Sexually Transmitted Diarrhea Becoming Drug Resistant—Should US Be Worried?
Experts say Americans should be "concerned" but not alarmed about treatment-resistant Shigella infections.
A bacterial infection called Shigella, which can spread through sexual contact, is becoming resistant to commonly used antibiotics in the United States, according to a 2026 report from the Centers for Disease Control and Prevention (CDC). This highly contagious bacterium causes an intestinal infection known as shigellosis, often leading to symptoms such as diarrhea, fever, and stomach cramps.
Between 2011 and 2015, only 0 percent of Shigella samples tested were classified as extensively drug-resistant (XDR), but by 2023, that number had risen to 8.5 percent. These strains resist five antibiotics typically used to treat the infection.
However, health experts stress that the rise in XDR Shigella cases does not necessarily mean a nationwide increase in infections. Most people who contract shigellosis recover without antibiotics, and the greatest risks are concentrated among certain populations. Although the number of cases has not significantly increased in recent years, the proportion of drug-resistant bacteria has grown.
CDC data from September 26, 2026, recorded 13,921 reported cases of shigellosis among U.S. residents, compared to 14,277 in the same period in 2025. These figures are subject to revision and do not encompass every infection in the country. Shigella is a group of bacteria responsible for approximately 450,000 infections in the U.S. annually, though many are asymptomatic or mild.
Shigellosis is particularly contagious due to its ability to spread through contaminated food and water, poor hand hygiene, contact with infected individuals, and even through sexual activity. Symptoms typically appear one to two days after exposure and include bloody diarrhea, fever, abdominal pain, and an urgent need to use the toilet. The illness usually resolves within five to seven days with rest and proper hydration, though severe cases may require medical care.
The CDC warns that no FDA-approved oral antibiotics can treat infections resistant to all five antibiotics. While antibiotic resistance is a concern, health experts advise not to be overly alarmed at this stage. Most Shigella infections are self-limiting and do not require antibiotics, though those with weakened immune systems or severe infections may need treatment.
Preventive measures, such as thorough handwashing, especially before and after sexual contact, can significantly reduce the risk of acquiring or transmitting Shigella.
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