Patients at Risk for Extensively Drug-Resistant Shigellosis

Extensively-drug resistant (XDR) Shigella is resistant to all commonly recommended empiric and alternative antibiotics:

(1) azithromycin

(2) ciprofloxacin

(3) ceftriaxone

(4) trimethoprim-sulfamethoxazole

(5) ampicillin

Routes of transmission:

(1) sexual contact

(2) other person-to-person contract

(3) contaminated food and water

People in the following groups are at increased risk:

(1) young children from 1-4 years (which may be associated with day care)

(2) men who have sex with men

(3) women who have sex with bisexual men

(4) homeless

(5) international travelers

(6) HIV-positive

(7) immunocompromised