Outbreak of sexually transmitted S. sonnei blaCTX-M-15 in England: an epidemiological and genomic investigation
Charles, H.; Greig, D. R.; Swift, C.; Olonade, I.; Simms, I.; Sinka, K.; Baker, K. S.; Godbole, G.; Jenkins, C.
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The diarrhoeal disease, shigellosis, can be sustained as a sexually transmissible enteric illness among gay, bisexual, and other men who have sex with men (GBMSM). Multiple extensively drug-resistant strains of Shigella have been detected through genomic surveillance, which have typically been associated with plasmids carrying the gene variant blaCTX-M-27. We report an increase in likely sexually transmissible cases of Shigella carrying blaCTX-M-15, which was previously associated with travel. In 2023, there were 117 cases belonging to the single 10-SNP single linkage cluster, t10.1814. While this cluster had been present in England since August 2019, genetic analyses revealed that blaCTX-M-15 entered the lineage on a novel resistance plasmid coincident with the first case of the outbreak. This highlights the shifting antimicrobial resistance landscape of sexually transmissible Shigella and the parallel emergence of resistance determinants against third generation cephalosporins in sexual transmission networks suggests high levels of antimicrobial selection pressure among GBMSM.
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