Why rising cases of this drug-resistant stomach bug are a ‘serious’ concern

The CDC warns the public an increase in drug-resistant strains of a bacterium called Shigella.

Shigella bacteria cause an infection called shigellosis. When severe, the infection can be life-threatening. Some symptoms include severe diarrhea, fever, and stomach pain. Shigella can spread easily from person to person and it only takes a small amount to make someone sick.

The CDC has stated that strains of extremely drug resistant (XDR) Shigella can spread antimicrobial resistance genes to other enteric bacteria.

“Given these potentially serious public health concerns, the CDC asks healthcare professionals to be vigilant about suspecting and reporting cases of XDR Shigella infection to their local or state health department and to educate patients and communities at increased risk on prevention and transmission. “

The percentage of infections with drug-resistant strains of Shigella has increased from zero in 2015 to 5% in 2022, according to the CDC.

In general, there are about 3 million antimicrobial resistant infections each year in the USA. The CDC estimates that more than 35,000 people die from it.

THE The United Nations estimates that up to 10 million people worldwide could die each year by 2050 due to antimicrobial resistance.

What are the symptoms of shigellosis?

According to the CDC, symptoms typically 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.

Most people infected with Shigella have the following symptoms:

  • Diarrhea that may be bloody or prolonged (lasting more than 3 days)

  • Fever

  • stomach pain

  • Feeling the urge to have a bowel movement (poo) even when the bowels are empty

How is Shigella spread?

Shigella spreads very easily and it only takes a small number of bacteria to make someone sick. People with Shigella infection can continue to pass the infection on to others for several weeks after their diarrhea has stopped.

People are infected by swallowing Shigella. The CDC has stated that Shigella can enter your mouth in some of the following ways; when you touch something with Shigella on it and then touch your mouth; eating food prepared by someone with Shigella; swallowing contaminated drinking water or water in which people swim and play; or being exposed to poo during sexual contact with an infected or recently recovered person.

How is a Shigella infection diagnosed?

Doctors may order lab tests to identify Shigella germs in an infected person’s stool.

There are many types of germs that cause diarrhea. The CDC said knowing which germ causes illness is important for healthcare providers to offer appropriate treatment.

How is a Shigella infection treated?

People with shigellosis usually heal on their own in five to seven days.

People with mild illness will likely only need fluids and rest. Bismuth subsalicylate (Pepto-Bismol) may help relieve symptoms.

People shouldn’t use drugs that slow down the gut and interfere with how the body digests food. These drugs include loperamide (eg, Imodium) or diphenoxylate with atropine (eg, Lomotil).

Doctors may prescribe antibiotics to people with severe cases to help them recover faster. But some antibiotics are not effective against certain types of Shigella. Your doctor may want to order a lab test to determine which antibiotics are most likely to work.

You should call your doctor if you don’t feel better within two days of starting antibiotics. They might need to do more tests or try a different type of antibiotic.

What to Know About Drug-Resistant Shigella

Antibiotics may not be effective in treating some Shigella infections due to antimicrobial resistance.

Antimicrobial resistance occurs when germs develop the ability to overcome drugs intended to kill them. As a result, the germs are not killed and continue to grow.

If the Shigella bacteria are resistant, healthcare providers might need to prescribe alternative medications. These drugs may be less effective and may need to be given through a vein (IV) rather than by mouth. The drugs could also be more toxic and more expensive.

Antibiotics recommended for serious infections include fluoroquinolones, azithromycin, and ceftriaxone. The CDC said any use of antibiotics can cause resistance. People should only use antibiotics when absolutely necessary.

How to protect yourself from Shigella

The CDC recommends following these tips to reduce your risk of getting sick from Shigella:

  • Wash hands thoroughly with soap and water at key times:

    • Before preparing food and eating.

    • After changing a diaper or helping clean up another person who pooped.

    • Do not prepare food for others if you have shigellosis, and wash your hands thoroughly after you recover.

  • If you are caring for a child in diapers who has shigellosis, promptly dispose of soiled diapers in a covered, lined trash can. Wash your hands and the child’s hands thoroughly with soap and water immediately after changing diapers. Clean up any leaks or spills of diaper contents immediately.

  • Avoid swallowing water from untreated ponds, lakes or swimming pools.

  • When traveling abroad, follow safe eating and drinking habits and wash your hands often with soap and water.

  • Avoid having sex (vaginal, anal, and oral) for a week after your partner has recovered from diarrhea. Because shigella the germs can be in the stool for several weeks, follow safe sex practices, or ideally avoid having sex for several weeks after your partner has recovered.

Who is most likely to get shigellosis?

According to the CDC, children under five are the most susceptible to getting shigellosis, but people of all ages are at risk of getting the disease. Many shigellosis outbreaks occur in daycares and schools. The infection usually spreads from young children to their families because the bacteria spreads so easily.

Travelers in places where water and food can be dangerous are also more likely to contract a Shigella infection. They are also more likely to get sick with types of Shigella that are harder to treat.

Gays, bisexuals and other men who have sex with men are among the high-risk groups for Shigella infection, according to the CDC.

People with weakened immune systems due to illnesses, conditions or medical treatments are at higher risk of serious illness. A severe Shigella infection can spread through the blood, which can be life threatening.

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