Extensively Drug-Resistant (XDR) Shigella Infections
CDC has been monitoring an increase in extensively drug-resistant (XDR) Shigella infections reported through national surveillance. CDC defines XDR Shigella bacteria as strains that are resistant to all commonly recommended empiric and alternative antibiotics — azithromycin, ciprofloxacin, ceftriaxone, trimethoprim-sulfamethoxazole (TMP-SMX), and ampicillin. XDR Shigella infections have been identified in Maryland.
The clinician letter (download PDF), distributed last week to Maryland healthcare providers, contains several recommendations to providers, including:
- Diagnostic recommendations, especially for patients at higher risk for Shigella infection
- Clinical management and antibiotic treatment information
- Patient counseling
- Maryland Reporting requirements for shigellosis, and laboratory submission requirements.
As a reminder, all Shigella infections in Maryland should be promptly investigated using the Gastroenteritis Case Report form at https://health.maryland.gov/phpa/IDEHASharedDocuments/Gastroenteritis%20Case%20Report%20form%202023_fillable.pdf