Shigella: Rising Antibiotic Resistance and Transmission Risks

Bacterial Infection Resistant to Antibiotics

A bacterial infection that can spread via sexual contact is showing increased resistance to commonly used antibiotics in the United States. Shigella is a highly contagious bacterium responsible for shigellosis, an intestinal infection characterized by diarrhea, fever, and stomach cramps.

Data from the Centers for Disease Control and Prevention (CDC) indicates a significant rise in extensively drug-resistant (XDR) Shigella strains. Between 2011 and 2015, no samples were classified as XDR. However, by 2023, 8.5% of tested samples showed resistance to multiple antibiotics used to treat this infection.

Currently, no nationwide surge in infections exists. Most individuals recover from shigellosis without antibiotics. Certain populations face higher risks. Dr. Sarath Nath from Stony Brook Medicine emphasized that while drug resistance has grown, the number of cases hasn’t.

Understanding Shigella

Shigella comprises a group of bacteria causing shigellosis. The CDC estimates approximately 450,000 infections occur annually in the U.S. Although it can spread through sexual activity, it’s not solely a sexually transmitted infection. Contaminated food, water, and direct contact can also transmit Shigella.

Shigellosis is highly contagious, requiring few bacteria to cause illness. Swallowing about 10 organisms can result in infection.

Symptoms of Shigellosis

Following exposure, symptoms appear within one to two days. These include diarrhea, potentially bloody, fever, abdominal pain, and a persistent urge to use the toilet. Symptoms usually persist for five to seven days.

Severe cases may necessitate medical intervention, especially for individuals with weakened immune systems. Bloody diarrhea, prolonged symptoms, and dehydration signal the need for medical advice.

Transmission Methods

Shigella spreads through the fecal-oral route. Bacteria transferred from an infected person’s stool can enter another individual’s mouth through contaminated food, drinking water, or poor hygiene.

Sexual transmission involves exposure to infected fecal matter. Gay, bisexual, and men who engage in sex with men have higher infection risks. A CDC analysis revealed 86.2% of patients with XDR shigellosis were male.

Aside from sexual transmission, vulnerable groups include young children, international travelers, homeless individuals, and those with compromised immunity.

Addressing Drug Resistance Concerns

Experts predict drug resistance in Shigella will rise. Matthew J. Bertini, founder of Austere Medicine Consultants, highlights the increase in XDR Shigella strains. The proportion of patients requiring hospitalization is rising.

Most healthy individuals face low individual risks. The broader public health issue is the declining efficacy of standard antibiotics. Shivan M. Shah from the University of South Florida suggests concern for susceptible groups with health conditions requiring treatment.

The CDC identified 510 XDR samples collected between 2011 and 2023, resistant to all major antibiotics like ampicillin and azithromycin. About 37.6% of hospitalized XDR patients had hospitalization records, but only 258 patient records were accessible.

Preventive Measures

Simple hygiene practices effectively reduce the risk of Shigella transmission. Wash hands and genital areas with soap and water before and after sexual activity. Condoms and clean sex toys are recommended.

Latex gloves help prevent transmission during activities involving the anal region. Avoid sexual contact during infection due to lingering bacteria.

Nath advises abstaining from sexual activity for two weeks post-diarrhea. Waiting is crucial as bacteria can remain in stool after symptom resolution.

For further information, contact Newsweek editors John Fitzpatrick and Sam Wilson.