention (CDC) collects and conducts broth microdilution antimicrobial susceptibility testing on Shigella to determine minimum inhibitory concentrations (MIC) for up to 15 drugs, including azithromycin. Isolates with decreased susceptibility to azithromycin were subjected to molecular methods (PCR, whole genome sequencing, and plasmid typing/transformation) to identify the genetic mechanisms of resistance.
  
  Results
  
  A total of 118 isolates with decreased susceptibility to azithromycin were tested; 65 (55%) isolates contained only mphA, one (<1%) isolate contained only ermB, and 51 (43%) isolates contained both mechanisms. Seven isolates contained IncFII plasmids with mphA, ermB, or mphA and ermB, while one isolate contained an IncB/O plasmid with mphA. One (<1%) isolate that contained neither mphA nor ermB contained mutations in rrlH, rplD, and rplV genes, and an insertion in rplV, the function of which are not yet known.
  
  Conclusions
  
  Additional studies are needed to understand the effect on treatment outcomes, epidemiology, and possible additional mechanisms responsible for decreased susceptibility of azithromycin in Shigella.
  
  
• Keywords:
  Anti-Bacterial Agents Antimicrobial Drug Resistance Azithromycin Drug Resistance, Bacterial Microbial Sensitivity Tests Shigella United States
• Source:
  J Glob Antimicrob Resist. 21:417-419
• Pubmed ID:
  31866575
• Pubmed Central ID:
  PMC10839632
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Volume:
  21
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:1d7e9c36434cc778c775b4c6eeb54c6dec2deff9d70726625ec665c09212ebea
• Download URL:
  https://stacks.cdc.gov/view/cdc/147681/cdc_147681_DS1.pdf
• File Type:
  [PDF - 63.57 KB ]