BACKGROUND: The erythromycin-resistance rate and phenotype distribution of Streptococcus propenes are quite different by geographical variation and study period. The aim of the present study was to determine the evolution of resistance to erythromycin and the frequency of erythromycin resistance phenotype of S. pyogenes isolated from Wonju Christian Hospital. METHODS: The minimal inhibitory concentrations (MICs) of erythromycin and clindamycin for 94 S. pyogenes isolated from clinical specimens between 1990 to 1998 were investigated. Double disk test of erythromycin (78microgram) and clindamycin (25microgram) were performed for 15 isolates of erythromycin resistant S. pyogenes to evaluate the erythromycin resistance phenotype. RESULTS: The resistance rates of 94 isolates of S. pyogenes were 16%(15/94) to erythromycin and 4%(4/94) to clindamycin. The frequency of erythromycin resistance phenotype in decreasing order were M phenotype (47%), inducible resistance phenotype (40%), and constitutive resistance phenotype (13%). Erythromycin-resistant S. pyogenes did not exist until 1993, but was isolated since 1994, and ranged from 14.0% to 24.0% during the period of 1994-1998. CONCLUSIONS: Our finding documents the emergence of high resistance rates to erythromycin in S. pyogenes at Wonju area since 1994. The M phenotype (47%) and inducible resistance phenotype (40%) account for the majority of erythromycin-resistant S. pyogenes.
Clindamycin ; Erythromycin* ; Gangwon-do ; Phenotype* ; Streptococcus pyogenes* ; Streptococcus*

BACKGROUND: Recent data suggest that the colonization rate of group B streptococci(GBS) in pregnant women and the incidence of neonatal infections by GBS is increasing trend in Korea, but the antimicrobial susceptibilities and serotypes in pregnant women have not been reported in Korea. So, we studied to define the antimicrobial susceptibility patterns and frequency of serotypes of GBS in pregnant women. METHODS: The susceptibility and serotyping of 60 GBS isolates from 27 pregnant women and four isolates from their two neonates were tested by an agar dilution method and agglutination test, respectively. The typing sera used in this study were Ia, Ib, II, III, IV, and V. RESULTS: Minimal inhibitory concentration range of 60 GBS from pregnant women were penicillin G 0.015-0.12 microgram/ml, vancomycin 0.5-2 microgram/ml, clindamycin 0.015-4.0 microgram/ml, chloramphenicol 2-4 microgram/ml, erythromycin 0.015-2 microgram/ml, tetracycline 0.5-256 microgram/ml, cephalothin 0.12-0.25 microgram/ml, ceftriaxone 0.03-0.12 microgram/ml, respectively. The resistance rate of GBS were 6.7% to clindamycin, 0% to erythromycin, and 98.3% to tetracycline. Most of GBS serotypes from pregnant women in decreasing order were Ib(48.3%), Ia(24.1%), III(20.7%). CONCLUSION: All GBS strains isolated from pregnant women are highly susceptible to commonly used antimicrobial agents with the exception of tetracycline. The low prevalence of severe neonatal GBS infections in Korea is not due to the absence of serotype III, but probably due to a low genital carriage rate of GBS by pregnant women.
Agar ; Agglutination Tests ; Anti-Infective Agents ; Ceftriaxone ; Cephalothin ; Chloramphenicol ; Clindamycin ; Colon ; Erythromycin ; Female ; Humans ; Incidence ; Infant, Newborn ; Korea ; Penicillin G ; Pregnant Women* ; Prevalence ; Serotyping ; Tetracycline ; Vancomycin

BACKGROUND: To access the accuracy and clinical usefulness of microplate identification (ID) system for the identification of Enterobacteriaceae, we compared microplate ID system with API 20E(bioMerieux, Etoile, France). METHODS: Ninety-two cultures of Enterobacteriaceae and one isolate of Aeromonas species were simultaneously identified by microplate ID system and the API 20E. Twenty biochemical tests used in microplate ID system were lactose, sucrose, and H2S in Kligler's iron agar media; indole, sucrose, raffinose, arabinose, trehalose, adonitol, dulcitol, sorbitol, cellibiose, methy-red, phenylalanine deaminase, ornithine decarboxylase, lysine decarboxylase, arginine dihydrolase, urease, and citrate in microplate; and oxidase test. The identification was obtained by considering percent likelihood(% ID), modal frequency and ID score method. RESULTS: Among the 92 cultures of Enterobacteriaceae and one isolate of Aeromonas species, agreement rate of identification according to the % ID between microplate ID system and API 20E were 90.3% to the species level and 97.8% to the genus level. CONCLUSIONS: For the identification of clinical Enterobacteriaceae isolates, the microplate ID system compares favorably with API 20E in identification accuracy and have the advantage of costsaving and easy to use.
Aeromonas ; Agar ; Arabinose ; Arginine ; Citric Acid ; Enterobacteriaceae* ; Galactitol ; Iron ; Lactose ; Lysine ; Ornithine Decarboxylase ; Oxidoreductases ; Phenylalanine ; Raffinose ; Ribitol ; Sorbitol ; Sucrose ; Trehalose ; Urease

No abstract available.
Child* ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Infant* ; Poisoning*

BACKGROUND: Pigment production and acidification of ribose are most frequently used biochemical tests for the differentiation of three enterococcal species carrying vanC genes such as Enterococcus gallinarum, Enterococcus casseliflavus, and Enterococcus flavescens. However, pigment production may occasionally be negative in E. casseliflavus, and some of E. casseliflavus may be negative or delayed reaction with ribose fermentation test. So, we performed this study to find out biochemical tests capable of distinguishing the strains possessing vanC genotypes. METHOD: A total of 17 enterococci composed of 14 clinical isolates with motility or pigment positive strains and three ATCC strains(E. gallinarum ATCC 49573, E. casseliflavus ATCC 25788, and E. flavescens ATCC 49997) Were tested by multiplex PCR of the vanC genes(vanC-1, vanC-2 and vanC-3)and various biochemical tests. RESULTS: Among the 17 isolates including three ATCC control strains, four were genotyped as VanC-1, 11 were VanC-2, one were vanC-2/3, and any of vanC genes were not detected in one clinical isolate, respectively, Among the enterococci with vanC genotype, acid production from alphaD-cyclodextrin and hippurate hydrolysis were positive only in VanC-1 gneotype(E. gallinarum), acid production from glycerol and methyl-alpha-D-mannopyranoside were positive only in vanC-2 genotype(E. casseliflavus), and acid production from rhamnose and pigment production were negative only in VanC-1 genotype. Acid production from alphaD-cyclodextrin was negative only in vanC-2 genotype. The positive rate of ribose fermentation of VanC-1, VanC-2, and VanC-2/3(E. flavescens) genotype were 100%, 82%, and 0%, respectively. CONCLUSION: Acid production from rhamnose, alphaD-cyclodextrin, betaD-cyclodextrin, glycerol and methly-alphaD-mannopyranoside, pigment production, and hippurate hydrolysis test were useful biochemical tests for differentitating E. gallinarum form E. casseliflavus. The production of acid from alphaD-cyclodextrin, glycerol, methyl-alpha-D-mannopyranoside and were suitable biochemical tests for differentiating E. casseliflavus from E. flavescens.
Enterococcus ; Fermentation ; Genotype ; Glycerol ; Hydrolysis ; Multiplex Polymerase Chain Reaction ; Phenotype* ; Rhamnose ; Ribose

No abstract available.
Dislocations* ; Tendons*

In Korean, there has been an increasing concern on rickettsiosis as a possile common cause of unknown febrile illness since Tsutsugamushi fever among koreans was reported first in 1986. We experienced 10 cases of Tsutsugamushi fever ocurring in the Mokpo area during the period of 3 months (Oct, to Dcc.) in 1990, which were diagnosed clinically and serologically by indirect immunofluorescent antibody test. The following results were obtained. The most frequent symptoms were fever (100%), headache (90%), chill (60%), conjunctival injection, and lymphadenopathy. Common laboratory findings were leukopenia (WBC<5000/mm3 30%), elevated ESR (>20mm/hr, 30%), positive CRP (60%), and elevated Alt/AST. Antibody titers against R. tsutsugamushi ranged from 1:80 to 1:1,280, but they showed no antibody reaction to Hantaan virus and leptospira. All patients showed good response to antibiotic therapy with chloramphenicol.
Chloramphenicol ; Fever ; Hantaan virus ; Headache ; Humans ; Jeollanam-do ; Leptospira ; Leukopenia ; Lymphatic Diseases ; Scrub Typhus*

BACKGROUND: This study is designed to provide data on the trend of serotypes of group B streptococci (GBS) isolated from clinical specimens during recent eight years and to elucidate the relationship between biochemical reactions and serotypes of GBS. METHODS: Serotyping, pigment production test, CAMP test, hippurate hydrolysis, and hemolysis test were performed for 150 GBS isolates from clinical specimens during March 1990 to February 1998. The typing sera used were Ia, Ib, II, III, IV, and V. Pigment production was detected by new Granada tube medium. The CAMP test and hippurate hydrolysis were performed by standard technique. Hemolytic patterns of GBS were determined on sheep blood agar and human blood agar plate. RESULTS: GBS were frequently isolated from cervix, urine, wound (pus), and blood. Striking increase of GBS isolates were notified from 1996 to 1997 period. Identification rates of GBS serotypes were Ib (38.0%), III (37.3%), Ia (9.3%), V (8.7%), nontypable strains (4.0%), and II (2.7%) in decreasing order. The proportion of serotype III increased markedly from 1996. Serotype V was not isolated until 1996, and ranked third in 1997. Seven (4.7%) isolates were nonhemolytic, and six of seven isolates revealed serotype III. Two (1.3%) isolates that were negative in both CAMP test and hippurate hydrolysis were serotype II. CONCLUSIONS: Clinical microbiology laboratories relying on beta hemolysis or pigment production for initial detection of GBS may underestimate the isolation rate of GBS and the proportion of serotype III which hardly makes hemolysis. It is therefore recommended that laboratories providing cultures for the GBS of genitalia specimens supplement other detection methods such as CAMP test or immunologic methods.
Agar ; Cervix Uteri ; Female ; Genitalia ; Hemolysis ; Humans ; Hydrolysis ; Serotyping ; Sheep ; Strikes, Employee ; Wounds and Injuries

In Korea, studies of splenectomies are mainly performed in adult groups, but a review of splenectomies in children is significant because the indications of a splenectomy and the importance of the spleen in children are different from those in adults. The authors reviewed 51 cases of splenectomies performed between January 1986 and April 1996 on children under 15 years of age. The indications of the splenectomy were divided based on hematologic diseases (37) and non-hematologic diseases (14). For the hematologic diseases, hereditary spherocytosis (24) was the most common indication of a splenectomy and idiopathic thrombocytopenic purpura (11) was the next most common. For the non-hematologic diseases, trauma (10) was the most common indication of a splenectomy. After the splenectomy, abnormal hematologic findings were improved in all hereditary spherocytosis patients and in nine of the idiopathic thrombocytopenic purpura patients (82%). To prevent postsplenectomy sepsis, 27 patients received antibiotic medication, but no one received a pneumococcal vaccination. One case of postsplenectomy sepsis occurred in a patient who had not received antibiotic medication. This study suggests that a splenectomy provides efficacious treatment for a number of pediatric disorders, but it is associated with a risk of postsplenectomy sepsis.
Adult ; Child* ; Hematologic Diseases ; Humans ; Korea ; Purpura, Thrombocytopenic, Idiopathic ; Sepsis ; Spleen ; Splenectomy* ; Vaccination

No abstract available.
Decompression* ; Head* ; Osteonecrosis*