Two trials of external quality assessment for clinical microbiology laboratory were performed in 2004. A total of 12 specimens were distributed. Six specimens were distributed to 293 laboratories with 277 returns in Trial I and six specimens to 293 laboratories with 274 returns in Trial II. The acceptable percentages of Gram-stain on Streptococcus pneumoniae, Escherichia coli, Pseudomonas aeruginosa, and Enterococcus faecalis were 96.0%, 98.5%, 97.4% and 98.2%, respectively. The acceptable percentages of bacterial identification on Streptococcus pneumoniae, Escherichia coli, Enterococcus faecalis, Staphylococcus saprophyticus, Shigella flexneri, Gemella spp., Pseudomonas aeruginosa, Enterococcus faecalis (Trial II), Streptococcus agalactiae, Listeria monocytogenes, Erysipelothrix rhusiopathiae, and Eikenella corrodens were 97.5% (including 33.7% of no growth), 99.6%, 93.2%, 82.3%, 95.4%, 50.7%, 98.4%, 92.3%, 87.0%, 78.9%, 92.5% (including 53.4% of no growth), respectively. The acceptable percentages for antimicrobial susceptibility tests on Escherichia coli and Pseudomonas aeruginosa were relatively high, but those on Streptococcus pneumoniae and Enterococcus faecalis were not high. In conclusion, the acceptable percentages of bacterial stain and identification were relatively good. However, it is necessary that the quality assurance of the individual laboratories should be improved for antimicrobial susceptibility tests on Streptococcus pneumoniae and Enterococcus faecalis, and the selection of the most appropriate antimicrobial agents to test should be also considered.
Anti-Infective Agents ; Eikenella corrodens ; Enterococcus faecalis ; Erysipelothrix ; Escherichia coli ; Gemella ; Korea* ; Listeria monocytogenes ; Pseudomonas aeruginosa ; Shigella flexneri ; Staphylococcus saprophyticus ; Streptococcus agalactiae ; Streptococcus pneumoniae

OBJECTIVE: To determine the causative organisms and predisposing factors of bacteremia in patients with systemic lupus erythemaosus (SLE). METHODS: We retrospectively evaluated medical records of 358 patients with SLE who were followed in Kangnam St. Mary? Hospital from 1992 to 1997. Bacteremic SLE patients were compared to non-bacteremic SLE patients in terms of laboratory and clinical variables. RESULTS: Twenty-nine episodes of bacteremia in 27 patients with SLE (26 women, 1 man) were identified. The episode of community acquired bacteremia (n=21, 72.4%) was more frequent than that of hospital acquired bacteremia (n=8, 27.6%). Isolated bacterial organisms from blood were as follows: gram negative organisms (n=14); Salmonella species (n=8), E. coli (n=4), P. mirabilis (n=1), K. pneumonia (n=1). gram positive organisms (n=15); S. aureus (n=6), Streptococcus pneumoniae (n=2), coagulase negative Staphylococci (n=2), Bacillus species (n=1), Streptococcus viridans (n=1), Streptococcus pyogenes (n=1), Enterococcus faecalis (n=1), Listeria monocytogenes (n=1). SLE was the most common underlying condition among Salmonella bacteremic patients. One of twenty seven bacteremic SLE patients (3.8%) died in spite of antibiotic therapy. Logistic regression analysis of the laboratory and clinical variables between bacteremic SLE patients and non-bacteremic SLE patients (n=140) showed that bacteremic SLE patients were more frequently associated with thrombocytopenia (p=0.008, odds ratio (OR)=7.8, 95% confidence interval (CI), 1.7 to 35.9), lupus nephritis (p=0.023, OR=5.3, 95% CI, 1.1 to 26.8), and high dose steroid therapy (prednisolone > 0.5mg/kg/day, p=0.008, OR=12.1, 95% CI 2.5 to 58.6) than non-bacteremic SLE patients. CONCLUSION: Our data suggested that Salmonella was the single most frequent isolate from the blood of SLE patients. Lupus nephritis and high dose steroid therapy were independent predisposing factors for the development of bacteremia in SLE patients.
Bacillus ; Bacteremia* ; Causality ; Coagulase ; Enterococcus faecalis ; Female ; Humans ; Listeria monocytogenes ; Logistic Models ; Lupus Erythematosus, Systemic* ; Lupus Nephritis ; Medical Records ; Mirabilis ; Odds Ratio ; Pneumonia ; Retrospective Studies ; Salmonella ; Streptococcus pneumoniae ; Streptococcus pyogenes ; Thrombocytopenia ; Viridans Streptococci

