A recent study by Somda et al. (2025) titled “Molecular epidemiology of extended-spectrum beta-lactamases and carbapenemases-producing Shigella in Africa: a systematic review and meta-analysis” published in BMC Infectious Diseases by Springer Nature reveals that Shigella flexneri is the dominant ESBL and CR-producing species in Africa, with prevalent resistance genes posing a major public health threat.
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Shigella flexneri is the dominant ESBL and carbapenemase-producing species in Africa, posing a major public health threat.– Somda et al. 2025
This systematic review and meta-analysis examines the molecular epidemiology of Shigella strains producing extended-spectrum beta-lactamase (ESBL) and carbapenemase in Africa, addressing the treatment challenges posed by multidrug-resistant Shigella infections. The study comprehensively reviews scientific literature to investigate the prevalence, species distribution, and genetic determinants of these resistant Shigella strains.
Shigella, a member of the Enterobacterales family, is a major cause of diarrheal diseases, particularly in developing countries. Among its four serogroups (A-D), Shigella flexneri and Shigella dysenteriae are the primary culprits of bacterial dysentery. The rising prevalence of multidrug-resistant Shigella strains poses a significant global public health concern, complicating treatment options and increasing the urgency for antimicrobial resistance (AMR) surveillance.
How the Study was Conducted
The researchers conducted a systematic literature search of studies published in English and French from African countries between January 1999 and July 2024. The databases searched include PubMed, Scopus, Web of Science, African Journals Online (AJOL), and Google Scholar. Inclusion criteria required full-text articles that reported the prevalence of ESBL and carbapenemase-producing Shigella, detailing study populations and resistance detection methods. Data were analyzed using a binary random-effects model through comprehensive meta-analysis software.
What the Authors Found
The meta-analysis estimated the overall pooled prevalence of ESBL and carbapenem-resistant (CR) Shigella at 41.2%. Shigella flexneri emerged as the most prevalent ESBL and CR-producing species at 34.5%, while Shigella sonnei was the least reported at 6.7%. The most common ESBL genes detected were blaTEM (25.9%), blaOXA-1 (25.7%), and blaCTX-M (10.8%). Carbapenemase genes, such as blaNDM, blaKPC, and blaIMP, were found to be less prevalent.
Why is this important?
Rising Resistance: With the increasing prevalence of ESBL and carbapenemase-producing Shigella strains, these findings highlight a significant public health threat in Africa. These resistant bacteria complicate treatment options and can lead to higher morbidity and mortality rates, especially among vulnerable populations like children, the elderly, and immunocompromised individuals.
Informed Choices: The study underscores the need for effective antimicrobial resistance (AMR) surveillance strategies. By identifying the prevalent resistance genes and Shigella species, healthcare providers can make more informed choices regarding antibiotic treatments and stewardship.
Guiding Policies: The data from this study can help inform public health policies and strategies aimed at controlling and preventing the spread of multidrug-resistant Shigella. Policymakers can use this information to allocate resources effectively, promote vaccination, and implement robust surveillance systems.
Future Research: The findings provide a foundation for future research on molecular epidemiology and resistance mechanisms. It also highlights the need for further studies and improved laboratory infrastructure to monitor and combat antimicrobial resistance.
Cross-Border Relevance: Given the interconnectedness of our world, the findings have implications beyond Africa. Travelers, trade, and migration can facilitate the spread of these resistant strains to other regions, making it a global health concern.
Raising Awareness: The study serves as an educational resource for healthcare professionals, researchers, and the general public. Awareness of the prevalence and impact of antimicrobial resistance can drive efforts to improve hygiene, sanitation, and responsible antibiotic use.
What the Authors Recommended
- The authors emphasize the need for effective antimicrobial resistance (AMR) surveillance strategies in Africa to monitor and control the spread of extended-spectrum beta-lactamase (ESBL) and carbapenemase-producing Shigella. This includes the implementation of robust national and regional surveillance systems.
- There is a call for policymakers to allocate adequate resources for the monitoring and control of antimicrobial resistance. This includes funding for research, improving laboratory infrastructure, and training healthcare professionals.
- The authors highlight the importance of raising public health awareness about the risks associated with ESBL and carbapenemase-producing Shigella. Public health campaigns can educate communities about the importance of hygiene, sanitation, and responsible antibiotic use.
- The findings underscore the need for updated treatment guidelines that consider the prevalence of these resistant Shigella strains. Healthcare providers should be aware of the local resistance patterns to make informed decisions about antibiotic therapy.
- The authors recommend fostering international collaboration and data sharing to combat antimicrobial resistance globally. This includes participating in global initiatives and sharing surveillance data to track the spread of resistant strains.
- The authors encourage further research to understand the molecular mechanisms of resistance and to develop new strategies to combat Shigella infections. This includes studies on the genetic determinants of resistance and the development of new antibiotics.
In conclusion, the study by Somda et al. (2025) highlights the alarming rise of ESBL and carbapenemase-producing Shigella in Africa, posing a significant public health challenge. The findings emphasize the urgent need for robust antimicrobial resistance (AMR) surveillance, improved laboratory infrastructure, and informed antibiotic stewardship to combat the growing threat of multidrug-resistant Shigella strains. Policymakers, healthcare professionals, and researchers must collaborate to implement effective prevention strategies, enhance public awareness, and guide treatment protocols. Given the potential for global spread, addressing this issue is not just a regional priority but a critical component of international public health efforts.
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