title: Molecular epidemiology of multidrug-resistant Shigella dysenteriae type 1 causing dysentery outbreaks in Central African Republic, 2003-2004.
abstract: Shigella dysenteriae type 1 (Sd1) represents a particular threat in developing countries because of the severity of the infection and its epidemic potential. Antimicrobial susceptibility testing and molecular subtyping by pulsed-field gel electrophoresis (PFGE) and plasmid profiling (PP) of Sd1 isolates collected during two dysentery outbreaks (2013 and 445 cases of bloody diarrhoea) in Central African Republic (CAR) during the period 2003-2004 were reported. Eleven Sd1 comparison strains (CS) acquired by travellers or residents of Africa (n=10) or Asia (n=1) between 1993 and 2003 were also analysed. The 19 Sd1 isolates recovered from CAR outbreaks were multidrug resistant, although susceptible to quinolones and fluoroquinolones. Molecular subtyping by PFGE was more discriminatory than PP. The PFGE using XbaI and NotI restriction enzymes indicated that the two outbreaks were due to two different clones and also revealed a genetic diversity among the CS recovered from outbreak or sporadic cases between 1993 and 2003. This study was the result of a fruitful collaboration between field physicians and microbiologists. The data collected will serve as the basis for establishing long-term monitoring of Sd1 in CAR.
authors.affiliation: Institut Pasteur de Bangui, BP 923, Bangui, Central African Republic.
authors.forename: Raymond
authors.initials: R
authors.lastname: Bercion
authors.forename: Marie
authors.initials: M
authors.lastname: Demartin
authors.forename: Carlos
authors.initials: C
authors.lastname: Recio
authors.forename: Peguy-Martial
authors.initials: PM
authors.lastname: Massamba
authors.forename: Thierry
authors.initials: T
authors.lastname: Frank
authors.forename: Josep M
authors.initials: JM
authors.lastname: Escribà
authors.forename: Francine
authors.initials: F
authors.lastname: Grimont
authors.forename: Patrick A D
authors.initials: PA
authors.lastname: Grimont
authors.forename: François-Xavier
authors.initials: FX
authors.lastname: Weill
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002488:Central African Republic / Q000453:epidemiology; D004269:DNA, Bacterial / Q000032:analysis; D004196:Disease Outbreaks; D024901:Drug Resistance, Multiple, Bacterial; D004405:Dysentery, Bacillary / Q000188:drug therapy / Q000453:epidemiology* / Q000235:genetics; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D006801:Humans; D008297:Male; D010641:Phenotype; D010957:Plasmids
chemical_list: D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial