Shigella Bacteremia, Georgia, USA, 2002–2012

Melissa Tobin-D'Angelo; Nadine Oosmanally; Siri N. Wilson; Evan J. Anderson; Suzanne Segler; Lynett Poventud


Emerging Infectious Diseases. 2020;26(1):122-124. 

In This Article

Abstract and Introduction


Shigella commonly causes gastroenteritis but rarely spreads to the blood. During 2002–2012, we identified 11,262 Shigella infections through population-based active surveillance in Georgia; 72 (0.64%) were isolated from blood. Bacteremia was associated with age ≥18 years, black race, and S. flexneri. More than half of patients with bacteremia were HIV-infected.


Shigella is among the more common bacterial causes of diarrhea. In the United States, ≈500,000 illnesses occur annually, and prevalence ranges from 3.8 to 5 cases per 100,000 population.[1,2] Transmission occurs not only through contaminated food and water but also through fecal–oral transmission; ingestion of only 10–100 Shigella organisms can cause disease.[1,3] Risk factors for Shigella include daycare attendance, international travel, and men having sex with men.[1,4] Although 4 main serogroups exist, S. sonnei accounts for ≈70% of US isolates, and S. flexneri accounts for ≈24%.[1]

Shigella bacteremia is uncommon, and risk factors are not well described in the United States. Internationally, many patients with Shigella bacteremia are HIV infected.[5,6] In the United States, case series describe Shigella bacteremia in children <1 year of age and in adults with malnutrition, HIV infection, and other immunocompromising conditions (e.g., diabetes mellitus, malignancy).[7,8] Data collected by the Georgia Department of Public Health as part of the Foodborne Disease Active Surveillance Network (FoodNet) provided an opportunity to better understand the epidemiology of Shigella bacteremia.