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Travel Medicine and Infectious Disease 2023Southeast Asia is attractive for tourism. Unfortunately, travelers to this region are at risk of becoming infected with Shigella. We conducted a meta-analysis to provide... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Southeast Asia is attractive for tourism. Unfortunately, travelers to this region are at risk of becoming infected with Shigella. We conducted a meta-analysis to provide updates on Shigella prevalence in Southeast Asia, along with their serogroups and serotypes.
METHODS
We conducted a systematic search using PubMed, EMBASE, and Web of Science for peer-reviewed studies from 2000 to November 2022. We selected studies that detected Shigella in stools by culture or polymerase chain reaction (PCR). Two reviewers extracted the data using a standardized form and performed quality assessments using the Joanna Briggs Institute checklist. The random effects model was used to estimate the pooled prevalence of Shigella.
RESULTS
During our search, we identified 4376 studies. 29 studies (from six Southeast Asian countries) were included in the systematic review, 21 each in the meta-analysis of the prevalence of Shigella (Sample size: 109545) and the prevalence of Shigella serogroups. The pooled prevalence of Shigella was 4% (95% CI: 4-5%) among diarrhea cases. Shigella sonnei was the most abundant serogroup in Thailand (74%) and Vietnam (57%), whereas Shigella flexneri was dominant in Indonesia (72%) and Cambodia (71%). Shigella dysenteriae and Shigella boydii were uncommon (pooled prevalence of 1% each). The pooled prevalence of Shigella was 5% (95% CI: 4-6%) in children aged <5 years. The pooled prevalence showed a decreasing trend comparing data collected between 2000-2013 (5%; 95% CI: 4-6%) and between 2014-2022 (3%; 95% CI: 2-4%). Shigella prevalence was 6% in studies that included participants with mixed pathogens versus 3% in those without. Shigella flexneri serotype 2a was the most frequently isolated (33%), followed by 3a (21%), 1b (10%), 2b (3%), and 6 (3%).
CONCLUSIONS
This study provides compelling evidence for the development of effective Shigella vaccines for residents of endemic regions and travellers to these areas.
Topics: Child; Humans; Dysentery, Bacillary; Shigella; Shigella dysenteriae; Shigella flexneri; Indonesia
PubMed: 36792021
DOI: 10.1016/j.tmaid.2023.102554 -
Antibiotics (Basel, Switzerland) Nov 2022Shigellosis remains one of the leading causes of morbidity and mortality worldwide and is the second leading cause of diarrheal mortality among all age groups. However,... (Review)
Review
Shigellosis remains one of the leading causes of morbidity and mortality worldwide and is the second leading cause of diarrheal mortality among all age groups. However, the global emergence of antimicrobial-resistant strains, limiting the choice of effective drugs for shigellosis, has become the major challenge in the treatment of infections. The aim of this systematic review and meta-analysis was to provide an updated picture of the prevalence of antimicrobial-resistant species in Asia. A comprehensive and systematic search was performed on three electronic databases (PubMed, ScienceDirect and Scopus), in which 63 eligible studies published between 2010 and 2022 were identified. From our meta-analysis of proportions using a random-effects model, the overall prevalence of spp. in Asian patients was estimated to be 8.0% (95% CI: 5.5-10.5). The pooled prevalence rates of multidrug-resistant (MDR) and extended-spectrum beta-lactamase (ESBL)-producing strains were 68.7% (95% CI: 59.9-77.5) and 23.9% (95% CI: 12.9-34.8), respectively. Concerning recommended antimicrobial drugs for , the prevalence of resistance was highest for ciprofloxacin (29.8%) and azithromycin (29.2%), followed by ceftriaxone (23.8%), in spite of their importance as first- and second-line treatments for shigellosis. In contrast, resistance to carbapenems, such as ertapenem (0.0%), imipenem (0.1%) and meropenem (0.0%), was almost non-existent among the 49 tested antibiotics. The significantly high prevalence estimation suggests that the multidrug-resistant is a pressing threat to public health worthy of careful and justified interventions. Effective antibiotic treatment strategies, which may lead to better outcomes for the control and treatment of shigellosis in Asia, are essential.
