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

국내 한 육아 기관을 다니는 소아에서 확인된 Extended-Spectrum β-Lactamase 생성 Shigella flexneri 감염

  • Nam, Eun Woo (Department of Pediatrics, Dankook University College of Medicine) ;
  • Lee, Kun Song (Department of Pediatrics, Dankook University College of Medicine) ;
  • Kim, Junyoung (Department of Water-Borne Disease, Korea Centers for Disease Control and Prevention) ;
  • Yoo, Cheon Kwon (Department of Water-Borne Disease, Korea Centers for Disease Control and Prevention)
  • 남은우 (단국대학교 의과대학 소아과학교실) ;
  • 이건송 (단국대학교 의과대학 소아과학교실) ;
  • 김준영 (질병관리본부 수인성질환과) ;
  • 유천권 (질병관리본부 수인성질환과)
  • Received : 2016.02.25
  • Accepted : 2016.06.03
  • Published : 2016.12.25

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 ${\beta}-lactamase$ (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.

국내 Shigella 감염은 대부분 Shigella sonnei 에 의해 발생하나 드물게 Shigella flexneri 에 의한 집단 감염이 보고되고 있다. 항생제 사용률이 높은 국내에서 extended-spectrum ${\beta}-lactamase$ (ESBL) 생성 S. sonnei 감염에 대한 보고는 있었으나 ESBL을 생성하는 S. flexneri 에 대한 예는 지금까지 없었다. 저자들은 국내 한 어린이집에 다니는 소아 2명에게서 CTX-M-14 유형 ESBL 생성 S. flexneri type 2a 감염 증례를 경험하였으며 이는 국내에서 ESBL을 생성하는 S. flexneri 감염의 첫 증례이다. 앞으로 국내에서도 Shigella 감염 시 ESBL 균주의 가능성을 고려하고 적극적인 역학조사와 경험적 항생제 투여에 대한 신중한 선택이 필요할 수 있을 것으로 생각된다.

Keywords

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