Methods: We analyzed routine surveillance data and additional antibiotic susceptibility testing results for shigellosis reported to the Minnesota Department of Health (MDH) during 2014.
Results: During 2014, 93 shigellosis cases were reported to MDH; median age was 37 (range, <1–87) years, 49 (53%) were male. All 80 cases with isolates available underwent DSA testing. Twenty (25%) had DSA: 16 (80%) were S. sonnei, and 4 (20%) were S. flexneri. Median age was 37 (range, 24–60 years); 18 (90%) were men. Nine (45%) were HIV-infected men, and 6 (30%) had documented azithromycin treatment for gonorrhea or Chlamydia infection during the previous year. Among the 16 S. sonnei isolates, 7 distinct pulsed-field gel electrophoresis patterns in two related groupings identified these as not belonging to a single cluster but suggestive of community transmission.
Conclusion: Increasing antibiotic resistance requires treatment based on antibiotic susceptibility testing results. DSA Shigella emergence in Minnesota underscores the need for systematic DSA testing, not routinely done by clinical laboratories because lack of CLSI azithromycin breakpoints. This information is needed by clinicians to limit transmission of an enteric infection with few treatment options.
S. Meyer, None
F. Leano, None
G. Dobbins, None
K. Smith, None