• Pediatric Infection and Vaccine
• /
• v.30 no.3
• /
• pp.152-158
• /
• 2023

Staphylococcus aureus (SA) is a common cause of skin and soft tissue infections. Panton-Valentine leukocidin (PVL) toxin-producing strain of SA has been discovered worldwide and is known to cause serious infections. However, reports of neonatal infections caused by PVL-positive SA are rare. Here, we report a case of severe skin and soft tissue infection caused by PVL-positive SA in a 7-day-old neonate. The patient was admitted to the emergency room with a history of fever for one day, tenderness, and sensation of buttocks heating. The infant presented with fever, tachycardia, poor general health, progressive tenderness, and edema of the buttocks on the day of admission. Ultrasonography and magnetic resonance imaging revealed necrotizing fasciitis involving the skin, soft tissue, and muscles. Specimens drained from the buttock lesions confirmed the presence of PVL-positive methicillin-resistant SA (MRSA), and there was no bacteremia. She recovered after one month of intravenous antibiotics and surgical drainages. One month after discharge, she was rehospitalized for otitis externa and was infected with MRSA again. Considering the PVL-positive strain, the patient was treated with intravenous linezolid and dressing. The patient underwent decolonization therapy in a 0.5% chlorhexidine bath and recovered completely without sequelae. This case suggests that aggressive drainage and antibiotic treatment are essential for PVL-producing MRSA infections, and additional decolonization is needed to prevent recurrence and community spread.

• Pediatric Infection and Vaccine
• /
• v.30 no.1
• /
• pp.33-38
• /
• 2023

A case of persistent Ralstonia mannitolilytica bacteremia in the neonatal intensive care unit prompted source investigation due to its rarity. After an extensive investigation, a contaminated ultrasonic nebulizer was identified as the source, and the infection was controlled by removing the source. This study emphasizes the importance of further investigations, even in single cases of rare pathogens.

• Neonatal Medicine
• /
• v.15 no.1
• /
• pp.44-53
• /
• 2008

Purpose : Epidemic keratoconjunctivitis (EKC) caused by adenovirus is a highly contagious disease, which has been reported as outbreaks involving adults in the community. However, there has been no report on EKC outbreak by adenovirus in a neonatal intensive care unit (NICU) in Korea. Aims of this study were to investigate the EKC outbreak by adenovirus type 8 in NICU and to confirm an effectiveness of polymerase chain reaction (PCR) for diagnosis. Methods : Conjunctival swab or nasopharyngeal aspirate specimens were taken from all patients and tested by viral culture and PCR. Adenovirus serotype was determined by sequencing of PCR product of selected region of hexon gene using the virus isolates or specimens. Results : An outbreak of EKC occurred which was involving 12 preterm infants in the NICU of the Seoul National University Children's Hospital between July 12th and August 1st, 2005. Three hospital staffs and one family member of the neonate were also affected. Adenovirus was detected in 12/12 (100%), 6/11 (54.5%) by PCR and virus culture, respectively. Eleven PCR-positive neonates were identified as serotype 8 by sequencing. The first affected 4 babies have had routine ROP (retinopathy of prematurity) examinations one week ago. While previous outbreaks were sustained for a few months, the event in our unit was controlled without complications in 3 weeks. Conclusion : We analyzed the EKC outbreak by adenovirus type 8 in NICU. Adenovirus serotype was identified by PCR and sequencing with high sensitivity for the first time in Korea, so we suggest this method can be very useful for rapid diagnosis and infection control.

• Pediatric Infection and Vaccine
• /
• v.15 no.2
• /
• pp.152-161
• /
• 2008

Purpose : Staphylococcal scalded skin syndrome (4S) is uncommon, but reports of 4S are on the increase during the recent years. The purpose of this study is to determine the clinical features and associated factors of 4S during the recent 10 years. Methods : We retrospectively reviewed the medical records and microbiologic results of 63 patients (27 neonates and 36 children) from January 1998 to December 2007. Results : Since 2003, the incidence of 4S has increased. The mean age of the patients was 16.3 months and the gender ratio was 1:1. The clinical types of 4S were 38 cases of the abortive type (60%), 19 cases of the intermediate type (30%) and 6 cases of the generalized type (10%). The culture results were 36 cases of Methicillin resistant S. aureus (MRSA), 4 cases of Methicillin sensitive S. aureus and 17 cases of no growth. The patients were treated with semi-synthetic penicillin. For the 9 patients who had MRSA isolated and who didn't improve with penicillin, they were treated with vancomycin instead of penicillin. All the patients had no complications. 4S abruptly increased in 2005, and especially in neonates, due to an MRSA outbreak at a local nursery room. The associated factors of 4S in neonates were hospitalization (27 cases), including nursery infection in 2005 (18 cases) and dermatitis (1 case). There was an unknown origin for some children, and the suggested factors for their infection were community acquired infection (24 cases), atopic dermatitis (9 cases) and hospitalization (3 cases). Conclusion : 4S has recently been increasing. The major associated factors of 4S are a history of hospitalization, an outbreak in a nursery room, atopic dermatitis and community acquired infection.

• Clinical and Experimental Pediatrics
• /
• v.50 no.7
• /
• pp.698-701
• /
• 2007

We report on two premature infants who developed nosocomial infection caused by Chryseobacterium meningosepticum in a neonatal intensive care unit (NICU). One premature infant developed sepsis, meningitis, and hydrocephalus, and was treated successfully with ciprofloxacin plus trimethoprim-sulfamethoxazole combination therapy for 4 weeks and with a ventriculoperitoneal shunt. The other premature infant, who was in a chronically debilitated state, had infection that had colonized only in the respiratory tract but had no clinical signs for 66 days. Extensive environmental surveillance demonstrated that the suction bottle apparatus was the source of infection. We prevented the spread of infection by closing the NICU temporarily, isolating the patients early in their infection, and eradicating the source of infection source.

