CDC Alert: Rise in Extensively Drug-Resistant Shigella Infections

The Centers for Disease Control and Prevention (CDC) have issued a serious public health alert regarding the rise of “extensively drug-resistant” Shigella infections, a bacterial strain that can spread antimicrobial resistance to other bacteria in the intestines.[0] The agency reported that 5% of Shigella infections reported in 2022 were caused by drug-resistant strains, up from 0% in 2015.[1]

Shigella is a stomach bug that can cause severe diarrhea, stomach cramps, and fever.[2] Symptoms typically start a day or two after becoming infected and last about a week, but some people may find that their bowel habits don’t go back to normal for “several months,” the CDC says.[3] While the infection primarily affects young children, it has also been seen in adult populations, particularly among international travelers, people living with HIV, men who have sex with men and people experiencing homelessness.

Bacterial transmission can occur through fecal-oral contact, direct person-to-person contact, and ingestion of contaminated food or water.[4] To avoid contracting or spreading the bacteria, the CDC recommends washing your hands with soap and water, especially after using the toilet, changing diapers, and before eating or preparing food.[5]

Azithromycin, ciprofloxacin, ceftriaxone, trimethoprim-sulfamethoxazole, and ampicillin are all ineffective against XDR Shigella[6] According to the CDC, there are currently no data from clinical studies of treatment of XDR Shigella to inform recommendations for the optimal antimicrobial treatment of these infections.[7]

In regards to transmission, 88% of those infected with the infection who answered questions on sexual contact reported male-to-male sexual contact.[8]

The CDC recommends that healthcare professionals be vigilant about suspecting and reporting cases of XDR Shigella infection to their local or state health department and educating patients and communities at increased risk about prevention and transmission.[9]

0. “CDC issues warning of drug-resistant stomach infection spreading across US” The Independent, 27 Feb. 2023,

1. “Doctors warn of stomach bugs spreading across Midwest” FOX 32 Chicago, 1 Mar. 2023,

2. “CDC issues ‘serious public health alert' over nationwide spike in drug-resistant stomach bug” Daily Mail, 27 Feb. 2023,

3. “CDC Warns Drug-Resistant Shigella Bacteria Is Causing More Stomach Infections” Everyday Health, 28 Feb. 2023,

4. “CDC issues warning over an increase of drug-resistant bacteria” WCVB Boston, 26 Feb. 2023,

5. “Shigella Bacteria: Characteristics, Symptoms, Treatment, And Prevention” Welcome2TheBronx, 1 Mar. 2023,

6. “Extensively Drug-Resistant Shigellosis on the Rise in the U.S.” Medpage Today, 24 Feb. 2023,

7. “CDC issues warning about rise in highly drug-resistant stomach bug” The Washington Post, 25 Feb. 2023,

8. “CDC issues new warning about an infection more common in gay men” Queerty, 28 Feb. 2023,

9. “Drug-resistant stomach bug Shigella on the rise, CDC warns” BBC, 27 Feb. 2023,

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