Drug-Resistant Shigella Surges as STI Cases Climb 15% Yearly

Shigella bacteria, which cause severe diarrhea and dysentery, are spreading faster through sexual contact and evolving into drug-resistant superbugs. The CDC found that extensively drug-resistant strains, which resist five common antibiotics, jumped from 0% of samples in 2011 to 8.5% by 2023. A July study showed sexually transmitted shigellosis grew 15% faster year-over-year between 2015 and 2020 than cases linked to travel or food. Roughly 450,000 Americans contract shigellosis annually.

How shigella spreads through sexual contact

Shigella spreads when infected fecal matter enters the mouth, often through unwashed hands or contaminated food and water. As few as 10 organisms can cause illness. Historically, the infection spread mainly through travel or day care. But since 2000, it has emerged as a sexually transmitted infection, particularly among gay, bisexual and other men who have sex with men. Experts now consider shigella endemic in some of these communities, meaning it is constantly present.

Drug resistance accelerates treatment crisis

Extensively drug-resistant shigella strains resist five antibiotics commonly used to treat the infection. The CDC found that among nearly 17,000 Shigella isolates, drug-resistant versions rose from 2011 to 2023. In 2011, zero percent of samples were resistant to five antibiotics. By 2023, 8.5 percent were. The vast majority of drug-resistant cases infected adult men who had not traveled internationally recently. UCLA hospital workers now see roughly one extensively drug-resistant case per month, compared to just one case all year in 2022.

Symptoms and treatment options

Shigella causes diarrhea that may contain blood or mucus, fever, stomach cramps, and vomiting. The infection can become life-threatening by causing dehydration, bacterial shock, neurological complications, and internal bleeding. Most people recover within five to seven days without antibiotics through fluids and rest. Severe cases may require treatment, but some strains are now close to untreatable as antibiotic options narrow.

Prevention and when to seek care

The CDC recommends thorough handwashing with soap and water, washing genital areas before and after sex, and using protective barriers during sexual activity. People with shigellosis should avoid sexual activity for at least two weeks after diarrhea ends. Anyone experiencing bloody or prolonged diarrhea, fever, severe stomach cramps, or signs of dehydration should contact a healthcare provider immediately.

Final Thoughts

Shigella’s shift to sexual transmission and growing antibiotic resistance create a public health challenge with shrinking treatment options. Awareness of transmission routes and prevention measures remain critical as drug-resistant cases accelerate.

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