Rachel V Thomas

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Drug-Resistant Shigella Rising In US, UK: Why Sexually Transmitted Diarrhea Is Harder To Treat

<span>Shigellosis</span>, an intestinal infection caused by <span>Shigella</span> bacteria, is becoming harder to treat as drug-resistant strains spread in the US and UK. 

Although the infection can spread through contaminated food and water, sexually transmitted Shigella has become an established part of transmission in some communities, particularly among gay, bisexual and other men who have sex with men (GBMSM).

An estimated 450,000 people acquire shigellosis each year in the US. While the infection can affect anyone, some strains have developed resistance to multiple antibiotics, making treatment increasingly challenging.

<h2>Drug-Resistant Shigella Rising In The US</h2>

A <span>CDC</span> analysis published in April 2026 found that extensively drug-resistant (XDR) Shigella isolates increased in the US between 2011 and 2023. Among 16,788 isolates analyzed, the proportion classified as XDR rose from 0% in 2011–2015 to 8.5% in 2023.

The CDC report found that 86.2% of XDR shigellosis patients with available sex data were men. However, sexual exposure information was not routinely collected, so the findings do not establish that these infections were sexually transmitted.

Molecular biologist Shangxin Yang said healthcare workers at the University of California, Los Angeles (UCLA), are now seeing roughly one case of extensively drug-resistant Shigella a month, compared with just one case throughout 2022.

"It's almost like an explosion of this pathogen in the community," Yang told CIDRAP News at the University of Minnesota.

The CDC has warned that <span>XDR Shigella</span> infections pose a treatment challenge because these strains are resistant to multiple antibiotics, and no FDA-approved oral antimicrobial treatment is available for them.

<h2><span rel="noindex">Sexually Transmitted Shigella Spreading Faster</span> In The UK</h2>

A July study published in The Lancet Infectious Diseases found that sexually transmitted Shigella strains are spreading faster than non-sexually transmitted strains in the UK and developing resistance to key antibiotics.

Over an evolutionary period of about 2.5 years, sexually transmitted strains spread an average of 117 kilometers between related cases, compared with 46 kilometers for non-sexually transmitted strains.

“Many men who have sex with men are unaware of the serious and increasing risk posed by sexually transmitted Shigella,” said Professor Kate Baker, senior author of the study from the University of Cambridge's Department of Genetics.

Baker said sexually transmitted shigellosis should be treated as a distinct public health threat requiring different surveillance, prevention and treatment strategies.

<h2>Why Is Sexually Transmitted Shigella Becoming Drug-Resistant?</h2>

Cambridge researchers found that antibiotic-resistant sexually transmitted Shigella strains were spreading 71% faster than drug-susceptible strains. More than 70% of sexually transmitted strains were resistant to at least one clinically important antibiotic.

“This isn’t just one form of sexually transmissible diarrhea. This is multiple overlapping variants emerging that are all quickly becoming resistant to the drugs we use to treat them,” Baker said.

They believe the rise in resistance may partly be driven by antibiotics prescribed to treat or prevent other sexually transmitted infections (STIs), including gonorrhea.

“Our evidence suggests that the variants of Shigella transmitting in sexual networks were actually getting resistant against treatments for other STIs, like gonorrhoea, so people need to remember that when they’re taking antibiotics they’re treating their whole body,” Baker said.

Another possible factor is bystander resistance, in which antibiotic exposure affects bacteria other than the intended target and can favor the survival and spread of resistant bacteria.

<h2>How To Prevent Sexually Transmitted Shigella</h2>

Precautions to reduce the risk of sexually transmitted shigellosis include:

<ul><li>Avoiding sexual activity during illness: Do not have sex while experiencing diarrhea or recovering from a recent diarrheal illness.</li><li>Waiting before resuming sexual activity: Wait at least two weeks after fully recovering before having sex again.</li><li>Telling your healthcare provider about possible exposure: Mention your sexual history if you seek care for diarrhea or related symptoms.</li><li>Asking about testing: Seek advice on appropriate testing and sexual health screening if you may have been exposed.</li></ul>

People experiencing symptoms should seek medical advice. Because some Shigella strains are resistant to multiple antibiotics, treatment should be guided by a healthcare professional, who can determine the appropriate approach based on the infection and its resistance profile.

