서울시 마포구 관내 어린이집 및 초등학교에서 집단 발병한 세균성 이질
Outbreak of Shigellosis Occurred in a Preschool and Two Elemetary Schools in Mapo-Gu, Seoul
Pur po se : Shigellosis is still an important cause of acute food-borne diarrheal diseasesthroughout the world. We investigated the transmission routes and clinical course through theoutbreak of shigellosis in Mapo-Gu, Seoul.Methods : From October 7th to November 19th in 2005, Mapo-Gu public health centerhad referred 32 patients with confirmed or suspected shigellosis to the National Medical Center.We had investigated source of infection, epidemiology, laboratory findings, and clinicalcourse of the cases occurred during this outbreak.Results : Among 32 patients, 24 patients had been confirmed with shigellosis, 8 patientshad been diagnosed with suspected shigellosis. They ranged in age from 5 months to 12years old and their mean age was 6.5 years. The clinical manifestations were as follows;diarrhea, fever, abdominal pain and asymptomatic condition. Symptoms had sustained for 3.7days on the average. S. sonnei were cultured by rectal swab and founded to be resistant toampicillin and TMP/SMX except to 3rd generation cephalosporin. After treatment with antibioticssuch as cefixime and ceftriaxone or imipenem and conservative treatment with electrolyteand fluid replacement for 5∼7 days, Stool cultures of the rectal swab grew no Shigellain these cases except 3 cases.Co nclusio n : An outbreak of shigellosis had occurred in a preschool and elementaryschool children. From the same results of antimicrobial susceptibility and pulsed-field gelelectrophoresis patterns in this study, we suggest that the outbreak of shigellosis in this reporthad been originated from a single strain. According to all negative results about suspectedfood and water cultures, we couldn't find out source of infection. Through materials offerred by Mapo-Gu Public Health Center, we presumed the trasmission routes probablywere person-to-person.
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