{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T22:02:38Z","timestamp":1792188158333,"version":"4.4.0"},"reference-count":34,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2024,10,4]],"date-time":"2024-10-04T00:00:00Z","timestamp":1728000000000},"content-version":"unspecified","delay-in-days":277,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"DOI":"10.13039\/100018336","name":"National Institute for Health Research Health Protection Research Unit","doi-asserted-by":"publisher","award":["111815"],"award-info":[{"award-number":["111815"]}],"id":[{"id":"10.13039\/100018336","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2024]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:p>We reviewed all diagnoses of <jats:italic>Shigella<\/jats:italic> species notified to the UK Health Security Agency from January 2016 to March 2023. An overall increase in notifications of shigellosis was seen between 2016 (<jats:italic>n<\/jats:italic> = 415\/quarter) and 2023 (<jats:italic>n<\/jats:italic> = 1\u00a0029\/quarter). However, notifications dramatically declined between March 2020 and September 2021 during the COVID-19 pandemic (<jats:italic>n<\/jats:italic> = 208\/quarter) highlighting the impact of travel and social distancing restrictions on transmission. <jats:italic>S. sonnei<\/jats:italic> diagnoses were more affected by lockdown restrictions than <jats:italic>S. flexneri<\/jats:italic>, most likely due to a combination of species-specific characteristics and host attributes. Azithromycin resistance continued to be associated with epidemics of sexually transmissible S. <jats:italic>flexneri<\/jats:italic> (adult males = 45.6% vs. adult females = 8.7%) and <jats:italic>S. sonnei<\/jats:italic> (adult males = 59.5% vs. adult females = 14.6%). We detected resistance to ciprofloxacin in <jats:italic>S. sonnei<\/jats:italic> from adult male cases not reporting travel at a higher frequency (79.4%) than in travel-associated cases (61.7%). Extensively drug-resistant <jats:italic>Shigella<\/jats:italic> species associated with sexual transmission among men almost exclusively had ESBL encoded by <jats:italic>bla<\/jats:italic><jats:sub>CTX-M-27<\/jats:sub>, whereas those associated with returning travellers had <jats:italic>bla<\/jats:italic><jats:sub>CTX-M-15<\/jats:sub>. Given the increasing incidence of infections and AMR, we recommend that enhanced surveillance is used to better understand the impact of travel and sexual transmission on the acquisition and spread of MDR and XDR Shigella species.<\/jats:p>","DOI":"10.1017\/s0950268824001006","type":"journal-article","created":{"date-parts":[[2024,10,4]],"date-time":"2024-10-04T06:15:35Z","timestamp":1728022535000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":17,"title":["Trends in shigellosis notifications in England, January 2016 to March 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