Drug-Resistant Shigella Spreads Through Sexual Contact, CDC Data Show
Extensively drug-resistant Shigella made up 8.5% of U.S. samples with resistance data in 2023, compared with none in 2011–2015, according to the CDC. The report examined 16,788 samples and found that more than 84% of the extensively resistant cases occurred in 2022 and 2023. Researchers say sexual contact among gay and bisexual men is helping drive transmission, though the CDC analysis did not measure sexual behavior.
The CDC review covered 16,788 Shigella samples with resistance data sent to PulseNet between 2011 and October 2023. Of these, 510—about 3%—met the definition for extensive drug resistance, meaning the bacteria did not respond to five common antibiotics. More than four-fifths of those cases appeared in 2022 and 2023.
Among patients with available details, most were adult men, median age 41. About 38% of those with hospitalization information were admitted, and no deaths were recorded. Nearly half of patients with known HIV status also had HIV; most with travel data had not recently been abroad.
The rise of extensively drug-resistant Shigella could complicate treatment for patients, especially men who have sex with men, people experiencing homelessness, and those with limited access to hygiene or healthcare. More resistant infections may lead to longer illness, higher hospitalization costs, and increased pressure on clinicians choosing antibiotics. Because transmission can occur through sexual contact and contaminated food or water, public health messaging may need to reach multiple communities without stigmatizing any group.