{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T19:26:54Z","timestamp":1777922814300,"version":"3.51.4"},"reference-count":33,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2017,7,1]],"date-time":"2017-07-01T00:00:00Z","timestamp":1498867200000},"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":["Microbial Drug Resistance"],"published-print":{"date-parts":[[2017,7]]},"abstract":"<jats:p>\n                    The aim of this study was to detect the decreased susceptibility to azithromycin (DSA) and associated mechanisms in\n                    <jats:italic toggle=\"yes\">Shigella<\/jats:italic>\n                    from China. Three hundred and ninety-two\n                    <jats:italic toggle=\"yes\">Shigella<\/jats:italic>\n                    isolates, including 134\n                    <jats:italic toggle=\"yes\">Shigella flexneri<\/jats:italic>\n                    and 258\n                    <jats:italic toggle=\"yes\">Shigella sonnei<\/jats:italic>\n                    isolates, were examined for minimum inhibitory concentrations (MICs) and zone sizes to azithromycin by broth microdilution and disk diffusion methods, respectively. The MICs were compared with corresponding zone diameters to find whether there was uniformity between both tests. Twelve macrolide-resistant genes located on mobile elements were determined for the DSA isolates by PCR, and chromosomal efflux pump activity was analyzed using Phe-Arg-\u03b2-naphthylamide inhibition test and quantitative real-time PCR.\n                    <jats:italic toggle=\"yes\">Shigella<\/jats:italic>\n                    isolates displayed MICs of 0.125\u2013512\u2009\u03bcg\/ml and zone sizes of 6\u201326\u2009mm against azithromycin. There were 80 (20.4%) isolates to be DSA. No significant difference was found between the DSA rates of\n                    <jats:italic toggle=\"yes\">S. flexneri<\/jats:italic>\n                    and\n                    <jats:italic toggle=\"yes\">S. sonnei<\/jats:italic>\n                    isolates (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.052). There was an intimate relativity between MICs and zone diameters (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009&lt;\u20090.001). Only the plasmid-borne\n                    <jats:italic toggle=\"yes\">mphA<\/jats:italic>\n                    conferring high-level DSA was detected in 55.0% (44\/80) DSA-\n                    <jats:italic toggle=\"yes\">Shigella<\/jats:italic>\n                    isolates. This study highlighted the prevalence of DSA-\n                    <jats:italic toggle=\"yes\">Shigella<\/jats:italic>\n                    and\n                    <jats:italic toggle=\"yes\">mphA<\/jats:italic>\n                    in the region studied. Clinical laboratories and clinicians should pay attention to the elevated azithromycin MICs in\n                    <jats:italic toggle=\"yes\">Shigella<\/jats:italic>\n                    spp.\n                  <\/jats:p>","DOI":"10.1089\/mdr.2016.0134","type":"journal-article","created":{"date-parts":[[2016,11,14]],"date-time":"2016-11-14T14:15:38Z","timestamp":1479132938000},"page":"596-601","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":9,"title":["Decreased Susceptibility to Azithromycin Among Clinical\n                    <i>Shigella<\/i>\n                    Isolates from China"],"prefix":"10.1177","volume":"23","author":[{"given":"Chuanling","family":"Zhang","sequence":"first","affiliation":[{"name":"Zhejiang Xiaoshan Hospital","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rulin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Shanghai Jiaotong University","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qi","family":"Yu","sequence":"additional","affiliation":[{"name":"Shanghai Jiaotong University","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xu","family":"Chu","sequence":"additional","affiliation":[{"name":"Zhejiang Xiaoshan Hospital","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jingyong","family":"Sun","sequence":"additional","affiliation":[{"name":"Shanghai Jiaotong University School of Medicine","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qingzhong","family":"Liu","sequence":"additional","affiliation":[{"name":"Shanghai Jiaotong University","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2017,7]]},"reference":[{"key":"e_1_3_3_2_2","first-page":"651","article-title":"Global burden of Shigella infections: implications for vaccine development and implementation of control strategies","volume":"77","author":"Kotloff K.L.","year":"1999","unstructured":"Kotloff K.L., , Winickoff J.P., , Ivanoff B., , Clemens J.D., , Swerdlow D.L., , Sansonetti P.J., , Adak G.K., , and Levine M.M.. 1999. 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