The California Department of Public Health (CDPH) issued a health advisory today regarding an increase in extensively drug-resistant (XDR) shigellosis in California. Los Angeles County has seen a significant increase with 5 XDR shigellosis cases reported in 2021 and 30 thus far identified in 2024. The highest number, 45, was identified in 2023. Shigella disproportionally affects men who have sex with men (MSM).
Healthcare providers are asked to be vigilant about suspecting and reporting cases of XDR Shigella infection, and to educate patients at increased risk for shigellosis about prevention and risk reduction practices.
Healthcare providers should tailor any shigellosis antibiotic treatment to available antimicrobial susceptibility testing (AST) data. Clinical laboratories should perform complete antimicrobial susceptibility testing that includes azithromycin, ciprofloxacin, ceftriaxone, trimethoprim-sulfamethoxazole [TMP-SMX], and ampicillin, on available Shigella isolates as resources allow.
