The US Centres for Disease Control and Prevention (CDC) has issued an alert about an observed increase in drug-resistant (XDR) Shigella infections in the country.
Shigella bacteria cause an infection called Shigellosis, which usually causes inflammatory diarrhoea that can be bloody and may also lead to fever, abdominal cramping and tenesmus, the CDC noted.
The agency said symptoms typically start within two days of infection and then persist for another seven, though some patients experience longer-term complications.
In 2022, about 5% of Shigella infections reported to the CDC were caused by XDR strains, compared with 0% in 2015.
Shigella bacteria cause an estimated 450 000 infections in the United States each year, resulting in around $93m in direct medical costs.
While infections “are generally self-limiting, antibiotics can prevent complications or shorten the duration of illness”. However, the antibiotic-resistant XDR strains have limited antimicrobial treatment options.
The CDC noted that healthcare providers might need to prescribe second- or third-choice drugs for treatment, but even these might be less effective, and may need to be taken through a vein instead of by mouth and may be more toxic.
Young children are particularly susceptible to Shigellosis, with under-fives most at risk.
The agency also lists travellers to places with poor food and water sanitation, gay and bisexual men, and people with compromised immune systems as groups that are especially at risk for the infection.
US CDC alert – Increase in Extensively Drug-Resistant Shigellosis in the United States (Open access)
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