PubMed: 36421297
DOI: 10.3390/antibiotics11111653 -
BMC Pediatrics Feb 2020Diarrhea, particularly of enteric bacterial pathogen, remains a major cause of morbidity and mortality in Ethiopia. Despite the high prevalence of diarrheal disease...
BACKGROUND
Diarrhea, particularly of enteric bacterial pathogen, remains a major cause of morbidity and mortality in Ethiopia. Despite the high prevalence of diarrheal disease among under-five children, antibiotic resistance of bacterial pathogens test is not part of routine childcare in the study area. This study aimed to investigate the prevalence and antimicrobial susceptibility status of Salmonella and Shigella species among diarrheic children attending public health institutions in Ambo town, west Showa, Ethiopia.
METHODS
Institutional based, cross-sectional study was carried out from January to July 2014 among 239 diarrheic children below five years of age in Ambo town, Ethiopia. Information about patient demographics, signs, and symptoms was obtained from the parents/guardians of each child using a questionnaire. Stool samples from diarrheic children were collected and processed for isolation of Salmonella and Shigella using conventional microbiology procedures. Suspected Salmonella isolates were confirmed by genus-specific PCR and serotyped using a slide agglutination test. Susceptibility to 10 commonly used antimicrobials was assessed using the Kirby Bauer disc diffusion method.
RESULTS
From the 239 children screened, only nine (3.8%) of them were positive for either Salmonella (n = 3) or Shigella (n = 6) and 19 (7.9%) positive for the intestinal parasite. Three species of Shigella were identified: Shigella flexinari (n = 3), Shigella boydii (n = 2), and Shigella sonnei (n = 1). The three Salmonella isolates were S. chicago, S. caracas, and S. saintpaul. Salmonella and Shigella isolates were resistant to ampicillin (88.9%), followed by tetracycline (66.7%), cotrimoxazole (55.6%), chloramphenicol (44.4%), amoxicillin (33.3%), nalidixic acid (11.1%) and cefotaxime (11.1%). All isolates were sensitive to amikacin, ciprofloxacin, and gentamycin.
CONCLUSION
In this study, either Salmonella or Shigella species were detected only in 3.8% of diarrheic children in Ambo town, suggesting the dominance of other causes of diarrhea in the study area. A further study targeting other causes of diarrhea should be conducted to establish the major causes of childhood diarrhea in the study area.
Topics: Animals; Anti-Bacterial Agents; Anti-Infective Agents; Child; Cross-Sectional Studies; Diarrhea; Ethiopia; Feces; Female; Humans; Male; Microbial Sensitivity Tests; Prevalence; Salmonella; Shigella
PubMed: 32103729
DOI: 10.1186/s12887-020-1970-0 -
The Pan African Medical Journal 2022Salmonella and Shigella infections are waterborne associated infections globally known to cause serious illnesses in all age groups, but can be more devastating in...
INTRODUCTION
Salmonella and Shigella infections are waterborne associated infections globally known to cause serious illnesses in all age groups, but can be more devastating in children below five years. Antimicrobial resistance has been known to worsen the existing challenge in the management of Salmonella and Shigella infections. The aim is to isolate and identify Salmonella and Shigella among children less than five years with diarrhea and to determine resistance to commonly prescribed drugs at the Lodwar County and Referral Hospital in Northern Kenya.
METHODS
using a cross-sectional study design, a descriptive experimental study was conducted on 196 children with diarrhea using rectal swabs. A structured questionnaire was used to collect sociodemographic information. Samples were then received in the microbiology laboratory, and macroscopic and microscopic examinations were done before culture on specific selective media. Thereafter, biochemical confirmation of the growths done then confirmed results tabulated before analysis.
RESULTS
from the total samples collected (196) Shigella dysenteriae cases were 4 (5%), while Shigella Flexneri were 7 (9%), Shigella sonnei were 3 (4%), Shigella boydii were 4 (5%) and Salmonella typhimurium were 2 (2.4%). From these, about 70% of the isolated Salmonella and Shigella demonstrated high antibiotic resistance to Amoxilliclav and Ampicillin, both with high minimum inhibitory concentrations (MICs) values of about 8ug/ml. While over 80% drug susceptibility was noted in Amikacin (1ug/ml), Ciprofloxacin (2ug/ml), Ceftriaxone (4ug/ml) and Ceftazidime (4ug/ml).
