• Clinical and Experimental Pediatrics
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• v.49 no.5
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• pp.500-506
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• 2006

Purpose : We evaluated an outbreak of Serratia marcescens infections in 24 neonates in a neonatal intensive care unit(NICU). Methods : From January to August, 2004 a nosocomial outbreak of S. marcescens occurred in our NICU. We describe the clinical characteristics of the outbreak and analyse the risk factors for infections with S. marcescens. After the outbreak stopped, 7 isolates from blood were typed using rapid amplified polymorphic DNA analysis(RAPD). Results : S. marcescens was isolated from 24 neonates, 19 infected and 5 colonized. Seven out of nineteen neonates had bacteremia, 4 had ventilator associated pneumonia, 4 had purulent conjunctivitis, 2 had UTI, 1 had meningitis and 1 had a wound infection. Three neonates died due to S. marcescens infection, 2 of 3 had ventilator associated pneumonia, 1 had meningitis complicated with abscess. The mortality rate of S. marcescens infection was 15.8%. Factors associated with S. marcescens infections were previous antibiotic therapy, indwelling catheter and use of ventilators. The isolated strains were resistant to most antibiotics, but frequently sensitive to imipenem, bactrim and amikacin. RAPD typing results show that at least 3 epidemic strains were related with this outbreak. But one genotype was predominant type in this outbreak. The control measures were instituted and the outbreak stopped within 2 months. Conclusion : S. marcescens can cause rapidly spreading outbreaks associated with fatal infections in neonates. If S. marcescens is isolated from clinical specimens, meticulous infection control measures and epidemiologic investigations should be done at an early stage of the outbreak.

• Clinical and Experimental Pediatrics
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• v.46 no.12
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• pp.1224-1229
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• 2003

Purpose : Bacterial meningitis is a serious disease, especially in the neonatal period, and it carries a significant degree of mortality and morbidity. Group B streptococcus(GBS) is a common cause of neonatal bacterial meningitis. The purpose of this study was to evaluate the clinical manifestations, treatment results and complications of GBS meningitis. Methods : We analyzed 29 cases retrospectively who had been admitted to the pediatric ward or NICU in Asan Medical Center from May 1990 to January 2002. They had proven GBS in culture or latex agglutination test in CSF. Results : The male to female ratio was 1 : 1.9. There were two cases of early onset type and 27 cases of late onset type. All cases had normal birth weight with full term at delivery. The perinatal predisposing factors were premature rupture of membrane(two cases), and maternal colonization(two cases). The most common presenting symptoms were fever and irritability. Associated diseases were GBS sepsis(21 cases). There was relatively high sensitivity to penicillin derivatives. There were abnormal brain CT or MRI findings in 16 cases(64%), such as infarction, encephalomalatic change, effusion, hydrocephalus, hemorrhage and abscess. The intensive care unit admission rate and the incidence of DIC were higher in the group with complications. Two cases were discharged against advice. Conclusion : We recommend early detection and active treatment in Group B streptococcal meningitis to improve the prognosis.

• Clinical and Experimental Pediatrics
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• v.49 no.3
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• pp.278-286
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• 2006

Purpose : Although suprapubic bladder aspiration(SBA) is the most reliable technique for identifying bacteriuria in young infant, no report has been published about the clinical manifestations of urinary tract infection(UTI) diagnosed by aspirated urine in Korea. This study was performed to examine clinical manifestations and related factors of UTI confirmed by a positive urine culture obtained by SBA in young infants. Methods : We reviewed medical records of 159 infants younger than six months of age, who had been admitted for UTI to Korea University Ansan Hospital from January 2002 to June 2005. Results : The male:female ratio was 5.1 : 1. The most common pathogen in urine culture was Escherichia coli(92.5 percent). Most of the gram-negative pathogens had high sensitivity to amikacin, or third generation cephalosporins and had low sensitivity to ampicillin, trimethoprim-sulfamethoxazole, or gentamicin. Hydronephrosis and vesicoureteral reflux(VUR) were present in 32.7 percent and 27.7 percent respectively. Renal cortical defects observed on DMSA scans were detected in 37.1 percent. Prolonged fever duration and hospital day, high erythrocyte sedimentation rate(ESR) and C-reactive protein(CRP) levels, hydronephrosis and VUR were related to the renal cortical defects(P<0.05). Rates of UTI-associated bacteremia and aseptic meningitis were 8.3 percent and 6.6 percent. Conclusion : Early differential diagnosis is very important in infants younger than 6 months of age with UTI because the clinical findings are non-specific and UTI-associated bacteremia and aseptic meningitis are concomitantly found. Because prolonged fever and higher ESR and CRP levels are risk factors of the renal cortical defects, radiologic evaluations and nephrologic follow-up were needed in identifying the predisposing congenital abnormalities and chronic renal scarring.

