Characterization of endemic strains of Shigella sonnei by use of plasmid DNA analysis and pulsed-field gel electrophoresis to detect patterns of transmission

Shigellosis is hyperendemic in Utah. Most isolates are Shigella sonnei, making it difficult to identify epidemiologic clustering. To better define transmission, molecular markers and epidemiologic data were examined for 90 cases. Plasmid analysis and pulsed-field gel electrophoresis (PFGE) of the S. sonnei isolates identified 11 and 4 patterns, respectively. Plasmid pattern I infections occurred in 8 day care centers over a 6-month period, suggesting spread between centers. Plasmid pattern III was isolated from children at 3 additional centers and pattern IV was associated with another day care center, suggesting different outbreaks. By PFGE, plasmid groups I and XI appeared identical, as were plasmid groups II and V; plasmid group X had a unique pattern. Plasmid groups III, IV, and VII-IX were closely related PFGE subtypes. Both plasmid analysis and PFGE allow better characterization of S. sonnei transmission patterns of 'endemic' strains and could lead to improved control measures.