Shigellosis in men who have sex with men (MSM) is caused by multidrug resistant Shigellae, exhibiting resistance to antimicrobials including azithromycin, ciprofloxacin and more recently the third-generation cephalosporins. We sequenced four bla CTX-M-27-positive MSM Shigella isolates (2018–20) using Oxford Nanopore Technologies; three S. sonnei (identified as two MSM clade 2, one MSM clade 5) and one S. flexneri 3a, to explore AMR context. All S. sonnei isolates harboured Tn7/Int2 chromosomal integrons, whereas S. flexneri 3a contained the Shigella Resistance Locus. All strains harboured IncFII pKSR100-like plasmids (67-83kbp); where present bla CTX-M-27 was located on these plasmids flanked by IS26 and IS903B, however bla CTX-M-27 was lost in S. flexneri 3a during storage between Illumina and Nanopore sequencing. IncFII AMR regions were mosaic and likely reorganised by IS26; three of the four plasmids contained azithromycin-resistance genes erm(B) and mph(A) and one harboured the pKSR100 integron. Additionally, all S. sonnei isolates possessed a large IncB/O/K/Z plasmid, two of which carried aph(3’)-Ib/aph(6)-Id/sul2 and tet(A). Monitoring the transmission of mobile genetic elements with co-located AMR determinants is necessary to inform empirical treatment guidance and clinical management of MSM-associated shigellosis.

中文翻译：

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在英国与 MSM 传播相关的志贺氏菌属中 CTX-M 质粒的获得和丢失

男男性接触者 (MSM) 中的志贺菌病是由多重耐药志贺菌引起的，对包括阿奇霉素、环丙沙星和最近的第三代头孢菌素在内的抗菌药物表现出耐药性。我们使用 Oxford Nanopore Technologies 对四个bla CTX-M-27阳性 MSM志贺氏菌分离株（2018-20）进行了测序；三个S. sonnei（标识为两个 MSM 进化枝 2，一个 MSM 进化枝 5）和一个S. flexneri 3a，以探索 AMR 上下文。所有S. sonnei分离株都含有 Tn7/Int2 染色体整合子，而S. flexneri 3a 含有志贺氏菌 阻力位点。所有菌株均含有 IncFII pKSR100 样质粒 (67-83kbp)；其中存在的bla CTX-M-27位于这些质粒上，两侧为 IS 26和 IS 903B，但是bla CTX-M-27在 Illumina 和 Nanopore 测序之间的储存期间在S. flexneri 3a 中丢失。IncFII AMR 区域是马赛克的，很可能被 IS 26重组；四种质粒中的三种含有阿奇霉素抗性基因erm(B ) 和mph(A )，一种含有 pKSR100 整合子。此外，所有S.宋内分离株所具有的大的INCB / O / K / Z质粒，其中的两个进行 aph(3')-Ib/aph(6)-Id/sul2和tet(A )。监测具有共同定位的 AMR 决定因素的移动遗传元素的传播对于为 MSM 相关志贺菌病的经验性治疗指导和临床管理提供信息是必要的。