• Pediatric Infection and Vaccine
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• v.17 no.1
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• pp.36-48
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• 2010

Purpose : In children on anticancer chemotherapy, bloodstream infections (BSIs) are a major cause of morbidity and mortality. We investigated febrile episodes and bloodstream infections in pediatric cancer patients to guide proper selection of empiric antibiotics for febrile pediatric hemato-oncologic patients. Methods : All febrile episodes treated in the division of hematology-oncology, the department of pediatrics, Hanyang University Hospital, between July 2005 and June 2008 were reviewed. Episodes with and without bloodstream infections were compared. Results : Forty cases (18.9%, 25 patients) of BSI occurred in 212 febrile episodes (63 patients). Thirty-seven cases (23.6%, 22 patients) of BSI occurred in 157 febrile episodes with neutropenia (54 patients). Microorganisms identified in BSI corresponded to 23 gram-positive bacteria (51.2%), 20 gram-negative bacteria (44.5%), and 2 fungi (4.4%). Rates of BSI between those who had received umbilical cord blood transplantation and those who had received transplantation from other source were significantly different (55.0% vs. 7.7%, P =0.001). No differences in mortality rate were observed among organisms in BSI patients. For febrile episodes the rate of BSI was higher among those with Chemoport than those with Hickman catheter (P =0.029) and gram-positive pathogens were more likely to be associated with Chemoport (P =0.001). Conclusion : The study showed the rate of BSI, distribution of pathogens with regard to neutropenia, transplantation, central venous catheters, and antimicrobial susceptibility of pathogens in order to help guide in the choice of optimal empiric antibiotics in pediatric febrile neutropenic hemato-oncologic patients.

• Korean Journal of Veterinary Research
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• v.44 no.2
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• pp.217-224
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• 2004

This study was carried out to investigate the antibiotic resistance pattern of Listeria spp. and Staphylococcus aureus. A total of 17 (14.8%) L. monocytogenes, 13 (11.3%) L. innocua, 7 (7%) L. welshimeri, and 83 (72.2%) S. aureus were isolated from commercial poultry carcasses in Seoul and Kyonggi province during the period between 2001 and 2003. Antibiotic susceptibility test of all Listeria strains isolated was performed by the disk agar diffusion method. Antibiotics used in the study were as follows; Amikacin (An), Ampicillin (Am), Cephalothin (Cf), Chloramphenicol (C), Ciprofloxacin (Cip), Erythromycin (E), Gentamicin (Gm), Imipenem (Ipm), Kanamycin (K), Minocycline (Mi), Neomycin (N), Norfloxacin (Nor), Ofloxacin (Ofx), Penicillin (P), Streptomycin (S), Tetracycline (Te), Tobramycin (Nn), Trimethoprim (Tmp), Trimethoprim/Sulfamethoxazloe (Sxt), and Vancomycin (Va). The antibiotic resistance pattern of S. aureus isolates was performed by the disk agar diffusion method. For the latter program, antibiotics used to the study were as follows; Cf, C, Cip, Clindamycin (Cc), E, Gm, Ipm, Nafcillin (Nf), Oxacillin (Ox), P, Te, Sxt, and Va. Of the 17 L. monocytogenes isolates, 94.1% were resistant to Te, 88.2% to Mi, 11.8% to Nor, 11.8% to S, 5.9% to Cip, and 5.9% to C. Of 13 L. innocua, 53.8% were resistant to Te, 23.1% to Mi, 23.1% to S, 7.7% to Cip, and 7.7% to Nor. Of 7 L. welshimeri, 57.1% were resistant to Te, and 14.3% to Am. Of 83 S. aureus, 100% were resistant to Te, 86.7% to Gm, 34.9% to P, 15.7% to Cip, 12% to Cc, 9.6% to E. The multiple antibiotic resistance patterns of L. monocytogenes isolates were observed in Te Mi Cip (5.9%), Te Mi Nor (5.9%), Te Mi (76.5%), and Te Nor (5.9%). Multiple antibiotic resistance was also found in L. innocua isolates. Resistant to Te Mi S Cip Nor was 7.7%, Te Mi S (7.7%), Te Mi (7.7%), and was 7.7% to Te S. Antibiotic resistance patterns for S. aureus isolats were demonstrated to Te Gm P Cip Cc E (6.0%), Te Gm Cip Cc E (3.6%), Te Gm P Cc (1.2%), Te Gm P (15.6%), Te Gm Cip (2.4%), Te P Cip (2.4%), Te Gm Cc (1.2%), Te Gm (56.6%), Te P (9.6%), and to Te Cip (1.2%). The results of this study suggest a high incidence of Lsteria spp. and S. aureus on poultry carcasses. The contaminated poultry carcasses may be a potential vehicle for foodborne infections due to multiple antimicrobial resistant organisms.