OBJECTIVE: To determine the causative organisms and predisposing factors of bacteremia in patients with systemic lupus erythemaosus (SLE). METHODS: We retrospectively evaluated medical records of 358 patients with SLE who were followed in Kangnam St. Mary? Hospital from 1992 to 1997. Bacteremic SLE patients were compared to non-bacteremic SLE patients in terms of laboratory and clinical variables. RESULTS: Twenty-nine episodes of bacteremia in 27 patients with SLE (26 women, 1 man) were identified. The episode of community acquired bacteremia (n=21, 72.4%) was more frequent than that of hospital acquired bacteremia (n=8, 27.6%). Isolated bacterial organisms from blood were as follows: gram negative organisms (n=14); Salmonella species (n=8), E. coli (n=4), P. mirabilis (n=1), K. pneumonia (n=1). gram positive organisms (n=15); S. aureus (n=6), Streptococcus pneumoniae (n=2), coagulase negative Staphylococci (n=2), Bacillus species (n=1), Streptococcus viridans (n=1), Streptococcus pyogenes (n=1), Enterococcus faecalis (n=1), Listeria monocytogenes (n=1). SLE was the most common underlying condition among Salmonella bacteremic patients. One of twenty seven bacteremic SLE patients (3.8%) died in spite of antibiotic therapy. Logistic regression analysis of the laboratory and clinical variables between bacteremic SLE patients and non-bacteremic SLE patients (n=140) showed that bacteremic SLE patients were more frequently associated with thrombocytopenia (p=0.008, odds ratio (OR)=7.8, 95% confidence interval (CI), 1.7 to 35.9), lupus nephritis (p=0.023, OR=5.3, 95% CI, 1.1 to 26.8), and high dose steroid therapy (prednisolone > 0.5mg/kg/day, p=0.008, OR=12.1, 95% CI 2.5 to 58.6) than non-bacteremic SLE patients. CONCLUSION: Our data suggested that Salmonella was the single most frequent isolate from the blood of SLE patients. Lupus nephritis and high dose steroid therapy were independent predisposing factors for the development of bacteremia in SLE patients.
Bacillus ; Bacteremia* ; Causality ; Coagulase ; Enterococcus faecalis ; Female ; Humans ; Listeria monocytogenes ; Logistic Models ; Lupus Erythematosus, Systemic* ; Lupus Nephritis ; Medical Records ; Mirabilis ; Odds Ratio ; Pneumonia ; Retrospective Studies ; Salmonella ; Streptococcus pneumoniae ; Streptococcus pyogenes ; Thrombocytopenia ; Viridans Streptococci

