In this article, the annual reports of the Korean Nosocomial Infections Surveillance System (KONIS) were referred for the description of the current status of healthcare-associated infections (HAI) in Korea. KONIS has been established with the cooperation of the Korean Society for Nosocomial Infection Control and the Korea Centers for Disease Control and Prevention since 2006. The KONIS surveillance of healthcare-associated infections at intensive care units (ICU) and surgical site infections was performed by 116 ICUs of 63 hospitals in 2009. According to the 2010 report of KONIS, the infection rate per 1,000 patient-days in ICU is 7.65. The device-associated infection rates of bloodstream infection, urinary tract infection, and pneumonia are 3.27, 4.80, and 1.86, respectively. Surgical site infection (SSI) rates of gastric surgery, colon surgery, rectal surgery, craniotomy, ventricular shunt and spinal fusion are 3.3%, 4.7%, 5.8%, 3.6%, 5.1% and 3.9%, respectively. The SSI rates of gastrectomy and knee prosthesis are over 90 percentiles of the data of National Healthcare Safety Network, USA. In conclusion, the current healthcare-associated infection rates are higher than those of other developed countries. Through the harmonized communication of various specialists such as infectious diseases physicians, clinical microbiologists, and infection control nurses, the HAI should be monitored and prevented.
Centers for Disease Control and Prevention (U.S.) ; Colon ; Communicable Diseases ; Craniotomy ; Cross Infection ; Delivery of Health Care ; Developed Countries ; Gastrectomy ; Infection Control ; Intensive Care Units ; Knee Prosthesis ; Korea ; Pneumonia ; Specialization ; Spinal Fusion ; Surgical Wound Infection ; Urinary Tract Infections

Methicillin-resistant Staphylococcus aureus (MRSA) is a typical pathogen of nosocomial infection, and has recently emerged as an important community-acquired pathogen. MRSA is notorious as a multidrug-resistant organism. Its resistance to all beta-lactams is mediated by PBP2a which is encoded by mecA, and it is also resistant to many antimicrobials of other classes due to frequently co-carrying resistance genes, which accounts for becoming a clinical and laboratory issue. This article reviews the microbiological characteristics, surveillance methods, and molecular epidemiology of MRSA.
Adenosine ; beta-Lactams ; Carrier State ; Cross Infection ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Molecular Epidemiology

Minimal inhibitory concentrations (MICs) against piperacillin/tazobactam were determined on a total of 50 clinical isolates of imipenem resistant Pseudomonas aeruginosa (IRPA). MIC50 and MIC90 were 32microgram/mL and 512microgram/mL, respectively. The susceptibility of IRPA against piperacillin/tazobactam was 59%. Of the 50 IRPA strains, only two were PCR positive for blaVIM and none for blaIMP.
Imipenem ; Polymerase Chain Reaction ; Pseudomonas aeruginosa* ; Pseudomonas*

Minimal inhibitory concentrations (MIC) of piperacillin/tazobactam were determined on 20 clinical isolates of extended-spectrum beta-lactamase (ESBL)-producing E. coli and 30 isolates of ESBL- producing Klebsiella pneumoniae. MIC50 and MIC90 for ESBL-producing E. coli were 8/4 microg/ml and 256/4 microg/mL, respectively. MIC50 and MIC90 for ESBL-producing K. pneumoniae were 8/4 microg/mL and > 512/4 microg/mL, respectively. The susceptibilities of ESBL-producing E. coli and K. pneumoniae to piperacillin/tazobactam were 80% and 60%, respectively. Of 20 ESBL-producing E. coli strains, 11 (55%) were TEM-and CTX-M-positive, and SHV-negative. Of 30 ESBL-producing K. pneumoniae strains, ten (33%) were PCR positive for SHV and negative for TEM and CTX-M.
beta-Lactamases ; Escherichia ; Escherichia coli ; Klebsiella ; Klebsiella pneumoniae ; Pneumonia ; Polymerase Chain Reaction

Minimal inhibitory concentrations (MIC) of piperacillin/tazobactam were determined on 20 clinical isolates of extended-spectrum beta-lactamase (ESBL)-producing E. coli and 30 isolates of ESBL- producing Klebsiella pneumoniae. MIC50 and MIC90 for ESBL-producing E. coli were 8/4 microg/ml and 256/4 microg/mL, respectively. MIC50 and MIC90 for ESBL-producing K. pneumoniae were 8/4 microg/mL and > 512/4 microg/mL, respectively. The susceptibilities of ESBL-producing E. coli and K. pneumoniae to piperacillin/tazobactam were 80% and 60%, respectively. Of 20 ESBL-producing E. coli strains, 11 (55%) were TEM-and CTX-M-positive, and SHV-negative. Of 30 ESBL-producing K. pneumoniae strains, ten (33%) were PCR positive for SHV and negative for TEM and CTX-M.
beta-Lactamases ; Escherichia ; Escherichia coli ; Klebsiella ; Klebsiella pneumoniae ; Pneumonia ; Polymerase Chain Reaction