• Neonatal Medicine
• /
• v.18 no.2
• /
• pp.265-271
• /
• 2011

Purpose: Extended spectrum $\beta$-lactamase (ESBL) producing organism is an important cause of infections in the neonatal intensive care unit (NICU) since 1990s. The aim of this study is to investigate the differences of clinical characteristics and hematologic studies between neonates with ESBL-positive organism and those with ESBL-negative organism. Methods: The subjects included 48 neonates admitted to NICU at Inje University Sanggye Paik Hospital from January 2005 to September 2010, from whom a total of 58 Escherichia coli or Klebsiella pneumonia were detected. The data were categorized in 2 groups, neonates with ESBL-positive and ESBL-negative. We compared clinical characteristics and hematologic studies between two groups. Results: Of 48 neonates and 53 isolates, ESBL-positive were 18 neonates and 20 isolates. Both ESBL-positive and ESBL-negative isolates were largely found in urine, each with 10 and 23. Of 20 ESBL-positive isolates, 13 (65%) and 7 (35%) were ESBL producing Escherichia coli and Klebsiella pneumonia, respectively. ESBL-positive neonates were associated with low 1 and 5 minutes Apgar scores (P=0.002 and P=0.001, respectively), more uses of oxygen (56% vs. 27%; P=0.005), longer duration of oxygen uses (15.8${\pm}$38.43 days vs. 4.3${\pm}$12.5 days; P=0.008) and more frequent anemia (33% vs. 7%; P=0.040). Conclusion: ESBL-positive neonates may have more anemia and lower Apgar score at birth. We can consider the use of cabapenem earlier if infant with previous antibiotics is confirmed to be infected with ESBL-positive organisms.

• Tuberculosis and Respiratory Diseases
• /
• v.41 no.2
• /
• pp.165-170
• /
• 1994

B군 연쇄상구균(group B streptococcus or Streptococcus agalactiae)은 신생아 뇌막염과 균혈증의 원인균으로 알려져 있고, 우리나라에서는 현재까지 23예의 신생아 B군 연쇄상구균 감염 임상 증례가 보고되었다. 그러나 성인에서의 B군 연쇄상구균 분리 동정에 대한 분석은 보고되었으나, 폐렴 증례는 아직 보고된 바 없고, S. agalactiae의 penicillin에 대한 최소억제농도가 대표적 연쇄상구균인 S. pyogenes 보다 높고 동물실험 및 시험관검사에서 penicillin과 aminoglycoside을 병합사용할 경우 상승작용이 관찰되었기 때문에, 치료제로 penicillin 또는 cephalosporin 을 aminoglycoside와 병합투여하여야 하는 특정을 지니고 있다. 저자들은 74세 남자 당뇨 환자에서 B군 연쇄상구균에 의한 폐렴과 패혈증이 발생한 증례를 치험하여 보고하고자 한다.

• The Journal of the Convergence on Culture Technology
• /
• v.10 no.2
• /
• pp.547-553
• /
• 2024

If congenital fever left untreated, it can cause atopic dermatitis. It is very important to manage the surface temperature of the neonatal's head during sleep. Baby pillows were mostly developed with cotton materials due to their delicate skin, or they were used for head correction due to their flexible skeletons. This paper measured the surface temperature of baby head in a sleep and analyzed the trends to figure out the PCM effect which to prevent the congenital fever. In addition it was performed a usability evaluation from baby's parents to investigate their satisfaction. According to the results, PCM is effective in regulating skin temperature of neonatal's head to prevent the congenital fever.

• Pediatric Infection and Vaccine
• /
• v.18 no.1
• /
• pp.15-22
• /
• 2011

Invasive Candida infections (ICI) have become the third most common cause of late-onset infection among premature infants in the neonatal intensive care unit (NICU). Risk factors include birth weight less than 1,000 g, exposure to more than two antimicrobials, third generation cephalosporin exposure, parenteral nutrition including lipid emulsion, central venous catheter, and abdominal surgery. Candida colonization of the skin and gastrointestinal tract is an important first step in the pathogenesis of invasive disease. Strict infection control measures against the infection should be done in the NICU. The following practices are likely to contribute to reducing the rate of ICI: (1) restriction of broad-spectrum antibiotics, antacids and steroid; (2) introduction of early feeding and promoting breast milk. Fluconazole prophylaxis may be an effective control measure to prevent Candida colonization and infections in individual units with high incidence of fungal infection. In addition, there is a need of further data including the development of resistant strains and the effect on long-term neurodevelopmental outcomes of infants exposed to drugs before the initiation of routine application of antifungal prophylaxis in the NICU.

• Pediatric Infection and Vaccine
• /
• v.6 no.1
• /
• pp.131-135
• /
• 1999

Respiratory Syncytial Virus(RSV) causes acute respiratory tract infections in young infancy such as bronchiolitis, pneumonia. RSV infections are uncommon in the first month of life. Clinical manifestations of neonatal RSV infection are respiratory symptoms, apnea and bacterial sepsis like illness such as lethargy, poor feeding, fever, rash. We report a case of neonatal pneumonia caused by RSV and accompanied by transient apnea and favorable clinical outcome.