We report extensively drug-resistant (XDR) Shigella sonnei infection in an immunocompromised patient in Texas, USA. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry failed to identify XDR Shigella, but whole-genome sequencing accurately characterized the strain. First-line antimicrobials are not effective against emerging XDR Shigella. Fosfomycin, carbapenems, and tigecycline are potential alternatives.
Keywords: MSM; Shigella sonnei; United States; XDR Shigella; antimicrobial resistance; bacteria; enteric infections; extensively drug-resistant Shigella; men who have sex with men; sexually transmitted infections; whole-genome sequencing.