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Peer reviewedOpen accessShigellosis

The spread of sexually transmissible drug-resistant shigellosis in England: a genomic epidemiology study

The Lancet Infectious Diseases·

Julia E Marshall, Noemie Lefrancq, Lewis C E Mason, Fariha Jawed, Yi Ling Tam, Claire Jenkins, Henrik Salje, Kate S Baker

DOI
10.1016/s1473-3099(26)00227-6
PMID
42419333
PMCID
OpenAlex
W7167730387
Study type
Genomic study
Publisher
Elsevier BV
Article type
journal-article
Integrity
current

Why this research matters now

The abstract frames sexually transmissible shigellosis as a public health concern requiring interventions beyond traditional enteric-disease measures. It also highlights antimicrobial stewardship as relevant across pathogens in a syndemic setting.

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Structured evidence summary

Research question

The study aimed to describe and compare patterns of Shigella sonnei transmission in a high-income setting, including sexually transmissible, travel-associated, and other transmission contexts. It also assessed antimicrobial resistance dynamics and an extensively drug-resistant clade as a secondary analysis.

Study design

This was a genomic epidemiology study using national genomic surveillance isolates. The authors applied phylodynamic and geospatial modelling to S sonnei isolates collected in the UK over specified study periods.

Population and setting

The setting was the United Kingdom, drawing isolates referred from 138 laboratories across 15 UK health regions. Cases were grouped as presumptive MSM, high-risk travel-associated, or neither category, using travel history, age, and sex-based definitions stated in the abstract.

Main findings

The abstract reports 3514 isolates, with 1197 from presumptive MSM, 1269 from non-pMSM, and 1048 from high-risk travel-associated cases. It reports faster spatial spread for sexually transmitted S sonnei than for non-pMSM cases, using mean pairwise spatial distance after up to 2.5 years of evolutionary time. The authors’ interpretation states that sexual transmission of shigellosis was distinct and increasing, and that public health approaches focused on enteric transmission may not address sexual transmission.

Public-health relevance

The abstract frames sexually transmissible shigellosis as a public health concern requiring interventions beyond traditional enteric-disease measures. It also highlights antimicrobial stewardship as relevant across pathogens in a syndemic setting.

Important limitations

The abstract is truncated within the findings section, limiting extraction of complete statistical results. This summary is also limited to the supplied single-article abstract and metadata; the full paper would be needed for decision-grade interpretation.

GIDS interpretation

This article is discoverable in a GIDS context through links to shigellosis, antimicrobial resistance, genomic epidemiology, surveillance, transmission dynamics, travel medicine, treatment, and the United Kingdom. These links provide indexing and editorial context only, without implying any connection to a live surveillance signal.

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Related GIDS surveillance

Literature context does not validate, explain, or change a surveillance signal. Exact and contextual relationships are shown separately.

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Evidence relationships

This article has 10 auditable classifier relationships to diseases, places, topics, and study design.

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