• Journal of Yeungnam Medical Science
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• v.16 no.1
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• pp.60-68
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• 1999

A nationwide survey was conducted to investigate the annual occurrence rate of neonatal sepsis, maternal risk factors in neonatal sepsis, localized infection in neonates, causative organisms in nosocomial infection and the most common causative organism for neonatal sepsis in Korea. Clinical and bacteriological data wele collected from 37 neonatal units to perform retrospective review of the medical records of the newborn infants who were confirmed as having neonatal sepsis and whose blood culture was collected to isolate organisms for one year study period from January to December in 1997. 78,463 neonates were born at 37 hospital in 1997, and 20,869 neonates were admitted to the neonatal units, During this period, 772 episodes of neonatal sepsis were recorded in 517 neonates. The occurrence rate of neonatal sepsis was 0.73%(0~2.95%). Male to female ratio was 1.15:1, and 303 cases(42.1%) were born prematurely. The main pathogens of early onset of sepsis were S. aureus(20%), S. epidermidis(14.4%) and coagulase negative staphylococcus(14. 4%). Gram negative bacilli including Enterobacter spp (7.2%), E. coli(5.1%), Klepstella(4.5%), Pseudomonas(3.7%) and Enterobacter faectum(3.6%) accounted for 24.1% of sepsis. Group B beta-hemolytic streptococcus were isolated only in two cases. Common obstetric factors were PROM(21.1%), difficulty delivery(18.7%), fetal tachycardia(5.3%), chorioamnionitis(4.9%), and maternal fever(4.7%). The main pathogens of late-onset sepsis were S. aureus(22.3%), S. epidermidis(20.4%) and CONS(9.9%). There were 6 cases(1.0%) of Candida sepsis, Frequent focal infections accompanying sepsis were pneumonia(26.1%), urinary tract infection(10.5%), meningitis(8.2%), and arthritis(3.6%), S. epidermidis(22.0%) and s. aureus(21.7%) were also the most common pathogens in 373 nosocomial infection.

• Pediatric Infection and Vaccine
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• v.24 no.2
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• pp.71-78
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• 2017

Purpose: The aim of this study was to identify the pathogens of blood stream infection (BSI) in children with hemato-oncologic disorders, to analyze susceptibility patterns of microorganisms to guide empirical antimicrobial therapy, and to compare temporal trends of the pathogen and antimicrobial susceptibility with those of previous studies. Methods: We retrospectively analyzed the medical records of children with hemato-oncologic disorders whose blood culture grew pathogens at the Seoul National University Children's Hospital between 2011 and 2015. Results: A total of 167 patients developed 221 episodes of bacteremia. Among 229 pathogens, gram-negative bacteria (GNB) accounted for 69.0% (64.0% in 2002 to 2005, 63.4% in 2006 to 2010); gram-positive bacteria (GPB) accounted for 28.8% (31.3% in 2002 to 2005, 34.6% in 2006 to 2010); and fungus accounted for 2.2%. Among GNB, Klebsiella species (53.2%, 84/158) and Escherichia coli (19.6%, 31/158) were common. Staphylococcus aureus (48.5%, 32/66) and viridans streptococci (21.2%, 14/66) were frequently isolated among GPB. The susceptibilities of oxacillin and vancomycin in GPB were 54.8% and 96.9% (51.5% and 95.5% in 2002 to 2005; 34.1% and 90.5% in 2006 to 2010), respectively, whereas in GNB, the susceptibilities of cefotaxime, piperacillin/tazobactam, and imipenem were 73.2%, 77.2%, and 92.6% (75.9%, 82.8%, and 93.4% in 2002 to 2005; 62.8%, 82.9%, 93.8% and in 2006 to 2010), respectively. There were no significant differences in the proportion of etiologic agents or the antimicrobial susceptibilities between the current study and that of the previous two studies from 2002 to 2010. Overall fatality rate was 13.1%. Conclusions: GNB predominated in BSI among children with hemato-oncologic disorders. The etiology of bacteremia and antimicrobial susceptibility were comparable to those of the previous studies. Thus, piperacillin/tazobactam can be used as the initial empirical antimicrobial agent in febrile neutropenia.