BACKGROUND: Viridans group streptococci (VGS) are being increasingly reported as pathogens causing septicemia in neutropenic and other immunocompromised patients since 1980s. In the past, VGS were nearly uniformly susceptible to beta-lactam antimicrobial agents, aminoglycosides, tetracyclines, and macrolides. Several recent published studies, however, indicate that antimicrobial resistance may be emerging as a problem with VGS. The purpose of this study was to determine the antimicrobial susceptibility of VGS strains isolated from blood cultures in recent period. METHODS: A total of 45 consecutive strains of VGS isolated from blood cultures between May 2001 and March 2002 at Wonju Christian Hospital were tested for antimicrobial susceptibility. Identification of VGS were performed by API Strep 32(bioMerieux sa, Marcy-l'Etoile, France) commercial kit. Antimicrobial susceptibility tests were done by NCCLS recommended disk diffusion method and penicillin MICs were determined by E test. RESULTS: Among the 45 VGS strains, frequently isolated organisms were Streptococcus mitis (31.1%), Streptococcus oralis (17.8%), Streptococcus constellatus (11.1%), and Streptococcus anginosus (8.9%). Overall intermediate-and resistant rates to antimicrobial agents of VGS were as follows: penicillin; 26.7% and 8.9%, erythromycin; 4.4% and 28.9%, clindamycin 2.2% and 22.2%, and ceftriaxone; 4.4% and 6.7%, respectively. Resistant rates of Streptococcus mitis and Streptococcus oralis were as follows: penicillin; 50% vs 50%, erythromycin 43% vs 37%, clindamycin 21% vs 37%, and ceftriaxone 7% vs 25%, respectively. CONCLUSIONS: These results indicate the species-related variability of susceptibility among VGS isolated from blood in recent period. In addition to S. mitis, S. oralis also displayed high rates of resistance to penicillin, macrolides, and ceftriaxone. The difference in susceptibilities between species of VGS indicates the importance of accurate identification and the need for continuing monitoring of antimicrobial resistance.
Aminoglycosides ; Anti-Infective Agents ; Ceftriaxone ; Clindamycin ; Diffusion ; Erythromycin ; Gangwon-do ; Immunocompromised Host ; Macrolides ; Penicillin Resistance ; Penicillins ; Sepsis ; Streptococcus anginosus ; Streptococcus constellatus ; Streptococcus mitis ; Streptococcus oralis ; Tetracyclines ; Viridans Streptococci*

Two trials of external quality assessment for clinical microbiology laboratories were performed in 2007. A total of 14 specimens were distributed. Six specimens were distributed to 317 laboratories with 305 (96.2%) returns in Trial I, and 8 specimens to 320 laboratories with 309 returns (96.5%) in Trial II. For the first time, two slide specimens for mycobacterium stain (AFB) were distributed in Trial II. The acceptable percentages of Gram stain were relatively good for both stainability and morphology. The acceptable percentages of bacterial identification (correct answers to species level) on Streptococcus pyogenes, Branhamella catarrhalis, Escherichia coli, Enterococcus faecalis, Aeromonas hydrophilia and Yersinia enterocolitica (Trial I) were 83.5%, 70.8%, 98.1%, 87.0%, 89.2%, and 97.0%, respectively. The acceptable percentages of bacterial identification on Staphylococcus aureus, Pseudomonas aeruginosa, Candida tropicalis, Listeria monocytogenes, Enterococcus casseliflavus and Klebsiella pneumoniae (Trial II) were 98.1%, 97.7%, 71.6%, 77.4%, 72.4% and 96.2%, respectively. The acceptable percentages for antimicrobial susceptibility tests on E. coli and E. faecalis (Trial I), and S. aureus and P. aeruginosa (Trial II) were relatively good compared to data of recent three years. The acceptable percentages for AFB stain in Trial II were relatively high. In summary, the acceptable percentages of bacterial stain and identification were relatively good. However, it is still necessary that the quality assurance of the individual laboratories should be improved for antimicrobial susceptibility tests, and the selection of the most appropriate antimicrobial agents to test should be also considered.
Aeromonas ; Candida tropicalis ; Enterococcus ; Enterococcus faecalis ; Escherichia coli ; Klebsiella pneumoniae ; Korea ; Listeria monocytogenes ; Moraxella (Branhamella) catarrhalis ; Mycobacterium ; Pseudomonas aeruginosa ; Staphylococcus aureus ; Streptococcus pyogenes ; Yersinia enterocolitica