CONCLUSION
Salmonella and Shigella are among the common contributors of diarrhea among children less than five years. Drug resistance among the commonly used antibiotics is a serious indicator that possible misuse of antibiotics especially the beta lactam penicillin's.
Topics: Anti-Bacterial Agents; Child; Child, Preschool; Cross-Sectional Studies; Diarrhea; Drug Resistance, Bacterial; Dysentery, Bacillary; Feces; Humans; Kenya; Microbial Sensitivity Tests; Prevalence; Salmonella; Shigella
PubMed: 35812262
DOI: 10.11604/pamj.2022.42.13.32025 -
Microbial Genomics Dec 2021serotype 6 is an understudied cause of diarrhoeal diseases in developing countries, and has been proposed as one of the major targets for vaccine development against...
serotype 6 is an understudied cause of diarrhoeal diseases in developing countries, and has been proposed as one of the major targets for vaccine development against shigellosis. Despite being named as , serotype 6 is phylogenetically distinct from other serotypes and more closely related to . This unique phylogenetic relationship and its low sampling frequency have hampered genomic research on this pathogen. Herein, by utilizing whole genome sequencing (WGS) and analyses of serotype 6 collected from epidemiological studies (1987-2013) in four Asian countries, we revealed its population structure and evolutionary history in the region. Phylogenetic analyses supported the delineation of Asian serotype 6 into two phylogenetic groups (PG-1 and -2). Notably, temporal phylogenetic approaches showed that extant Asian serotype 6 could be traced back to an inferred common ancestor arising in the 18 century. The dominant lineage PG-1 likely emerged in the 1970s, which coincided with the times to most recent common ancestors (tMRCAs) inferred from other major Southeast Asian serotypes. Similar to other serotypes in the same period in Asia, genomic analyses showed that resistance to first-generation antimicrobials was widespread, while resistance to more recent first-line antimicrobials was rare. These data also showed a number of gene inactivation and gene loss events, particularly on genes related to metabolism and synthesis of cellular appendages, emphasizing the continuing role of reductive evolution in the adaptation of the pathogen to an intracellular lifestyle. Together, our findings reveal insights into the genomic evolution of the understudied serotype 6, providing a new piece in the puzzle of epidemiology and evolution.
Topics: Asia; Drug Resistance, Bacterial; Evolution, Molecular; Genome, Bacterial; High-Throughput Nucleotide Sequencing; Phylogeny; Serotyping; Shigella flexneri; Whole Genome Sequencing
PubMed: 34904947
DOI: 10.1099/mgen.0.000736 -
Food Science & Nutrition Nov 2021The emergence of multidrug-resistant is a significant threat to global public health. Limited studies have investigated the incidence, antimicrobial susceptibility, and...
The emergence of multidrug-resistant is a significant threat to global public health. Limited studies have investigated the incidence, antimicrobial susceptibility, and genetic diversity of isolated from food products. Conventional culture-based, serologic, molecular, disk diffusion, PCR, and RAPD-PCR methods were used to determine the prevalence rate, phenotypic and genotypic antibiotic resistance profile, and genetic diversity of the isolates from food samples including vegetable salad, ground meat, and raw cow's milk (405 samples). The prevalence rate of in food samples was 4.44%. The incidence of (3.7%) was higher than that of (0.74%). and were not detected in food samples examined. Also, no were recovered from raw cow's milk. This study showed that the isolates were resistant to sulfamethoxazole/trimethoprim (83.3%), amoxicillin (66.6%), streptomycin (66.6%), tetracycline (61.1%), ampicillin (50%), amoxicillin-clavulanic acid (50%), azithromycin (50%), and chloramphenicol (50%) and completely sensitive to cefoxitin, cefepime, amikacin, and gentamicin. All isolates were multidrug-resistant. We detected resistance gene in all isolates; however, no isolate harbored gene. RAPD-PCR categorized the isolates into five main clusters. The highest antibiotic resistance was observed in the isolates of cluster R4. The finding of this study also indicated an association between antimicrobial resistance profiles and genotyping properties of the isolates. Novel food monitoring systems, including surveillance of multidrug-resistant foodborne pathogens, especially in developing countries, are required to control the foodborne diseases.
