Together with plague, smallpox and typhus, epidemics of dysentery have been a major scourge of human populations for centuries(1). A previous genomic study concluded that Shigella dysenteriae type 1 (Sd1), the epidemic dysentery bacillus, emerged and spread worldwide after the First World War, with no clear pattern of transmission(2). This is not consistent with the massive cyclic dysentery epidemics reported in Europe during the eighteenth and nineteenth centuries(1,3,4) and the first isolation of Sd1 in Japan in 1897(5). Here, we report a whole-genome analysis of 331 Sd1 isolates from around the world, collected between 1915 and 2011, providing us with unprecedented insight into the historical spread of this pathogen. We show here that Sd1 has existed since at least the eighteenth century and that it swept the globe at the end of the nineteenth century, diversifying into distinct lineages associated with the First World War, Second World War and various conflicts or natural disasters across Africa, Asia and Central America. We also provide a unique historical perspective on the evolution of antibiotic resistance over a 100-year period, beginning decades before the antibiotic era, and identify a prevalent multiple antibiotic-resistant lineage in South Asia that was transmitted in several waves to Africa, where it caused severe outbreaks of disease.

We studied the prevalence of resistance to extended-spectrum cephalosporins (ESC) among 1,078 Salmonella enterica isolates collected from adults admitted to Botkin Hospital, St. Petersburg, Russia, for gastroenteritis between 2002 and 2005. Only two ESC-resistant isolates were detected, giving a low percentage of strains resistant to ESC (0.2%). One multidrug-resistant (MDR) isolate of the Virchow serotype produced a CTXM-3 extended-spectrum beta-lactamase (ESBL). The bla(CTX-M-3) gene was located downstream from an ISEcp1 element, on an 80-kb conjugative plasmid. The Virchow isolate possessed a class 1 integron with a 2.2-kb gene cassette (dhfrXII-orfF-aadA2). The second ESC-resistant isolate belonged to serotype Newport, was also MDR and produced a CMY-2 cephamycinase. This CMY-2-producing isolate (also called Newport MDR-AmpC) possessed a class 1 integron with a 1-kb gene cassette including a new variant of the aadA gene, aadA24. A large plasmid (>125 kb) was involved in transfer of the bla(CMY-2) gene. The ESC-resistant S. enterica isolates detected in this study were different from those (S. enterica serotype Typhimurium DT193 producing CTXM-4 or CTX-M-5 ESBLs) involved in several nosocomial outbreaks between 1994 and 2003 in Russia. This is the first description of both CTX-M-3 ESBL-producing S. enterica and Newport MDR-AmpC in Russia.

The spread of carbapenemase-producing Enterobacteriaceae is a global problem; however, no exact data on the epidemiology of carbapenemase in the Baltic countries and St. Petersburg area is available. We aimed to evaluate the epidemiology of carbapenemase-producing Escherichia coli and Klebsiella pneumoniae in the Baltic States and St. Petersburg, Russia, and to compare the different methods for carbapenemase detection. From January to May 2012, all K. pneumoniae (n = 1983) and E. coli (n = 7774) clinical isolates from 20 institutions in Estonia, Latvia, Lithuania, and St. Petersburg, Russia were screened for carbapenem susceptibility. The IMP, VIM, GIM, NDM, KPC, and OXA-48 genes were detected using real-time PCR and the ability to hydrolyze ertapenem was determined using MALDI-TOF MS. Seventy-seven strains were found to be carbapenem nonsusceptible. From these, 15 K. pneumoniae strains hydrolyzed ertapenem and carried the bla NDM gene. All of these strains carried integron 1 and most carried integron 3 as well as genes of the CTX-M-1 group. No carbapenemase-producing E. coli or K. pneumoniae strains were found in Estonia, Latvia, or Lithuania; however, NDM-positive K. pneumoniae was present in the hospital in St. Petersburg, Russia. A MALDI-TOF MS-based assay is a suitable and cost-effective method for the initial confirmation of carbapenemase production.

