• Clinical and Experimental Pediatrics
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• v.49 no.10
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• pp.1116-1119
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• 2006

Pyomyositis is a primary bacterial infection of the skeletal muscles. Although infection can affect any skeletal muscle, the large muscle groups such as the quadriceps or gluteal muscles are most often the focus of this disease, and most commonly the inflammation is focal, involving a single muscle. The mechanism of pyomyositis is poorly understood. The local mechanical trauma at the time of an incidental bacteremia is frequently postulated as a mechanism that could explain the high incidence of the disease in tropical areas and its male preponderance. Staphylococcus aureus is the most common organism responsible for pyomyositis. Mycobacterium tuberculosis primarily affects the lungs, and the prevalence of active pulmonary tuberculosis co-existing with musculoskeletal tuberculosis has been about 30 percent. We report here on a case of an otherwise healthy 17-month-old girl, who had tuberculous pyomyositis at the upper arm after the hepatitis A vaccination with no evidence of any coexistent active tuberculosis.

• The Journal of the Korea institute of electronic communication sciences
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• v.12 no.4
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• pp.707-714
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• 2017

There have recently been an increasing number of reports claiming that the periodontal disease, the most typical oral disease, is closely associated with various systemic diseases such as cardiovascular disease. Therefore, it is imperative to explore the methods that can ensure effective and cost-effective monitoring of periodontal disease in specific population groups, as well as individuals in the electronic medical record environment. However, traditional periodontal examination methods, such as periodontal probe, are considerably demanding and time-consuming for dental specialists, and furthermore, cause the risk of bacteremia as they are invasive procedures. Thus, the objective of this study was to validate the capability of new method for screening the periodontal disease using the self-reported questionnaire for periodontitis which is the non-invasive procedure to replace radiography.

• Tuberculosis and Respiratory Diseases
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• v.42 no.1
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• pp.105-109
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• 1995

Pulmonary involvement of salmonella infection is very rare and only one case of salmonella empyema had been reported in Korea. A 53-year-old woman presented to Kyung Hee Medical Center with 2-months history of left chest pain and mild fever. 3 months prior to admission, the patient was taken to laparoscopic laser cholecystectomy due to gall stone in other hospital. Chest X-ray taken on admission day showed pneumonic infiltration at left lower lung field with pleural effusion. Salmonella Group B was identified from the cultures of stool, blood, and pleural fluid. After consecutive therapy with two weeks of ceftriaxone and three weeks of ciprofloxacin combined with repeated pleural aspirations, the patient was recovered and discharged. But she was readmitted two months later due to fever and generalized malaise. The result of blood culture showed growth of Salminella Group B. The excisional biopsy of right supraclavicular lymph node disclosed necrotizing lymphadenitis. She was recovered clinically and no more bacteremia occurred after two weeks of ciprofloxacin therapy. We present very rare case of empyema due to salmonella infection and review the pertinent literature.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.7
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• pp.3423-3426
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• 2016

Background: Sepsis is an emergency condition with high mortality and morbidity rate. There are limited data on the association of cancer as a risk factor for mortality in sepsis patients in the emergency department (ED). Materials and Methods: This retrospective study was conducted at the ED, Faculty of Medicine, Ramathibodi Hospital, Bangkok, Thailand. The study period was between January 1st and December $31^{st}$, 2014. The inclusion criteria were as follows: adult patients over 15 years of age who presented at the ED with suspicion of sepsis, received treatment at the ED, and whose blood culture was found to be positive. Clinical data were recorded from medical records including the Mortality in Emergency Department Sepsis score (MEDS score). The primary outcome of this study was mortality at one month. Multivariate logistic regression analysis was used to identify independent factors associated with death. Results: During the study period, there were 775 eligible patients. The two most common pathogens identified from blood cultures were Staphylococcus aureus (193 patients; 24.9%) and Escherichia coli (158 patients; 20.4%). At one month after presenting at the ED, 110 patients (14.2%) had died. There were four significant factors for death, having cancer, being on an endotracheal tube, initial diagnosis of bacteremia, and high MED scores. Having cancer had an adjusted OR of 2.12 (95% CI of 1.29, 3.47). Conclusions: Cancer patients have double the risk of mortality if presenting with sepsis at the ED.

