Frontiers in Medicine (Aug 2022)
Clonal serotype 1c multidrug-resistant Shigella flexneri detected in multiple institutions by sentinel-site sequencing
- Karrie K. K. Ko,
- Karrie K. K. Ko,
- Karrie K. K. Ko,
- Karrie K. K. Ko,
- Karrie K. K. Ko,
- Joash Jun Keat Chu,
- Kar Mun Lim,
- Hatairat Yingtaweesittikul,
- Wenjie Huang,
- Wenjie Huang,
- Shireen Yan Ling Tan,
- Shireen Yan Ling Tan,
- Kenneth Choon Meng Goh,
- Kenneth Choon Meng Goh,
- Si Huei Tan,
- Tong Yong Ng,
- Matthias Maiwald,
- Matthias Maiwald,
- Matthias Maiwald,
- Jonathan Wei Zhong Chia,
- Delphine Yanhong Cao,
- Yen Ee Tan,
- Yen Ee Tan,
- James Heng Chiak Sim,
- James Heng Chiak Sim,
- Tse Hsien Koh,
- Tse Hsien Koh,
- Niranjan Nagarajan,
- Chayaporn Suphavilai
Affiliations
- Karrie K. K. Ko
- Department of Microbiology, Singapore General Hospital, Singapore, Singapore
- Karrie K. K. Ko
- Department of Molecular Pathology, Singapore General Hospital, Singapore, Singapore
- Karrie K. K. Ko
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore, Singapore
- Karrie K. K. Ko
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Karrie K. K. Ko
- Duke-NUS Medical School, Singapore, Singapore
- Joash Jun Keat Chu
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore, Singapore
- Kar Mun Lim
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore, Singapore
- Hatairat Yingtaweesittikul
- Advanced Research Center for Computational Simulation, Chiang Mai University, Chiang Mai, Thailand
- Wenjie Huang
- Department of Microbiology, Singapore General Hospital, Singapore, Singapore
- Wenjie Huang
- Duke-NUS Medical School, Singapore, Singapore
- Shireen Yan Ling Tan
- Department of Microbiology, Singapore General Hospital, Singapore, Singapore
- Shireen Yan Ling Tan
- Duke-NUS Medical School, Singapore, Singapore
- Kenneth Choon Meng Goh
- Department of Microbiology, Singapore General Hospital, Singapore, Singapore
- Kenneth Choon Meng Goh
- Duke-NUS Medical School, Singapore, Singapore
- Si Huei Tan
- Department of Laboratory Medicine, Changi General Hospital, Singapore, Singapore
- Tong Yong Ng
- Department of Pathology, Sengkang General Hospital, Singapore, Singapore
- Matthias Maiwald
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Matthias Maiwald
- Duke-NUS Medical School, Singapore, Singapore
- Matthias Maiwald
- Department of Pathology and Laboratory Medicine, KK Women's and Children's Hospital, Singapore, Singapore
- Jonathan Wei Zhong Chia
- 0Department of Laboratory Medicine, Tan Tock Seng Hospital, Singapore, Singapore
- Delphine Yanhong Cao
- Department of Microbiology, Singapore General Hospital, Singapore, Singapore
- Yen Ee Tan
- Department of Microbiology, Singapore General Hospital, Singapore, Singapore
- Yen Ee Tan
- Duke-NUS Medical School, Singapore, Singapore
- James Heng Chiak Sim
- Department of Microbiology, Singapore General Hospital, Singapore, Singapore
- James Heng Chiak Sim
- Duke-NUS Medical School, Singapore, Singapore
- Tse Hsien Koh
- Department of Microbiology, Singapore General Hospital, Singapore, Singapore
- Tse Hsien Koh
- Duke-NUS Medical School, Singapore, Singapore
- Niranjan Nagarajan
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore, Singapore
- Chayaporn Suphavilai
- Genome Institute of Singapore, Agency for Science, Technology and Research, Singapore, Singapore
- DOI
- https://doi.org/10.3389/fmed.2022.964640
- Journal volume & issue
-
Vol. 9
Abstract
Shigella flexneri is a major diarrhoeal pathogen, and the emergence of multidrug-resistant S. flexneri is of public health concern. We report the detection of a clonal cluster of multidrug-resistant serotype 1c (7a) S. flexneri in Singapore in April 2022. Long-read whole-genome sequence analysis found five S. flexneri isolates to be clonal and harboring the extended-spectrum β-lactamases blaCTX−M−15 and blaTEM−1. The isolates were phenotypically resistant to ceftriaxone and had intermediate susceptibility to ciprofloxacin. The S. flexneri clonal cluster was first detected in a tertiary hospital diagnostic laboratory (sentinel-site), to which the S. flexneri isolates were sent from other hospitals for routine serogrouping. Long-read whole-genome sequence analysis was performed in the sentinel-site near real-time in view of the unusually high number of S. flexneri isolates received within a short time frame. This study demonstrates that near real-time sentinel-site sequence-based surveillance of convenience samples can detect possible clonal outbreak clusters and may provide alerts useful for public health mitigations at the earliest possible opportunity.
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