PubMed: 34760266
DOI: 10.1002/fsn3.2603 -
Clinical Infectious Diseases : An... Apr 2023We evaluated the burden of Shigella spp from children aged 0-59 months with medically attended moderate-to-severe diarrhea and matched controls at sites in Mali, The...
BACKGROUND
We evaluated the burden of Shigella spp from children aged 0-59 months with medically attended moderate-to-severe diarrhea and matched controls at sites in Mali, The Gambia, and Kenya participating in the Vaccine Impact on Diarrhea in Africa (VIDA) study from 2015 to 2018.
METHODS
Shigella spp were identified using coprocultures and serotyping in addition to quantitative polymerase chain reaction (qPCR). Episode-specific attributable fractions (AFe) for Shigella were calculated using Shigella DNA quantity; cases with AFe ≥0.5 were considered to have shigellosis.
RESULTS
The prevalence of Shigella was determined to be 359 of 4840 (7.4%) cases and 83 of 6213 (1.3%) controls by culture, and 1641 of 4836 (33.9%) cases and 1084 of 4846 (22.4%) controls by qPCR (cycle threshold <35); shigellosis was higher in The Gambia (30.8%) than in Mali (9.3%) and Kenya (18.7%). Bloody diarrhea attributed to Shigella was more common in 24- to 59-month-old children (50.1%) than 0- to 11-month-old infants (39.5%). The Shigella flexneri serogroup predominated among cases (67.6% of isolates), followed by Shigella sonnei (18.2%), Shigella boydii (11.8%), and Shigella dysenteriae (2.3%). The most frequent S. flexneri serotypes were 2a (40.6%), 1b (18.8%), 6 (17.5%), 3a (9.0%), and 4a (5.1%). Drug-specific resistance among 353 (98.3%) Shigella cases with AMR data was as follows: trimethoprim-sulfamethoxazole (94.9%), ampicillin (48.4%), nalidixic acid (1.7%), ceftriaxone (0.3%), azithromycin (0.3%), and ciprofloxacin (0.0%).
CONCLUSIONS
A high prevalence of shigellosis continues in sub-Saharan Africa. Strains are highly resistant to commonly used antibiotics while remaining susceptible to ciprofloxacin, ceftriaxone, and azithromycin.
Topics: Child; Infant; Humans; Child, Preschool; Infant, Newborn; Dysentery, Bacillary; Azithromycin; Ceftriaxone; Shigella; Anti-Bacterial Agents; Ciprofloxacin; Diarrhea; Mali; Microbial Sensitivity Tests
PubMed: 37074444
DOI: 10.1093/cid/ciac969 -
Frontiers in Microbiology 2023and enterotoxigenic (ETEC) are major bacterial pathogens of diarrheal disease that is the second leading cause of childhood mortality globally. Currently, it is well...
and enterotoxigenic (ETEC) are major bacterial pathogens of diarrheal disease that is the second leading cause of childhood mortality globally. Currently, it is well known that spp., and . are very closely related with many common characteristics. Evolutionarily speaking, spp., are positioned within the phylogenetic tree of . . Therefore, discrimination of spp., from . is very difficult. Many methods have been developed with the aim of differentiating the two species, which include but not limited to biochemical tests, nucleic acids amplification, and mass spectrometry, etc. However, these methods suffer from high false positive rates and complicated operation procedures, which requires the development of novel methods for accurate and rapid identification of spp., and . . As a low-cost and non-invasive method, surface enhanced Raman spectroscopy (SERS) is currently under intensive study for its diagnostic potential in bacterial pathogens, which is worthy of further investigation for its application in bacterial discrimination. In this study, we focused on clinically isolated . strains and species (spp.), that is, . , . , . , and . , based on which SERS spectra were generated and characteristic peaks for spp., and . were identified, revealing unique molecular components in the two bacterial groups. Further comparative analysis of machine learning algorithms showed that, the Convolutional Neural Network (CNN) achieved the best performance and robustness in bacterial discrimination capacity when compared with Random Forest (RF) and Support Vector Machine (SVM) algorithms. Taken together, this study confirmed that SERS paired with machine learning could achieve high accuracy in discriminating spp., from . , which facilitated its application potential for diarrheal prevention and control in clinical settings. Graphical abstract.
