Rapid emergence of extensively drug-resistant Shigella sonnei in France

This study reports the monitoring of antimicrobial susceptibility of 7,121 Shigella sonnei isolates collected in France between 2005 and 2021. We detected a dramatic increase in the proportion of isolates simultaneously resistant to ciprofloxacin (CIP), third-generation cephalosporins (3GCs) and azithromycin (AZM) from 2015. In order to study the increase of XDR S. sonnei in France, a total of 3,140 S. sonnei isolates from the whole collection were sequenced, including all 164 XDR isolate. This rapid emergence of XDR S. sonnei, including an international epidemic strain, is alarming, and good laboratory-based surveillance of shigellosis will be crucial for informed decision-making and appropriate public health action.