TY - JOUR
T1 - Shigella isolates from the global enteric multicenter study inform vaccine development
AU - Livio, Sofie
AU - Strockbine, Nancy A.
AU - Panchalingam, Sandra
AU - Tennant, Sharon M.
AU - Barry, Eileen M.
AU - Marohn, Mark E.
AU - Antonio, Martin
AU - Hossain, Anowar
AU - Mandomando, Inacio
AU - Ochieng, John B.
AU - Oundo, Joseph O.
AU - Qureshi, Shahida
AU - Ramamurthy, Thandavarayan
AU - Tamboura, Boubou
AU - Adegbola, Richard A.
AU - Hossain, Mohammed Jahangir
AU - Saha, Debasish
AU - Sen, Sunil
AU - Faruque, Abu Syed Golam
AU - Alonso, Pedro L.
AU - Breiman, Robert F.
AU - Zaidi, Anita K.M.
AU - Sur, Dipika
AU - Sow, Samba O.
AU - Berkeley, Lynette Y.
AU - O'Reilly, Ciara E.
AU - Mintz, Eric D.
AU - Biswas, Kousick
AU - Cohen, Dani
AU - Farag, Tamer H.
AU - Nasrin, Dilruba
AU - Wu, Yukun
AU - Blackwelder, William C.
AU - Kotloff, Karen L.
AU - Nataro, James P.
AU - Levine, Myron M.
N1 - Publisher Copyright:
© The Author 2014.
PY - 2014/10/1
Y1 - 2014/10/1
N2 - 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.
AB - 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.
KW - Serotyping
KW - Shigella
KW - Shigellosis
KW - Vaccines
UR - http://www.scopus.com/inward/record.url?scp=84916892138&partnerID=8YFLogxK
U2 - 10.1093/cid/ciu468
DO - 10.1093/cid/ciu468
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C2 - 24958238
AN - SCOPUS:84916892138
SN - 1058-4838
VL - 59
SP - 933
EP - 941
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 7
ER -