Shigella sonnei, an emerging multidrug-resistant sexually transmitted pathogen in Franche-Comté, France

Figures & data

Table 1. Demographic, clinical characteristics, laboratory and imaging findings in MSM patients with Shigella sonnei infections, Nord Franche-Comte Hospital, France.

		Patient 1	Patient 2	Patient 3
Demographic and socio-behavioural characteristics
Age, y		31	31	34
Recent travel		No	No	No
Sexual behaviour		MSM (genito-oral and digital-anal activities)	MSM (genito-oral activities)	MSM (genito-oral activities)
Chemsex		No	No	No
PrEP user		Yes (intermittent)	No, under ART	Yes (continuous)
HIV status/ (if positive: CD4/mm^3)		Negative	Positive (984/mm^3)	Negative
Clinical characteristics, laboratory and imaging findings
Clinical presentation		Fever, nausea, diarrhoea, abdominal pain	Fever, chills, fatigue, diarrhoea, abdominal pain	Fever, diarrhoea
Duration of symptoms, days		7	5	2
Laboratory data (On admission)	White-cell count/mm^3 (4,000–10,000/mm^3)	17,910	8940	–
	Lymphocytes/mm^3 (1500–4000/mm^3)	930	2280	–
	Haemoglobin, g/dL (13.5–17.5 g/dL)	12.6	13.8	–
	Creatinine, μmol/L (65–120 μmol/L)	75	83	–
	Alanine aminotransferase, U/L (8–45 U/L)	14	17	–
	Aspartate aminotransferase, U/L (10–40 U/L)	33	35	–
	C-reactive protein, mg/L (<5 mg/L)	293	45	–
Radiological data	Abdominal imaging features	Colitis with mesenteric lymphadenitis	ND	ND
Serotyping and biotype determination*		ND	Shigella sonnei g	Shigella sonnei g
Antimicrobial Testing Susceptibility (MICs of Shigella sonnei isolates)
Ampicillin		R	R	R
Amoxicillin-clavulanic acid		S	S	S
Cefotaxime/Ceftriaxone		S	S	S
Piperacillin-tazobactam		S	S	S
Imipenem/Ertapenem		S	S	S
Amikacin		S
Azithromycin		R (>256 mg/l)	R (>256 mg/l)	R (>256 mg/l)
Ciprofloxacin		R	R	R
Trimethoprim/sulphamethoxazole		R	R	R

*S. sonnei g is non-specific antibody, which was not available to provide the infection source.

MSM: Men who have sex with men; PrEP: pre-exposure prophylaxis; HIV: human immunodeficiency virus; ART: antiretroviral therapy; ND: not determined; MICs: minimal inhibitory concentrations; R: resistant; S: susceptible.