• Journal of Life Science
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• v.24 no.10
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• pp.1118-1124
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• 2014

Porcine respiratory disease complex (PRDC) is a common respiratory disease in nursery and grow-finishing pigs. A complex of viral and bacterial agents is known to be involved in the etiology of PRDC. The purpose of this study was to investigate common etiologic agents associated with PRDC in the field and compare detection methods for identifying these agents. To understand the mechanism of polymicrobial infection in PRDC, changes in the expression of cytokines were investigated. In 461 pig samples examined, most of the affected pigs ranged from 3 to 10 weeks old (73.4%), and 348 (75.4%) samples were confirmed as polymicrobial infection. Of the polymicrobial-infected cases, two (50.3%), three (32.2%), four (13.8%), five (3.2%), and six (0.5%) agents were detected. Two- or three-agent infections were the most common, with PRRSV/PCV-2 (44.6%) the most common two-agent infection. PRRSV/PCV-2/H. parasuis (11.0%) was the most common three-agent infection. Comparison of two detection methods (PCR and IHC) in the polymicrobial cases showed that 78.4% were PCV-2 positive with the PCR method, and 26.2% were PCV-2 positive with IHC. SIV was 7.8% by the PCR method and 3.7% positive by the IHC. This result indicates that the PCR method is more useful than IHC for detecting causative agents in PRDC. In the analysis of cytokines in the two- and three-agent infected samples, interleukin (IL)-$1{\alpha}$, IL-2, IL-4, IL-6, IL-10, and INF-${\alpha}$ showed the same expression pattern. All cytokines were suppressed, except IL-6. These findings indicate that changes in cytokine expression could be used to understand the mechanism of polymicrobial infection in PRDC.

• Journal of Chest Surgery
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• v.47 no.2
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• pp.155-159
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• 2014

Cardiac tamponade due to purulent pericarditis with a characteristic greenish fluid is rare in this antibiotic era. It is highly fatal despite early diagnosis and advanced treatment. Gram-positive cocci are the leading cause of purulent pericarditis, which usually results from a direct or hematogenous spread of organisms to the pericardium from the primary foci of infection. We describe an index case of rapidly developing pericardial tamponade caused by oropharyngeal polymicrobial infection in the absence of a primary source of infection in a 62-year-old man, who was successfully managed with emergency large-volume pericardiocentesis followed by pericardiectomy.

• Pediatric Infection and Vaccine
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• v.17 no.2
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• pp.83-90
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• 2010

Purpose : Although the incidence of polymicrobial bloodstream infection (PBSI) has increased, only a few studies have so far focused on children. Therefore, in an effort to prevent more serious situations in pediatric patients, we analyzed the clinical features, organisms, and laboratory results of PBSI. Methods : We performed a retrospective review of the case records of 97 patients with polymicrobial bloodstream infection in the Severance hospital, from 2001 to 2008. Using t-test and chi-square test, we analyzed the underlying medical conditions, clinical characteristics, organisms, and laboratory results of those patients. Results : Annual incidence of polymicrobial bloodstream infection increased from 1.4 % in 2001 to 10.9% in 2008 in pediatric patients. Immunocompromised hemato-oncological malignancy was found in 31 (31.9%) patients, and was the most common underlying medical condition; cardiovascular disease was found in 15 patients (15.4%), neurologic disease in 10 patients (10.3%), and so on. Gram positive organisms were recovered in 143 cases and gram negative organisms were recovered in 101 cases of PBSI. Staphylococcus epidermidis was the most common organism. Factors affecting mortality included underlying medical disease, immune status, nosocomial infection, and central catheter-related infection, for which the rate of mortality showed a greater increase (P<0.05). Conclusion : Due to the close connection between PBSI and fatal conditions or high mortality, it requires more aggressive management. Compared with previous studies, we discovered that immunocompromised hemato-oncological malignancy was the most common underlying medical condition and that frequency of gram-positive bacteria and fungus isolated has increased.

