• Pediatric Infection and Vaccine
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• 제22권3호
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• pp.143-146
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• 2015

중동호흡기증후군 코로나바이러스(Middle East respiratory coronavirus, MERS-CoV)로 인한 질환은 2012년부터 보고되었다. 현재까지 대부분의 질환은 성인에서 발생하였으며 소아에 대한 보고는 매우 부족한 실정이다. 그리하여 본 연구에서는 소아에서 MERS-CoV 감염증의 역학적 특성과 임상 양상을 분석하였다. 전세계적으로 MERS-CoV에 감염된 소아는 34명이었으며(2015년 10월 29일 기준), 이는 전체 환자의 2.1%를 차지하였다. 소아 환자들의 중앙 연령은 13세(범위, 9개월부터 17세까지)이었으며, 성별이 보고된 자료(n=33) 중 57.6%가 남자였다. 전체 환자 중에서 약 반은 무증상 감염이었으며, 대부분의 증상이 있는 환자는 호흡기 증상을 동반하였다. MERS-CoV에 감염된 환자들의 예후는 대부분 양호하였으나, 사망한 환자는 4명이었으며 이 중 3명은 기저 질환이 있었다. 전세계적으로 소아에서 발생한 MERS-CoV 감염에 대한 보고 자료를 분석한 결과 MERS-CoV 감염은 소아에서 발생이 낮고 성인에 비해 예후가 좋은 것으로 나타났다.

• Neonatal Medicine
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• 제25권4호
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• pp.144-152
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• 2018

Purpose: The aim of this study was to investigate the clinical characteristics of Respiratory syncytial virus (RSV) infection during the neonatal period to provide information that is useful in clinical practice and suggest extension of the palivizumab administration. Methods: Neonates admitted to the National Health Insurance Service Ilsan Hospital neonatal intensive care unit due to respiratory symptoms and for whom multiplex reverse transcription-polymerase chain reaction and multiplex real time-polymerase chain reaction tests were performed between October 2011 and May 2016 were included in this study. Medical records were retrospectively reviewed, and data was collected for 156 neonates. Results: Among the 156 neonates, RSV was detected in 114 (73.1%), non-RSV in 25 (16%), and no virus in 17 (10.9%). The majority were full term infants (92.4%) and peak incidence of RSV infection was in January. Post-natal care center infection was more common in the RSV group (46.6%) than that in the other virus groups (24%, P=0.0243). Clinical symptoms were severe in the RSV group in contrast to that in the non-RSV or others groups. The RSV group frequently needed oxygen therapy (P=0.0001) and the duration of hospital stays were longer (P=0.0001). Conclusion: RSV is a significant cause of respiratory infection in neonates and the severity is higher in contrast to that with other viral causes of infection. Infants in post-natal care centers have a high-risk of developing RSV infections; therefore, palivizumab administration may be considered in this group to prevent hospitalization and reduce the duration of hospital stay.

• Journal of Nutrition and Health
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• 제52권3호
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• pp.258-267
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• 2019

본 연구는 한국인 건강한 성인에게서 12주간 동충하초 주정추출물의 섭취가 면역기능 증진 및 상기도감염 예방효과에 대해 확인하였다. 면역관련 지표인 NK-cell activity는 시험식품 섭취군이 플라세보군에 비해 유의적으로 증가하여 (p = 0.047) 면역증강 효과에 대해 확인하였다. 또한, 점막 면역에 주요 역할을 하는 항체 IgA 변화량은 시험식품 섭취군에서 플라세보군에 비해 통계적으로 유의하게 증가하였다 (p = 0.035). 본 연구대상자의 상기도감염(URI) 발생률은 시험식품 섭취군과 플라세보군, 두 군 간 유의한 차이는 관찰할 수 없었다. 안전성 평가인 진단검사의학 검사와 활력진후 결과에서도 섭취군 내 및 섭취군 간 의미 있는 변화 또는 차이는 관찰되지 않았다. 본 연구에서 동충하초주정추출물의 섭취가 URI 발생률에 대한 유의한 변화는 관찰할 수는 없었으나 면역지표인 NK-cell 활성 증가와 혈청 IgA 농도 증가를 통해 선천성 면역과 후천성 면역을 증진시키는 작용이 있어, 잠재적인 상기도감염 예방 효과에 관련성 있을 것으로 사료되며, 항생제의 약물 의존도를 낮추며 삶의 질 개선 및 국민보건 향상에 기여할 것으로 사료된다.

• Tuberculosis and Respiratory Diseases
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• 제60권5호
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• pp.571-575
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• 2006

최근 비결핵성 마이코박테리아 폐질환에 대한 관심이 증가되고 있으며 이에 대한 다양한 보고가 이뤄지고 있다. 외국 문헌에서는 M. avium 감염의 대표적인 임상상인 상엽 공동형과 결절성 기관지 확장증 형과는 다른 형태의 M. avium 기관지 질환이 후천성 면역 결핍증 환자뿐만 아니라 면역 적격자인 건강한 성인에서도 드물게 보고 되고 있으나, 국내에서는 지금까지 이에 대한 보고가 없었다. 본 저자들은 이전 폐질환이 없는 건강한 면역 적격자에서 M. avium 감염에 의한 기관지 질환을 경험하고 이 환자의 임상적인 소견과 경과를 문헌 고찰과 함께 보고하는 바이다.

