• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제19권1호
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• pp.54-60
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• 2016

Purpose: The aim of this study is to investigate the association between elevated alanine aminotransferase (ALT) and urosepsis in children with acute pyelonephritis (APN). Methods: We retrospectively identified all children who were managed in our hospital with APN during a decade period. In our study a diagnosis of APN was defined as having a positive urine culture and a positive (99m)Tc-dimercaptosuccinic acid scintigraphy. We compared those with elevated ALT and those with normal ALT according to the following variables: age, gender, duration of fever prior to admission, presence of hypotension, C-reactive protein (CRP), creatinine, presence of anemia, white blood cells count, platelet count, blood culture result, and grades of vesicoureteral reflux. In addition, the correlation between elevated ALT and positive blood culture was analyzed in detail. Results: A total of 996 children were diagnosed with APN, of which 883 were included in the study. ALT was elevated in 81 children (9.2%). In the analysis of demographic characteristics, the number of children with elevated ALT was higher in children between 0 to 3 months, boys, and in those with positive blood culture (p=0.002, 0.036, and 0.010, respectively). In multivariate analysis of variables associated with positive blood culture, age younger than 3 months, elevated ALT, elevated CRP, and elevated creatinine showed statistical significance (p=0.004, 0.030, 0.043, and 0.044, respectively). Conclusion: Our study demonstrates the association between elevated ALT and increased prevalence of urosepsis in addition to elevated CRP, elevated creatinine, and age younger than 3 months in children with APN.

• 대한임상검사과학회지
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• 제50권4호
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• pp.414-421
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• 2018

본 연구에서는 일개 대학병원에서 2년간 분리된 혈액배양 양성배지에서 MALDI-TOF MS system을 이용하여 Gram-positive bacilli를 동정한 결과를 균종별, 분기별로 분석하였다. Corynebacterium striatum은 총 89균주 중 66균주 (74.2%), Bacillus cereus는 60균주 중 44 균주 (73.3%), Listeria monocytogenes는 25균주 중 25균주 (100%)로 2.0이상의 높은 스코어에서 동정되었다. 미 동정 된 균주는 303균주 중 293균주는 혈액배양에서 1회 분리 균주로 감염균으로서의 의의가 없는 오염 균주로 간주되었다. 감염균으로서 의의가 있는 동일 환자 2회 이상 분리 균주 대상 16S-rRNA sequencing 비교결과 총 50균주 중 43균주가 일치해 86.0% 동정이 가능하였다. 일치하지 않은 7균주 중 5균주는 MALDI-TOF MS로도 동정이 되지 않았다. 결론적으로 혈액배양에서 Gram-positive bacilli가 동정되는 경우, 일차적으로 MALDI-TOF MS를 이용하여 동정해보고 이를 활용한다면 어렵고 비용이 많이 들던 Gram-positive bacilli 동정이 저비용으로 더욱 간편하고 정확해지며, Gram-positive bacilli에 의한 감염 진단에도 도움이 될 것으로 판단된다.

• Journal of Microbiology
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• 제43권3호
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• pp.257-259
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• 2005

Although automated continuous-monitoring blood culture systems are both rapid and sensitive, false-positive and false-negative results still occur. The objective of this study, then, was to evaluate negative results occurring with BacT/Alert 3D blood culture systems. A total of 1032 samples were cultured with the BacT/Alert 3D automated blood culture system, using both aerobic (BPA) and anaerobic (BPN) media, and 128 of these samples yielded positive results. A total of 904 negative blood samples were then subcultured in $5\%$ sheep blood agar, eosin methylene blue, chocolate agar, and sabouraud-dextrose agar. Organisms growing on these subcultures were subsequently identified using both Vitek32 (bioMerieux, Durham, NC) and conventional methods. Twenty four $(2.6\%)$ of the 904 subcultures grew on the subculture media. The majority $(83.3\%)$ of these were determined to be gram-positive microorganisms. Fourteen $(58.3\%)$ were coagulase-negative staphylococci, two $(8.3\%)$ were Bacillus spp., one $(4.2\%)$ was Staphylococcus aureus, and one $(4.2\%)$ was identified as Enterococcus faecium. Streptococcus pneumoniae and Neisseria spp. were isolated together in two $(8.3\%)$ vials. Gram-negative microorganisms comprised $12.5\%$ of the subcultures, of which two $(8.3\%)$ were found to be Pseudomonas aeruginosa, and one $(4.2\%)$ was Pseudomonas fluorescens. The other isolate $(4.2\%)$ was identified as Candida albicans. We conclude that the subculture of negative results is valuable in the BacT/Alert 3D system, especially in situations in which only one set of blood cultures is taken.

