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CDC Issues Health Advisory for Extensively Drug-Resistant Shigella

The Centers for Disease Control and Prevention (CDC) issued a health advisory with reporting guidelines and education recommendations for patients with extensively drug-resistant (XDR) Shigella infections.

In 2022, about 5 percent of Shigella infections reported to CDC were caused by XDR strains, compared with 0 percent in 2015. CDC defines XDR Shigella bacteria as strains that are resistant to all commonly recommended empiric and alternative antibiotics. Currently, there are no data from clinical studies of treatment of XDR Shigella to inform recommendations for the optimal antimicrobial treatment.

For patients who may have a Shigella infection, CDC recommends that clinicians:

  • Not prescribe antibiotic treatment unless it is clinically indicated or called for by public health officials.
  • Order stool cultures for microbial testing and order follow-up stool cultures for patients with continued symptoms after antibiotic use.
  • Tailor any necessary antibiotic use to susceptibility results.
  • Counsel patients on preventing bacterial spread.

Additionally, health care professionals and clinical laboratories should report all cases to their local or state health department. They can also report information about treatment response and clinical outcomes of XDR Shigella infections to

Contact Senior Director of Policy Erin O’Malley at or 202.585.0127 with questions.


About the Author

Faridat Animashaun is a policy associate at America's Essential Hospitals.

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