[Objective] To study the synergic effect of praziquantel (PZQ) and host acquired immunity on Clonorchis sinensis. [Methods] Acquired immunity to C. sinensis was induced by immunization with crude adult worm antigen (AW Ag) and excretory-secretory antigen (ES Ag) or infection with C. sinensis metacercariae. The effect was assessed by the worm reduction rate compared with the control groups after challenge infection with 50 metacercariae and treated orally with a subcurative dose of praziquantel (50 mg/kg). Significant test was performed by analysis of variance (ANOVA) and Nparl way Kruskal-Wallis test. All calculations were performed by PC-SAS system. [Results] 1. PZQ was more effective against C. sinensis larvae than against adult worms in the control (P＜0. 001), ES Ag (P＜0.01) or crude AW Ag immunization group (P＜0. 001). 2. As compared with the control, the worm reduction rate after challenge infection was significantly higher (P＜0. 001) in ES Ag immunized group (35.60%) and metacercaria infection group (97.5 % ) and less in crude AW Ag group (23.4 %). The PZQ efficacy was significantly enhanced in ES Ag immunized group. [Conclusion] The efficacy of PZQ against C. sinensis could be synergically enhanced in rats by inducing host acquired immunity.

Objective To study the protective immunity and antibody(IgG,IgG1 and IgG2a)response against adult and larva infection of T.spiralis Korean isolate in rats.Methods Fony-six rats were randomly divided into 7 groups.Group A(A1,A2,10 rats)was used for the determination of protective efficacy from adult stage infection,group B (B1,B2,14 rats)was for the protective efficacy from muscle larva stage infection,group C(C1,C2,17 rats)was for challenge control,and group D(5 rats)served as normal control.Rats in groups A,B and C were infected with 1000 T.spiralis muscle larvae,and the infected rats were treated with flubendazole(20 mg/ks,10 d)at day 7(A1,A2) and at day 30(B1,B2).Rats in groups A and B were re-infected with 500 T.spiralis muscle larvae at day 10 after treatment.Rats in groups A1 and B1 were killed at day 7 and day 30 to inspect the reduction of adult worms in the intestines.Rats in groups A2 and B2 were killed at day 30 to detect the reduction of muscle larvae in diaphragms.Rats in groups C and D were killed at the same time,and all rats were bled at the same time.Specific anti-Trichinella IgG,IsG1 and IgG2a were detected by ELISA.Results Adult stage infection induced protective efficacy by 100% against adult stage and by 99.96% against larva stage.Larval stage infection induced protective efficacy by 99.92% against adult stage and 99.89% against muscle larvae.Anti-muscle stage larval ES Ag(IgG 3.0,IgG1 2.2,IgG2a 0.8)and anti-adult crude Ag antibodies(IgG 1.9,IgG1 0.8,IgG2a 0.3) significantly increased in the muscle larval stage infection compared to normal control(IgG 0.5,IgG1 0.1,IgG2a 0.1)and adult stage infection(IgG 0.5,IgG1 0.09,IgG2a 0.09) (P<0.01).Higher specific IgG1 antibody(IgG1 2.2) in larva stage infection was shown than specific IgG2a antibody response(IgG2a 0.8)(P<0.01).Conclusion Protective immunity against both adult and larva worms has been induced from adult and muscle larva stage infections of T.spiralis.

Objective: PD-1 inhibitors have demonstrated improved health outcomes in cancer patients. PD-1 inhibitors are well-tolerated and associated with immune-related adverse events. The objectives of this study are to analyze use patterns of PD-1 inhibitors in patients with cancer and to investigate the incidence of thyroid-related adverse reactions in patients treated with PD-1 inhibitors. Methods: The study included patients who had been administered PD-1 inhibitors (either nivolumab or pembrolizumab) at the Samsung Medical Center between October 1, 2016 and June 30, 2017. Data was collected from electronic medical records and tested using Mann-Whitney tests and Chi-Square tests for statistical significance. Associations between PD-1 inhibitors and incidence of adverse events were tested using Cox regression for age, gender, BMI, ECOG PS and medication. Results: Two hundred fifteen patients were identified as eligible for analyses. Thyroid-related adverse events occurred in 20% of patients (n=43). Thyroid function tests (TFTs) was performed in 109 patients (50.7%). Positive results of PD-L1 testing were found in 53.2% of the 94 patients who had the test. Approved doses of nivolumab (3 m/kg) and pembrolizumab (200 mg) were administered in 70.4% and 53% of patients, respectively. The analysis of risk factor of thyroid-related adverse reaction did not show statistically significant differences (Cox regression). Conclusion Thyroid-related adverse events are common in patients treated with PD-1 inhibitors and hypothyroidism is the most frequent adverse reaction. Routine TFTs monitoring is strongly recommended to evaluate thyroid function in real-world clinical practice.

