• Clinical and Experimental Pediatrics
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• 제62권6호
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• pp.235-239
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• 2019

Purpose: In Kawasaki disease (KD) patients, coronary artery complications, incomplete and refractory types occur more frequently in patients with streptococcal or other bacterial/viral infections. Recently, we observed a higher incidence of coronary lesions in KD patients with high anti-streptolysin O (ASO) titer. Therefore, we hypothesized that KD patients diagnosed with concurrent streptococcal infection have poor prognosis, with respect to treatment response and development of coronary artery lesions. Methods: A retrospective review was performed in 723 patients with KD who were admitted to 2 major hospitals between June 2010 and September 2017. Results: Among 723 patients with KD, 11 initially showed an elevated ASO titer (>320 IU/mL) or elevated follow-up ASO titer after treatment. Of these patients, 5 showed no response to the first intravenous immunoglobulin treatment, 3 had abnormalities of the coronary arteries. This is a significantly higher proportion of patients with a high ASO titer (n=3,27.3%) than those with a normal ASO titer (n=53 [7.4%], P=0.047). A severe clinical course was seen in 81.8% of patients in the high ASO group versus 14.5% of patients in the normal ASO group. Conclusion: It is not certain whether acute streptococcal infection may cause KD, but this study revealed that KD with high ASO titers showed higher rates of severe clinical course. It may be helpful to analyze concurrent streptococcal infection in patients with a severe clinical course.

• Pediatric Infection and Vaccine
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• 제10권2호
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• pp.143-144
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• 2003

• Molecules and Cells
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• 제41권6호
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• pp.495-505
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• 2018

Several bacterial etiological agents of streptococcal disease have been associated with fish mortality and serious global economic loss. Bacterial identification based on biochemical, molecular, and phenotypic methods has been routinely used, along with assessment of morphological analyses. Among these, the molecular method of 16S rRNA sequencing is reliable, but presently, advanced genomics are preferred over other traditional identification methodologies. This review highlights the geographical variation in strains, their relatedness, as well as the complexity of diagnosis, pathogenesis, and various control methods of streptococcal infections. Several limitations, from diagnosis to control, have been reported, which make prevention and containment of streptococcal disease difficult. In this review, we discuss the challenges in diagnosis, pathogenesis, and control methods and suggest appropriate molecular (comparative genomics), cellular, and environmental solutions from among the best available possibilities.

• Pediatric Infection and Vaccine
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• 제12권2호
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• pp.213-217
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• 2005

저자들은 건강하던 43일된 영아에서 신경학적 후유증으로 좌측 감각신경성 난청과 경련이 발생한 A군 ${\beta}$용혈성 연구균에 의한 뇌수막염 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Pediatric Infection and Vaccine
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• 제6권2호
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• pp.194-202
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• 1999

목 적 : 이전까지는 국내에서 발생 증례가 적었던 GBS 감염증이 최근에는 자주 접하게 되었다. 이에 최근 수년간의 발생 증례에 대한 고찰을 하여 그 임상적, 역학적 특성을 고찰하고자 하였다. 방 법 : 1985년 6월부터 1999년 6월까지 서울대학교 병원 소아과에서 균이 증명된 GBS 감염증 환아들을 대상으로 하였다. 이들의 의무 기록을 후향적으로 검토하였고, 분려된 일부 균주의 혈청형과 항균제 감수성을 경시하였다. 결 과 : 기간 별 증례 수를 비교해 보면, 1990년대 후반에 그 이전보다 증례가 많았다. 총 27례중 25례가 신생아 감염증이었고, 지발형이면서 뇌막염인 증례가 많았다. 혈청형은 III(6균주), Ib(6), Ia(1)와 II(1)였다. 검사된 10개의 항균제에 대하여 모든 균주가 감수성을 보였다. 결 론 : 국내에서 신생아 GBS 감염증은 증가하고 있는 추세이므로, 신생아 패혈증 또는 뇌막염의 원인균으로서 GBS의 가능성을 고려하여야 하며, 향후 빈도가 더욱 증가하면 산모에게 산전 검사와 예방적 항생제 요법 등을 고려해야 할 것으로 사료된다.

• Childhood Kidney Diseases
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• 제24권1호
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• pp.53-57
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• 2020

Streptococcus agalactiae or group B streptococcus (GBS) is associated with infections in neonates and pregnant women. Herein, we describe a rare case of GBS renal abscess with peritonitis and pleural effusion in a 17-year-old girl with type 1 diabetes mellitus. The girl was admitted due to fever and right flank pain. Laboratory findings included leukocytosis and increased C-reactive protein level and erythrocyte sedimentation rate. Her serum glucose level was 484 mg/dL. Urinalysis showed no pyuria. Renal sonography revealed parenchymal swelling in the right kidney. The patient was administered intravenous cefotaxime. Urine and blood cultures were negative. Fever seemed to improve, but the following day, she complained of abdominal pain and fever. Antibiotic was switched to imipenem, and abdominal and pelvic CT revealed a ruptured right renal abscess, peritonitis, and bilateral pleural effusion with atelectasis. Pigtail catheter drainage of the abscess was performed. Culture from the abscess was positive for GBS, and fever subsided 2 days after the drainage. She was discharged with oral cefixime. The clinical course of urinary tract infections (UTIs) can be atypical in patients with diabetes, and GBS can be a cause of UTIs. Prompt diagnosis and management are necessary to prevent complications in patients showing atypical courses.