Two trials of external quality assessment for clinical microbiology laboratories were performed in 2007. A total of 14 specimens were distributed. Six specimens were distributed to 317 laboratories with 305 (96.2%) returns in Trial I, and 8 specimens to 320 laboratories with 309 returns (96.5%) in Trial II. For the first time, two slide specimens for mycobacterium stain (AFB) were distributed in Trial II. The acceptable percentages of Gram stain were relatively good for both stainability and morphology. The acceptable percentages of bacterial identification (correct answers to species level) on Streptococcus pyogenes, Branhamella catarrhalis, Escherichia coli, Enterococcus faecalis, Aeromonas hydrophilia and Yersinia enterocolitica (Trial I) were 83.5%, 70.8%, 98.1%, 87.0%, 89.2%, and 97.0%, respectively. The acceptable percentages of bacterial identification on Staphylococcus aureus, Pseudomonas aeruginosa, Candida tropicalis, Listeria monocytogenes, Enterococcus casseliflavus and Klebsiella pneumoniae (Trial II) were 98.1%, 97.7%, 71.6%, 77.4%, 72.4% and 96.2%, respectively. The acceptable percentages for antimicrobial susceptibility tests on E. coli and E. faecalis (Trial I), and S. aureus and P. aeruginosa (Trial II) were relatively good compared to data of recent three years. The acceptable percentages for AFB stain in Trial II were relatively high. In summary, the acceptable percentages of bacterial stain and identification were relatively good. However, it is still necessary that the quality assurance of the individual laboratories should be improved for antimicrobial susceptibility tests, and the selection of the most appropriate antimicrobial agents to test should be also considered.
Aeromonas ; Candida tropicalis ; Enterococcus ; Enterococcus faecalis ; Escherichia coli ; Klebsiella pneumoniae ; Korea ; Listeria monocytogenes ; Moraxella (Branhamella) catarrhalis ; Mycobacterium ; Pseudomonas aeruginosa ; Staphylococcus aureus ; Streptococcus pyogenes ; Yersinia enterocolitica

Streptococcus viridans, 16cases(8.6%) of alpa and beta-hemolytic streptococcus, 4cases(3.1%) of Strep.-group D non enterococci, 7cases(5.1%) of Staphylococcus Coa. neg., 5cases(3.9%) of Staphylococcus aureus, 3cases(2.3%) of Enterococcus faecalis, 1case(0.8%) of Bacillus species, 1case(0.8%) of Peptostreptococcus, 1case(0.8%) of Clostridium and Gram negative bacterial species, which were 4cases(3.1%) of Acinetobacter baumannii, 2cases(1.6%) of Pseudomonas aeruginosa, 2cases(1.6%) of Burkholderia cepacia, 1case(0.8%) of Neisseria species, 1case(0.8%) of Klebsiella pneumoniae, 1case(0.8%) of Klebsiella oxytoca , 1case(0.8%) of Escherichia coli. 5. In drug sensitivity test, high resistant tendency was found in Penicillin system(Penicillin G 83.3%, Ampicillin 60%) and Aminoglycosides (Gentamycin 50%, Tobramycin 45.5%), but tertiary Cephalosporin system(Cefoperazone 9.1%, Ceftazidime 18.2%), and glycopeptides system (Teicoplanin 0%, Vancomycin 0%) showed lower resistancy.]]>
Acinetobacter baumannii ; Airway Obstruction ; Aminoglycosides ; Ampicillin ; Bacillus ; Burkholderia cepacia ; Ceftazidime ; Clostridium ; Early Diagnosis ; Enterococcus faecalis ; Escherichia coli ; Female ; Glycopeptides ; Humans ; Incidence ; Klebsiella oxytoca ; Klebsiella pneumoniae ; Male ; Neisseria ; Penicillins ; Peptostreptococcus ; Periapical Abscess ; Pseudomonas aeruginosa ; Retrospective Studies ; Staphylococcus ; Staphylococcus aureus ; Streptococcus ; Suppuration ; Surgery, Oral ; Tobramycin ; Vancomycin ; Viridans Streptococci