• 한국임상약학회지
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• 제22권1호
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• pp.47-54
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• 2012

목적: 급성 상기도 감염에 사용되는 항생제 처방유형을 조사하여 항생제 사용을 개선하는데 있다. 방법: 2011년 1월부터 6월까지 경상대학교 병원을 포함한 10개 국립대학병원을 대상으로 급성 상기도 감염에 사용한 항생제 처방율을 조사하고, 경상대학교병원에서 급성 상기도 감염에 사용한 2011년 1월부터 6월까지의 외래환자를 대상으로 항생제 처방 내역을 전자의무기록을 통하여 후향적으로 분석한 후 처방의를 대상으로 항생제 사용 적정성 검토를 위한 그룹미팅 및 교육, 급성 상기도 감염에 항생제 처방 시 경고 안내문을 보여주는 등 중재활동 후 2011년 12월에 처방유형을 조사 하였다. 결과: 경상대학교병원에서 2011년 1월부터 6월까지 급성 상기도 감염에 항생제 사용은 1739명의 상기도 감염 외래환자 중에서 874명 (42.3%)으로 나타났다. 진료과별 급성 상기도 감염에 대한 항생제 처방은 소아과, 이비인후과, 내과, 응급의학과, 호흡기내과, 흉부외과 등에서 처방하였으며 소아과에서 1044명의 상기도 감염환자 중 556건(53.3%)로 가장 빈번하게 사용하였으며 처방율은 이비인후과에서 58.9% (225/382)로 가장 높았다. 사용한 항생제로는 amoxicillin-clavulanic acid가 371례 (36.3%)로 가장 빈번하게 처방된 약제이며, azithromycin이 85례 (9.7%) 처방되었다. 급성 상기도 감염 중 급성 편도염에 항생제 처방율이 가장 높았으며 (70.8%, 80/113), 급성 인두염에 가장 빈번하게 사용되었다 (61.1%, 319/522). 균동정을 위한 혈액배양 의뢰 건수는 1739 상기도 감염 환자 중 15명 (항생제 미사용 4명, 사용 11명)이 의뢰되었으며 모두 음성이었다. 중재활동 후 2011년 12월 상기도 감염에 항생제 처방건수는 소아과에서 1건, 이비인후과에서 2건으로 나타났다. 결론: 처방의를 대상으로 적절한 항생제를 사용을 권장하는 지속적인 교육 및 항생제 처방시 경고 안내문을 띄우는 등의 중재활동과 지속적인 모니터링 및 피드백은 급성 상기도 감염에 있어서 항생제 처방유형에 변화를 보였다.

• Clinical and Experimental Pediatrics
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• 제55권2호
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• pp.42-47
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• 2012

$Mycoplasma$ $pneumoniae$ (MP), the smallest self-replicating biological system, is a common cause of upper and lower respiratory tract infections, leading to a wide range of pulmonary and extra-pulmonary manifestations. MP pneumonia has been reported in 10 to 40% of cases of community-acquired pneumonia and shows an even higher proportion during epidemics. MP infection is endemic in larger communities of the world with cyclic epidemics every 3 to 7 years. In Korea, 3 to 4-year cycles have been observed from the mid-1980s to present. Although a variety of serologic assays and polymerase chain reaction (PCR) techniques are available for the diagnosis of MP infections, early diagnosis of MP pneumonia is limited by the lack of immunoglobulin (Ig) M antibodies and variable PCR results in the early stages of the infection. Thus, short-term paired IgM serologic tests may be mandatory for an early and definitive diagnosis. MP infection is usually a mild and self-limiting disease without specific treatment, and if needed, macrolides are generally used as a first-choice drug for children. Recently, macrolide-resistant MP strains have been reported worldwide. However, there are few reports of apparent treatment failure, such as progression of pneumonia to acute respiratory distress syndrome despite macrolide treatment. The immunopathogenesis of MP pneumonia is believed to be a hyperimmune reaction of the host to the insults from MP infection, including cytokine overproduction and immune cell activation (T cells). In this context, immunomodulatory treatment (corticosteroids or/and intravenous Ig), in addition to antibiotic treatment, might be considered for patients with severe infection.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제23권1호
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• pp.35-48
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• 2020

