{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T12:43:21Z","timestamp":1790858601495,"version":"4.1.0"},"reference-count":28,"publisher":"American Society for Microbiology","issue":"3","license":[{"start":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T00:00:00Z","timestamp":1741046400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,3,4]],"date-time":"2025-03-04T00:00:00Z","timestamp":1741046400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Microbiol Spectr"],"published-print":{"date-parts":[[2025,3,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n          <jats:sec>\n            <jats:title\/>\n            <jats:p>\n              We performed phenotypic susceptibility testing and whole-genome sequencing to investigate\n              <jats:italic>in vitro<\/jats:italic>\n              mecillinam activity against multidrug-resistant (MDR)\n              <jats:italic>Shigella<\/jats:italic>\n              . Ninety-five isolates (53 [56%]\n              <jats:italic>Shigella sonnei<\/jats:italic>\n              and 42 [44%]\n              <jats:italic>Shigella flexneri<\/jats:italic>\n              ) were included. The MIC\n              <jats:sub>50<\/jats:sub>\n              and MIC\n              <jats:sub>90<\/jats:sub>\n              were 1 and 2 \u00b5g\/mL, respectively, by agar dilution, and all zone diameters were \u226515 mm by disc diffusion testing. No known clinically relevant mecillinam resistance mutations (including\n              <jats:italic>cys<\/jats:italic>\n              B) were detected. The favorable MIC profile and absence of resistance markers make pivmecillinam an agent worth considering for the treatment of infections caused by MDR\n              <jats:italic>Shigella<\/jats:italic>\n              . Clinically feasible susceptibility testing methods and standardized interpretations for mecillinam and\n              <jats:italic>Shigella<\/jats:italic>\n              spp. are needed to guide therapy.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>IMPORTANCE<\/jats:title>\n            <jats:p>\n              Rapidly emerging resistance in\n              <jats:italic>Shigella<\/jats:italic>\n              species leaves few antibiotic treatment options. The World Health Organization recommends pivmecillinam, a prodrug of mecillinam, for the treatment of\n              <jats:italic>Shigella<\/jats:italic>\n              infections. However, little is known about the susceptibility of\n              <jats:italic>Shigella<\/jats:italic>\n              spp. to mecillinam in North America. We performed mecillinam susceptibility testing on our collection of resistant\n              <jats:italic>Shigella<\/jats:italic>\n              isolates and investigated genetic mechanisms of resistance using whole-genome sequencing. We observed a favorable mecillinam susceptibility profile and a lack of known genetic mechanisms of resistance. However, in the absence of standardized laboratory guidelines for mecillinam susceptibility testing, interpreting susceptibility test results is challenging. We propose that further studies are needed to correlate susceptibility testing data with clinical outcomes, with the aim of establishing standardized clinical breakpoints for\n              <jats:italic>Shigella<\/jats:italic>\n              spp. and mecillinam.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1128\/spectrum.01006-24","type":"journal-article","created":{"date-parts":[[2025,2,7]],"date-time":"2025-02-07T14:01:36Z","timestamp":1738936896000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":4,"title":["Mecillinam activity against multidrug-resistant\n            <i>Shigella sonnei<\/i>\n            and\n            <i>Shigella flexneri<\/i>"],"prefix":"10.1128","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9299-2040","authenticated-orcid":true,"given":"Aleksandra","family":"Stefanovic","sequence":"first","affiliation":[{"name":"Division of Medical Microbiology and Virology, St. Paul\u2019s Hospital, Providence Health Care","place":["Vancouver, Canada"]},{"name":"Department of Pathology and Laboratory Medicine, University of British Columbia","place":["Vancouver, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leah","family":"Gowland","sequence":"additional","affiliation":[{"name":"Division of Medical Microbiology and Virology, St. Paul\u2019s Hospital, Providence Health Care","place":["Vancouver, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gordon","family":"Ritchie","sequence":"additional","affiliation":[{"name":"Division of Medical Microbiology and Virology, St. Paul\u2019s Hospital, Providence Health Care","place":["Vancouver, Canada"]},{"name":"Department of Pathology and Laboratory Medicine, University of British Columbia","place":["Vancouver, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Providence Health Care","place":["Vancouver, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sam","family":"Chorlton","sequence":"additional","affiliation":[{"name":"BugSeq Bioinformatics Inc.","place":["Vancouver, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4158-6955","authenticated-orcid":true,"given":"Nancy","family":"Matic","sequence":"additional","affiliation":[{"name":"Division of Medical Microbiology and Virology, St. Paul\u2019s Hospital, Providence Health Care","place":["Vancouver, Canada"]},{"name":"Department of Pathology and Laboratory Medicine, University of British Columbia","place":["Vancouver, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Leung","sequence":"additional","affiliation":[{"name":"Division of Medical Microbiology and Virology, St. Paul\u2019s Hospital, Providence Health Care","place":["Vancouver, Canada"]},{"name":"Department of Pathology and Laboratory Medicine, University of British Columbia","place":["Vancouver, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Payne","sequence":"additional","affiliation":[{"name":"Division of Medical Microbiology and Virology, St. Paul\u2019s Hospital, Providence Health Care","place":["Vancouver, Canada"]},{"name":"Department of Pathology and Laboratory Medicine, University of British Columbia","place":["Vancouver, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9320-4499","authenticated-orcid":true,"given":"Christopher F.","family":"Lowe","sequence":"additional","affiliation":[{"name":"Division of Medical Microbiology and Virology, St. Paul\u2019s Hospital, Providence Health Care","place":["Vancouver, Canada"]},{"name":"Department of Pathology and Laboratory Medicine, University of British Columbia","place":["Vancouver, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc G.","family":"Romney","sequence":"additional","affiliation":[{"name":"Division of Medical Microbiology and Virology, St. Paul\u2019s Hospital, Providence Health Care","place":["Vancouver, Canada"]},{"name":"Department of Pathology and Laboratory Medicine, University of British Columbia","place":["Vancouver, Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciae575"},{"key":"e_1_3_3_3_2","unstructured":"Agerberth B Kane A Bardhan PK Rhida BA Dakar-Fann CB Brandes N Breiman R Brondi DL Brooks A Carter J et al.. 2005. 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