Emerging Infectious Diseases (Sep 2016)

Travel- and Community-Based Transmission of Multidrug-Resistant Shigella sonnei Lineage among International Orthodox Jewish Communities

  • Kate S. Baker,
  • Timothy J. Dallman,
  • Adi Behar,
  • François-Xavier Weill,
  • Malika Gouali,
  • Jeremy Sobel,
  • Maria Fookes,
  • Lea Valinsky,
  • Ohad Gal-Mor,
  • Thomas Connor,
  • Israel Nissan,
  • Sophie Bertrand,
  • Julian Parkhill,
  • Claire Jenkins,
  • Dani Cohen,
  • Nicholas R. Thomson

DOI
https://doi.org/10.3201/eid2209.151953
Journal volume & issue
Vol. 22, no. 9
pp. 1545 – 1553

Abstract

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Shigellae are sensitive indicator species for studying trends in the international transmission of antimicrobial-resistant Enterobacteriaceae. Orthodox Jewish communities (OJCs) are a known risk group for shigellosis; Shigella sonnei is cyclically epidemic in OJCs in Israel, and sporadic outbreaks occur in OJCs elsewhere. We generated whole-genome sequences for 437 isolates of S. sonnei from OJCs and non-OJCs collected over 22 years in Europe (the United Kingdom, France, and Belgium), the United States, Canada, and Israel and analyzed these within a known global genomic context. Through phylogenetic and genomic analysis, we showed that strains from outbreaks in OJCs outside of Israel are distinct from strains in the general population and relate to a single multidrug-resistant sublineage of S. sonnei that prevails in Israel. Further Bayesian phylogenetic analysis showed that this strain emerged approximately 30 years ago, demonstrating the speed at which antimicrobial drug–resistant pathogens can spread widely through geographically dispersed, but internationally connected, communities.

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