This study has evaluated the correlation between different carbapenemases detection methods on carbapenem non-susceptible Klebsiella pneumoniae strains from Northern and Eastern Europe; 31 institutions in 9 countries participated in the research project, namely Finland, Estonia, Latvia, Lithuania, Russia, St. Petersburg, Poland, Belarus, Ukraine, and Georgia. During the research program, a total of 5,001 clinical K. pneumoniae isolates were screened for any carbapenem non-susceptibility by the disk diffusion method, Vitek 2 or Phoenix system following the EUCAST guideline on detection of resistance mechanisms, version 1.0. Strains isolated from outpatients and hospitalized patients from April 2015 to June 2015 were included. All types of samples (blood, pus, urine, etc.) excluding fecal screening or fecal colonization samples have been represented. In total, 171 carbapenemase screening-positive K. pneumoniae isolates (3.42%) were found and characterized. Several methods were used for detection of carbapenemases production, including Luminex assay (PCR and hybridization), whole genome sequencing, MALDI-TOF based Imipenem degradation assay, and immunochromatography testing. Minimal inhibitory concentration determination for Meropenem by agar-based gradient method was also used. Finally, 83 K. pneumoniae strains were carbapenemase negative by all confirmation methods (49.4% of all screening-positive ones), 74 – positive by three methods (44.0%), 8 – positive by two methods (4.8%) and 3 – positive by only one method (1.8%). The sensitivity of the tests was 96.3% for Whole genome sequencing and MALDI-TOF assay (both three undetected cases), and 95.1% for Luminex-Carba (4 undetected cases). The most commonly detected carbapenemases were NDM ( n = 54) and OXA-48 ( n = 26), followed by KPC-2, VIM-5, and OXA-72 (one case of each). Our results showed that different types of carbapenemases can be detected in the countries involved in the project. The sensitivity of our methods for carbapenemase detection (including screening as a first step and further confirmation tests) was >95%, but we would recommend using different methods to increase the sensitivity of detection and make it more precise.

The gut microbiota of healthy people, living in different regions, may vary considerably. The article presents the results of comparative qualitative and quantitative study of the intestine aerobic and anaerobic microbiota of residents of the Republic of Guinea (46) and Russia (60). The content of microorganisms (Enterobacteriaceae, Enterococcus spp., Lactobacillus spp., Bifidobacterium spp., Staphylococcus spp., Candida spp., non-fermentative gram-negative bacteria and others) in 1.0 gram of faeces was determined by bacteriological methods. Generic and species identification was performed using Vitek 2 Compact (bioMerieux, France), tube biochemical tests and MALDI-TОF mass spectrometry (Bruker Daltonics, Germany). Pearson χ 2 criterion, p < 0.05 and Fisher's exact test (medstatistica.ru) were used to assess the differences in the compared groups. 95% confidence intervals were calculated by the method of Wilson. Microbiological disorders were characterized by a decrease in the number of obligate microorganisms, an increase in the number of facultative (opportunistic) microorganisms (above 10 6 CFU/g) and the emergence of their associations. Dysbiotic disorders were identified in both compared groups: in 100% patients from Republic of Guinea (95% CI:92.3-100) and in 86.7% patients from St. Petersburg (95% CI:75.8-93.1). Severe degree of microbiota disorders in the residents of the Republic of Guinea was revealed at 19.6% (95% CI:10.7-33.2), in group of residents of St. Petersburg in 9.6% (95% CI:4.2-20.6). In both groups the microbiota disorders of third degree were detected less frequently, compared with the microbiota disorders of second degree. The study has found no significant differences in the content of obligate bacteria (Bifidobacterium spp. and Lactobacillus spp.), however, significant differences in the species composition of the facultative part of the microbiota were revealed. The residents of the Republic of Guinea had "atypical" E. coli (lactosonegative and hemolytic) and non-fermenting gram-negative bacteria Comamonas kerstersii more frequently. Opportunistic microorganism associations have been found in 30.4% of the residents of the Republic of Guinea (95% CI:19.1-44.8) and 18.3% of residents of St. Petersburg (95% CI:10.6-29.9). Opportunistic microorganism associations from the residents of the Republic of Guinea always contained Staphylococcus aureus. It is necessary to conduct further research on a bigger population to access the differences in the compared groups in Staphylococcus aureus and Hafnia alvei.