ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2025
Increased Severity of Multidrug-Resistant Shigella sonnei Infections in People Experiencing Homelessness.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Review
- Genome-wide analysis exploring mechanisms used bymSystems · 2026Article
- Looking Beyond the Surface: A Case of Shigella Enterocolitis in a Patient Presenting With Weakness and Substance Use.Cureus · 2026Article
- Sexually transmitted enteric infections in men who have sex with men.Clinical microbiology reviews · 2025Review
- Multiplex Polymerase Chain Reaction Panels for Gastrointestinal Infections: Current Evidence, Regulatory Hurdles, and the Way Forward.Open forum infectious diseases · 2025Article
- Time-series analysis of climatic drivers of pediatric rotavirus and adenovirus infections in post-pandemic China.BMC public health · 2025Article
- High Rates of Bacteremia and Fluoroquinolone Resistance During an Outbreak of Shigellosis Among People Experiencing Homelessness and Opioid Use Disorder in Philadelphia, Pennsylvania.Open forum infectious diseases · 2025Article
- An Outbreak of Multidrug-ResistantTropical medicine and infectious disease · 2025Review
- Mecillinam activity against multidrug-resistantMicrobiology spectrum · 2025Article
- AnalyzingInfection and drug resistance · 2025Article
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Authors and funding
16 authors.
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Abstract
backgroundShigella sonnei has caused sexually transmitted enteric infections in men who have sex with men (MSM) in Vancouver. We recently observed a high rate of multidrug-resistant (MDR) S. sonnei bacteremia among persons experiencing homelessness (PEH). We aimed to describe the wider epidemiology, clinical outcomes, and genomics of S. sonnei infections over time.
methodsA retrospective review of 163 patients with S. sonnei infections was undertaken from 2015 to 2022. We collected demographic, clinical, and microbiological data over 2 time periods: historical (2015-2020) and recent (2021-2022). Severe shigellosis definition included hospitalization, bacteremia, or death. Whole-genome sequencing was performed to identify genotype, infer relatedness, and predict antimicrobial resistance.
resultsS. sonnei infections increased from 8.3 (historical period) to 56.5 (recent period) cases/year. Over time, the primary population characteristics associated with shigellosis shifted from MSM (45; 98%) to PEH (86; 77%). The population intersection between MSM and PEH historically and recently was similar and occurred in 3 (6%) and 10 (9%) of patients, respectively. Severe shigellosis was significantly higher in the recent versus historical period (69 [61%] vs 7 [14%]; P < .001). A dominant clone of MDR S. sonnei, 3.6.1.1.2 (CipR.MSM5), emerged with resistance to all first- and second-line agents, yet with susceptibility to ceftriaxone.
conclusionsWe observed a substantial increase in severe shigellosis and shift from sexually transmitted S. sonnei infections in MSM to likely environmental transmission among PEH. More severe disease associated with the 3.6.1.1.2 clone of MDR S. sonnei in PEH could be a result of underlying vulnerabilities of the affected population.
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