Objective: PD-1 inhibitors have demonstrated improved health outcomes in cancer patients. PD-1 inhibitors are well-tolerated and associated with immune-related adverse events. The objectives of this study are to analyze use patterns of PD-1 inhibitors in patients with cancer and to investigate the incidence of thyroid-related adverse reactions in patients treated with PD-1 inhibitors. Methods: The study included patients who had been administered PD-1 inhibitors (either nivolumab or pembrolizumab) at the Samsung Medical Center between October 1, 2016 and June 30, 2017. Data was collected from electronic medical records and tested using Mann-Whitney tests and Chi-Square tests for statistical significance. Associations between PD-1 inhibitors and incidence of adverse events were tested using Cox regression for age, gender, BMI, ECOG PS and medication. Results: Two hundred fifteen patients were identified as eligible for analyses. Thyroid-related adverse events occurred in 20% of patients (n=43). Thyroid function tests (TFTs) was performed in 109 patients (50.7%). Positive results of PD-L1 testing were found in 53.2% of the 94 patients who had the test. Approved doses of nivolumab (3 m/kg) and pembrolizumab (200 mg) were administered in 70.4% and 53% of patients, respectively. The analysis of risk factor of thyroid-related adverse reaction did not show statistically significant differences (Cox regression). Conclusion Thyroid-related adverse events are common in patients treated with PD-1 inhibitors and hypothyroidism is the most frequent adverse reaction. Routine TFTs monitoring is strongly recommended to evaluate thyroid function in real-world clinical practice.

BACKGROUND: We utilized results from the ARTEMIS DISK Global Antifungal Surveillance Program to evaluate the species distribution and fluconazole and voriconazole susceptibilities of yeast isolates from clinical specimens in South Korea from 2001 to 2007. METHODS: Data were collected on 5,665 yeast isolates from all body sites at three locations. All investigators tested clinical yeast isolates using the CLSI M44-A disk diffusion method. Test plates were automatically read and results were recorded using the BIOMIC image analysis plate reader system (Giles Scientific, USA). Species, drug, zone diameter, susceptibility category, and quality control results were collected quarterly via e-mail for analysis. RESULTS: Candida albicans was the most common isolate, but a progressive increase in non-C. albicans Candida and noncandidal yeast species has been observed in recent years. The overall percentages of isolates in each category (susceptible, susceptible dose dependent, and resistant) were 98.8%, 0.5%, and 0.7% and 99.2%, 0.2%, and 0.6% for fluconazole and voriconazole, respectively. Candida of 3 species exhibited decreased susceptibility to fluconazole (<90% S) in the order of that seen with the resistant (R) species: C. krusei, C. guilliermondii, and C. glabrata. Emerging resistance to fluconazole or voriconazole was documented among isolates of Cryptococcus neoformans, Trichosporon spp., and Rhodotorula spp. CONCLUSIONS: The species distribution and antifungal susceptibilities of yeasts may differ according to specimen type, testing method, hospital, and geographic region. Therefore, further large-scaled, long-term surveillance studies are needed to isolate yeasts and to confirm the species distribution and antifungal susceptibilities of yeast isolates from clinical specimens in Korea.
Antifungal Agents/*pharmacology ; Candida/isolation & purification ; Cryptococcus neoformans/isolation & purification ; Disk Diffusion Antimicrobial Tests ; *Drug Resistance, Fungal ; Fluconazole/pharmacology ; Hospitals ; Humans ; Pyrimidines/pharmacology ; Republic of Korea ; Rhodotorula/isolation & purification ; Triazoles/pharmacology ; Trichosporon/isolation & purification ; Yeasts/*drug effects/isolation & purification

BACKGROUND: Clostridium difficile is the main etiologic agent of antibiotic-associated diarrhea and the most common cause of hospital-acquired diarrhea. Recently, the incidence of C. difficile infections (CDI) has increased and new highly virulent C. difficile strains have emerged. Therefore, accurate and rapid diagnosis is needed. We compared the results of using chromID C. difficile (chromID CD, bioMerieux, France) with the conventional C. difficile Selective Agar (CDSA; BD, USA) for the isolation of C. difficile. METHODS: A total of 738 stool specimens of suspected CDI patients at the Severance Hospital from July to August 2011 were inoculated onto CDSA. Among them, 104 stool specimens revealed colonies on CDSA that were then re-inoculated onto chromID CD. The stool samples were stored at -20degrees C until the time of the re-inoculation. Cultured agars were interpreted after 24 hrs and 48 hrs, respectively. Species identification was performed on the basis of colony characteristics on agar plates as well as the ATB 32A system (API System SA, France). RESULTS: The recovery rates of CDSA and chromID CD were 30.1% and 77.5% after 24 hrs, and 77.5% and 98.6% after 48 hrs, respectively. All of the C. difficile isolates were recovered as typical gray/black colonies on chromID CD. CONCLUSION: The performance of chromID CD for the isolation of C. difficile was better than that of conventional CDSA. The chromID CD could provide easy and sensitive detection of C. difficile even after 24hrs of incubation.
Agar ; Clostridium ; Clostridium difficile ; Diarrhea ; Humans ; Incidence