• Clinical and Experimental Pediatrics
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• 제57권4호
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• pp.178-185
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• 2014

Purpose: Blood culture is the most important tool for detecting bacteremia in children with fever. However, blood culture contamination rates range from 0.6% to 6.0% in adults; rates for young children have been considered higher than these, although data are limited, especially in Korea. This study determined the contamination rate and risk factors in pediatric patients visiting the emergency room (ER) or being admitted to the ward. Methods: We conducted a retrospective chart review of blood cultures obtained from children who visited Yonsei Severance Hospital, Korea between 2006 and 2010. Positive blood cultures were labeled as true bacteremia or contamination according to Centers for Disease Control and Prevention/National Healthcare Safety Network definitions for laboratory-confirmed bloodstream infection, after exclusion of cultures drawn from preexisting central lines only. Results: Among 40,542 blood cultures, 610 were positive, of which 479 were contaminations and 131 were true bacteremia (overall contamination rate, 1.18%). The contamination rate in the ER was significantly higher than in the ward (1.32% vs. 0.66%, P<0.001). The rate was higher in younger children (2.07%, 0.94%, and 0.61% in children aged <1 year, 1-6 years, and >6 years, respectively). Conclusion: Overall, contamination rates were higher in younger children than in older children, given the difficulty of performing blood sampling in younger children. The contamination rates from the ER were higher than those from the ward, not accounted for only by overcrowding and lack of experience among personnel collecting samples. Further study to investigate other factors affecting contamination should be required.

• 고신대학교 의과대학 학술지
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• 제33권3호
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• pp.337-346
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• 2018

Objectives: Serum procalcitonin (PCT) is a specific biomarker that rises after bacterial infection, and levels of PCT are known to correlate with the severity and mortality of patients with pneumonia and sepsis. However, the usefulness of PCT levels in acute pyelonephritis is unknown. This study aimed to evaluate the effectiveness of using the PCT level as a predictive test for bacteremia in acute pyelonephritis. Methods: Between January 2012 and June 2013, 140 patients diagnosed with acute pyelonephritis were admitted to Haeundae Paik Hospital. Serum PCT, C-reactive protein (CRP), and white blood cell (WBC) levels at pre- and post- treatment were measured. Blood and urine cultures were obtained from all patients. The levels of PCT, CRP, and WBCs were each compared between the blood culture-positive and blood culture-negative groups to assess their effectiveness in predicting bacteremia. Results: Pre-treatment PCT level was 0.77 ng/mL (95% CI: 0.42-1.60 ng/mL) in the blood culture-negative group and 4.89 ng/mL (95% CI: 2.88-9.04 ng/mL) in the blood culture-positive group, and the increase between the two groups was statistically significant. The area under the receiver operating characteristic curve of PCT level for prediction of bacteremia was 0.728. A cut-off value of 1.23 ng/mL indicated a sensitivity of 79.0 % and specificity of 60.0 % for PCT level. Conclusions: Serum PCT level is a useful predictive test for bacteremia in acute pyelonephritis. Through the early detection of bacteremia, serum PCT level can help estimate the prognosis and predict complications such as sepsis.

• 한국산학기술학회논문지
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• 제10권9호
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• pp.2516-2522
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• 2009

본 연구는 혈액에서 분리되는 미생물의 균종과 항균제 감수성 검사 결과 양상은 환자의 일반적 특성에 따라 다르므로 혈액배양 결과를 분석한 자료는 감염증 환자의 경험적 치료를 위한 중요한 근거가 되고, 특히 ESBL을 생성하는 균주의 경우 항균제의 사용과도 밀접한 관련이 있어 이 연구를 하게 되었다. 혈액배양 결과와 항균제 내성 결과를 분석한 결과는 다음과 같다. 1. 39.305건의 혈액배양이 의뢰되어 양성 환자 수는 2,216명(20.0%)이었고, 이중에서 ESBL양성 환자 수는 40명 이었으며, 혈액배양 양성은 4,798건(12.2%)이었으며 ESBL양성 균주는 86건(중복 배양 균주 포함)이었다. 2. ESBL을 생성하는 세균 중에서 분리된 균종은 E. coli, K. pneumoniae, K. oxitoca의 순 이었다. 3. 성별로는 여자가 다소 많았고, 연령별로는 50세 이상의 군에서 E. coli, 1세 미만의 군에서는 K. pneumoniae, K. oxitoca 의 분리가 많았고, 지역별로는 충청남도 13명(32.5%)로 가장 많았다. 4. 3년간 일개대학병원의 혈액배양에서 ESBL양성인 균종 중 가장 흔히 분리되는 것은 E. coli이고, K. pneumoniae, K. oxitoca 등이 다음으로 분리 되었고, 50세 이상의 환자에서 E. coli의 분리 비율이 높았다.

