A gut pathogen, Shigella, long associated with contaminated food, water and young children, has shifted into a sexually transmitted infection that is rapidly increasing in several countries and becoming alarmingly drug-resistant. In the United States about 450,000 people acquire shigellosis annually, and a CDC analysis of nearly 17,000 isolates found extensively drug-resistant (XDR) strains rose from 0% in 2011 to 8.5% in 2023. Most drug-resistant infections are in adult men, many without recent travel; more than a third of XDR cases were hospitalized and nearly half of those with known status had HIV. Clinicians report a sharp local rise - UCLA saw one XDR case a month recently versus one all of 2022 - and the United Kingdom shows parallel trends with 2025 testing finding resistance in 86% of Shigella sonnei and 94% of S. flexneri samples.
Research implicates sexual transmission networks among gay, bisexual and other men who have sex with men, and antibiotic selection pressures as key drivers. “Bystander resistance” from treating other STIs is highlighted, with one observation that reduced azithromycin use for gonorrhea coincided with slower azithromycin resistance in Shigella. Public-health advice urges testing, hygiene and barrier use during oral/anal sex, clinician sexual-history inquiries for dysentery patients, and awareness that sexually acquired Shigella often requires different management because of higher antimicrobial resistance.
Summary generated by AI from the linked article. hn.today is not affiliated with Hacker News or Y Combinator.
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