We determined the antimicrobial susceptibility of 90 clinical isolates of Stenotrophomonas maltophilia collected in 2009 at a tertiary care hospital in Korea. Trimethoprim-sulfamethoxazole, minocycline, and levofloxacin were active against most of the isolates tested. Moxifloxacin and tigecycline were also active and hold promise as therapeutic options for S. maltophilia infections.
Anti-Infective Agents/*pharmacology ; Hospitals ; Korea ; Microbial Sensitivity Tests ; Minocycline/pharmacology ; Ofloxacin/pharmacology ; Stenotrophomonas maltophilia/*drug effects ; Trimethoprim-Sulfamethoxazole Combination/pharmacology

BACKGROUND: beta-lactam antibiotics are one of the most common antimicrobial agents. However, the increasing of beta-lactamase-producing bacteria makes these agents less useful. Therefore, agents stable for beta-lactamase have been developed. This study was conducted to determine the activities of the combination agent ceftriaxone-sulbactam and to compare its activities with other agents. METHODS: A total of 437 clinical isolates of aerobic and anaerobic bacteria were collected in Severance Hospital from 2007 to 2011. Using 23 antimicrobial agents, antimicrobial susceptibility tests were performed using the Clinical and Laboratory Standards Institute (CLSI) agar dilution method. RESULTS: The minimal inhibitory concentrations (MICs) of ceftriaxone and ceftriaxone-sulbactam were similar to or lower than those of other beta-lactam antibiotics for methicillin-susceptible Staphylococcus aureus (MSSA), Streptococcus pneumoniae, S. pyogenes, and viridans group streptococci. For Moraxella catarrhalis, Neisseria gonorrhoeae, Haemophilus influenzae, and H. parainfluenzae, ceftriaxone and the ceftriaxone-sulbactam combination also show low MIC50 and MIC90. For extended-spectrum beta-lactamase (ESBL)-producing E. coli, the MICs of ceftriaxone-sulbactam were lower than those of other cephalosporins. Among the anaerobes, ceftriaxone-sulbactam showed good activity compared to ceftriaxone alone for the Bacteroides fragilis group, B. thetaiotaomicron, other Bacteroides sp., Prevotella sp., and Porphyromonas sp. CONCLUSIONS: Ceftriaxone-sulbactam showed good antimicrobial activity and thus is useful for the treatment of infections by MSSA, S. pneumoniae, S. pyogenes, viridans group streptococci, M. catarrhalis, N. gonorrhoeae, H. influenzae, H. parainfluenzae, E. coli, and K. pneumoniae, B. fragilis group, B. thetaiotaomicron, other Bacteroides sp., Prevotella sp., and Porphyromonas sp.
Agar ; Anti-Bacterial Agents ; Anti-Infective Agents ; Bacteria ; Bacteria, Anaerobic ; Bacteroides ; Bacteroides fragilis ; beta-Lactamases ; Ceftriaxone ; Cephalosporins ; Haemophilus influenzae ; Influenza, Human ; Moraxella (Branhamella) catarrhalis ; Neisseria gonorrhoeae ; Paramyxoviridae Infections ; Pneumonia ; Porphyromonas ; Prevotella ; Staphylococcus aureus ; Streptococcus pneumoniae ; Sulbactam

BACKGROUND: Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) has been used for the identification of bacteria worldwide. To our knowledge, the evaluation of MALDI-TOF MS for the identification of bacteria in Korea has not been studied. In this paper we compared the identification results of aerobic bacteria using MALDI-TOF MS to those results using conventional biochemical methods. METHODS: We evaluated the performance of a MALDI-TOF MS system (Bruker Daltonics, Leipzig, Germany) on consecutive aerobic isolates collected from January to February of 2011 which were identified using conventional methods (biochemical testing and commercial identification kits). Either directly smearing onto the target plate or protein extraction methods were additionally used if no reliable or discordant results were obtained. RESULTS: Among 523 isolates tested, 506 (97%) isolates had valid scores (> or =2.0), 11 (2%) isolates gave intermediate scores (1.7< or = score <2.0), and 6 (1%) isolates yielded no reliable identification (score <1.7). Of the 506 valid results (score > or =2.0) by MALDI-TOF MS, the identification matched at the species level in 486 (96%) isloates, matched at the genus level in 17 (3%) isloates, and was discordant at the genus and species levels in 3 (1%) isloates. CONCLUSION: The overall matching rate at the species level of MALDI-TOF MS was very high. When MALDI-TOF MS did not yield reliable results by direct smear, additional direct smears or protein extraction methods could be used to obtain better results. Our results showed that MALDI-TOF MS is a very useful method for the identification of aerobic bacteria isolated in clinical microbiology laboratories.
Bacteria ; Bacteria, Aerobic ; Korea ; Mass Spectrometry

Vibrio fluvialis is a haplophilic gram-negative bacterium normally found in coastal water and seafood and causes gastroenteritis. There have been a few reports on V. fluvialis gastroenteritis in Korea, but no previous report of isolation from blood. We isolated V. fluvialis from the blood of two patients undergoing cancer chemotherapy.
Bacteremia* ; Drug Therapy* ; Gastroenteritis ; Humans ; Korea ; Seafood ; Vibrio*