Dutch shigellosis surveillance finds rising extensive drug resistance and transmission clusters

Researchers analysed Dutch national surveillance data for 3,020 notified shigellosis cases from 2018 to 2024, spanning the introduction of national genomic surveillance in 2022. The observational study used logistic regression to examine associations involving demographic characteristics, travel, recent contact with men who have sex with men (MSM), disease severity and Shigella species.

Incidence fell during 2020–2021 and returned to pre-pandemic levels in 2023–2024. Males accounted for 1,887 cases (62.5%). Among 1,731 cases with available contact data, 732 (42.3%) reported recent MSM contact, equivalent to 24.2% of all notified cases. The proportion of extensively drug-resistant (XDR) isolates rose from 1/58 in 2018 to 24/109 (22.0%) in 2023 (p < 0.001). Recent MSM contact and XDR infection were each associated with cluster membership; recent MSM contact was also associated with XDR infection (all p < 0.001).

The authors report that genomic surveillance improved cluster detection and the timeliness of resistance data. They emphasise hygiene promotion and awareness of shigellosis and antimicrobial resistance. Interpretation should account for incomplete contact data and resistance estimates based on subsets of isolates rather than all notified cases. These observational associations do not establish causation.