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Objectives@#In March 2023, an alternative school in the Republic of Korea reported 12 cases of shigellosis. This study aims to analyze the epidemiological characteristics in order to determine the cause of the cluster outbreak of shigellosis and to develop prevention strategies. @*Methods@#This study focused on 12 patients with confirmed Shigella infection and investigated their demographics, clinical features, epidemiology, diagnostics, and antimicrobial susceptibility. Following the identification of Shigella, we conducted follow-up rectal smear cultures to manage patients, implementing isolation and control measures. @*Results@#This study investigated the emergence of multidrug-resistant Shigella following missionary activities in Cambodia, documenting a cluster infection within an alternative school in Daejeon, the Republic of Korea. The outbreak affected 56 participants, resulting in the confirmation of 12 cases. The incidence rates varied by gender and occupation, with higher rates among males and teachers. All 12 cases demonstrated multidrug resistance. Challenges included delayed pathogen confirmation and suboptimal adherence to isolation criteria. The incident prompted revisions in the criteria for isolation release, focusing on symptom resolution. The study underscores the necessity for strengthened surveillance, educational initiatives focusing on prevention in endemic areas, and improved oversight of unlicensed educational establishments. @*Conclusion@#Successful response strategies included swift situation assessment, collaborative efforts, effective infection control measures, and modified criteria for isolation release. Continued surveillance of multidrug-resistant strains is recommended, especially in regions with a high prevalence.
RESUMEN
BACKGROUND: About more than 70% of Staphylococcus aureus isolates in tertiary-care hospitals are known to be resistant to methicillin in Korea. But the prevalence of methicillin-resistant S. aureus (MRSA) in the community and non-tertiary hospitals has not been known yet. The aim of this study was to determine the prevalence of resistance among S. aureus isolates in non-tertiary hospitals. METHODS: The isolates were collected at one laboratory center from August 1998 to May 1999. Antimicrobial susceptibility tests against 11 antibiotics were performed by disk diffusion method. Minimum inhibitory concentrations (MIC) for oxacillin and vancomycin were determined by microbroth dilution method. The mecA gene was detected by polymerase chain reaction. The medical facilities which sent specimen to the laboratory were classified into 3 groups; clinic, hospital and general hospital. RESULTS: Of total 469 S. aureus isolates, 296 (63.1%) were from pus, 47 (10.0%) from sputum, 23 (5.0%) from urine, and 22 (4.6%) from blood. Overall prevalence of MRSA in non-tertiary hospital was 43.5% (204/469). Among 3 hospital groups, MRSA in general hospitals (55%) was significantly more prevalent than in hospitals (40%) or clinics (37%). MICs of oxacillin against MRSA isolated from pus and blood ranged from 8 to > or =256 microgram/mL, but 74% (83 isolates) of them was > or =256 microgram/mL. MICs of vancomycin were distributed from 1 to 2 microgram/mL, irrespective of methicillin resistance or hospital groups. The mecA gene was detected in all of methicillin-resistant isolates with MICs of < or =128 microgram/mL. CONCLUSION: In non-tertiary hospitals, 43% of S. aureus isolates were methicillin resistant. This result showed that MRSA in non-tertary hospitals was less prevalent than in tertiary hospitals.