• Journal of Korean Neurosurgical Society
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• v.46 no.2
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• pp.123-129
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• 2009

Objective: This study was aimed to identify the incidence and risk factors of vancomycin-resistant enterococcus (VRE) colonization in neurosurgical practice of field, with particular attention to intensive care unit (ICU). Methods: This retrospective study was carried out on the Neurosurgical ICU (NICU), during the period from January. 2005 to December. 2007, in 414 consecutive patients who had been admitted to the NICU. Demographics and known risk factors were retrieved and assessed by statistical methods. Results: A total of 52 patients had VRE colonization among 414 patients enrolled, with an overall prevalence rate of 6.1%. E. faecium was the most frequently isolated pathogen, and 92.3% of all VRE were isolated from urine specimen. Active infection was noticed only in 2 patients with bacteremia and meningitis. Relative antibiotic agents were third-generation cephalosporin in 40%, and vancomycin in 23%, and multiple antibiotic usages were also identified in 13% of all cases. Multivariate analyses showed Glasgow coma scale (GCS) score less than 8, placement of Foley catheter longer than 2 weeks, ICU stay over 2 weeks and presence of nearby VRE-positive patients had a significantly independent association with VRE infection. Conclusion: When managing the high-risk patients being prone to be infected VRE in the NICU, extreme caution should be paid upon. Because prevention and outbreak control is of ultimate importance, clinicians should be alert the possibility of impending colonization and infection by all means available. The most crucial interventions are careful hand washing, strict glove handling, meticulous and active screening, and complete segregation.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.2
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• pp.1115-1119
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• 2013

Background: Febrile neutropenia (FN) is a serious complication following chemotherapy and is associated with significant mortality and financial expenditure. The aim of this study was to evaluate risk factors for longer length of stay (LOS) and mortality and cost of treatment among hospitalized adults with cancer who developed febrile neutropenia in Thailand. Materials and Methods: Information on illness of inpatients and casualties came from hospitals nationwide and from hospital withdrawals from the 3 health insurance schemes in fiscal 2010. The data covered 96% of the population and were analyzed by age groups, hospital level, and insurance year schemes in patients with febrile neutropenia. Results: A total of 5,809 patients were identified in the study. The mortality rate was 14%. The median LOS was 8.67 days and 69% of patients stayed for longer than 5 days. On bivariate analysis, age, cancer type, and infectious complications (bacteremia/sepsis, hypotension, fungal infections, and pneumonia) were significantly associated with longer LOS and death. On multivariate analysis, acute leukemia and infectious complications were linked with longer LOS and death significantly. The median cost of hospitalized FN was THB 33,686 (USD 1,122) with the highest cost observed in acute leukemia patients. Conclusions: FN in adult patients results in significant mortality in hospitalized Thai patients. Factors associated with increased mortality include older age (>70), acute leukemia, comorbidity, and infectious complications.

• Korean Journal of Microbiology
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• v.38 no.4
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• pp.270-270
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• 2002

Pathogenic Salmonella typhimurium can invade the intestinal epithelium and cause a wide range of diseases including gastroenteritis and bacteremia in human and animals. To identify the genes involved in the infection, the invasion determinant was obtained from S. typhimurium 82/6915 and was subcloned into pGEM-7Z. A subclone DHl (pSV6235) invaded HEp-2 and Chinese hamster ovary epithelial cells and contained a 4.4 kb fragment of S. typhimurium genomic region. Compared with the host strain E. coli DHl, the subclone DHl (pSV6235) invaded cultured HEp-2 and Chinese hamster ovary cells at least 75- and 68-fold higher, respectively. The invasion rate of E. coli DHl for the cells significantly increased by harbouring the genomic region derived from pathogenic S. typhimurium 82/6915.

