{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T11:40:04Z","timestamp":1788435604440,"version":"build-2803163510"},"reference-count":26,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2016,6,1]],"date-time":"2016-06-01T00:00:00Z","timestamp":1464739200000},"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":["Health Security"],"published-print":{"date-parts":[[2016,6,1]]},"abstract":"<jats:p>\n                    Shigellosis is a leading cause of enteric infections in the United States. We compared antimicrobial resistance in\n                    <jats:italic toggle=\"yes\">Shigella<\/jats:italic>\n                    infections related to overseas travel (travel-associated) and in those acquired domestically by analyzing antimicrobial resistance patterns, geographic distributions, and pulsed-field gel electrophoresis (PFGE) patterns. We tested samples (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    \u2009=\u2009204) from a collection of isolates recovered from patients in Pennsylvania between 2006 and 2014. Isolates were grouped into travel- and non-travel-associated categories. Eighty-one (79.4%) of the\n                    <jats:italic toggle=\"yes\">Shigella<\/jats:italic>\n                    isolates acquired during international travel were resistant to multiple antibiotics compared to 53 (52.1%) of the infections transmitted in domestic settings. A majority (79.4%) of isolates associated with international travel demonstrated resistance to aminoglycosides and tetracyclines, whereas 47 (46.1%) of the infections acquired domestically were resistant to tetracycline. Almost all isolates (92.2%) transmitted in domestic settings were resistant to aminoglycosides, and 5 isolates from adult male patients were resistant to azithromycin, a drug often used for empiric treatment of severe shigellosis. Twenty (19.6%) isolates associated with illnesses acquired during overseas travel in 4 countries were resistant to quinolones. One\n                    <jats:italic toggle=\"yes\">S. sonnei<\/jats:italic>\n                    PFGE pattern was traced to a multidrug-resistant isolate acquired overseas that had caused a multistate outbreak of shigellosis, suggesting global dissemination of a drug-resistant species. Resistance to certain drugs\u2014for example, tetracycline\u2014increased in both overseas- and domestic-acquired infections during the study period. The prevalence of resistance to macrolides (azithromycin) and third-generation cephalosporins (ceftriaxone) was less than 1%; however, efforts to better monitor changes in drug resistance over time combined with increased antimicrobial stewardship are essential at the local, national, and global levels.\n                  <\/jats:p>","DOI":"10.1089\/hs.2016.0026","type":"journal-article","created":{"date-parts":[[2016,6,17]],"date-time":"2016-06-17T12:31:43Z","timestamp":1466166703000},"page":"143-151","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":10,"title":["Surveillance for Travel and Domestically Acquired Multidrug-Resistant Human\n                    <i>Shigella<\/i>\n                    Infections\u2014Pennsylvania, 2006-2014"],"prefix":"10.1177","volume":"14","author":[{"given":"Yu Lung","family":"Li","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deepanker","family":"Tewari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Courtney C.","family":"Yealy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Fardig","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nkuchia M.","family":"M'ikanatha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2016,6,17]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid1701.P11101"},{"key":"e_1_3_2_3_2","unstructured":"Centers for Disease Control and Prevention.. Antibiotic Resistance Threats in the United States . 2013. Atlanta GA: US Department of Health and Human Services; 2013. http:\/\/www.cdc.gov\/drugresistance\/pdf\/ar-threats-2013-508.pdf. Accessed May10 2016."},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.4315\/0362-028X.JFP-11-058"},{"key":"e_1_3_2_5_2","unstructured":"Pennsylvania Department of Health.. PA National Electronic Disease Surveillance System (PA-NEDSS). http:\/\/www.portal.state.pa.us\/portal\/server.pt\/community\/pa_national_electronic_disease_surveillance_system_%28pa-nedss%29\/14215\/pa-nedss_-_faq\/557082. Accessed June19 2015."