• Title/Summary/Keyword: Clinical spectrum

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Clinical Significance of Extended-spectrum β-lactamase-producing Bacteria in First Pediatric Febrile Urinary Tract Infections and Differences between Age Groups

  • Park, Sun Yeong;Kim, Ji Hong
    • Childhood Kidney Diseases
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    • v.21 no.2
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    • pp.128-135
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    • 2017
  • Purpose: Extended-spectrum ${\beta}$-lactamase-producing bacteria-induced urinary tract infections are increasing and require more potent antibiotics such as carbapenems. We evaluated the clinical significance of extended-spectrum ${\beta}$-lactamase -urinary tract infection in children younger than 5 years to select proper antibiotics and determine prognostic factors. Differences were compared between age groups. Methods: We retrospectively studied 288 patients with their first febrile urinary tract infection when they were younger than 5 years. Patients were divided into extended-spectrum ${\beta}$-lactamase-positive and extended-spectrum ${\beta}$-lactamasenegative urinary tract infection groups. Clinical characteristics and outcomes were compared between the groups; an infant group was separately analyzed (onset age younger than 3 months). Results: Extended-spectrum ${\beta}$-lactamase urinary tract infection occurred in 11 % patients who had more frequent previous hospitalization (P=0.02) and higher recurrence rate (P=0.045). During the antimicrobial susceptibility test, the extended-spectrum ${\beta}$-lactamase-positive urinary tract infection group showed resistance to third-generation cephalosporins; however, 98% patients responded clinically. In the infant group, extended-spectrum ${\beta}$-lactamase-positive urinary tract infection occurred in 13% patients and was associated with a longer pre-onset hospitalization history (P=0.002), higher C-reactive protein level (P=0.04), and higher recurrence rate (P=0.02) than that in the older group. Conclusion: Extended-spectrum ${\beta}$-lactamase urinary tract infection requires more attention because of its higher recurrence rate. The antimicrobial susceptibility test demonstrated resistance to third-generation cephalosporins, but they can be used as first-line empirical antibiotics because of their high clinical response rate. Aminoglycosides can be second-line antibiotics before starting carbapenems when third-generation cephalosporins do not show bactericidal effects for extended-spectrum ${\beta}$-lactamase urinary tract infection.

Real-Time PCR Analysis of SHV Extended-Spectrum beta-Lactamases Producing Klebsiella pneumoniae (SHV ESBL생성 Klebsiella pneumoniae 균주의 실시간중합효소반응분석)

  • Yang, Byoung-Seon;Yook, Keun-Dol
    • Korean Journal of Clinical Laboratory Science
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    • v.41 no.4
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    • pp.153-157
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    • 2009
  • The production of extended-spectrum ${\beta}$-lactamases ($ESBL_S$) of the TEM or SHV type by bacterial pathogens is a major threat to the use of the clinically important expanded-spectrum cephalosporins. The characterization of the SHV ESBLs producing Klebsiella pneumoniae strains present in clinical isolates is time-consuming processes. We describe here in the development of a novel system, which consists of a real time PCR. We found 11 K. pneumoniae strains to be presumptive strains ESBLs producers by clinical and laboratory standards institute (CLSI) guidelines. The double disk synergy test showed 8 ESBL positive and conventional PCR showed 10 SHV ESBL positive, which were K. pneumoniae strains isolates. By real time PCR analysis, SHV gene in 11 of 11 strains were identified. When sequencing analysis was compared with real time PCR, both analysis were presented 99% similarity. In this study, we used a rapid, sensitive, and specific real-time PCR (RT-PCR) method for detection of the assay SHV ESBL producing K. pneumoniae strains in clinical isolates.

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Report on Seven Cases on Patients with Autism Spectrum Disorder Treated by Kwakhyangjungkisanhapyukmijihwangtang-gamibang (곽향정기산합육미지황탕가미방(藿香正氣散合六味地黃湯加味方)을 처방한 자폐스펙트럼장애 환아 7례)

  • Lee, Ji Na;Kim, Deog Gon;Lee, Jin Yong
    • The Journal of Pediatrics of Korean Medicine
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    • v.29 no.1
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    • pp.50-59
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    • 2015
  • Objectives The purpose of this study is to report seven cases of autism spectrum disorder treated by oriental medicine. Methods Seven patients who are diagnosed with autism spectrum disorder were treated with herbal medicine (Kwakhyangjungkisanhapyukmijihwangtang-gamibang), and the effect was measured. Results After the treatment, cognitive skill, speech, motor function, communication skill, and the patients' general conditions have gotten better. Conclusions This study has shown that the oriental medical treatment for autism spectrum disorder was effective, but further studies are needed.

