{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T11:17:54Z","timestamp":1790248674763,"version":"4.1.0"},"reference-count":39,"publisher":"American Society for Microbiology","issue":"4","license":[{"start":{"date-parts":[[2018,3,27]],"date-time":"2018-03-27T00:00:00Z","timestamp":1522108800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2018,4,1]],"date-time":"2018-04-01T00:00:00Z","timestamp":1522540800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"name":"National Institutes for Health Research","award":["3557"],"award-info":[{"award-number":["3557"]}]},{"DOI":"10.13039\/100004440","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["098051"],"award-info":[{"award-number":["098051"]}],"id":[{"id":"10.13039\/100004440","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004440","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["106698\/Z\/14\/Z"],"award-info":[{"award-number":["106698\/Z\/14\/Z"]}],"id":[{"id":"10.13039\/100004440","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004440","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["10008\/Z\/12\/Z"],"award-info":[{"award-number":["10008\/Z\/12\/Z"]}],"id":[{"id":"10.13039\/100004440","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000691","name":"Academy of Medical Sciences","doi-asserted-by":"publisher","award":["SGCL015\/1005"],"award-info":[{"award-number":["SGCL015\/1005"]}],"id":[{"id":"10.13039\/501100000691","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001275","name":"Oak Foundation","doi-asserted-by":"publisher","award":["B9R00910"],"award-info":[{"award-number":["B9R00910"]}],"id":[{"id":"10.13039\/100001275","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:p>\n            Infection by\n            <jats:named-content content-type=\"genus-species\">Shigella<\/jats:named-content>\n            spp. is a common cause of dysentery in Southeast Asia. Antimicrobials are thought to be beneficial for treatment; however, antimicrobial resistance in\n            <jats:named-content content-type=\"genus-species\">Shigella<\/jats:named-content>\n            spp. is becoming widespread. We aimed to assess the frequency and mechanisms associated with decreased susceptibility to azithromycin in Southeast Asian\n            <jats:named-content content-type=\"genus-species\">Shigella<\/jats:named-content>\n            isolates and use these data to assess appropriate susceptibility breakpoints.\n            <jats:named-content content-type=\"genus-species\">Shigella<\/jats:named-content>\n            isolates recovered in Vietnam and Laos were screened for susceptibility to azithromycin (15 \u03bcg) by disc diffusion and MIC. Phenotypic resistance was confirmed by PCR amplification of macrolide resistance loci. We compared the genetic relationships and plasmid contents of azithromycin-resistant\n            <jats:named-content content-type=\"genus-species\">Shigella sonnei<\/jats:named-content>\n            isolates using whole-genome sequences. From 475 available\n            <jats:named-content content-type=\"genus-species\">Shigella<\/jats:named-content>\n            spp. isolated in Vietnam and Laos between 1994 and 2012, 6\/181\n            <jats:named-content content-type=\"genus-species\">S. flexneri<\/jats:named-content>\n            isolates (3.3%, MIC \u2265 16 g\/liter) and 16\/294\n            <jats:named-content content-type=\"genus-species\">S. sonnei<\/jats:named-content>\n            isolates (5.4%, MIC \u2265 32 g\/liter) were phenotypically resistant to azithromycin. PCR amplification confirmed a resistance mechanism in 22\/475 (4.6%) isolates (\n            <jats:italic>mphA<\/jats:italic>\n            in 19 isolates and\n            <jats:italic>ermB<\/jats:italic>\n            in 3 isolates). The susceptibility data demonstrated the acceptability of the\n            <jats:named-content content-type=\"genus-species\">S. flexneri<\/jats:named-content>\n            (MIC \u2265 16 g\/liter, zone diameter \u2264 15 mm) and\n            <jats:named-content content-type=\"genus-species\">S. sonnei<\/jats:named-content>\n            (MIC \u2265 32 g\/liter, zone diameter \u2264 11 mm) breakpoints with a &lt;3% discrepancy. Phylogenetic analysis demonstrated that decreased susceptibility has arisen sporadically in Vietnamese\n            <jats:named-content content-type=\"genus-species\">S. sonnei<\/jats:named-content>\n            isolates on at least seven occasions between 2000 and 2009 but failed to become established. While the proposed susceptibility breakpoints may allow better recognition of resistant isolates, additional studies are required to assess the impact on the clinical outcome. The potential emergence of azithromycin resistance highlights the need for alternative options for management of\n            <jats:named-content content-type=\"genus-species\">Shigella<\/jats:named-content>\n            infections in countries where\n            <jats:named-content content-type=\"genus-species\">Shigella<\/jats:named-content>\n            is endemic.\n          <\/jats:p>","DOI":"10.1128\/aac.01748-17","type":"journal-article","created":{"date-parts":[[2018,1,27]],"date-time":"2018-01-27T11:27:51Z","timestamp":1517052471000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":48,"title":["Azithromycin Resistance in Shigella spp. in Southeast Asia"],"prefix":"10.1128","volume":"62","author":[{"given":"Thomas C.","family":"Darton","sequence":"first","affiliation":[{"name":"The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam"},{"name":"Department of Infection, Immunity and Cardiovascular Disease, University of Sheffield Medical School, Sheffield, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ha Thanh","family":"Tuyen","sequence":"additional","affiliation":[{"name":"The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao Chung","family":"The","sequence":"additional","affiliation":[{"name":"The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul N.","family":"Newton","sequence":"additional","affiliation":[{"name":"Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Vientiane, Laos"},{"name":"Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, Oxford, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9189-7244","authenticated-orcid":false,"given":"David A. B.","family":"Dance","sequence":"additional","affiliation":[{"name":"Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Vientiane, Laos"},{"name":"Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, Oxford, United Kingdom"},{"name":"Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rattanaphone","family":"Phetsouvanh","sequence":"additional","affiliation":[{"name":"Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Vientiane, Laos"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viengmon","family":"Davong","sequence":"additional","affiliation":[{"name":"Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit, Vientiane, Laos"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James I.","family":"Campbell","sequence":"additional","affiliation":[{"name":"The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nguyen Van Minh","family":"Hoang","sequence":"additional","affiliation":[{"name":"The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guy E.","family":"Thwaites","sequence":"additional","affiliation":[{"name":"The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam"},{"name":"Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, Oxford, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher M.","family":"Parry","sequence":"additional","affiliation":[{"name":"Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom"},{"name":"School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duy Pham","family":"Thanh","sequence":"additional","affiliation":[{"name":"The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Baker","sequence":"additional","affiliation":[{"name":"The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam"},{"name":"Centre for Tropical Medicine, Nuffield Department of Clinical Medicine, Oxford University, Oxford, United Kingdom"},{"name":"Department of Medicine, University of Cambridge, Cambridge, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60844-2"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(15)00151-5"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.3201\/eid2107.150363"},{"key":"e_1_3_3_5_2","first-page":"651","article-title":"Global burden of Shigella infections: implications for vaccine development and implementation of control strategies","volume":"77","author":"Kotloff KL","year":"1999","unstructured":"Kotloff KL, Winickoff JP, Ivanoff B, Clemens JD, Swerdlow DL, Sansonetti PJ, Adak GK, Levine MM. 1999. 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