Drug-Resistant Gonorrhea (Shigella) Infections Rising Among Homosexuals

A drug-resistant strain of Shigella, a bacterial infection that affects the intestines, is spreading through sexual networks among some gay and bisexual men in the United Kingdom, according to a new study by researchers from the University of Cambridge and the UK Health Security Agency (UKHSA).

The findings raise concerns about the growing spread of antibiotic-resistant infections and the limited treatment options available for some patients.

Cases Continue to Rise

The study found that England recorded 2,560 sexually transmitted Shigella infections in 2025, an increase from 2,318 cases in 2024 and 2,052 in 2023, indicating a steady upward trend.

Researchers also discovered that sexually transmitted strains spread over much greater distances than infections linked to contaminated food or international travel. On average, related sexually transmitted cases were separated by 117 kilometres, compared with 46 kilometres for non-sexually transmitted strains.

Growing Antibiotic Resistance

Researchers warned that antibiotic resistance is becoming an increasingly serious challenge.

More than 70 per cent of sexually transmitted Shigella strains were found to be resistant to at least one commonly used antibiotic.

The situation is particularly concerning for Shigella sonnei, with more than half of the identified cases classified as extensively drug-resistant, significantly reducing the number of effective treatment options available.

The study also found that up to one-third of people who contract the infection through sexual transmission require hospital treatment, with most patients remaining in hospital for four to five days.

How Shigella Spreads

Shigella is transmitted through the faecal-oral route, meaning infection occurs when bacteria from faeces enter another person’s mouth.

Health experts say this can happen during oral-anal sexual contact, through the sharing of sex toys, or via hand-to-mouth contact after touching the genitals or anus.

Symptoms typically develop within one to three days after exposure and may include severe or bloody diarrhoea, stomach cramps, fever above 38°C, and vomiting.

Health Advice

The UK’s National Health Service (NHS) and the Terrence Higgins Trust are urging anyone experiencing symptoms to avoid sexual activity until at least two weeks after they have fully recovered to reduce the risk of transmitting the infection.

They also recommend using condoms or dental dams during oral, anal and digital sexual activity and encourage anyone with symptoms to seek medical attention at a sexual health clinic.

Health professionals advise requesting a Shigella-specific test, rather than assuming the illness is ordinary food poisoning, to ensure timely diagnosis and appropriate treatment.

Researchers say the findings highlight the importance of continued surveillance, early testing and responsible antibiotic use to help slow the spread of drug-resistant infections.