TY - JOUR AU - Bowen, Anna AU - Grass, Julian AU - Bicknese, Amelia AU - Campbell, Davina AU - Hurd, Jacqueline AU - Kirkcaldy, Robert T1 - Elevated Risk for Antimicrobial Drug–Resistant Shigella Infection among Men Who Have Sex with Men, United States, 2011–2015 T2 - Emerging Infectious Disease journal PY - 2016 VL - 22 IS - 9 SP - 1613 SN - 1080-6059 AB - Shigella spp. cause ≈500,000 illnesses in the United States annually, and resistance to ciprofloxacin, ceftriaxone, and azithromycin is emerging. We investigated associations between transmission route and antimicrobial resistance among US shigellosis clusters reported during 2011–2015. Of 32 clusters, 9 were caused by shigellae resistant to ciprofloxacin (3 clusters), ceftriaxone (2 clusters), or azithromycin (7 clusters); 3 clusters were resistant to >1 of these drugs. We observed resistance to any of these drugs in all 7 clusters among men who have sex with men (MSM) but in only 2 of the other 25 clusters (p<0.001). Azithromycin resistance was more common among MSM-associated clusters than other clusters (86% vs. 4% of clusters; p<0.001). For adults with suspected shigellosis, clinicians should culture feces; obtain sex histories; discuss shigellosis prevention; and choose treatment, when needed, according to antimicrobial drug susceptibility. Public health interviews for enteric illnesses should encompass sex practices; health messaging for MSM must include shigellosis prevention. KW - Shigella KW - shigellosis KW - men who have sex with men KW - United States KW - antimicrobial drug resistance KW - bacteria KW - azithromycin KW - ceftriaxone KW - and fluoroquinolones KW - antimicrobial resistance KW - fluoroquinolones DO - 10.3201/eid2209.160624 UR - https://wwwnc.cdc.gov/eid/article/22/9/16-0624_article ER - End of Reference