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Molecular Epidemiology of Metallo-β-lactamase Producing Pseudomonas aeruginosa Clinical Isolates (임상에서 분리된 Metallo-β-lactamase 생성 Pseudomonas aeruginosa의 분자역학)

  • Choi, Myung-Won
    • Journal of Life Science
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    • v.22 no.9
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    • pp.1268-1276
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    • 2012
  • The emergence and dissemination of carbapenem-resistant bacteria have resulted in limitations of antibiotic treatment and potential outbreaks of metallo-${\beta}$-lactamase (MBL) producing Pseudomonas aeruginosa resistant to carbapenems. In this study, we conducted molecular characterization of the MBL genes of the ${\beta}$-lactam drug-resistant P. aeruginosa and prepared basic data for treatment and prevention of proliferation of antimicrobial-resistant bacterial infections. Forty-two P. aeruginosa isolates of 254 were resistant to imipenem or meropenem. Among the 42 isolates, 28 isolates were positive for the Hodge test, and 23 isolates were positive for the EDTA-disk synergy test (EDST). MBLs were detected in 59.5% (25/42) of P. aeruginosa isolates. Eight isolates harbored $bla_{IMP-6}$, whereas 17 isolates harbored $bla_{VIM-2}$. The $bla_{IMP-6}$ gene was in a class 1 integron containing five gene cassettes: $bla_{IMP-6}$, qac, aacA4, $bla_{OXA-1}$, and aadA1. Some strains that produce IMP-6 and VIM-2 showed epidemiological relationships. The $bla_{IMP-6}$ gene in carbapenem-resistant P. aeruginosa showed an identical pattern to a gene cassette that was reported at a hospital in Daegu, Korea. Therefore, MBL-producing P. aeruginosa is already endemic in the community. We are concerned that the existence of carbapenem-resistant bacteria containing the blaMBL gene may increase pressure on antibiotic selection when treating infections. We believe that we should select appropriate antibiotics based on the antibiotic susceptibility test and continue the research to prohibit the emergence and spread of antibiotics resistant bacteria.

Molecular epidemiological study of measles virus throughout an imported epidemic outbreak in Gyeonggi-do in 2014 (2014년 경기지역에서 발생한 해외유입 홍역 바이러스의 분자역학적 특성 분석)

  • Yun, Hee-Jeong;Park, Po-Hyun;Hwang, Sun-Il;Huh, Jeong-Weon;Nam, Soo-Jung;Yong, Kum-Chan;Yoon, Mi-Hye
    • Korean Journal of Microbiology
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    • v.53 no.1
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    • pp.1-8
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    • 2017
  • Measles virus is a highly contagious, exanthematic virus, preventable by the use of an effective live-attenuated vaccine. However, measles virus remains endemic in many area of the world causing nearly 200,000 deaths per year and still a major cause of child mortality, mostly in developing countries. In March 2014, Republic of Korea was certified as a 'national measles elimination' by the WHO as a result of a high-quality case-based surveillance system and population immunity, which was achieved by a high vaccination rate (>95.0% since 1996). But, since the beginning of 2014, the Gyeonggi province has experienced a resurgence of measles cases. In this study, we investigated the characteristics of measles viruses isolated from confirmed measles in Gyeonggi province during January 1, 2014 ~ July 31, 2014, 60 isolates were obtained from 72 confirmed measles specimens. Genotypic distributions and genetic diversities of isolated measles virus were analyzed by sequencing of nucleoprotein (N) gene. 58 (96.7%) imported cases were identified. The predominant genotype was B3, which reflects the circulating measles virus in adjacent countries. The sequences of nucleoprotein (N) gene of isolated MeV were showed that the strains characterized showed the highest degree of identity (99%) with the Philippine related strains in 2013-2014. Therefore, infected traveler returning from the Philippines transmitted secondary infection in Korea.