Purpose: Gastrointestinal symptoms are often related to antibiotic treatment. Their incidence, risk and protective conditions in children are not well defined and represent the aims of this study. Methods: We prospectively enrolled inpatient children submitted to antibiotic treatment. Indication, type, dose and duration of treatment, probiotic supplementation and gastrointestinal symptoms were recorded at recruitment, after two and four weeks. Antibiotic-associated diarrhea (AAD) was defined as the presence of at least 3 loose/liquid stools within 14 days from antibiotic onset. Results: AAD occurred in 59/289 (20.4%) of patients, with increased risk in children younger than 3 years (relative risk [RR]=4.25), in lower respiratory (RR=2.11) and urinary infections (RR=3.67), intravenous administration (RR=1.81) and previous AAD episodes (RR=1.87). Abdominal pain occurred in 27/289 (9.3%), particularly in children >6 years (RR=4.15), with previous abdominal pain (RR=7.2) or constipation (RR=4.06). Constipation was recorded in 23/289 (8.0%), with increased risk in children having surgery (RR=2.56) or previous constipation (RR=7.38). Probiotic supplementation significantly reduced AAD (RR=0.30) and abdominal pain (RR=0.36). Lactobacillus rhamnosus GG (LGG) and L. reuteri significantly reduced AAD (RR=0.37 and 0.35) and abdominal pain (RR=0.37 and 0.24). Conclusion: AAD occurred in 20.4% of children, with increased risk at younger age, lower respiratory and urinary tract infections, intravenous treatment and previous AAD. LGG and L. reuteri reduced both AAD and associated abdominal pain.

• Journal of Microbiology and Biotechnology
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• 제28권10호
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• pp.1730-1735
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• 2018

Bacterial pneumonia is one of the most common causes of mortality in Korea. In 2016, the mortality rate from pneumonia was 16,476 deaths per 100,000, which was an 11% increase from the previous year. The aim of our study was to determine the distribution of the bacterial pathogens causing respiratory symptoms in different age groups over a 10-year period. Between January 2008 and September 2017, 1,861 specimens from 1,664 patients admitted to Dankook University Hospital with respiratory symptoms were examined. We used multiplex polymerase chain reaction (PCR) to detect six bacterial pneumonia pathogens: Bordetella pertussis, Chlamydophila pneumoniae, Haemophilus influenzae, Legionella pneumophila, Mycoplasma pneumoniae, and Streptococcus pneumoniae. We detected bacterial pneumonia pathogens in 1,281 (68.83%) specimens. Of the 1,709 pathogens detected, S. pneumoniae was the most common (48.57%; n = 830) followed by H. influenzae (40.08%; n = 685). Most infections were found among children younger than 10 years (92.69%; n = 1,584). Although S. pneumoniae was the most common pathogen detected in all age groups, M. pneumoniae infection increased in prevalence with age (p < 0.05). The rate of co-infection was also high among these patients (31.1%; n = 399), which peaked in 2015 (54.55%; n = 42/77). The prevalence of bacterial pneumonia in Cheonan, along with the proportion of co-infections among patients increased over the 10-year study period. The findings will aid the development of treatment and prevention guidelines.

• 한국동물위생학회지
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• 제38권1호
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• pp.1-7
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• 2015

This study was investigated to diagnose pathogenic organisms of atrophic piglets in northern area of the Gyeongnam province, Korea. Samples such as feces, blood and necropsy specimens of 42 atrophic piglets (${\leq}10$ weeks old) were taken from May to December 2013 for this survey. Samples were examined by reverse transcriptase-polymerase chain reaction (RT-PCR) assay and bacteria isolation for detection of pathogenic agents. 93 pathogens were isolated from 42 samples can be classified into ll groups. We identified bacterial agents in 56 cases (60.2%) and viral agents in 31 cases (33.3%). However, 6 cases (6.5%) were undetected. Among these pathogens, the most prevalent disease were porcine reproductive and respiratory syndrome (PRRS) in 22 cases (23.7%). The major diseases were Colibacillosis in 15 cases (16.1%), Glasser's disease in 12 cases (12.9%), and porcine epidemic disease (PED) in 9 cases (9.7%). Mixed infections were accounted for 77.8% of atrophic piglets. In particular, the rate of mixed infections with PRRS virus showed the highest frequency (71.4%). In addition, there is a seasonal variation. Viral pathogens were dominantly detected in winter, but in the rest of the season bacterial agents were mainly detected. Gastrointestinal diseases occurred mainly in the pre-weaning piglets, the respiratory diseases and wasting diseases occurred mainly in the post-weaning piglets.

• Journal of Microbiology
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• 제44권4호
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• pp.375-382
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• 2006

From its initial colonization to causation of disease, Streptococcus pneumoniae has evolved strategies to cope with a number of stressful in vivo environmental conditions. In order to analyze a global view of this organism's response to heat shock, we established a 2-D electrophoresis proteome map of the S. pneumoniae D39 soluble proteins under in vitro culture conditions and performed the comparative proteome analysis to a 37 to $42^{\circ}C$ temperature up-shift in S. pneumoniae. When the temperature of an exponentially growing S. pneumoniae D39 culture was raised to $42^{\circ}C$, the expression level of 25 proteins showed changes when compared to the control. Among these 25 proteins, 12 were identified by MALDI-TOF and LC-coupled ESI MS/MS. The identified proteins were shown to be involved in the general stress response, energy metabolism, nucleotide biosynthesis pathways, and purine metabolism. These results provide clues for understanding the mechanism of adaptation to heat shock by S. pneumoniae and may facilitate the assessment of a possible role for these proteins in the physiology and pathogenesis of this pathogen.