BACKGROUND: Cefroxadine is an oral first-generation cephalosporin, which has been used for several years. But, the susceptibility data of cefroxadine were rarely reported in Korea. The current study attempted to determine the antibacterial activity of cefroxadine against the major clinical isolates. METHODS: According to the NCCLS recommendations, antibacterial activities of cefroxadine were measured against total 500 major clinical isolates. MICs were determined by the agar dilution method, a series of doubling dilutions from 128 to 0.03 /mL, on Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, Citrobacter freundii, Serratia marcescens, Proteus mirabilis, and Staphylococcus spp. In case of Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella catarrhalis, broth microdilution method, a series of doubling dilutions from 16 to 0.015 /mL, was performed. RESULTS: Cefroxadine had variable activity against Enterobacteriaceae. MIC cumulative curves showed that cefroxadine had relatively low MIC distributions against E. coli, K. pneumoniae and P. mirabilis, showing MIC50 were 4, 4, and 8 /mL, respectively. Against E. cloacae, C. freundii, and S. marcescens, cefroxadine 's MIC50 values ranged from 128 to >128 /mL. For clinical isolates of methicillin-susceptible Staphylococcus aureus and methicillin-susceptible Staphylococcus epidermidis, cefroxadine had MIC90 values were 4 /mL and 8 /mL, respectively. Cefroxadine had MIC50 values of 1 /mL and >16 /mL for penicillin-susceptible and penicillin-not-susceptible strains of S. pneumoniae, respectively. Cefroxadine had MIC50 values of 8 /mL and 4 /mL against H. influenzae and M. catarrhalis, respectively. CONCLUSION: Cefroxadine had good activity against gram-positive bacteria, except penicillin-resistant S. pneumoniae, and showed moderate antimicrobial activity against M. catarrhalis, E. coli, P. mirabilis, and K. pneumonaie. Cefroxadine had variable activity against Enterobacteriaceae other than the above-mentioned species.
Agar ; Citrobacter freundii ; Cloaca ; Enterobacter cloacae ; Enterobacteriaceae ; Escherichia coli ; Gram-Positive Bacteria ; Haemophilus influenzae ; Influenza, Human ; Klebsiella pneumoniae ; Korea ; Mirabilis ; Moraxella (Branhamella) catarrhalis ; Pneumonia ; Proteus mirabilis ; Serratia marcescens ; Staphylococcus ; Staphylococcus aureus ; Staphylococcus epidermidis ; Streptococcus pneumoniae

Rapid diagnosis of respiratory virus infection is of vital importance for clinical laboratories to enable physicians and infection control team to start prompt action and to prevent the spread of pathogens. Conventional methods of viral cell culture, immunofluorescence assay are accurate, but time-consuming and labor intensive. Recent advances in molecular techniques give us another options to rapidly identify respiratory viruses. Rapid antigen tests are designed for detection of respiratory syncytial virus or influenza virus. They are the simplest and fastest, but require more sensitive test due to their low sensitivities and negative predictive values. Nucleic acid amplification tests are based on multiplex RT-PCR. They use different target amplification, probing, and signal detection techniques. Five to twenty types of respiratory virus can be simultaneously identified using such methods. Each laboratory should adopt its own strategy for rapid identification and confirmation of respiratory viruses considering turnaround time, sample amount, facilities, and laboratory staffs.
Cell Culture Techniques ; Diagnosis* ; Fluorescent Antibody Technique ; Infection Control ; Nucleic Acid Amplification Techniques ; Orthomyxoviridae ; Respiratory Syncytial Viruses