A study on measurement of the pollution levels and disinfection of medical radiation shielding for lead apron (의료방사선 차폐용 납 가운의 오염도 측정 및 소독에 관한 연구)

  • Kim, Hyeon-Ju
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.5
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    • pp.490-497
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    • 2016
  • This study compared and analyzed the pollution levels of radiation shielding aprons and ways to sterilize them using 30 lead aprons. After collecting samples from the center of the lead apron, where contact is most frequent, experiments were conducted employing Coagula and Latex methods. Using the culture medium where bacteria grew, measurements of the pathogen count and identification were performed. The greatest number of pathogens were $7.16{\pm}10$, which were detected on the lead apron from general X-ray room #2, but there was no significant difference according to the facilities (p > 0.05). Compared to how many pathogens remained between using the disinfectant ethanol and tissue, the pathogens decreased by $0.01{\pm}0.4$ (p < 0.05) after using disinfectant ethanol and by $0.87{\pm}1.7$(p < 0.05) after using disinfectant tissue. The Pearson correlation test revealed a significant correlation (-0.296, p < 0.05) between them. According to this research, there were pathogens on the lead aprons and the number of pathogens was determined by statistical analysis. It is expected that the rate of radiology technologists, patients, and medical equipment infected by pathogens will be reduced by the proper use of sterilization with a disinfectant ethanol.

Genotypic Detection of Extended-Spectrum β-Lactamase-Producing of Klebsiella pneumoniae (Extended-Spectrum β-Lactamase 생성 Klebsiella pneumoniae 균주의 유전형 검출)

  • Yook, Keun-Dol;Yang, Byoung-Seon;Park, Jin-Sook
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.3
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    • pp.1191-1196
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    • 2013
  • Among Gram-negative pathogens in Korea, the incidence of resistance to third generation cephalosporins is becoming an ever-increasing problem. The production of extended-spectrum ${\beta}$-lactamase (ESBL) is the main mechanism of bacterial resistance to a third-generation cephalosporins and monobactams. Accurate identification of the ESBL genes are necessary for surveillance and epidemiological studies of the mode of transmission in the hospital. This study was conducted to detect the genes encoding ESBL of 46 K. penumoniae isolated from Daejeon, Chungnam and Chungbuk regional university hospitals from February to August in 2012. The phenotypes of the isolated specimens were examined according to the combination disc test (CDT) by the Clinical and Laboratory Standards Institute (CLSI). Forty two ESBL producing K. penumoniae isolates could be detected using ceftazidime (CAZ) discs with and without clavulanate (CLA). By CDT, 42 K. pneumoniae strains were confirmed to be ESBL strains. Genotyping was performed by multiplex PCR with type-specific primers. By PCR analysis, TEM gene in 46 strains, SHV gene in 37 strains and CTX-M genes in 14 strains were identified. Ten isolates did carry genes encoding ESBLs of all types TEM, SHV and CTX-M. The multiplex polymerase chain reaction (PCR) analysis was better to detect and differentiate ESBL producing K. penumoniae strains in clinical isolates.

Molecular epidemiological study of norovirus gastroenteritis outbreaks in Gyeonggi-Do from 2014 to 2015 (2014-2015년 경기지역 노로바이러스성 식중독의 분자역학적 특성분석)

  • Nam, Soo-Jung;Park, Po-Hyun;Bang, Sun-Jae;Huh, Jeong-Weon;Yun, Hee-Jeong;Park, Kwang-Hee;Yoon, Mi-Hye
    • Korean Journal of Microbiology
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    • v.54 no.1
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    • pp.24-30
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    • 2018
  • Norovirus infection is a leading cause of nonbacterial gastroenteritis outbreaks. New variants of GII.4 have emerged approximately every 2~3 years and have caused norovirus gastroenteritis pandemics globally. In this study, analysis and molecular genetic characteristics of the norovirus gastroenteritis outbreaks 2,917 samples in Gyeonggi-Do from 2014 to 2015. As a result, 247 samples out of 2,917 samples are positive for norovirus. Norovirus molecular genetic characteristics of the GI 8 types (GI-1, 2, 3, 4, 5, 6, 12, 14), GII 10 types (GII - 2, 3, 4, 5, 6, 11, 12, 14, 16, 17). Genome sequences of isolated noroviruses were similar to those of new GII.17 Kawasaki 2014 variants with 96.6 identity, suggesting that these viruses were imported from overseas. 44% of virus incidence was originated from school meal service. Therefore, a continuous monitoring and school sanitation should be required for preventing a massive virus outbreak.