• Journal of Microbiology
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• 제39권3호
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• pp.236-239
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• 2001

Group A Streptococcus strain ST4529 is a provisional new ems type which has been recently reported in Malaysia (Jomal, et al. 1999. Energ. Infect . Dis. 5,10-14). This strain was found to be opacity factor (OF) negative with a Tl phenotype. Usually, OF negative strains with T1 phenotypes are associated with acute rheumatic fever. However, strain ST4529 was isolated from the blood of a patient with septicemia. Comparison of the deduced amino acid sequence of the mature hypervariable N-terminus of ST4529 showed only 43% identity with that of M5, the closest matched OF negative strain with a T1 phenotype. Thus, ST4529 most probably encodes a new serospecifically unique M protein which is associated with septicemia rather than pharyngitis infections. The strains with these phenotypes are very important because their sequences should be considered for developing any anti-streptococcal vaccines.

• Pediatric Infection and Vaccine
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• 제14권1호
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• pp.104-110
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• 2007

연구균은 화농성 감염 및 비화농성 감염을 일으키며, 대개 수일의 잠복기를 걸쳐 발열, 등의 임상 증상과 함께 화농성 병변을 보인다. 화농성 병변은 부위 및 질환에 따라서 항생제와 외과적 처치를 적절히 조합하여야 하며, 외과적 처치가 필요한 경우는 이를 지체하여서는 안된다. 저자들은 다른 전신 증상의 동반없이 경부 종괴로 발현한 인두주위 농양 및 심한 전신 증상을 동반한 괴사성 근막염, 복통으로 발현된 괴사성 폐렴 각 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

• Childhood Kidney Diseases
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• 제19권2호
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• pp.184-189
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• 2015

Poststreptococcal glomerulonephritis (PSGN) is one of the most well-known and important infectious renal diseases resulting from a prior infection with group A ${\beta}$-hemolytic streptococcus. The typical clinical characteristics of the disease reflect acute onset with gross hematuria, edema, hypertension and moderate proteinuria after the antecedent streptococcal infection. In children, usually PSGN is healed spontaneously but if it combines with fast progressing glomerulonephritis, it would be developed to chronic renal failure. Therefore, it is important to make a fast diagnosis and treatment by simple tools to predict the course and the prognosis of disease. Sonography is a simple tool for diagnosis but there is no typical renal sonographic finding in PSGN, so it is difficult to predict the course and the prognosis of disease by sonographic findings. In comparison between two cases of renal sonographic findings in PSGN, a patient who showed more increased echogenicity in more extended area of renal sonography had the severe results of renal pathology, prolonged treatment period and low serum C3 level. Here, we report the different findings of renal sonography and pathology depending on the degree of severity between two patients. Thus, it is necessary to gather more information from further studies to make a consensus about the relationship between the renal sonography and the prognosis of disease in PSGN.

• Restorative Dentistry and Endodontics
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• 제20권2호
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• pp.549-576
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• 1995

Bacteria are one of the most important causative agents of the pulpal and periapical diseases. Streptococci are one of the most frequently isolated facultative anarerobic bacteria in the infected root canals. Bacterial cell wall components have a direct effect in the pathogenesis of the pulpal and periapical infections. Hyaluronidase produced by bacteria has been implicated in dissemination of the diseases. The purpose of this study was to evaluate the effect of cell wall extract of streptococci on the L929 cells using inverted microscope and the transmission electron microscopy (TEM). Hyaluronidase production of streptococcal strains were investigated to determine the correlation between the severity of cell damage and the activity of enzymes. Bacterial cell wall extracts of S. sanguis, S. mitis and S. uberis isolated from infected root canals and ATCC type strains of S. mutans (ATCC 10449) and E. faecalis (ATCC 19433) were prepared by sonication and confirmed with SDS-PAGE. Silver stain of SDS-PAGE of sonic extract was efficient at $100{\mu}g$/ml concentration of cell wall protein, while Coomasie blue stain was efficient at $100{\mu}g$/ml concentration. Inverted microscope showed that sonic extract-treated L929 cells were round and detached from the substratum while others lost their fibroblastic shapes. Transmission electron microscopic examination revealed that streptococcal extracts induced death of L929 cells. Sonic extracts of streptococci had variable effect on microstructure of L929 cells. significant chromatin condensation was observed in the nucleus of the cells. Disappearance of cell surface microvilli and nuclear fragments with dense chromatin were observed. The cell nucleus had an irregular shape and numerous large vacuoles were seen in the cytoplasm and some breaks of the cell membrane could be seen. Cell organelles were in various stages of destruction and cristae of mitochondria were disoriented or disappeared. Eighteen strains of streptococci did not produce hyaluronidase.