Horizontal antimicrobial resistance transfer drives epidemics of multiple Shigella species

• Published in: Nature communications 2018-04, Vol.9 (1), p.1462-10, Article 1462
• Main Authors: Baker, Kate S., Dallman, Timothy J., Field, Nigel, Childs, Tristan, Mitchell, Holly, Day, Martin, Weill, François-Xavier, Lefèvre, Sophie, Tourdjman, Mathieu, Hughes, Gwenda, Jenkins, Claire, Thomson, Nicholas
• Format: Article
• Language: English
• Subjects: 45; 45/23; 45/43; 631/326/22/1434; 692/4017; 692/699/255/1318; 692/700/478/174; Adolescent; Adult; Anti-Bacterial Agents - pharmacology; Antiinfectives and antibacterials; Antimicrobial agents; Antimicrobial resistance; Azithromycin - pharmacology; Bacteriology; Drug resistance; Drug Resistance, Bacterial - genetics; Dysentery, Bacillary - microbiology; Epidemics; Epidemiology; Gene transfer; Gene Transfer, Horizontal; Genome-Wide Association Study; Genomic analysis; Homosexuality, Male; Horizontal transfer; Humanities and Social Sciences; Humans; Life Sciences; Male; Microbial Sensitivity Tests; Microbiology and Parasitology; Middle Aged; multidisciplinary; Phenotype; Phylogeny; Plasmids - metabolism; Public health; Science; Science (multidisciplinary); Shigella; Shigella - genetics; Time Factors; Young Adult
• ISSN: 2041-1723; 2041-1723
• DOI: 10.1038/s41467-018-03949-8

Horizontal gene transfer has played a role in developing the global public health crisis of antimicrobial resistance (AMR). However, the dynamics of AMR transfer through bacterial populations and its direct impact on human disease is poorly elucidated. Here, we study parallel epidemic emergences of multiple Shigella species, a priority AMR organism, in men who have sex with men to gain insight into AMR emergence and spread. Using genomic epidemiology, we show that repeated horizontal transfer of a single AMR plasmid among Shigella enhanced existing and facilitated new epidemics. These epidemic patterns contrasted with slighter, slower increases in disease caused by organisms with vertically inherited (chromosomally encoded) AMR. This demonstrates that horizontal transfer of AMR directly affects epidemiological outcomes of globally important AMR pathogens and highlights the need for integration of genomic analyses into all areas of AMR research, surveillance and management. Antimicrobial resistance (AMR) in Shigella species is a public health concern. Here, Baker et al. show how horizontal transfer of an AMR plasmid among Shigella species contributes to epidemics in men who have sex with men in England.