Drug-resistant Shigella infections are rising in the United States, according to new CDC findings that point to a sharp increase in extensively drug-resistant cases over the past decade. The data adds urgency to concerns about an intestinal infection that already causes hundreds of thousands of illnesses each year.
The CDC reviewed 16,788 Shigella samples collected between January 2011 and October 2023. Researchers found that the share of extensively drug-resistant, or XDR, Shigella cases climbed from 0% in 2011–2015 to 8.5% in 2023. 510 of the tested isolates were classified as XDR, meaning they were resistant to multiple antibiotic classes. The first XDR Shigella samples were detected in 2016.
The United States records about 450,000 Shigella infections each year. The 2023 rate could mean more than 36,000 Americans may now be infected annually with the drug-resistant form.
Shigella causes shigellosis, an intestinal infection transmitted by the faecal-oral route. Transmission can happen through person-to-person contact, sexual contact, contaminated food or water, and poor hygiene. That makes the infection highly contagious and easy to spread in homes, shared settings and during travel. Most XDR cases reported no recent international travel, suggesting the resistant strain is spreading within the U.S. itself.
Symptoms Can Appear Quickly
People with shigellosis may develop diarrhoea that can be bloody, along with fever and stomach pain. Symptoms usually begin within 1 to 2 days of exposure and often last 5 to 7 days, though some cases can continue longer. Some patients may face more severe illness, especially when common antibiotics no longer work. That is one reason the rise of XDR Shigella has drawn attention from public health officials.
The resistant variant is known as XDR Shigella because treatment options are much more limited. There are currently no FDA-approved oral antibiotics specifically for these extensively resistant strains. That does not mean every case will become severe, but it does make management more difficult when patients need treatment. Doctors should consider antimicrobial susceptibility testing in severe or persistent cases.
