MMWR Morb Mortal Wkly Rep<\/i>. 2026;doi:10.15585\/mmwr.mm7513a1.
The report mentioned that XDR Shigella<\/i> spreads easily from person-to-person through fecal-oral contact or sexual activity. It cited prior studies that identify men who have sex with men as a \u201ctransmission route\u201d for Shigella<\/i> while also noting that of the 116 patients infected with XDR shigellosis with HIV status information, 54 (46.6%) had HIV. <\/p>\n
The study also noted of the 492 patients with XDR shigellosis and available sex and age information, median age was 41 years. And of the 473 patients aged at least 18 years, 86.2% were men.<\/p>\n
Jason E. Zucker, MD,<\/b> assistant professor of medicine at Columbia University Medical Center, told Healio he sees Shigella<\/i> cases come through his group\u2019s sexual health clinic. <\/p>\n
\u201cAnecdotally,\u201d he said, \u201cit does seem that more are resistant to antibiotics, though I don\u2019t have hard data on that from our clinic specifically.\u201d<\/p>\n
Zucker, who was not part of the CDC study, also said it is important to educate \u2014 not shame \u2014 people about Shigella<\/i> as an STI.<\/p>\n
\u201cThe starting point is recognizing that the sexual practices that can transmit Shigella<\/i> are common and normal,\u201d Zucker said. \u201cEffective education means integrating Shigella<\/i> into the same conversations we already have about STI prevention.\u201d<\/p>\n
CDC guidelines advise preventing contact with feces during sex, using barriers and washing hands after touching objects that have been in contact with the anal area. <\/p>\n
\u201cThe goal is to deliver guidance that reduces harm in a way that feels practical and empowering rather than shaming,\u201d Zucker added.<\/p>\n
In the study, oral carbapenems, pivmecillinam and fosfomycin are mentioned as possible treatments for XDR shigellosis, although none have been approved by the FDA for this indication.<\/p>\n
\u201cTreatment of XDR shigellosis remains challenging because no optimal therapy has been established,\u201d the report added.<\/p>\n
Shigella<\/i> causes an estimated 450,000 infections each year nationwide, making it a leading cause of diarrheal illness, according to the CDC. Common symptoms of the infection include diarrhea, fever, stomach pain and experiencing a feeling to pass stool when bowels are empty. <\/p>\n
Meanwhile, Zucker said most shigellosis cases will resolve on their own. He also said the rise of XDR Shigella<\/i> \u201cshould prompt a broader conversation about sexual health, make sure the patient is up-to-date on STI screening, discuss [pre-exposure prophylaxis] if they\u2019re not already on it and assess whether they\u2019re connected to HIV prevention or care.\u201d<\/p>\nFor more information:<\/h2>\n
Jason E. Zucker, MD<\/b>, <\/b>can be reached at jz2700@cumc.columbia.edu. <\/p>\n\n
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