{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T13:42:01Z","timestamp":1777642921698,"version":"3.51.4"},"reference-count":34,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2022,8,1]],"date-time":"2022-08-01T00:00:00Z","timestamp":1659312000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Foodborne Pathogens and Disease"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:p>\n                    Multiple drug-resistant (MDR)\n                    <jats:italic toggle=\"yes\">Shigella<\/jats:italic>\n                    isolates have been reported worldwide. Between May 2017 and September 2018, 55\n                    <jats:italic toggle=\"yes\">Shigella flexneri<\/jats:italic>\n                    2a isolates were collected from 3322 stool samples of 0\u201310-year-old outpatients with diarrhea at the Children's Hospital of Urumqi, China. All isolates were characterized using serotyping, antimicrobial susceptibility testing, and whole-genome sequencing. A total of 54 of 55 (98.2%) isolates exhibited MDR phenotypes and had accumulated multiple resistance determinants, particularly of fluoroquinolones and cephalosporins preferred for shigellosis treatment: point mutations in quinolone resistance-determining regions (QRDRs) of topoisomerases (GyrA (S83L, D87N) and ParC (S80I) [\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u20099]; GyrA (S83L) and ParC (S80I) [\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u200945]) and acquisition of\n                    <jats:italic toggle=\"yes\">qnrS1<\/jats:italic>\n                    (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u20093) and\n                    <jats:italic toggle=\"yes\">bla<\/jats:italic>\n                    <jats:sub>CTX-M<\/jats:sub>\n                    (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u20098). Over 70% of isolates acquired two point mutations of GyrA (S83L) and ParC (S80I) in QRDRs and 11 highly resistant isolates accumulated three point mutations in QRDRs or acquired\n                    <jats:italic toggle=\"yes\">qnrS1<\/jats:italic>\n                    . Four\n                    <jats:italic toggle=\"yes\">S. flexneri<\/jats:italic>\n                    2a isolates from three single-nucleotide polymorphism clusters exhibited coresistance to ciprofloxacin, cefotaxime, or azithromycin (AZM), which are used as first- and second-line shigellosis treatment antimicrobials in clinics. Our data indicated that fluoroquinolones should be terminated in shigellosis treatment for outpatients in Urumqi. The transferable antimicrobial resistance determinants have been identified for third-generation cephalosporins and AZM. Novel strategies are urgently required for developing empirical medication to reduce the antimicrobial selective pressure and prevent dissemination of MDR\n                    <jats:italic toggle=\"yes\">S. flexneri<\/jats:italic>\n                    2a isolates.\n                  <\/jats:p>","DOI":"10.1089\/fpd.2021.0113","type":"journal-article","created":{"date-parts":[[2022,8,2]],"date-time":"2022-08-02T16:45:04Z","timestamp":1659458704000},"page":"522-528","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":6,"title":["Dissemination of Multiple Drug-Resistant\n                    <i>Shigella flexneri 2a<\/i>\n                    Isolates Among Pediatric Outpatients in Urumqi, China"],"prefix":"10.1177","volume":"19","author":[{"given":"Wenli","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Clinical Examination, The Children's Hospital, Urumqi, Xinjiang, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine L.","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Biology, University of Maryland, College Park, Maryland, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Biological Detection, The National Institutes for Food and Drug Control, Beijing, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lan","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Biological Detection, The National Institutes for Food and Drug Control, Beijing, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingyun","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Biological Detection, The National Institutes for Food and Drug Control, Beijing, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yinghua","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Biological Detection, The National Institutes for Food and Drug Control, Beijing, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9497-9253","authenticated-orcid":false,"given":"Shenghui","family":"Cui","sequence":"additional","affiliation":[{"name":"Department of Biological Detection, The National Institutes for Food and Drug Control, Beijing, China."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,8,11]]},"reference":[{"key":"e_1_3_6_2_1","doi-asserted-by":"publisher","DOI":"10.1089\/mdr.2017.0204"},{"key":"e_1_3_6_3_1","volume-title":"Shigella","author":"Aslam A","year":"2019","unstructured":"Aslam A, , Okafor CN. Shigella (Shigellosis). StatPearls Publishing: Treasure Island, FL, USA; 2019."},{"key":"e_1_3_6_4_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-018-25764-3"},{"key":"e_1_3_6_5_1","doi-asserted-by":"publisher","DOI":"10.1089\/cmb.2012.0021"},{"key":"e_1_3_6_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1472-765X.2011.03092.x"},{"key":"e_1_3_6_7_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2209.160624"},{"key":"e_1_3_6_8_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.02412-14"},{"key":"e_1_3_6_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-1-4939-9877-7_20"},{"key":"e_1_3_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2015.12.021"},{"key":"e_1_3_6_11_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1002055"},{"key":"e_1_3_6_12_1","unstructured":"Clinical and Laboratory Standards Institute (CLSI). Performance Standards for Antimicrobial Susceptibility Testing; Twenty-sixth Informational Supplement M100-S29. 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The repurposing of tebipenem pivoxil as alternative therapy for severe gastrointestinal infections caused by extensively drug-resistant Shigella spp. Elife, 2022; 11:e69798.","journal-title":"Elife"},{"key":"e_1_3_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(17)30276-1"},{"key":"e_1_3_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2012.02.005"},{"key":"e_1_3_6_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2018.0243"},{"key":"e_1_3_6_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(18)30475-4"},{"key":"e_1_3_6_18_1","doi-asserted-by":"publisher","DOI":"10.1093\/bioinformatics\/btn025"},{"key":"e_1_3_6_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31529-X"},{"key":"e_1_3_6_20_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.40.6.2153-2162.2002"},{"key":"e_1_3_6_21_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2209.152058"},{"key":"e_1_3_6_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-0691.2012.03768.x"},{"key":"e_1_3_6_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/bioinformatics\/btu153"},{"key":"e_1_3_6_24_1","first-page":"122","volume":"19","author":"Shahin K","year":"2019","unstructured":"Shahin K, , Bouzari M, , Wang R, et al. Distribution of antimicrobial resistance genes and integrons among Shigella spp. isolated from water sources. 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