• Pediatric Infection and Vaccine
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• v.24 no.3
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• pp.183-187
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• 2017

Group A streptococcus is a common cause of upper respiratory infection in children; however, it is a rare cause of pseudoaneurysm in pediatrics with only limited reports of cases associated with cardiac surgery and underlying disease. We report a case of infectious pseudoaneurysm of the right internal iliac artery caused by group A streptococcus in a previously healthy 5-year-old boy who presented with scarlet fever and group A streptococcal bacteremia. He was admitted to the hospital with fever, rash on the whole body, and sore throat, accompanied by severe leg pain. He was treated with surgical removal and antibiotics. Because a pseudoaneurysm may develop in children without vascular-related underlying diseases, we should consider the possibility of this important clinical diagnosis in patients with scarlet fever.

• Archives of Plastic Surgery
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• v.40 no.5
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• pp.536-541
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• 2013

Background Pathogens in the nasal cavity during nasal surgery could lead to a systemic infectious condition, such as bacteremia, nosocomial infection, or toxic shock syndrome. However, there is no research about the prevalence of nasal carriage in patients with nasal bone fracture. Methods This was a prospective, double-blind, randomized study about the rate of nasal carriage in 200 patients with nasal bone fracture in Korea. Nasal secretions were taken from both the middle nasal meatus and colonized. All analyses were carried out using SPSS software. Results Pathogens were identified in 178 of the 200 cases. Coagulase-negative staphylococci (CNS) were the most cultured bacteria in 127 (66.84%) of the 190 total patients after excluding 10 cases of contaminated samples, and methicillin-resistant coagulase-negative staphylococci (MRCNS) were found in 48 (25.26%). Staphylococcus aureus was the second most identified pathogen, found in 36 (18.95%), followed by 7 cases (3.68%) of methicillin-resistant Staphylococcus aureus (MRSA). The prevalence rate of MRSA in the females was higher than that in the males (RR=4.70; 95% CI, 1.09-20.18), but other demographic factors had no effect on the prevalence rate of MRSA and MRCNS. Conclusions The prevalence rate of these pathogens in patients with nasal bone fracture in Korea was similar to other reports. However, few studies have addressed the prevalence rate of CNS and MRCNS in accordance with risk factors or the change in prevalence according to specific prophylaxis against infectious complications. Additional research is needed on the potential connections between clinical factors and microbiological data.

• Korean Journal of Veterinary Research
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• v.39 no.2
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• pp.343-352
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• 1999

Vancomycin resistant enterococci (VRE) have emerged as an important nosocomial pathogen. Since 1989 the Center for Disease Control, United States, has reported a rapid increase in the incidence of enterococcal bacteremia and endocarditis infection by VRE. It was suggested that the use of avoparcin was associated with the appearance of VRE in animal husbandry. To date, several detection methods have been used based on conventional methods of culture and gene detection. However, these methods have some limitations such as time-consuming, laborious and additional differential needs. Therefore, In this study a multiplex PCR method was established to detect and differentiate resistance types of enterococci which specifically amplify the four van genes encoding vancomycin resistance elements. Using the method, we investigated the incidence rates and types of VRE from farms using or not using avoparcin. A total of 1091 animal fecal samples were collected from 70 pig and 32 poultry farms. A total of 425 of enterococci were isolated from samples. Of the 425 isolates, 11 of the them showed a pattern of high-level vancomycin resistance (MIC : $64{\sim}256{\mu}g/ml$) which was associated with the presence of the vanA or vanB gene. Fifty-seven isolates showed a pattern of low-level vancomycin resistance (MIC : $3{\sim}8{\mu}g/ml$) associated with the vanC-1 or vanC-2 gene. Interestingly, all isolates with high-level vancomycin resistance were from farms that have never used avoparcin. Moreover, the high-level VRE isolation rate in Korea (2.58%) was much lower than that of other countries (50% in England, 7% in Belgium) where avoparcin have been used. In conclusion, the multiplex PCR method established in this study could be applied for detection of VRE.