US Surge in Extensively Drug-Resistant Shigella Cases

Cases of extensively drug-resistant Shigella bacteria, which cause the intestinal infection shigellosis, have surged across the United States, prompting warnings from public health officials about a growing threat to treatment options. The Centers for Disease Control and Prevention detailed the increase in a report released on April 9, analyzing nearly 17,000 samples collected from 2011 through October 2023 and identifying 505 cases of the resistant strain, up from none in the 2011-2015 period to 8.5 percent of infections in 2023.

The resistant strain, known as XDR Shigella, resists all five common oral antibiotics typically used for shigellosis: ampicillin, azithromycin, ceftriaxone, ciprofloxacin, and trimethoprim-sulfamethoxazole. "No Food and Drug Administration-approved oral antimicrobial agents are available to treat these," the CDC stated. As a result, clinicians often turn to intravenous therapies or unapproved alternatives, complicating care for severe cases. About one-third of patients with XDR infections required hospitalization, compared to the typical one percent rate for shigellosis overall.

Shigellosis symptoms usually include diarrhea that can be bloody and...