ABSTRACT
Objective:The objective of this study was to investigate a large outbreak of shigellosis in Papua New Guinea that began in a camp for internally displaced persons before spreading throughout the general community.Methods:Outbreak mitigation strategies were implemented in the affected area to curtail the spread of the disease. Data were collected from the surveillance system and analysed by time, place and person. Rectal swab samples were tested by standard culture methods and real-time polymerase chain reaction to determine the etiology of the outbreak.Results:Laboratory analysis at two independent institutions established that the outbreak was caused by Shigella sp., with one strain further characterized as Shigella flexneri serotype 2. Approximately 1200 suspected cases of shigellosis were reported in a two-month period from two townships in Morobe Province, Papua New Guinea. The outbreak resulted in at least five deaths, all in young children.Discussion:This outbreak of shigellosis highlights the threat of enteric diseases to vulnerable populations such as internally displaced persons in Papua New Guinea, as has been observed in other global settings.
ABSTRACT
In view of the dearth of information relating to antibiotic resistance in community- and hospital-acquired bacterial infections in Papua New Guinea (PNG), we carried out a prospective, hospital-based observational study of surgical patients between October 2008 and October 2009. In a sample of 115 patients (median age 30 years; 55% males) suspected of having a bloodstream infection, blood cultures were positive in 11 (10%) and a significant pathogen was isolated in 9 (8%). Staphylococcus aureus was isolated in 4 patients (44%) and 3 were methicillin resistant; all these isolates were considered community acquired because cultures were performed within 48 hours of admission. Of the remaining 5 isolates, 4 were Gram-negative organisms with at least intermediate resistance to chloramphenicol that were grown from blood taken > 48 hours post-admission and thus considered nosocomially acquired. These data suggest two distinct patterns of bacterial infection in PNG surgical inpatients that have implications for national antibiotic prescription guidelines.