Two trials of external quality assessment for clinical microbiology laboratories were performed in 2008. A total of 16 specimens were distributed. Eight specimens were distributed to 330 laboratories with 319 (96.7%) returns in Trial I, and 8 specimens to 335 laboratories with 319 returns (95.2%) in Trial II. Two slide specimens for mycobacterium stain (AFB) were distributed in Trial I and II. The acceptable percentages of Gram stain were relatively good for both stainability and morphology except for Acinetobacter baumannii. The acceptable percentages of bacterial identification (correct answers to species level) on Klebsiella pneumoniae, Staphylococcus aureus, Neisseria meningitidis, Serratia marcescens, Erysipelothrix rhusiopathiae and Candida albicans (Trial I) were 97.4%, 99.2%, 55.6%, 97.0%, 79.2%, and 92.0%, respectively. The acceptable percentages of bacterial identification on A. baumannii, Enterococcus faecalis, Streptococcus pyogenes, Haemophilus parainfluenzae, Elizabethkingia meningoseptica, and Yersinia pseudotuberculosis (Trial II) were 92.0%, 90.8%, 4.5%, 53.1%, 74.8% and 94.3%, respectively. The acceptable percentages for antimicrobial susceptibility tests on K. pneumoniae and S. aureus (Trial I), and A. baumannii and E. faecalis, (Trial II) were relatively good compared to data of the last year. The acceptable percentages for AFB stain in Trial I and II were relatively high. In summary, the acceptable percentages of bacterial stain and identification were relatively good except some cases with poor specimen quality. However, it is still necessary that the quality assurance of the individual laboratories should be improved for antimicrobial susceptibility tests, and the selection of the most appropriate antimicrobial agents to test should be also considered.
Acinetobacter baumannii ; Anti-Infective Agents ; Candida albicans ; Enterococcus faecalis ; Erysipelothrix ; Haemophilus parainfluenzae ; Klebsiella pneumoniae ; Korea ; Mycobacterium ; Neisseria meningitidis ; Pneumonia ; Serratia marcescens ; Staphylococcus aureus ; Streptococcus pyogenes ; Yersinia pseudotuberculosis

Human mouth environment is known to include a variety bacteria, including Streptococcus spp., Staphylococcus spp., Actinomyces spp., Lactobacillus spp., Candida spp., Enterobacteriaceae, et al. Human oral microorganisms can cause dental caries, gingivitis, periodontitis, respiratory tract infection, and cardiovascular disease. Thus, right denture cleaning is essential to oral and general human health. The aim of this study was to evaluate the bactericidal effect of a sodium dichloroisocyanurate-based effervescent tablet (Aos Denti Germ, Aos Company, Chungbuk, Korea) against oral microorganisms. A total of 5 species Streptococcus spp. (Streptococcus anginosus, Streptococcus mitis, Streptococcus mutans, Streptococcus oralis, and Streptococcus sobrinus), Actinomyces oris, Candida albicans, and Escherichia coli were used in this study. All strains were exposed to the distilled water prepared with effervescent tablet. After the exposure, the mixture of strains and effervescent tablet was inoculated onto blood agar or MacConkey agar plate and cultured at 36℃. All strains were killed immediately on exposure to effervescent tablet. The results suggested that effervescent tablet could be used as an effective denture cleanser for dental hygiene.
Actinomyces ; Agar ; Bacteria ; Candida ; Candida albicans ; Cardiovascular Diseases ; Chungcheongbuk-do ; Dental Caries ; Denture Cleansers ; Dentures* ; Enterobacteriaceae ; Escherichia coli ; Gingivitis ; Humans ; Lactobacillus ; Mouth ; Oral Hygiene ; Periodontitis ; Respiratory Tract Infections ; Sodium ; Staphylococcus ; Streptococcus ; Streptococcus mitis ; Streptococcus mutans ; Streptococcus oralis ; Water

The study was conducted to investigate the distribution of pathogenic bacteria related to agricultural herb products that are sold on the market in South Korea. A survey was conducted on the microbial contamination levels and antibiotic susceptibility of Bacillus cereus (B. cereus) among 194 agricultural herb products on sale in Seoul. Distributions of those isolates were 252 coliforms, 148 Bacillus spp., 75 Enterococcus spp., 10 Staphylococcus spp., and 6 Listeria spp., respectively. The number of B. cereus isolates was 34, Escherichia coli isolates was three, Enterococcus faecium isolate was one, and Enterococcus faecalis isolate was one. Antibiotic susceptibility of B. cereus isolates was tested against 36 kinds of antibiotic susceptibility discs by disc diffusion method. B. cereus isolates were resistant to 20 kinds of antibiotics and semi-resistant to 11 kinds of antibiotics. On the basis of these results, any agricultural herb product can be assumed to be resistant or semi-resistant to the antibiotics used in human. In conclusion, we suggest sanitary control and special management regarding B. cereus contamination in agricultural herb products.
Anti-Bacterial Agents ; Bacillus cereus ; Bacillus* ; Bacteria ; Commerce ; Diffusion ; Enterococcus faecalis ; Enterococcus faecium ; Enterococcus* ; Escherichia coli ; Humans ; Korea ; Listeria* ; Methods ; Seoul ; Staphylococcus*