Sexually transmitted Shigella flexneri and Shigella sonnei in men who have sex with men

Sexually transmitted enteric infections in men who have sex with men (MSM) can be caused by viruses (eg, hepatitis A), bacteria (eg, Shigella) and protozoa (eg, Giardia) and can cause hepatitis, proctocolitis and enteritis.1 Enteric infections in MSM occur in sporadic outbreaks related to sexual networks involving transmission of other STIs, geosocial app use for meeting sexual partners and chemsex (high-risk sexual behaviour and recreational drug use, including injecting drug use).1 2Shigella is a Gram-negative bacteria closely related to Escherichia coli causing a self-limiting diarrhoea illness caused by four subtypes (S. dysenteriae, S. flexneri, S. boydii and S. sonnei). Sexually transmitted S. flexneri in MSM has been shown to be associated with significant morbidity.3S. flexneri and S. sonnei outbreaks in MSM have shown decreasing susceptibility and resistance to azithromycin and ciprofloxacin: antimicrobials should only be used in severe diarrhoea with…

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