Shigella isolates with reduced susceptibility to the fluoroquinolone ciprofloxacin continue to increase, the CDC warned on Friday. Additionally, the agency is now seeing a rise in isolates resistant to the macrolide azithromycin.
Preliminary data from 2016 show that 8% of tested isolates had reduced ciprofloxacin susceptibility, and 10% had reduced azithromycin susceptibility. In 2017, the proportions were 17% and 22%, respectively.
Shigellosis usually resolves without treatment within 5 to 7 days. When antibiotic therapy is needed, clinicians should carefully monitor patients, the CDC advises. If a suspected fluoroquinolone or azithromycin treatment failure occurs, providers should:
- Consider reaching out to an infectious disease specialist to discuss other treatment options
- Obtain a stool specimen for additional antimicrobial susceptibility testing
- Report the treatment failure and send an isolate to the state health department
CDC is particularly concerned about people who are at high risk for multidrug-resistant Shigella infections and are more likely to require antibiotic treatment, such as men who have sex with men, patients who are homeless, and immunocompromised patients. These patients often have a more severe disease, prolonged shedding, and recurrent infections.
Shigellosis is a type of food poisoning caused by infection with the Shigella species. It is a major public health problem in developing countries where sanitation is poor. Shigellosis is spread by means of fecal-oral transmission.
For more reference log on to CDC https://emergency.cdc.gov/han/han00411.asp