Key Point:
- Drug-resistant Shigella infections in the U.S. rose to 8.5% by 2023, signaling a growing public health threat.
- The strain resists multiple common antibiotics, and no FDA-approved oral treatment currently exists.
- Most infections occur domestically, making hygiene, safe food practices, and early medical care essential for prevention.
The Centers for Disease Control and Prevention warns drug-resistant shigella infections are rising across the United States after surveillance data showed cases increased to 8.5% in 2023, posing a growing public health threat with limited treatment options.
Drug-Resistant Shigella Infections Increase Nationwide
U.S. health officials say drug-resistant Shigella infections are increasing steadily, raising concerns among public health experts about treatment challenges and community spread.
In an April nine report, the Centers for Disease Control and Prevention said resistant infections rose 8.5% between 2011 and 2023. Researchers analyzed more than 16,700 laboratory-confirmed Shigella samples collected nationwide from January 2011 through October 2023.
The agency reported no drug-resistant infections during the 2011–2015 period. The first resistant strain appeared in 2016, followed by consistent growth in reported cases.
CDC officials described the trend as “a public health threat,” noting that the bacteria historically responded well to antibiotics but have evolved resistance to several commonly prescribed drugs.
The strain now shows resistance to ampicillin, azithromycin, ceftriaxone, ciprofloxacin, and trimethoprim-sulfamethoxazole. Officials said there is currently no Food and Drug Administration–approved oral treatment specifically for these resistant infections.
“This increase limits effective treatment choices and makes infection control more difficult,” CDC researchers said in the report.
Symptoms, Transmission, and At-Risk Groups Identified
Shigella infections typically cause diarrhea, fever, and stomach pain, according to the Mayo Clinic. Symptoms usually begin within one or two days after exposure and last five to seven days, though severe cases may persist longer.
The infection spreads through fecal-oral transmission, contaminated food or water, and certain types of sexual contact. Public health experts emphasize that person-to-person transmission remains the primary driver of outbreaks.
Most identified patients were adult men, with a median age of 41. Among those who reported travel histories, 82.4% had not traveled internationally, suggesting domestic transmission is responsible for most cases.
Health officials said children, travelers, people experiencing homelessness, and individuals engaging in anal sex face a higher risk of infection.
“People should seek medical care if they experience high fever, bloody diarrhea, frequent vomiting, or signs of dehydration,” Mayo Clinic guidance states, particularly for individuals with weakened immune systems.
Health Officials Urge Prevention And Hygiene Measures
Because treatment options are limited, prevention remains the most effective defense against infection, officials said.
The CDC recommends frequent handwashing, avoiding swallowing water while swimming, practicing safe food and water habits during travel, and avoiding sexual activity for at least two weeks after infection to prevent spread.
Public health experts say awareness is critical as antibiotic resistance continues to grow worldwide.
“Antimicrobial resistance is making once-manageable infections harder to treat,” CDC officials said, urging clinicians and communities to prioritize hygiene and early medical evaluation.
Health agencies continue monitoring cases nationwide while encouraging healthcare providers to report infections quickly to help track emerging resistance patterns.
Officials said early recognition and preventive behavior can reduce transmission and protect vulnerable populations as the resistant strain spreads within communities.
