Eun Woo Nam; Kun Song Lee; Junyoung Kim; Cheon Kwon Yoo

doi:10.14776/piv.2016.23.3.223

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Nam, Lee, Kim, and Yoo: Infection of Extended-Spectrum β-Lactamase Producing Shigella flexneri in Children Attending a Childcare Center in Korea

Case Report

Pediatric Infection & Vaccine 2016; 23(3): 223-228.

Published online: 20 December 2016

DOI: https://doi.org/10.14776/piv.2016.23.3.223

Infection of Extended-Spectrum β-Lactamase Producing Shigella flexneri in Children Attending a Childcare Center in Korea

Eun Woo Nam¹, Kun Song Lee¹, Junyoung Kim², Cheon Kwon Yoo²

¹Department of Pediatrics, Dankook University College of Medicine, Cheonan, Korea.

²Department of Water-Borne Disease, Korea Centers for Disease Control and Prevention, Cheongju, Korea.

Corresponding author (pdlks@dankook.ac.kr)

Received 25 February 2016 Revised 11 April 2016 Accepted 3 June 2016

Abstract

Shigella is a common cause of bacterial enteritis worldwide. Shigella sonnei accounts for 90% of Shigella infections and Shigella flexneri is rarely reported in Korea. Although the incidence of Shigella infection has decreased, the incidence of organisms with antibiotic resistance has gradually increased in Korea. An outbreak of extended-spectrum β-lactamase (ESBL)-producing S. sonnei in children was reported in Korea; however, ESBL-producing S. flexneri has not yet been reported. We report the first two cases of multidrug-resistant CTX-M-14-producing S. flexneri infections in Korean children.

Keywords: Shigella, Beta-lactamases

Figures and Tables

Fig. 1

The pulsed filed gel electrophoresis (PFGE)-NotI patterns from outbreak strains of Shigella flexneri 2a. AMP, ampicillin; SAM, amoxicillin/clavulanic acid; CEP, cephalothin; CTX, cefotaxime; NAL, nalidixic acid; CHL, chloramphenicol; TET, tetracycline; SXT, trimethoprim-sulfamethoxazole.

Fig. 2

Detection of extended-spectrum β-lactamases by multiplex polymerase chain reaction. M, 100 bp ladder; 1, outbreak 1; 2, outbreak 2; and 3, negative control. 501 bp. blactx-m14; 296 bp, blaoxa-1.

Fig. 3

The clinical course: duration of fever (A) and frequency of diarrhea (B).

Table 1

Antibiotic Susceptibility Data of Extended-Spectrum β-Lactamase-Producing Shigella flexneri Type 2a in Two Patients^*

^*The results of antibiotic susceptibility data are same.

Abbreviations: MIC, minimum inhibitory concentration; R, resistant; S, susceptible.

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