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Clin Infect Dis. 2014 Oct;59(7):933-41. doi: 10.1093/cid/ciu468. Epub 2014 Jun 23.

Shigella isolates from the global enteric multicenter study inform vaccine development.

Author information

1
Center for Vaccine Development, University of Maryland School of Medicine, Baltimore.
2
Escherichia and Shigella Reference Unit, Enteric Diseases Laboratory Branch Division of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
3
Medical Research Council Unit (United Kingdom), Fajara, The Gambia.
4
International Centre for Diarrhoeal Disease Research, Mohakhali, Dhaka, Bangladesh.
5
Centro de Investigação em Saúde de Manhiça, Manhiça, Mozambique and the Centre de Recerca en Salut Internacional de Barcelona, Hospital Clinic/Universitat de Barcelona, Spain.
6
Kenya Medical Research Institute/Centers for Disease Control and Prevention, Kisumu, Kenya.
7
Department of Paediatrics and Child Health, The Aga Khan University, Karachi, Pakistan.
8
National Institute of Cholera and Enteric Diseases, Kolkata, India.
9
Centre pour le Développement des Vaccins du Mali, Bamako, Mali.
10
Kenya Medical Research Institute/Centers for Disease Control and Prevention, Kisumu, Kenya Global Disease Detection Division, Kenya Office of the US Centers for Disease Control and Prevention, Nairobi, Kenya.
11
National Institute of Cholera and Enteric Diseases, Kolkata, India Program for Appropriate Technology in Health (PATH), New Delhi, India.
12
Center for Vaccine Development, University of Maryland School of Medicine, Baltimore US Food and Drug Administration, Rockville.
13
Division of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
14
Department of Veterans Affairs, Cooperative Studies Program Coordinating Center, Perry Point, Maryland.
15
Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel.

Abstract

BACKGROUND:

Shigella, a major diarrheal disease pathogen worldwide, is the target of vaccine development. The Global Enteric Multicenter Study (GEMS) investigated burden and etiology of moderate-to-severe diarrheal disease in children aged <60 months and matched controls without diarrhea during 3 years at 4 sites in Africa and 3 in Asia. Shigella was 1 of the 4 most common pathogens across sites and age strata. GEMS Shigella serotypes are reviewed to guide vaccine development.

METHODS:

Subjects' stool specimens/rectal swabs were transported to site laboratories in transport media and plated onto xylose lysine desoxycholate and MacConkey agar. Suspect Shigella colonies were identified by biochemical tests and agglutination with antisera. Shigella isolates were shipped to the GEMS Reference Laboratory (Baltimore, MD) for confirmation and serotyping of S. flexneri; one-third of isolates were sent to the Centers for Disease Control and Prevention for quality control.

RESULTS:

Shigella dysenteriae and S. boydii accounted for 5.0% and 5.4%, respectively, of 1130 Shigella case isolates; S. flexneri comprised 65.9% and S. sonnei 23.7%. Five serotypes/subserotypes comprised 89.4% of S. flexneri, including S. flexneri 2a, S. flexneri 6, S. flexneri 3a, S. flexneri 2b, and S. flexneri 1b.

CONCLUSIONS:

A broad-spectrum Shigella vaccine must protect against S. sonnei and 15 S. flexneri serotypes/subserotypes. A quadrivalent vaccine with O antigens from S. sonnei, S. flexneri 2a, S. flexneri 3a, and S. flexneri 6 can provide broad direct coverage against these most common serotypes and indirect coverage against all but 1 (rare) remaining subserotype through shared S. flexneri group antigens.

KEYWORDS:

Shigella; serotyping; shigellosis; vaccines

PMID:
24958238
PMCID:
PMC4166982
DOI:
10.1093/cid/ciu468
[Indexed for MEDLINE]
Free PMC Article

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