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Shigellosis, an intestinal infection caused by Shigella bacteria, is becoming harder to treat as drug-resistant strains spread in the US and UK. Although the infection can spread through contaminated food and water, sexually transmitted Shigella has become an established part of transmission in some communities, particularly among gay, bisexual and other men who have sex with men (GBMSM).An estimated 450,000 people acquire shigellosis each year in the US. While the infection can affect anyone, some strains have developed resistance to multiple antibiotics, making treatment increasingly challenging.Drug-Resistant Shigella Rising In The USA CDC analysis published in April 2026 found that extensively drug-resistant (XDR) Shigella isolates increased in the US between 2011 and 2023. Among 16,788 isolates analyzed, the proportion classified as XDR rose from 0% in 2011–2015 to 8.5% in 2023.The CDC report found that 86.2% of XDR shigellosis patients with available sex data were men. However, sexual exposure information was not routinely collected, so the findings do not establish that these infections were sexually transmitted.Molecular biologist Shangxin Yang said healthcare workers at the University of California, Los Angeles (UCLA), are now seeing roughly one case of extensively drug-resistant Shigella a month, compared with just one case throughout 2022."It's almost like an explosion of this pathogen in the community," Yang told CIDRAP News at the University of Minnesota.The CDC has warned that XDR Shigella infections pose a treatment challenge because these strains are resistant to multiple antibiotics, and no FDA-approved oral antimicrobial treatment is available for them.Sexually Transmitted Shigella Spreading Faster In The UKA July study published in The Lancet Infectious Diseases found that sexually transmitted Shigella strains are spreading faster than non-sexually transmitted strains in the UK and developing resistance to key antibiotics.Over an evolutionary period of about 2.5 years, sexually transmitted strains spread an average of 117 kilometers between related cases, compared with 46 kilometers for non-sexually transmitted strains.“Many men who have sex with men are unaware of the serious and increasing risk posed by sexually transmitted Shigella,” said Professor Kate Baker, senior author of the study from the University of Cambridge's Department of Genetics.Baker said sexually transmitted shigellosis should be treated as a distinct public health threat requiring different surveillance, prevention and treatment strategies.Why Is Sexually Transmitted Shigella Becoming Drug-Resistant?Cambridge researchers found that antibiotic-resistant sexually transmitted Shigella strains were spreading 71% faster than drug-susceptible strains. More than 70% of sexually transmitted strains were resistant to at least one clinically important antibiotic.“This isn’t just one form of sexually transmissible diarrhea. This is multiple overlapping variants emerging that are all quickly becoming resistant to the drugs we use to treat them,” Baker said.They believe the rise in resistance may partly be driven by antibiotics prescribed to treat or prevent other sexually transmitted infections (STIs), including gonorrhea.“Our evidence suggests that the variants of Shigella transmitting in sexual networks were actually getting resistant against treatments for other STIs, like gonorrhoea, so people need to remember that when they’re taking antibiotics they’re treating their whole body,” Baker said.Another possible factor is bystander resistance, in which antibiotic exposure affects bacteria other than the intended target and can favor the survival and spread of resistant bacteria.How To Prevent Sexually Transmitted ShigellaPrecautions to reduce the risk of sexually transmitted shigellosis include:Avoiding sexual activity during illness: Do not have sex while experiencing diarrhea or recovering from a recent diarrheal illness.Waiting before resuming sexual activity: Wait at least two weeks after fully recovering before having sex again.Telling your healthcare provider about possible exposure: Mention your sexual history if you seek care for diarrhea or related symptoms.Asking about testing: Seek advice on appropriate testing and sexual health screening if you may have been exposed.People experiencing symptoms should seek medical advice. Because some Shigella strains are resistant to multiple antibiotics, treatment should be guided by a healthcare professional, who can determine the appropriate approach based on the infection and its resistance profile.

drug-resistant shigella rising in us, uk: why sexually transmitted diarrhea is harder to treat

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