PubMed: 36970678
DOI: 10.3389/fmicb.2023.1101357 -
Journal of Bacteriology Dec 2019Colicin U is a protein produced by the bacterium (serovars 1 and 8). It exerts antibacterial activity against strains of the enterobacterial genera and Here, we...
Colicin U is a protein produced by the bacterium (serovars 1 and 8). It exerts antibacterial activity against strains of the enterobacterial genera and Here, we report that colicin U forms voltage-dependent pores in planar lipid membranes; its single-pore conductance was found to be about 22 pS in 1 M KCl at pH 6 under 80 mV in asolectin bilayers. In agreement with the high degree of homology between their C-terminal domains, colicin U shares some pore characteristics with the related colicins A and B. Colicin U pores are strongly pH dependent, and as we deduced from the activity of colicin U in planar membranes at different protein concentrations, they have a monomeric pore structure. However, in contrast to related colicins, we observed a very low cationic selectivity of colicin U pores (1.5/1 of K/Cl at pH 6) along with their atypical voltage gating. Finally, using nonelectrolytes, we determined the inner diameter of the pores to be in the range of 0.7 to 1 nm, which is similar to colicin Ia, but with a considerably different inner profile. Currently, a dramatic increase in antibiotic resistance is driving researchers to find new antimicrobial agents. The large group of toxins called bacteriocins appears to be very promising from this point of view, especially because their narrow killing spectrum allows specific targeting against selected bacterial strains. Colicins are a subgroup of bacteriocins that act on Gram-negative bacteria. To date, some colicins are commercially used for the treatment of animals (1) and tested as a component of engineered species-specific antimicrobial peptides, which are studied for the potential treatment of humans (2). Here, we present a thorough single-molecule study of colicin U which leads to a better understanding of its mode of action. It extends the range of characterized colicins available for possible future medical applications.
Topics: Cell Membrane; Colicins; Hydrogen-Ion Concentration; Ion Channel Gating; Lipid Bilayers; Permeability; Potassium Chloride; Shigella boydii
PubMed: 31548276
DOI: 10.1128/JB.00493-19 -
Infection and Immunity Nov 2023There are no licensed vaccines for , a leading cause of children's diarrhea and a common etiology of travelers' diarrhea. To develop a cross-protective vaccine, in this...
There are no licensed vaccines for , a leading cause of children's diarrhea and a common etiology of travelers' diarrhea. To develop a cross-protective vaccine, in this study, we constructed a polyvalent protein immunogen to present conserved immunodominant epitopes of invasion plasmid antigens B (IpaB) and D (IpaD), VirG, GuaB, and Shiga toxins on backbone protein IpaD, by applying an epitope- and structure-based multiepitope-fusion-antigen (MEFA) vaccinology platform, examined protein ( MEFA) broad immunogenicity, and evaluated antibody function against invasion and Shiga toxin cytotoxicity but also protection against lethal challenge. Mice intramuscularly immunized with MEFA protein developed IgG responses to IpaB, IpaD, VirG, GuaB, and Shiga toxins 1 and 2; mouse sera significantly reduced invasion of , serotype 2a, 3a, or 6, and type 1 and neutralized cytotoxicity of Shiga toxins of and Shiga toxin-producing . Moreover, mice intranasally immunized with MEFA protein (adjuvanted with dmLT) developed antigen-specific serum IgG, lung IgG and IgA, and fecal IgA antibodies, and survived from lethal pulmonary challenge with or serotype 2a, 3a, or 6. In contrast, the control mice died, became unresponsive, or lost 20% of body weight in 48 h. These results indicated that this MEFA protein is broadly immunogenic, induces broadly functional antibodies, and cross-protects against lethal pulmonary challenges with or serotypes, suggesting a potential application of this polyvalent MEFA protein in vaccine development.
Topics: Humans; Child; Animals; Mice; Shigella sonnei; Shigella flexneri; Diarrhea; Travel; Antigens, Bacterial; Shigella; Shigella Vaccines; Lung; Shiga Toxins; Immunoglobulin G; Immunoglobulin A; Antibodies, Bacterial; Dysentery, Bacillary
PubMed: 37795982
DOI: 10.1128/iai.00316-23