• Journal of Chest Surgery
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• 제13권1호
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• pp.48-51
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• 1980

Open heart surgery patients have additional risks arising from the special nature of the operative procedure. And postoperative infections in patients with extracorporeal circulation are associated with high incidence of serious sequelae. To investigate the incidence and organisms of contamination, and the relation between the duration of extracorporeal circulation and contamination, following study was done. Eighty-four of the open heart surgery patients were examined with cultures from the blood and priming solution before and after bypass. 1. Cultures before bypass were sterile, but 2 cases of cultures from the blood and priming solution after bypass were positive, and culture positive group was 5% of all patients. 2. The organisms were Gram-negative, aerobic coliform bacilli; 3. The culture positive group had significantly longer bypass time.

• 대한임상검사과학회지
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• 제51권2호
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• pp.155-163
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• 2019

검사는 2010년부터 2017년까지 162,551 검체중 11,233 검체(6.9%)가 배양 양성이었으며, 이중 11,865 균주가 배양되었다. 배양된 균종 중 그람양성구균이 47.8%, 그람음성간균 38.8%, 그람양성간균 4.2%, 진균 6.8%, 혐기성균이 2.3%를 나타냈다. 배양결과를 성별로 비교하면 남성에서 분리된 균이 55.0% (2,732/4,969)로 여성에서 분리된 45.0% (2,237/4,969) 보다 많았다. 또한 연령별로는 70대가 28.7% (1,426/4,969)로 가장 많이 분리되었으며, 10대의 1.2% (62/4,969)와 많은 차이를 보였다. MRSA에 대한 내성률은 2016년 66.7%에서 2017년에는 46.8%로 많은 감소를 보였으며, E. faecium의 vancomycin 내성률은 35.0% (48/137)로 나타났다. 한편 장내세균에서 E. coli의 ESBL 양성률은 2010년 17.2%에서 2017년 28.8%로 증가하였으나, K. pneumoniae에서는 오히려 양성률이 감소하였다. P. aeruginosa의 MRPA는 11.8% (14/119), A. baumannii에서의 MRAB는 64.3% (161/252)로 높은 내성을 나타내었다. 혈액 검체에서 분리되는 미생물의 균종과 항균제 감수성 양상은 시기, 지역 및 대상환자 등에 따라 다르므로 병원균을 주기적으로 분석하고 이에 대한 항균제 감수성 정도의 변화양상을 파악하는 것이 병원에서 내성균의 감독과 조절에 큰 도움이 될 것으로 판단된다.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제31권1호
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• pp.31-38
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• 2005

Thorough screening of donors medical and social history, extensive serological and bacterial screening combined with developed processing and sterilization methods have improved the safety of the allogeneic tissues in recent decades. The risk of bacterial infection through allogenic tissue transplantation is one of the major problems facing tissue banks. The purpose study is to report the contamination rate in 358 retrieved tissues obtained strictly aseptic conditions, between 2001 and 2002 in Korea Tissue Bank. Samples from 9 donors(total 13 donors) were used in blood culture, and in 7 donors the blood culture were negative. Of the 358 tissues cultured in their entirety, 186(52%) were initially culture negative and 177(48%) were positive. Organism low pathogenicity were cultures from 20.2% of the tissues. To minimize the bacterial load, donors should be obtain in operating rooms, using aseptic techniques with only a few personnel for procurement. The procurement cultures from donors and retrieved tissues with multiple should be carefully interpreted. Blood cultures should be taken account, since these can help to find contamination not detect swab culture. A prospective cohort study is needed to determine which of the varied processing and sterilization methodologies gives the best quality.

• Journal of Microbiology
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• 제39권3호
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• pp.213-218
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• 2001

The treatment of Patients with bacteraemia and septicemia requires accurate and rapid identification of the pathogen so that the physician can be guided regarding the selection of the proper antimicrobial therapy. The usual procedure is to withdraw an aliquot of the positive blood culture sample for gram staining and subculturing on the media for the growth and subsequent identification, and susceptibility determinations. It was noticed that during the process some microbiologists would sniff the effluent gases that are products of metabolism and in some cases guess the identity of the bacterium. That Prompted us to engage in systematic investigation of two gram positive and two gram negative bacteria using an electronic nose that had been proven successful in distinguishing the aroma of coffee beans from different sources. The investigation was successful in illustrating the efficacy of such a device in this clinical setting to distinguish Escherichia coli, Pseudomonas aeruginosa, Staphylococcus aureus and Enterococcus faecalis. A representative set of patterns obtained with this apparatus is displayed as well. A representative set of patterns obtained with this apparatus is displayed as well. No effort was made to determine an optimal set of sensors for some specific set of bacterial metabolism gaseous products.