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Amid the rapid increase in drug-resistant cases, in the case of acute diarrhea, “Shigellosis should be considered”

Amid the rapid increase in drug-resistant cases, in the case of acute diarrhea, “Shigellosis should be considered”

 


March 1, 2023

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CDC has issued a health advisory warning clinicians of a surge in widespread drug-resistant patients. dysentery The United States urges consideration of this infection in cases of acute diarrhea, especially among high-risk patients.

“By 2022, about 5% Shigella Causes of infections reported to the CDC include: [extensively drug-resistant (XDR)] compared to 0% in 2015,” the agency notes in its health advisory. “Clinicians treating patients infected with the XDR strain have limited antimicrobial treatment options. Shigella Bacteria are contagious [and] XDR Shigella Strains can spread antimicrobial resistance genes to other gut bacteria. “



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CDC previously defined XDR Shigella Bacteria as regularly all resistant strains Recommended antibioticazithromycin, ciprofloxacin, ceftriaxone, trimethoprim-sulfamethoxazole, and ampicillin.

“Currently, there are no data from clinical studies regarding the treatment of XDR. Shigella to inform recommendations for optimal antimicrobial treatment of these infections,” the agency said. “As such, the CDC does not have recommendations for optimal antimicrobial treatment for his XDR. Shigella Infection.

Historically, shigellosis has primarily affected children aged 1 to 4 years in the United States, but the CDC has Shigella Strains are increasingly being reported among adult populations, including gay, bisexual and other adults. men having sex with men (MSM), individuals experiencing homelessness, international travelers, and individuals living with HIV.

According to the CDC, between January 1, 2015 and January 22, 2023, 239 XDRs were reported. Shigella Isolates consisting primarily of Shigella sonnei (66%) and Shigella flexneri (34%).

“Consider dysentery in the differential diagnosis of acute diarrhea, especially in patients at high risk of diarrhea. Shigella Infectious diseases including infants, MSM, people experiencing homelessness, international travelers, immunocompromised people [and] people living with HIV,” the CDC noted. “If shigellosis is suspected, ask patients about relevant exposures and social history, including sexual activity, housing conditions, and international travel.”

CDC reported that it will continue to monitor XDR. Shigella infections and Shigella Isolates with “unique or worrisome antimicrobial susceptibility patterns and genetic resistance markers”. In addition, analyzes for antimicrobial resistance are currently underway. Shigella Infections in the United States, using data from the National Antimicrobial Resistance Surveillance System for Enterobacteriaceae.

Given the severity of this public health threat, CDC urges health care providers to remain vigilant in reporting suspected cases of XDR bacillary dysentery to local or state health departments, Requested education of patients and communities at high risk for transmission.

Sources

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2/ https://www.healio.com/news/gastroenterology/20230301/cdc-consider-shigellosis-for-acute-diarrhea-amid-surge-in-drug-resistant-cases

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