BACKGROUND: Cefditoren is an oral cephalosporin with excellent activity against Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella catarrhalis, which are the predominant bacterial causes of community-acquired respiratory tract infections. The current study attempted to determine the antibacterial activity of cefditoren against the major clinical isolates. METHODS: According to the NCCLS recommendations, antibacterial activities of cefditoren were measured against total 504 major clinical isolates. MICs were determined by the agar dilution method, a series of doubling dilutions from 128 to 0.03 microgram/mL, on E. coli, K. pneumoniae, E. cloacae, C. freundii, S. marcescens, P. mirabilis, and Staphylococcus spp. In case of H. influenzae, S. pneumoniae, and M. catarrhalis, broth microdilution method, a series of doubling dilutions from 16 to 0.015 microgram/mL, was performed. RESULTS: Cefditoren had variable activity against Enterobacteriaceae. MIC cumulative curves showed that cefditoren had low MIC distributions against E. coli and P. mirabilis, and MIC90 were 8 and 0.5 microgram/mL, respectively. Against K. pneumoniae, E. cloacae, C. freundii, and S. marcescens, cefditoren's MIC90 values ranged from 32 to >128 microgram/mL. For clinical isolates of methicillin-susceptible S. aureus and methicillin-susceptible S. epidermidis, cefditoren had MIC90 values of 1 microgram/mL and 0.5 microgram/mL, respectively. Cefditoren had MIC90 values of 1 microgram/mL for penicillin-susceptible and penicillin-not-susceptible strains of S. pneumoniae. Cefditoren had MIC90 values of 0.03 microgram/mL and 0.5microgram/mL against H. influenzae and M. catarrhalis, respectively. CONCLUSION: Cefditoren had excellent activity against S. pneumoniae, H. influenzae, and M. catarrhalis. Cefditoren had variable activity against Enterobacteriaceae. The results of this study confirm the excellent activity of cefditoren against the major respiratory tract pathogens and suggest that cefditoren could be a good antibiotic for empiric oral treatment of community-acquired respiratory tract infections.
Agar ; Cloaca ; Enterobacteriaceae ; Haemophilus influenzae ; Influenza, Human ; Mirabilis ; Moraxella (Branhamella) catarrhalis ; Pneumonia ; Respiratory System ; Respiratory Tract Infections ; Staphylococcus ; Streptococcus pneumoniae

BACKGROUND: Cefditoren is an oral cephalosporin with excellent activity against Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella catarrhalis, which are the predominant bacterial causes of community-acquired respiratory tract infections. The current study attempted to determine the antibacterial activity of cefditoren against the major clinical isolates. METHODS: According to the NCCLS recommendations, antibacterial activities of cefditoren were measured against total 504 major clinical isolates. MICs were determined by the agar dilution method, a series of doubling dilutions from 128 to 0.03 microgram/mL, on E. coli, K. pneumoniae, E. cloacae, C. freundii, S. marcescens, P. mirabilis, and Staphylococcus spp. In case of H. influenzae, S. pneumoniae, and M. catarrhalis, broth microdilution method, a series of doubling dilutions from 16 to 0.015 microgram/mL, was performed. RESULTS: Cefditoren had variable activity against Enterobacteriaceae. MIC cumulative curves showed that cefditoren had low MIC distributions against E. coli and P. mirabilis, and MIC90 were 8 and 0.5 microgram/mL, respectively. Against K. pneumoniae, E. cloacae, C. freundii, and S. marcescens, cefditoren's MIC90 values ranged from 32 to >128 microgram/mL. For clinical isolates of methicillin-susceptible S. aureus and methicillin-susceptible S. epidermidis, cefditoren had MIC90 values of 1 microgram/mL and 0.5 microgram/mL, respectively. Cefditoren had MIC90 values of 1 microgram/mL for penicillin-susceptible and penicillin-not-susceptible strains of S. pneumoniae. Cefditoren had MIC90 values of 0.03 microgram/mL and 0.5microgram/mL against H. influenzae and M. catarrhalis, respectively. CONCLUSION: Cefditoren had excellent activity against S. pneumoniae, H. influenzae, and M. catarrhalis. Cefditoren had variable activity against Enterobacteriaceae. The results of this study confirm the excellent activity of cefditoren against the major respiratory tract pathogens and suggest that cefditoren could be a good antibiotic for empiric oral treatment of community-acquired respiratory tract infections.
Agar ; Cloaca ; Enterobacteriaceae ; Haemophilus influenzae ; Influenza, Human ; Mirabilis ; Moraxella (Branhamella) catarrhalis ; Pneumonia ; Respiratory System ; Respiratory Tract Infections ; Staphylococcus ; Streptococcus pneumoniae

An outbreak of anthrax occurred in a village of Kyungsangbookdo province in February, 1994. The source of infection was raw meat and liver from an infected cow. Among those who ate the meat or liver, 28 developed gastrointestinal anthrax, and 3 patients died. We report a patient with anthrax tonsillitis. She ate raw bovine liver. The diagnosis was confirmed by the isolation of Bacillus anthracis from a tonsillarswab. Epidemiologically anthrax in Korea occurs as an outbreak of gastrointestinal anthrax by the ingestion of beef. Gastrointestinal anthrax should be considered in the differential diagnosis of a food-borne outbreak caused by ingestion of raw bovine meat.
Anthrax* ; Bacillus anthracis ; Diagnosis ; Diagnosis, Differential ; Eating* ; Foodborne Diseases ; Humans ; Korea ; Liver* ; Meat ; Palatine Tonsil ; Tonsillitis