• Archives of Plastic Surgery
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• v.33 no.3
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• pp.330-334
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• 2006

Polymicrobial nature of diabetic foot infection has been well documented in the literature. Initial antibiotic therapy of diabetic foot infection is usually empiric until reliable culture data is shown. This study was carried out to determine the common bacteriological flora of diabetic foot infection and antimicrobial sensitivity pattern in order to enhance possible empiric treatment. The specimens were obtained from wounds of 207 cases of diabetic foot ulcer, and the bacteriological isolation, and antimicrobial susceptibility tests of the isolates were carried out by standard microbiological methods. Staphylococcus aureus was the most common isolate, with 46.2% of recover rate among total bacterial isolated cases. Among gram-negative organisms, Pseudomonas aeruginosa was most common. Gram-positive organisms showed significant susceptibility to clindamycin, trimethoprim/sulfamethoxazole, and levofloxacin, besides vancomycin. Cefoperazone, piperacillin/tazobactam, and amikacin in addition to imipenem were most effective agents compared to gram-negative organisms. Diabetic foot infection requires use of combined antimicrobial therapy for initial management. Our results indicate that the most effective antibiotic combination for diabetic foot infection of Korean patients is clindamycin plus cefoperazone.

• The Journal of the Korean Society for Microbiology
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• v.20 no.1
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• pp.35-44
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• 1985

Isolation and identification of anaerobic bacteria from blood cultures are still technically demanding procedures. Recently, with the use of gas liquid chromatography, the accuracy of identification is much improved. However, there has never been a satisfactory data analysis on anaerobic bacteremia in Korea. The authors evaluated both the clinical and the bacteriological data of 129 anaerobic bacteremias found at the Yonsei Medical Center during the period of 1973 to 1984. The most frequently isolated anaerobic bacteria were Bacteroides (52.7%), among which the major species was B. fragilis (38.7%). Incidence of anaerobic bacteremia by sex was 57% in male and 43% in female. Mortality was higg in groups below 1-year old and above 50-year old. The cause of death seemed closely correlated with the patient's age, general condition and the severity of the underlying disease. Various neoplasms were the most common (20%) underlying diseases predisposing the anaerobic bacteremia. Biliary tract was considered the most frequent route of infection in anaerobic bacteremia. The frequent clinical signs in anaerobic bacteremia were fever (65%), followed by liver function abnormality (29%), jaundice (20%) and hypotention(18%). When analysis of positive rate of blood culture was made on the patients from whom 4 cultures were done within 24 hours, it was found that 33% of the samples were positive. Isolation rate of anaerobic bacteria in thioglycollate medium was 83.8%, while it was 44% in Tryptic soy broth. Among the anaerobic bacteremia, 25.4% were polymicrobial infections with aerobic bacteria (92.5%), such as E. coli(33.3%). From these studies, it is concluded that B. fragilis is the most important causative organism in anaerobic bacteremia, with high fatality, particularly in those who have underlying diseases. The ports of entry are mainly biliary, gastrointestinal and female genital tract. Fever is the most frequent clinical sign. Single blood culture is not sufficient to detect all anaerobic bacteremia, therefore more cultures with optimal time interval are needed. The incidence of polymicrobial infection in anaerobic bacteremia is higher than that in overall bacteremia.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.30 no.6
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• pp.540-544
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• 2004

The oral lesion of acquired syphilis - primary, secondary, and tertiary - is comparatively rare. Most of the time secondary syphilis manifests itself as a systemic disease with maculopapular eruptions of the skin, generalized lymphadenopathy, fever, and occasional eruptions on the mucous membranes. The lesions of the tertiary stage may occur anywhere in the body, including the oral cavity. Necrotizing faciitis of the head and neck is an uncommon, rapidly spreading soft tissue infection of polymicrobial origin characterized by extensive necrosis and gas formation in the subcutaneous tissue and superficial fascia. This is characterized by its fulminating, devastating, and rapid-progressing course. The mortality rate is high if it is not treated promptly and vigorously. Patients with an impaired immune system and those with small-vessel disease such as diabetes mellitus are more prone to develop this infection.

