The evolution and international spread of extensively drug resistant Shigella sonnei

Lewis C.E. Mason, David R. Greig, Lauren A. Cowley, Sally R. Partridge, Elena Martinez, Grace A. Blackwell, Charlotte E. Chong, P. Malaka De Silva, Rebecca J. Bengtsson, Jenny L. Draper, Andrew N. Ginn, Indy Sandaradura, Eby M. Sim, Jonathan R. Iredell, Vitali Sintchenko, Danielle J. Ingle, Benjamin P. Howden, Sophie Lefèvre, Elisabeth Njampeko, François Xavier WeillPieter Jan Ceyssens, Claire Jenkins, Kate S. Baker

Research output: Contribution to journalArticlepeer-review

1 Citation (SciVal)


Shigella sonnei causes shigellosis, a severe gastrointestinal illness that is sexually transmissible among men who have sex with men (MSM). Multidrug resistance in S. sonnei is common including against World Health Organisation recommended treatment options, azithromycin, and ciprofloxacin. Recently, an MSM-associated outbreak of extended-spectrum β-lactamase producing, extensively drug resistant S. sonnei was reported in the United Kingdom. Here, we aimed to identify the genetic basis, evolutionary history, and international dissemination of the outbreak strain. Our genomic epidemiological analyses of 3,304 isolates from the United Kingdom, Australia, Belgium, France, and the United States of America revealed an internationally connected outbreak with a most recent common ancestor in 2018 carrying a low-fitness cost resistance plasmid, previously observed in travel associated sublineages of S. flexneri. Our results highlight the persistent threat of horizontally transmitted antimicrobial resistance and the value of continuing to work towards early and open international sharing of genomic surveillance data.

Original languageEnglish
Article number1983
Number of pages1
JournalNature Communications
Issue number1
Early online date8 Apr 2023
Publication statusPublished - 30 Apr 2023

ASJC Scopus subject areas

  • Chemistry(all)
  • Biochemistry, Genetics and Molecular Biology(all)
  • General
  • Physics and Astronomy(all)


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