CDC issues warning about rise in highly drug-resistant stomach bug


The Centers for Disease Control and Prevention is warning clinicians and public health departments of a sharp increase in serious gastrointestinal infections caused by bacteria resistant to common antibiotics.

In a health advisory released Friday, the CDC said the agency was monitoring an increase in the number of people infected with strains of shigella bacteria highly resistant to available drugs. shigella the infections, known as shigellosis, usually cause diarrhea that can be prolonged and bloody, as well as fever and abdominal cramps.

In the past, shigellosis mainly affected children under 4 years old. But the CDC said it has seen a recent increase in drug-resistant infections among adults, especially men who have sex with men, international travelers, people living with HIV and the homeless.

Most people recover without treatment with antibiotics. But people with weakened immune systems, including those with HIV or receiving chemotherapy, can get more serious illness. Severe shigellosis can spread through the blood, which can be life-threatening.

drug resistant shigella infections “are difficult to treat and easily transmitted, especially among vulnerable populations,” CDC physician Naeemah Logan said in an email. These “superbug” infections “pose a serious threat to public health, and we want to make sure providers are aware of the growing potential for antibiotic failure.”

The agency has scheduled a call next week to update clinicians on the increase in cases and how to manage them.

shigella cause approximately 450,000 infections in the United States each year. In 2022, approximately 5% of shigella infections reported to the CDC were caused by super-resistant strains, compared to none in 2015.

Of 237 patients with resistant infections that were reported during this period, more than 90% of them happened during the pandemic, between 2020 and 2022, according to the CDC. Resistant infections have been reported in 29 states, with the highest numbers in California (76), Colorado (36) and Massachusetts (34), according to CDC data.

These strains are resistant to five commonly recommended antibiotics, including azithromycin, ciprofloxacin and ceftriaxone.

Last year, the CDC said the pandemic had caused an overall increase in superbug infections and deaths in US hospitals, undoing years of progress. Public health efforts had reduced resistant infections in hospitals by almost 30% between 2012 and 2017. But in 2020, the pandemic has pushed hospitals, health services and communities to near breaking points.

Sicker patients needed more frequent and longer use of medical devices, such as catheters and ventilators, which break down the body’s natural protective barrier – the skin – and thus increase the risk of infection. Additionally, clinicians unfamiliar with the coronavirus initially relied heavily on antibiotics to treat patients. But these life-saving drugs work against bacteria, not viruses.

The exceptionally high levels of antibiotic use likely allowed drug resistance to develop and spread.

shigella bacteria spread quickly and easily through direct person-to-person contact, including sexual contact. They are also spread indirectly through contaminated food, water and other routes. It only takes a small number of bacteria to make someone sick, and infected people can pass the germs on to others for several weeks after their diarrhea stops.

The CDC said it currently has no recommendations on how best to treat highly resistant people. shigella infections.

In recent months, global cases of shigellosis have increased. In January 2022, the UK reported an increase in cases of extremely antibiotic-resistant infections, primarily among men who have sex with men.

By mid-February, a dozen countries, including the United States, had reported more than 250 shigella infections since September 2022 among people who have traveled to Cape Verde in West Africa, according to the European Center for Disease Control and Prevention.

Symptoms of shigellosis usually begin one to two days after infection and last for seven days. In some cases, bowel habits do not return to normal for several months.

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