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A highly contagious intestinal infection that can be spread during sex is becoming increasingly difficult to treat as antibiotic-resistant strains become more common.
An April report from the Centers for Disease Control and Prevention identified nearly 17,000 samples of Shigella, which causes shigellosis, which can cause diarrhea, fever and abdominal cramps, collected between 2011 and 2023. In 2023, 8.5% of Shigella samples with resistance data were classified as extremely drug resistant, or XDR – resistant to all five antibiotics according to the CDC definition – compared to none in 2011. to 2015.
The findings indicate a growing resistance problem, not an increase in overall infections, noted Dr. Tyler Evans, a California-based infectious disease physician and CEO of Wellness Equity Alliance.
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“The infection is not increasing. The bacteria are changing,” Evans told Fox News Digital. “The number of cases may remain stable while treatment options quietly disappear.”
The percentage of Shigella isolates classified as extremely drug resistant increased to 8.5% in 2023, according to the CDC. (Léonie Asendorpf/photo alliance via Getty Images)
There are no FDA-approved oral antibiotics for XDR Shigella, he said.
Shigella bacteria can be spread when small amounts of stool reach a person’s mouth, including through contaminated food or water, unwashed hands, or sexual activity.
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“Shigella is not considered a typical sexually transmitted infection,” Dr. Andi Toufexis, a Texas-based family physician specializing in sexual health, told Fox News Digital. “However, this gastrointestinal bacteria can be spread during sex when one partner comes into contact with the other’s feces.”
Most of the patients with extremely drug-resistant Shigella in the CDC analysis were adult men. (iStock)
Shigella is not new and sexual transmission has been documented since the 1970s, Toufexis said. What is changing is the increasing share of tested samples rated XDR.
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The CDC report found that most people with XDR Shigella were adult men. Data on sexual exposure was not systematically collected, so the report could not establish exactly how each infection was acquired, but previous research showed that sexual contact between men who have sex with men was an important route of transmission.
Eighty-six percent of XDR patients were men, with a median age of 41 years, and among those whose HIV status was known, almost half were living with HIV, Evans noted. People experiencing homelessness and those with weakened immune systems may also face increased risks, he said.
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Children under the age of 5 are especially susceptible to contracting Shigella, according to the CDC, and many outbreaks in the United States have been linked to daycares and schools. Previous outbreaks in the United States primarily affected children and involved antibiotic-susceptible strains.
Washing your hands before preparing food can help reduce the spread of Shigella.
According to the CDC report, 37.6% of patients with hospitalization data were hospitalized for an antibiotic-resistant infection. The CDC reported no deaths among the XDR cases analyzed and said infections may be underestimated because not all positive samples were cultured or tested for resistance. Most patients with a travel history reported no recent international travel, although travel information was missing for many.
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Evans said Americans should be “concerned and not panicked” about infection.
Most Shigella infections resolve on their own, Toufexis added, but severe illness may require treatment.
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Dr. Michael Aziz, an internist at Lenox Hill Hospital in New York and author of “The Perfect 10 Diet” and “The Ageless Revolution,” urged people who suspect Shigella to consult a doctor before taking antidiarrheal medications such as Imodium. “You want to get the bacteria out, you want to get it out of your system,” Aziz told Fox News Digital.
Experts advise people with Shigella not to take antidiarrheal medications such as Imodium, which can slow down the gut.
To reduce the risk of infection, doctors recommend washing your hands, genitals, and anal area before and after sex, using condoms or dental dams, and cleaning sex toys after each use. If you or a partner have diarrhea, avoid sex and wait at least two weeks after symptoms end before resuming, Toufexis said.
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“Feeling better doesn’t always mean an infection is completely gone,” she said.
Gn Health
