Antimicrobial resistance in sexually transmitted Shigella in men who have sex with men: A systematic review.

BACKGROUND: Outbreaks of sexually transmitted Shigella flexneri and Shigella sonnei in men who have sex with men (MSM) are a major public health issue. While most cases can be managed conservatively, a minority require antimicrobial treatment. Recent reports have highlighted increasing antimicrobial resistant (AMR) strains of Shigella spp. in men who have sex with men. We aimed to systematically review antimicrobial resistance (and decreased antimicrobial sensitivity) in sexually transmitted shigella in men who have sex with men, focussing on macrolides, quinolones, and third generation cephalosporins. METHODS: We systematically searched 4 bibliographical databases (EMBASE, medline, EMCARE and CINAHL) from January 2011 to November 2021. We used a 2-stage process to assess eligibility: the primary author conducted an initial screen and then 3 authors conducted independent full-text reviews to determine the final eligible manuscripts. We only included manuscripts in English which included men who have sex with men with sexually transmitted shigella where data on antimicrobial resistance was available. RESULTS: Thirty-nine manuscripts met the inclusion criteria. A majority of the manuscripts (N = 34) described reduced susceptibility or antimicrobial resistant to macrolides, quinolones and third generation cephalosporins in circulating strains of shigella within sexual networks of men who have sex with men. Extensively drug resistant outbreaks of shigella in men who have sex with men have been reported containing genetic markers of ceftriaxone resistance (e.g. BlaCTX-M27) where isolates also contained markers of reduced susceptibility, and antimicrobial resistant to macrolides and quinolones. CONCLUSION: There is little role for macrolides, quinolones or third generation cephalosporins in the management of sexually transmitted shigella in men who have sex with men. More research is needed to develop novel strategies for shigella control in men who have sex with men, as antimicrobial options are diminishing.

Factors associated with sexually transmitted shigella in men who have sex with men: a systematic review.

BACKGROUND: Outbreaks of sexually transmitted shigella have been reported in men who have sex with men (MSM) since the 1970s and present a major public health issue. Understanding the factors associated with the sexual transmission of shigella may inform future control strategies. METHODS: We systematically searched four bibliographical databases (January 2000-February 2022) for manuscripts in English. We used a two-stage process to assess eligibility: the primary author conducted an initial screen and then three authors conducted independent full-text reviews to determine the final eligible manuscripts. We only included manuscripts that included MSM diagnosed with sexually transmitted shigella where specific factors associated with transmission were identified. RESULTS: Thirteen manuscripts met the inclusion criteria that included 547 individuals. Sexually transmitted shigella in MSM was associated with: residing in a capital city/urban region, living with HIV (including engaging in seroadaptive sexual behaviour, having a low CD4 count, having a HIV viral load >100 000 and not engaging with HIV care), using HIV pre-exposure prophylaxis, use of geospatial mobile phone applications to meet sexual partners, visiting sex on premises venues, chemsex and recreational drug use, sexual behaviour (including multiple non-regular sexual partners and oral-anal sexual contact) and concomitant STIs. CONCLUSION: We have highlighted some important risk behaviours and factors that are associated with sexually transmitted shigella in MSM that can be used to target future shigella control interventions.

Fast removal of high quantities of toxic arsenate via cationic p(APTMACl) microgels.

Hydrogels are resourceful materials and can be prepared in different morphology, size, surface charge and porosity adopting different polymerization techniques and reaction conditions. The cationic poly(3-acrylamidopropyl)trimethylammonium chloride (p(APTMACl)) microgels were synthesized by photo-initiated inverse suspension polymerization technique. These microgels were utilized as absorbents for the removal of toxic arsenate (As) from different aqueous environments. The experimental parameters affecting absorption efficiency were investigated, and it was demonstrated that these types of microgels are highly efficient in removing arsenate anions from different aqueous environments compared to the previously reported bulk hydrogel, and cryogel of the same material. A removal efficiency of approximately 97.25% was obtained by immersing 0.5 g microgel in 250 ppm 100 mL solution of arsenate anions for 60 min. Both Langmuir and Freundlich adsorption isotherms were applied to adsorption of arsenate anions by p(APTMACl) microgels, and the Langmuir isotherm was a better representation of the adsorption of arsenate with a high value of R(2) (0.9982). Furthermore, mag-p(APTMACl) microgels were synthesized for the adsorption of arsenate anions to provide easy removal of the microgel composite by using an externally applied magnetic field. Furthermore, re-usability of the p(APTMACl) microgels was also investigated for the adsorption of arsenate anions.

Synthesis and characterization of new microgel from tris(2-aminoethyl)amine and glycerol diglycidyl ether as poly(TAEA-co-GDE).

Here, we report a new microgel preparation from tris(2-aminoethyl)amine (TAEA) and glycerol diglycidyl ether (GDE) as p(TAEA-co-GDE) via simple microemulsion polymerization/crosslinking by using L-α lecithin as surfactant and gasoline as organic phase. The p(TAEA-co-GDE) microgels were visualized using optical microscopy and scanning electron microscopy (SEM) with size ranges <10 µm. The prepared particles were found to be positively charged, 23.61 ± 1.2 mV at pH~4.5, according to zeta-potential measurements, and the charge of particles decreased with increase in pH of the medium and become negatively charged after pH 10. The microgel particles were protonated (quaternized) or deprotanated by HCl and NaOH treatments, changing their zeta potential to 33 ± 1.3 mV and 14.53 ± 1.8 mV, respectively. Thermal properties of the prepared particles were observed by TG analysis before and after quaternization, and also after Co(II), Cu(II) and Cd(II) metal ion absorption. Here, we also demonstrated in situ CdS quantum dot (Q-dots) preparation within p(TAEA-co-GDE) microgels. The peak energy of 2.5 eV was observed in the fluorescence spectrum of p(TAEA-co-GDE)-CdS microgel by applying an excitation wavelength of 300 nm. Furthermore, the prepared p(TAEA-co-GDE) particles showed antibacterial characteristics against common bacteria such as Escherichia coli ATCC 8739, Staphylococcus aureus ATCC 6538, Bacillus subtilis ATCC 6633 and Pseudomonas aeruginosa ATCC 10145 and have great potential for biomedical use. Additionally, p(TAEA-co-GDE) particles are found to be biocompatible against L929 Fibroblast cells.