• Journal of Preventive Medicine and Public Health
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• v.16 no.1
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• pp.41-50
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• 1983

The incidence of sexually transmitted disease, especially gonorrhoea has risen despite the progress in its diagnosis and treatment. For the effective control programs of sexually transmitted disease, it should be required socio-medical approaches. A study on gonorrhoea and penicillinase-producing Neisseria gonorrhoeae(PPNG) was conducted in Jeonju and Kunsan area from March, 1982 through August, 1982. The 221 entertrainers were studied in order to determine the prevalences of gonorhoea and PPNG. Socio-demographic informations of the entertainers were obtained by interviewing them. Gonococci were cultured on Thayer-Martin enrichment media for isolation, and PPNG was confirmed using beta-lactamase reagent ($PADAC^{tm}$ Beta-Lactamase Test Strips, Galbiochem-Behring). The results of the study are summarized as follows; 1. The average age of the entertainers studied was $26.1{\pm}4.7$ years. 2. The average years of working in entertaining business was $2.4{\pm}1.4$ years, and the average income per month was $239,592{\pm}90,480$ won. On the education level, 70.6% of the entertainers were middle or high school graduates 3. 47.5% of the entertainers were using contraceptives. 90.5% have experienced artificial abortion. 4. 37(16.7%) out of 221 entertainers were revealed to gonorrhoea, and 13 (35.1%) of gonorrhoea patients were by PPNG. 5. The prevalence rates of gonorrhoea and the proportion of PPNG by age were not significant statistically. Meanwhile, the colelations between the rates of gonorrhoea and education, frequency of love-making with customers and type of sexual partner were highly significant statistically. 6. 37 strains of gonococci isolated were almostly resistant to several antimicrobial agents, especially amikacin, clindamycin and chloramphenicol. Furthermore PPNG strains were completely resistant to not only above drugs but also penicillin.

• Journal of Food Hygiene and Safety
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• v.29 no.2
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• pp.123-130
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• 2014

A simultaneous determination was developed for 9 aminoglycoside antibiotics (amikacin, apramycin, dihydrostreptomycin, gentamicin, hygromycin B, kanamycin, neomycin, spectinomycin, and streptomycin) in meat by liquid chromatography tandem mass spectrometry (LC-MS/MS). Each parameter was established by multiple reaction monitoring in positive ion mode. The developed method was validated for specificity, linearity, accuracy, and precision based on CODEX validation guideline. Linearity was over 0.98 with calibration curves of the mixed standards. Recovery of 9 aminoglycosides ranged on 60.5~114% for beef, 60.1~112% for pork and 63.8~131% for chicken. The limit of detection (LOD) and limit of quantification (LOQ) were 0.001~0.009 mg/kg and 0.006~0.03 mg/kg, respectively in livestock products including beef, pork and chicken. This study also performed survey of residual aminoglycoside antibiotics for 193 samples of beef, pork and chicken collected from 9 cities in Korea. Aminoglycosides were not found in any of the samples.

• Journal of Food Hygiene and Safety
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• v.32 no.2
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• pp.147-153
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• 2017

The purpose of this study was to isolate Escherichia coli from flies and to assess pathogenic genes and antibiotic resistance of the isolates. A total of 188 flies were captured in agricultural environment including fruits farms (n = 19), fermented soybean farms (n = 9), municipal waste (n = 46), livestock farms (n = 66), slaughterhouses (n = 38), and manure ground (n = 10). E. coli isolates of captured flies were tested for pathogenic gene and antibiotic resistance using PCR methods and VITEK2 systems. As a result, E. coli from 63% (119/188) of the captured flies has been detected, and the detection rate of E. coli was the highest (89%, 31/34) in flies captured at particular slaughterhouse. Of the 34 isolates, 94% (32/34) were pathogenic gene (ST gene) positive. Twenty-six percent (31/119) of the E. coli isolates were observed being resistant to one or more antibiotics. Markedly, one of E. coli isolates from Livestock farms was resistant to 7 antibiotics including ampicillin, ampicillin/sulbactam, cefazolin, cefotaxime, gentamicin, levofloxacin, and trimethoprim/sulfamethoxazole. In addition, it was ESBL positive. The results of the present study may suggest a risk of transmission of pathogenic and antimicrobial resistant bacteria from flies to livestock environment Therefore, it may need to prevent introducing flies into the agricultural production environment for safe food production.