Prevalence of Lactose Malabsorption in Children by Breath Hydrogen Test (소아에서 호기내 수소검사를 이용한 유당 흡수장애 유병률)

  • Chung, Ju-Young;Bae, Sun-Hwan;Choi, Kwang-Hae;Ko, Jae-Sung;Seo, Jeong-Kee
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.5 no.1
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    • pp.62-67
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    • 2002
  • Purpose: The aim of this study was to investigate the age of onset and the prevalence of lactose malabsorption in early childhood in Korea. Methods: We conducted a study of lactose malabsorption by breath hydrogen test in healthy children aged between 25~96 months old. Standard lactose loading (2 g lactose/kg, maximum 40g) test was done in 129 children and cow's milk (10 mL/kg) loading in 126 children followed by breath sampling of 60 and 120 minutes after the loading. An increase above baseline of 20 ppm or more was used as a criteria for positive responses. Results: The prevalence of lactose malabsorption was 7% in 25~36 months old, 19% in 37~48 months old, 35% in 49~60 months old, 55% in 61~72 months old, 82% in 72~84 months old, 80% in 85~96 months old children. Only 1% of the children showed positive result in breath hydrogen test after the cow's milk challenge. Conclusion: The prevalence of lactose malabsorption was increased between 37 months and 60 months of age, reached to adult level of prevalence after 72 months of age. When physiological dose of lactose was used as the challenge, the number of lactose malabsorbers become clinically insignificant.

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Oropharyngeal Carriage and Antimicrobial Resistance of S. pneumoniae in Children of Seoul (서울 지역 소아의 구인강에서 폐구균 보균율과 항균제 내성)

  • Kim, Young Kee;Lee, Chang Kyu
    • Pediatric Infection and Vaccine
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    • v.4 no.2
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    • pp.218-224
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    • 1997
  • Purpose: The antimicrobial resistance of S. pneumoniae has encountered with increasing frequency from around the world. In our country, penicillin resistant strains of S. penumococci are rapidly increasing. It has been known that colonized pneumococci in upper respiratory tract cause sinisitis, otitis media, meningitis and pneumonia. We tried to reveal the colonization rate of pneumonocci in upper respiratory tract, their antimicrobial resistance and DNA fingerprinting pattern in normal children. Methods: We got specimens from 117 children of day-care center in Seoul through oropharyngeal swab. After incubation on BAP, optochin test and slide latex agglutination test were used for identification. Antimicobial susceptibility test to penicillin, vancomycin, erythromycin and TMP-SMZ was done with disk diffusion method. Penicillin MIC was gotten through the broth microdilution method. Genotyping of 45 pneumococci was done by rep-PCR using REP1R-Dt and REP2-Dt primer. Results: The carriage rate of pneumococci in the day-care center children was 38%(45/117). The resistance of penicillin, erhthromycin, TMP/SMZ, vancomycin by the disk diffusion method are 89%, 91%, 64% and 0%, respectively. 64% of the isolates showed multiple resistance. 7 types of DNA fingerprinting were gotten and 78% of isolates belonged to three types. Conclusion: We found that the antimicrobial resistance of children attending the day-care center in Seoul was much higher than expected. We assumed that this might be due to their easy and frequent exposure to antimicrobial agents and crowded day-care center environment.

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Carriage Rates of Methicillin-resistant Staphylococcus aureus in Neonates with Neonatal Jaundice (신생아황달 환아에서의 메티실린내성 황색포도알균 보균율에 관한 연구)

  • Na, Dong Cheon;Seo, Jae Min;Lee, Jung Hyun;Lee, Won Uk;Kim, Eun Ryoung
    • Pediatric Infection and Vaccine
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    • v.18 no.2
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    • pp.143-153
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    • 2011
  • Purpose : It is known that carriage rates of Staphylococcus aureus (S. aureus) are highest in newborns and that the asymptomatic carriage of methicillin-resistant Staphylococcus aureus (MRSA) is associated with invasive MRSA infection with the colonizing strain. This study was carried out to investigate the carriage rates of MRSA in neonates with neonatal jaundice. Methods : We reviewed the medical records of 545 neonates admitted with neonatal jaundice to neonatal intensive care units between January 2006 and December 2010. Nasal and inguinal swab specimens had been taken from them and cultured for the isolation of S. aureus. Antimicrobial susceptibility tests had been done for such isolates to determine methicillinresistance. Results : Out of 545 neonates, 318 (58.3%) were colonized with S. aureus and 214 (39.3%) were colonized with MRSA. Results of the antibiogram analysis showed that 65.7% of MRSA isolates were likely to be community-associated (CA) MRSA. Conclusion : Based on the MRSA carriage rate of 39.3%, a surveillance program for MRSA colonization is considered necessary in neonates transferred from other clinics or hospitals. Out of MRSA isolates, 65.7% were likely to be CA-MRSA. This suggests that CA-MRSA strains were already present in obstetric clinic environments where the neonates were born. It is thought that MRSA surveillance programs in these environments are also necessary.