• Pediatric Infection and Vaccine
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• v.5 no.2
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• pp.296-301
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• 1998

Flavobacterium species are nonfastidious, oxidase-positive gram-negative rods that do not ferment glucose. These organism are widely distributed in nature and in hospital environments. In past, one of flavobacteria, Flavobacterium indologenes, was treated with non-pathogenic organism. Recently, several investigators have demonstrated the infection of this organism in human. Nowadays, the growth of F. indologenes in specimen should be considered a potential pathogen in infectious patients including neonate, especially in the setting of malignancy and with use of invasive procedures. The resistance of this organism to multiple antibiotics and the high incidence of polymicrobial bacteremia make it difficult to determine optimal therapeutic options. We experienced a case of neonatal bacterial meningitis causing by F. indologenes. So we report this case to evoke more concerns about the infections of this organism in human.

• Journal of Chest Surgery
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• v.25 no.3
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• pp.271-275
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• 1992

One hundred forty patients with empyema thoracis were managed under the general anesthesia at the Seoul National University Hospital between 1980 and 1990. The patients, who were managed by thoracentesis or intercostal tube drainage alone, were excluded in this study. There were 92 males and 48 females, ranging from 8 to 80 years of age. Underlying pathologic lesions of empyema thoracis were primary bronchopulmonary infection [84%], postoperative empyema[11%], malignancy, paragonimiasis, spontaneous pneumothorax and so on. A single causal organism was isolated only in 17 patients[the most common being staphylococcus aureus, pseudomonas, & streptacoccus pneumoniae], multiple organism in 31, and no growth in 32. Surgical treatment modalities were decortication[75], pleuropneumonectomy[30], decortication with lobectomy[10], empyemectomy[9], open drainage[13], Clagett procedure [6], thoracoplasty with or without muscle transposition[9]. Hospital mortality were in 2 cases[1.4%], one empyema related and the other nonrelated. In this study, bacteriologic findings were nonspecific and often polymicrobial. We conclude that early thoracotomy can be lifesaving in the presence of a benign clinical course.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.41 no.2
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• pp.90-96
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• 2015

Necrotizing fasciitis (NF) is an infection that spreads along the fascial planes, causing subcutaneous tissue death characterized by rapid progression, systemic toxicity, and even death. NF often appears as a red, hot, painful, and swollen wound with an ill-defined border. As the infective process continues, local pain is replaced by numbness or analgesia. As the disease process continues, the skin initially becomes pale, then mottled and purple, and finally, gangrenous. The ability of NF to move rapidly along fascial planes and cause tissue necrosis is secondary to its polymicrobial composition and the synergistic effect of the enzymes produced by the bacteria. Treatment involves securing the airway, broad-spectrum antimicrobial therapy, intensive care support, and prompt surgical debridement, repeated as needed. Reducing mortality rests on early diagnosis and prompt aggressive treatment.

• Journal of Microbiology and Biotechnology
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• v.14 no.2
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• pp.401-410
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• 2004

Soil samples from five different areas in Korea were collected during 2001/02 and examined for presence of the genus Clostridium. Direct immuno-fluorescent assay (IFA) examination showed that Clostridium septicum, Cl. novyi and Cl. chauvoei were detected in the soil of specific areas in Korea. Sixteen species of Clostridium were isolated and cultivated from the soil samples. Cl. peifringens was detected in all sampling locations, while the other species were not. The in vitro activity of 14 antibiotic agents was determined against 421 clostridia isolated from the soil contaminated with animal feces in Korea. Trovafloxacin was effective against all isolates of the genus Clostridium except one isolate of Cl. subterminale, two of Cl. tetani, and three of Cl novyi with $MIC_{50}$ $8- 16\mu$g $ml^{-1}$. Thirteen species of Clostridium were resistant to vancomycin except for Cl. perfringens, Cl. sporogenes, and Cl. subterminale. Imipenem and trovafloxacin showed high antimicrobial activities (>95%) against all strains in the clostridia investigated. Therefore, antibiotic agents such as imipenem and trovafloxacin are the most suitable agents for polymicrobial infection as broad-spectrum monotherapy.