Detection of Extended-Spectrum β-Lactamase Producing Klebsiella pneumoniae by Multiplex Polymerase Chain Reaction (Multiplex Polymerase Chain Reaction을 이용한 Extended-Spectrum β-Lactamase 생성 Klebsiella pneumoniae 균주의 검출)

  • Yang, Byoung-Seon
    • Korean Journal of Clinical Laboratory Science
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    • v.38 no.3
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    • pp.173-178
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    • 2006
  • The production of extended-spectrum ${\beta}$-lactamases ($ESBL_S$) is the main mechanism of bacterial resistance to third-generation cephalosporins and monobactams, whose prevalence varies depending on the different geographical areas. In the last years it has increased notably to the point of being considered a health problem of great importance. The characterization of the ESBLs producing Klebsiella penumoniae strains present in clinical isolates is time-consuming. I describe here the development of a new system, which consists of a multiplex PCR. I found 51 K. pneumoniae strains to be presumptive strains ESBLs producers by clinical and laboratory standards institute (CLSI) guidelines. The double disc synergy test showed 47 positive K. pneumoniae, which were K. pneumoniae isolates. All ESBLs producing K. pneumoniae strains were resistant to antibiotic amikacin, gentamicin and ciprofloxacin. By multiplex PCR analysis, $bla_{TEM}$ gene in 17 strains 44 $bla_{SHV}$ genes and $bla_{CTX}$ genes in 33 strains were identified. In this study, the multiplex polymerase chain reaction (PCR) assay was a good method to detect and differentiate ESBLs producing K. penumoniae strains in clinical isolates.

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Recent Clinical Research on Effect of Acupuncture for Autism Spectrum Disorder (자폐스펙트럼장애의 침치료에 대한 최근 임상 연구 동향 - RCT 중심으로 -)

  • Lee, Ji Na;Lee, Sun Haeng;Lee, Jin Yong
    • The Journal of Pediatrics of Korean Medicine
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    • v.29 no.4
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    • pp.119-126
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    • 2015
  • Objectives The purpose of this study is to investigate recent clinical studies on effect of acupuncture for Autism Spectrum Disorder in other countries. We have analyzed the studies on effect of acupuncture for Autism Spectrum Disorder within randomized controlled trail (RCT) for 6years (from 2010 to 2015). Methods The search database includes Medline, Embase, Cochrane library and CNKI (China National Knowledge Infrastructure). To narrow the search, the following key search terms were used: 'autism or ASD or Asperger's Syndrome or pervasive developmental disorder, acupuncture'. The search was limited to the publication date from 2010 to 2015. 7 control studies in Medlin, Embase, Cochrane library and 5 control studies in CNKI were selected for analysis. Results and Conclusions 1. The acupuncture and rehabiliation treatment is more effective than only acupuncture treatment. Especially, Retention of needling is helpful. 2. It is necessary to set up standard scale in assessment of ASD patients and serum arginine-vasopressin (AVP) can be substitution. 3. Head acupuncture and tongue acupuncture is effective for ASD.

A Comparison between Korean and Chinese Clinical Studies for the Treatment of Autism Spectrum Disorder (자폐 스펙트럼 장애에 대한 한국과 중국의 한방치료 연구 동향 비교)

  • Cho, Youn Soo;Baek, Jung Han
    • The Journal of Pediatrics of Korean Medicine
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    • v.32 no.2
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    • pp.26-42
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    • 2018
  • Objectives The purpose of this study is to figure out the recent trend of the treatment for autism spectrum disorder (ASD) by comparing Korean and Chinese clinical studies. Methods National Digital Science Library (NDSL), Oriental medicine Advanced Searching Integrated System (OASIS), Research Information Sharing Service (RISS) and Korean Traditional Knowledge Portal (KTKP) were used to search Korean studies which were published from January, 2011 to May, 2017. Also Chinese National Knowledge Infrastructure (CNKI) and Wanfang data were used to search Chinese studies which were published from the same period. Key words of 'Autism' and 'Autism spectrum disorder' were used. Results 3 Korean studies and 21 Chinese studies were selected and analyzed to find out the most commonly used diagnostic criteria, treatments, including herbal medicine and acupuncture, and treatment assessment procedures. Conclusions As a result of comparing Korean and Chinese clinical studies for the treatment of ASD, both Korean and Chinese medicine treatments showed their effectiveness. However, there were some differences between two countries' clinical trends. In order for this study to be helpful, more highly evidenced clinical studies should be followed.