Epidemiology and Clinical Severity of the Hospitalized Children with Viral Croup (바이러스성 크루프로 입원하는 소아 환자의 역학적 특성과 임상적 중증도 평가)

  • Jeon, In Soo;Cho, Won Je;Lee, Jeongmin;Kim, Hwang Min
    • Pediatric Infection and Vaccine
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    • v.25 no.1
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    • pp.8-16
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    • 2018
  • Purpose: In this study, the clinical and epidemiological characteristics of patients admitted for viral croup were analyzed to evaluate disease severity based on the organism that caused the infection. Methods: We retrospectively reviewed the medical records of 302 patients who were admitted to the Department of Pediatrics at the Wonju Severance Hospital between May 2013 and December 2016 for viral croup. Patients who showed positive results on multiplex polymerase chain reaction were subsequently diagnosed with respiratory virus infection. The Westley scoring system was used to evaluate the severity of viral croup. Results: Of the 302 patients, 149 were admitted due to severe viral croup, including 88 boys and 61 girls, with a boy-to-girl ratio of 1.44:1. About 110 cases of parainfluenza virus infection have been reported, which accounted for almost half of the total cases. The other identified viruses included influenza virus, human rhinovirus, and respiratory syncytial virus. Analysis of the association between severe viral croup and causative pathogen revealed that only parainfluenza type 2 virus showed a significantly high risk. Parainfluenza type 2 virus did not show an age-based difference in frequency but showed relatively a higher frequency of infections during the summer and fall. Conclusions: In this study, parainfluenza virus type 2 was the only virus associated with severe viral croup. To facilitate proper preventive management, treatment, and prognosis evaluation of viral croup, prospective and multicenter studies should assess the additional variables and the severity of the virus. Additionally, further studies should be conducted to assess age-dependent influences, as well as the regional and seasonal incidence of viral infection.

Carbapenemase-Producing Klebsiella oxytoca Detection Using Molecular Methods (분자학적 방법을 이용한 Carbapenemase-Producing Klebsiella oxytoca 검출)

  • Yang, Byoung Seon;Park, Ji Ae
    • Korean Journal of Clinical Laboratory Science
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    • v.51 no.4
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    • pp.428-435
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    • 2019
  • The rapid increase and dissemination of carbapene mases, such as Klebsiella pneumoniae carbapenemase (KPC), has become a major problem within the field of healthcare-related infection. There are few antibiotics to treat carbapenem-resistant Enterobacteriaceae (CRE) infections, so the identification of resistant bacterial mechanisms is critical to initiate infection control and conduct epidemiological research. A rapid and effective method for detecting KPC-producing bacteria is needed to avoid therapeutic failures and introduce measures to prevent and control the dissemination of these multi-resistant bacteria. During the study period, 31 isolates (seven isolates of Acinetobacter spp., six isolates of Morganella morganii, five isolates of Pseudomonas aeruginosa, five isolates of Proteus mirabilis, one isolate of Proteus vulgaris, two isolates of Enterobacter cloacae, one isolate of Enterobacter aerogenes, one isolate of Klebsiella pneumoniae, one isolate of Klebsiella oxytoca, one isolate of Serratia marcescens and one isolate of Escherichia coli) were identified by the VITEK. Gram negative rod bacteria were the most frequently isolated from urine (35.5%), blood (19.4%), sputum (16.1%), pus (9.7%), ascitic fluid (9.7%), tracheal aspirates (6.5%) and bile juice (3.2%). Analysis using the PCR method identified the blaKPC gene in the K. oxytoca1 strain, but the blaIMP, blaVIM and blaOXA-48 genes are not amplified. In conclusion, diagnosis using the PCR method can accurately and quickly diagnose KPC, thus establishing quick preventive measures to prevent the spread of KPC in hospitals.