University of Tasmania
Browse

File(s) under permanent embargo

Travel destinations and sexual behavior as indicators of antibiotic resistant Shigella strains - Victoria, Australia

journal contribution
posted on 2023-05-20, 03:40 authored by Lane, CR, Sutton, B, Valcanis, M, Kirk, M, Walker, C, Lalor, K, Nicola StephensNicola Stephens

Background. Knowledge of relationships between antibiotic susceptibility of Shigella isolates and travel destination or other risk factors can assist clinicians in determining appropriate antibiotic therapy prior to susceptibility testing. We describe relationships between resistance patterns and risk factors for acquisition in Shigella isolates using routinely collected data for notified cases of shigellosis between 2008 and 2012 in Victoria, Australia.

Methods. We included all shigellosis patients notified during the study period, where Shigella isolates were tested for antimicrobialsensitivity using Clinical and Laboratory Standards Institute breakpoints. Cases were interviewed to collect data on risk factors,including recent travel. Data were analyzed using Stata 13.1 to examine associations between risk factors and resistant strains.

Results. Of the 500 cases of shigellosis, 249 were associated with overseas travel and 210 were locally acquired. Forty-six of 51 isolates of Indian origin displayed decreased susceptibility or resistance to ciprofloxacin. All isolates of Indonesian origin were susceptible to ciprofloxacin. Twenty-six travel-related isolates were resistant to all tested oral antimicrobials. Male-to-male sexual contact was the primary risk factor for 80% (120/150) of locally acquired infections among adult males, characterized by distinct periodic Shigella sonnei outbreaks.

Conclusions. Clinicians should consider travel destination as a marker for resistance to common antimicrobials in returning travelers, where severe disease requires empirical treatment prior to receipt of individual sensitivity testing results. Repeated outbreaks of locally acquired shigellosis among men who have sex with men highlight the importance of prevention and control measures in this high-risk group.

History

Publication title

Clinical Infectious Diseases

Volume

62

Issue

6

Pagination

722-729

ISSN

1058-4838

Department/School

Tasmanian School of Medicine

Publisher

Univ Chicago Press

Place of publication

1427 E 60Th St, Chicago, USA, Il, 60637-2954

Rights statement

Copyright 2015 The Authors

Repository Status

  • Restricted

Socio-economic Objectives

Disease distribution and transmission (incl. surveillance and response)

Usage metrics

    University Of Tasmania

    Exports

    RefWorks
    BibTeX
    Ref. manager
    Endnote
    DataCite
    NLM
    DC