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Master Thesis

La Shigellose : une nouvelle IST ?

Abstract : Objectives: sexual transmitted shigellosis among Men who have Sex with Men (MSM) and emergence of antibiotic resistances is a well-known issue worldwide but has never been described in France. Our first purpose was to confirm the circulation of a multi- resistant cluster in Bordeaux area. Furthermore, completing an epidemiologic study we were also interested in giving behavioral study tracks to explain this new dissemination. Methods: this was a descriptive epidemiological retrospective study. From January 1st 2015 to September 30th 2018, we studied male patients over 18 years old with a positive culture for Shigella spp. with or without a positive Polymerase Chain Reaction (PCR) for Shigella spp. / E. coli enteroinvasive beforehand. Data was extracted from the University Hospital and private laboratories in Bordeaux. Strains sent to the E. coli, Shigella, Salmonella National Reference Center (CNR-ESS) were identified through cgMLST analysis. Socio-behavioral data was collected from patients’ medical records when followed by the Infectious Diseases Department or from surveys filled in through general practitioners prescribers of bacteriological exams. Results: we observed a huge increase of male cases with positive culture for Shigella spp. during the third quarterly of 2018 with a sex ratio of 9. During this period, 27 male strains of S. sonnei g constituted the cgMLST HC10/698 cluster. Bacteriological data showed a multi-drug resistant strain with high minimum inhibitory concentration (MIC) concerning azithromycin (AZM) with MIC > 256 mg/L and ciprofloxacin (CIP) with MIC 33 mg/L. Median age for shigellosis diagnosis among the cluster was 39 years old. Seven out these 27 subjects fulfilled a self-report: 6/7 were MSM, among them six usually practiced bucco-anal and digito-anal sex, half of them were usually involved in genito-oral activities just after anal sex; all except one did not report any travel out of Gironde, France during and before the infection. Conclusions: a cluster of a multi-drug resistant Shigella sonnei g was identified during the study period. Stool bacteriological analysis should be prescribed by general practitioners to adapt the management and limit the spread. Hypothesis of sexual transmission should be considered when diarrheas occur in MSM. Preventive behavior should be privileged to manage the occurrence of other sexually transmitted infections.
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Master Thesis
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Submitted on : Monday, March 2, 2020 - 4:00:44 PM
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Chloé Bourguignon. La Shigellose : une nouvelle IST ?. Médecine humaine et pathologie. 2019. ⟨dumas-02495897⟩



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