PDPH – Increase in Extensively Drug-Resistant Shigellosis in the United States

The Philadelphia Department of Public Health released a health alert on March 6, 2023. Below is a summary.

The Centers for Disease Control and Prevention (CDC) issued a Health Alert regarding Extensively Drug- Resistant (XDR) shigellosis in the United States. According to the CDC, 5% of Shigella infections reported in 2022 were caused by XDR strains, up from 0% in 2015. In recent years there have been sporadic cases of XDR Shigella. Similar to national trends, there have been shifts in the epidemiology of shigellosis in Philadelphia with increased infections among adults including gay, bisexual, and other men who have sex with men and persons experiencing homelessness.

Providers using culture-independent diagnostic test (CIDT) instead of culture for diagnosis of enteric infections should request that the clinical laboratory perform reflex culture when CIDT is positive for Shigella species. If a culture is positive for Shigella, order antimicrobial susceptibility testing to inform antimicrobial selection.

Shigellosis is a reportable disease in Philadelphia. Labs and clinicians should report all cases of shigellosis with antibiotic susceptibility test results to the Philadelphia Department of Public Health’s Division of Disease Control through electronic laboratory reporting, faxing a report to 215-238-6947, or calling 215-685-6748. All positive isolates or specimens are required to be submitted to the Pennsylvania Department of Health Bureau of Laboratories within five workdays of the positive test result.

You can view the full health alert here. (PDF)

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