Genomic Epidemiology of Fluoroquinolone-Resistant Strains of Shigella sonnei and Shigella flexneri in the Iberian Peninsula From 2015 to 2022

J Infect Dis. 2025 Jun 2;231(5):1176-1185. doi: 10.1093/infdis/jiae596.

Abstract

Fluoroquinolone resistance in Shigella is among the serious antimicrobial resistance threats. We investigated the genomic epidemiology of fluoroquinolone-resistant (FQR) strains of S sonnei and S flexneri from 2015 to 2022 in Spain and Portugal. We determined the antimicrobial resistance profiles of 416 isolates (S flexneri and S sonnei), and FQR isolates were subjected to whole genome sequencing. The percentage of FQR isolates gradually increased to reach 38% and 80% of S flexneri and S sonnei isolates, respectively, in 2022. S sonnei isolates from men were significantly more likely to be FQR (relative risk, 4.9; 95% CI, 2.7-9.0). Genomic analysis revealed 2 major genetic clusters of FQR S sonnei from the CipR.MSM5 lineage, previously associated with extreme antimicrobial resistance and transmission in men having sex with men. This study contributes to a better understanding of FQR shigellosis transmission and highlights the added value of enhanced surveillance for these pathogens.

Keywords: Shigella spp; Portugal; Spain; antimicrobial resistance surveillance; fluoroquinolones.

MeSH terms

  • Adolescent
  • Adult
  • Anti-Bacterial Agents* / pharmacology
  • Drug Resistance, Bacterial* / genetics
  • Dysentery, Bacillary* / epidemiology
  • Dysentery, Bacillary* / microbiology
  • Female
  • Fluoroquinolones* / pharmacology
  • Genome, Bacterial
  • Humans
  • Male
  • Microbial Sensitivity Tests
  • Middle Aged
  • Molecular Epidemiology
  • Portugal / epidemiology
  • Shigella flexneri* / drug effects
  • Shigella flexneri* / genetics
  • Shigella flexneri* / isolation & purification
  • Shigella sonnei* / drug effects
  • Shigella sonnei* / genetics
  • Shigella sonnei* / isolation & purification
  • Spain / epidemiology
  • Whole Genome Sequencing
  • Young Adult

Substances

  • Anti-Bacterial Agents
  • Fluoroquinolones