Emerging Infectious Diseases (Apr 2020)

Decreased Susceptibility to Azithromycin in Clinical Shigella Isolates Associated with HIV and Sexually Transmitted Bacterial Diseases, Minnesota, USA, 2012–2015

  • Dana Eikmeier,
  • Pamela Talley,
  • Anna Bowen,
  • Fe Leano,
  • Ginette Dobbins,
  • Selina Jawahir,
  • Annastasia Gross,
  • Dawn Huspeni,
  • Allison La Pointe,
  • Stephanie Meyer,
  • Kirk Smith

DOI
https://doi.org/10.3201/eid2604.191031
Journal volume & issue
Vol. 26, no. 4
pp. 667 – 674

Abstract

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Shigellosis outbreaks caused by Shigella with decreased susceptibility to azithromycin (DSA-Shigella) among men who have sex with men (MSM) have been reported worldwide. We describe sexual health indicators and antimicrobial drug resistance for shigellosis cases in Minnesota, USA. We analyzed a sample of isolates received during 2012–2015 and cross-referenced cases with the Minnesota Department of Health Sexually Transmitted Disease Database to ascertain patients’ HIV status and recent chlamydia, gonorrhea, and syphilis infections. Of 691 Shigella isolates, 46 (7%) were DSA-Shigella; 91% of DSA-Shigella patients were men, of whom 60% were living with HIV. Among men, those with DSA-Shigella infection had greater odds of living with HIV, identifying as MSM, or having a recent diagnosis of a sexually transmitted disease. DSA-Shigella was associated with MSM, HIV infection, and recent sexually transmitted disease. To decrease spread of DSA-Shigella, interventions targeted at communities at high risk are needed.

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