},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.82.9.1273"},{"key":"e_1_3_2_7_2","volume-title":"Manual of Clinical Microbiology","author":"Farmer J","year":"1995","unstructured":"Farmer JIII. Enterobacteriaceae: introduction and identification. In: Murray P, , Baron E, , Pfaller M, , Tenover F, , Yolken R, eds. Manual of Clinical Microbiology. 6th ed. Washington, DC: American Society for Microbiology; 1995.","edition":"6"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1089\/fpd.2006.3.59"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1089\/fpd.2006.3.9"},{"key":"e_1_3_2_10_2","unstructured":"US Food and Drug Administration.. The National Antimicrobial Resistance Monitoring System. FDA website. Updated April 29 . 2016. http:\/\/www.fda.gov\/AnimalVeterinary\/SafetyHealth\/AntimicrobialResistance\/NationalAntimicrobialResistanceMonitoringSystem\/default.htm. Accessed May10 2016."},{"key":"e_1_3_2_11_2","unstructured":"Centers for Disease Control and Prevention.. National Antimicrobial Resistance Monitoring System: Enteric Bacteria Human Isolates Final Report 2012. Atlanta GA: US Department of Health and Human Services; 2014. http:\/\/www.cdc.gov\/narms\/pdf\/2013-annual-report-narms-508c.pdf. Accessed May10 2016."},{"issue":"12","key":"e_1_3_2_12_2","first-page":"318","article-title":"Importation and domestic transmission of Shigella sonnei resistant to ciprofloxacin\u2014United States","volume":"64","author":"Centers for Disease Control and Prevention","year":"2015","unstructured":"Centers for Disease Control and Prevention. Importation and domestic transmission of Shigella sonnei resistant to ciprofloxacin\u2014United States. MMWR Morb Mortal Wkly Rep, 2015; 64(12):318-320.","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"e_1_3_2_13_2","unstructured":"State of Pennsylvania. Reporting of cases by health care practitioners and health care facilities. http:\/\/www.pacode.com\/secure\/data\/028\/chapter27\/028_0027.pdf. Accessed June19 2015."},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0077836"},{"key":"e_1_3_2_15_2","unstructured":"Clinical Laboratory Standards Institute.. W Pennsylvania. Performance Standards for Antimicrobial Susceptibility Testing; Twentieth Informational Supplement. CLSI-document M100-S20. Clinical Laboratory Standards Institute;. 2010. http:\/\/clsi.org\/blog\/2015\/01\/08\/clsi-publishes-new-antimicrobial-susceptibility-testing-standards\/. Accessed May31 2016."},{"key":"e_1_3_2_16_2","unstructured":"Centers for Disease Control and Prevention.. National Antimicrobial Resistance Monitoring System for Enteric Bacteria: Human Isolates Final Report 2013. Atlanta GA: US Department of Health and Human Services; 2014. http:\/\/www.cdc.gov\/narms\/pdf\/2013-annual-report-narms-508c.pdf. Accessed May31 2016."},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis230"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.50.1.49-54.2006"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis052"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/162.5.1107"},{"issue":"21","key":"e_1_3_2_21_2","first-page":"597","article-title":"Notes from the field: outbreaks of Shigella sonnei infection with decreased susceptibility to azithromycin among men who have sex with men\u2014Chicago and Metropolitan Minneapolis-St. Paul, 2014","volume":"64","author":"Bowen A","year":"2015","unstructured":"Bowen A, , Eikmeier D, , Talley P, et al; Centers for Disease Control and Prevention. Notes from the field: outbreaks of Shigella sonnei infection with decreased susceptibility to azithromycin among men who have sex with men\u2014Chicago and Metropolitan Minneapolis-St. Paul, 2014. MMWR Morb Mortal Wkly Rep, 2015; 64(21):597-598.","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"e_1_3_2_22_2","unstructured":"Panel on Opportunistic Infections in HIV-Infected Adults and Adolescents.. Guidelines for the Prevention and Treatment of Opportunistic Infections in HIV-Infected Adults and Adolescents: Recommendations from the Centers for Disease Control and Prevention the National Institutes of Health and the HIV Medicine Association of the Infectious Diseases Society of America. Atlanta GA: US Department of Health and Human Services CDC; 2014. http:\/\/aidsinfo.nih.gov\/contentfiles\/lvguidelines\/adult_oi.pdf. 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