Multiplex PCR for Detection of Quinolone Resistance qnr Genes in Extended-Spectrum β-Lactamase Producing Escherichia coli and Klebsiella pneumoniae (Multiplex PCR을 이용한 Extended-Spectrum β-Lactamase 생성 Escherichia coli와 Klebsiella pneumoniae의 Quinolone 내성 qnr유전자 검출)

  • Yang, Byoung-Seon
    • Korean Journal of Clinical Laboratory Science
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    • v.39 no.3
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    • pp.161-166
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    • 2007
  • To develop a rapid and reliable single-tube-based PCR technique for detection simultaneously the quinolone resistance qnrA, qnrB and qnrS genes. After multiple alignment, primers were designed to detect known qnr variants. I was used for A total of 43 extented-spectrum ${\beta}$-lactamases (ESBLs) producing Escherichia coli and Klebsiella pneumoniae isolated from university hospital were tested for screening, as with qnr genes. In optimized conditions, all positive controls confirmed the specificity of the PCR primers. Out of 43 isolates, qnrA genes were detected 19 (44.2%), qnrB genes 5 (11.7%), qnrS genes 15 (34.9%) and 8 (18.6%) isolates were not detected. I report here a fast and reliable technique for rapid screening of qnr positive strains to be used for epidemiological surveys.

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Random Amplified Polymorphic DNA Analysis for Typing Extended-Spectrum-β-Lactamase of Klebsiella pneumoniae

  • Yang, Byoung-Seon
    • Korean Journal of Clinical Laboratory Science
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    • v.37 no.3
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    • pp.149-154
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    • 2005
  • Fifty-one extended-spectrum-${\beta}$-lactamase(ESBL) producing Klebsiella pneumoniae strains were isolated from national university hospitals. All K. pneumoniae strains showed resistance to broad-spectrum antibiotic and most of them presented resistance to amikacin, gentamicin and ciprofloxacin. The results of amplified polymorphic DNA (RAPD) pattern for randomly isolated fifty-one strains were as follows; both twenty-one strains from Chungnam National University hospital and ten strains from Chungbuk National University hospital showed RAPD type Ia and Ib. However, twenty strains isolated from Gyeongsang National University hospital belonged to RAPD type IIa and IIb. All isolates were divided into four molecular types and showed high level of genetic diversity. These results suggested that RAPD analysis provided a rapid and simple method for analysing genotypes of ESBL.

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Review of Traditional Chinese Medicine Clinical Studies on Tuina Treatment of Children's Autism Spectrum Disorder (소아 자폐스펙트럼 장애의 추나 치료에 대한 중의학 임상 연구 고찰)

  • Park, Jem Ma
    • The Journal of Pediatrics of Korean Medicine
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    • v.35 no.3
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    • pp.28-42
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    • 2021
  • Objectives The purpose of this study is to investigate the effect of Tuina treatment for children with Autism Spectrum Disorder (ASD), and to propose guidance to future studies or application in clinical setting. Methods The articles published from year 2000 to May 2021 by China National Knowledge Infrastructure (CNKI) were searched by setting up field as '中醫學', '中藥', '中西醫結合' and by setting up keyword as '小儿自閉症', '儿童自閉症', '自閉症譜系障碍', 'Autism', 'Autism spectrum disorder' that corresponds to participant and '推拿', '導引', '按摩', 'Tuina', 'massage'. Results Nine selected articles were analyzed and summarized by authors and year published, characteristics, diagnostic criteria, treatment methods and contents, treatment duration, evaluation criteria and results of the study. The articles were also reviewed by reported side effects, and evaluated the quality of the study according to Cochrane Handbook's Risk of Bias 2 (RoB 2) assessment of the Randomized Control Trial (RCT) articles. All studies used Tuina treatment to achieve effective results for pediatric autism spectrum disorder. Conclusion Pediatric Tuina treatment (TM) is a non-invasive treatment that does not stimulate patients with unstable ASD but increase patient adherence, and can be safely and simply operated. Therefore, pediatric Tuina treatment is worth utilizing as a clinical basis for further development of ASD treatment.

Myelin oligodendrocyte glycoprotein antibody-associated disorders: clinical spectrum, diagnostic evaluation, and treatment options

  • Lee, Yun-Jin;Nam, Sang Ook;Ko, Ara;Kong, JuHyun;Byun, Shin Yun
    • Clinical and Experimental Pediatrics
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    • v.64 no.3
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    • pp.103-110
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    • 2021
  • Inflammatory or immune-mediated demyelinating central nervous system (CNS) syndromes include a broad spectrum of clinical phenotype and different overlapping diseases. Antibodies against myelin oligodendrocyte glycoprotein (MOG-Ab) have been found in some cases of these demyelinating diseases, particularly in children. MOG-Ab is associated with a wider clinical phenotype not limited to neuromyelitis optica spectrum disorder, with most patients presenting with optic neuritis, acute disseminated encephalomyelitis (ADEM) or ADEM-like encephalitis with brain demyelinating lesions, and/or myelitis. Using specific cell-based assays, MOG-Ab is becoming a potential biomarker of inflammatory demyelinating disorders of the CNS. A humoral immune reaction against MOG was recently found in monophasic diseases and recurrent/multiphasic clinical progression, particularly in pediatric patients. This review summarizes the data regarding MOG-Ab as an impending biological marker for discriminating between these diverse demyelinating CNS diseases and discusses recent developments, clinical applications, and findings regarding the immunopathogenesis of MOG-Ab-associated disorders.