BACKGROUND: A rapid and sensitive surveillance culture has a pivotal role in infection control of methicillinresistant Staphylococcus aureus (MRSA). This study was aimed to compare the performance of MRSASelect (Bio-Rad, France) to that of mannitol salt agar containing 6 microgram/mL of oxacillin (MSA-OX) for detecting MRSA in surveillance cultures. METHOD: From May to June 2006, 86 nasal swabs and 21 sputum specimens were enrolled. All specimens were inoculated onto MRSASelect and MSA-OX, which were incubated for 2 days and 3 days, respectively, and colonies were read daily by a technologist. Pink colonies on MRSASelect and yellow colonies on MSA-OX were examined with Gram stain, Pastorex(R) Staph-plus (Bio-Rad) and mecA-PCR. After the final reading, both media were re-examined by a superviser. RESULTS: Of the 107 specimens cultured, 32 (29.9%) were positive for MRSA. Of these, 27 were detected by both media, one by MSA-OX only, and 4 by re-examination. The day-1 and day-2 sensitivities/specificities of MRSASelect were 78.1%/97.3% and 84.4%/97.3%, respectively, while those of MSA-OX were 53.1%/100% and 78.1%/92.1%, respectively. With MRSASelect, two more positives were detected at day 2, but their incubation was less than 18 hour at day 1. There were six false positive organisms detected: three Enterobacter spp., one Acinectobacter spp., and two coagulase-negative staphylococci (CNS). But, the two CNS grew on MSA-OX only. CONCLUSION: MRSASelect with 1-day incubation showed a sensitivity equivalent to and a specificity better than MSA-OX with 2-day incubation. MRSASelect should be a useful medium for MRSA surveillance when it is read after an incubation of 18-28 hours with the confirmatory Gram stain of screen-positives.
Agar ; Enterobacter ; Infection Control ; Mannitol ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Oxacillin ; Sensitivity and Specificity ; Sputum ; Staphylococcus aureus

Comamonas testosteroni and Acinetobacter guillouiae are gram-negative bacilli of low virulence that are widely distributed in nature and normal flora. Despite their common occurrence in environments, they rarely cause infectious disease. We experienced a case of septic shock by C. testosterone and A. guillouiae, and isolated them by 16S ribosomal RNA sequencing method from the blood cultures of a previous healthy female during postoperative supportive care. This is the first case of septic shock required ventilator care and continuous renal replacement therapy due to these organisms in Korea.
Acinetobacter* ; Bacteremia ; Comamonas testosteroni* ; Comamonas* ; Communicable Diseases ; Female ; Humans ; Korea ; Renal Replacement Therapy ; RNA, Ribosomal, 16S ; Shock, Septic* ; Testosterone ; Ventilators, Mechanical ; Virulence

There are several problems in mycobacterial detection and drug susceptibility testing. One problem is that some test results are unnecessarily delayed because the tests are postponed until patients revisit clinics and pay the cost of the tests. Another problem is that critical and important tests are not requested because patients do not agree with their necessity. These inefficient practices may be due to the fee-for-service policy that the Korean medical insurance system is adopting and because many test methods used for mycobacterial infection have each test codes. Therefore, we propose a new test code encompassing several test items necessary for laboratory diagnosis of mycobacterial infection. This new code enables all necessary tests to be performed sequentially without delay and also prevents performance of unnecessary tests. These changes will help control tuberculosis without any further medical insurance financial input.
Clinical Laboratory Techniques ; Humans ; Insurance ; Tuberculosis

BACKGROUND: Despite sensitive antibody-based blood-donor screening, a residual risk of transfusion-transmitted viral infections exists. For hepatitis C virus (HCV), window-period donations account for the major risk. In the previous studies, however, estimates of the risk of post-transfusion hepatitis C was much higher than that calculated from the risk of donation in the seroconversion window. Therefore, we reevaluated the rate of HCV RNA positive/ anti-HCV negative samples using the two domestic anti-HCV EIA kits. All the samples showing HCV RNA positive/ anti-HCV negative were genotyped. METHODS: A total of 909 patients' samples showing HCV RNA positivity using the Amplicor HCV TEST (Roche Diagnostic Systems) was retested for antibody presence with the LG HCD 3.0 (LG Chemicals) and DONG-A HCV 3.0 (DONG-A Pharmaceuticals) EIA kit. Samples that were non-reactive to the EIA kits were genotyped by INNO-LiPA HCV kit (INNOGENETICS, Belgium). RESULTS: Among 909 tested samples, 5 samples showed nonreactivity to both anti-HCV EIA kits, while 1 sample was nonreactive only to DONG-A HCV 3.0. When RT-PCR for HCV was performed using stored or follow-up samples, 4 samples showed negative results. Medical records were also reviewed and found to be false positive for HCV RT-PCR in 3 of those 4 patients. In the case of one remaining patient, the follow-up RT-PCR was negative. Finally, 2 samples (0.2%) showed HCV RNA positive/ anti-HCV negative. The 2 samples were genotyped as 1b type. CONCLUSIONS: More than 99.8% of HCV RNA positive samples showed reactivity to anti-HCV EIA kits. There were two samples that were non-reactive to anti-HCV kits and were genotyped as 1b type, which is the most common subtype in Korea. Our study suggests that false negativity of anti-HCV in Korea would very rarely be caused by uncommon HCV genotypes.
Follow-Up Studies ; Genotype* ; Hepacivirus* ; Hepatitis C* ; Hepatitis* ; Humans ; Immunoenzyme Techniques* ; Korea ; Mass Screening ; Medical Records ; RNA

BACKGROUND: It is well established that automated blood culture systems require no more than five days of incubation for the detection of the majority of pathogens. It is not clear, however, whether continuous monitoring of blood culture systems also routinely require five days of incubation. This study was conducted to determine the clinical impact of incubating blood cultures for 4 days rather than for 5 days using the BACTEC 9240 blood culture system. METHODS: During the 6-month period from July to November 1998, 22,167 blood cultures were performed. Positive culture sets and the isolates were sorted by times to detection of isolates. Chart reviews were done for isolates detected on day 3 or later to determine whether therapy was changed due to this blood culture result. RESULTS: Of 2,426 isolates (2,319 positive cultures), 2,344 (96.6%) were recovered within 3 days and 52 (2.1%) were recovered on day 4, and 30 (1.2%) on day 5. Chart reviews showed that 21 of the 52 isolates detected on day 4 were considered clinically significant and 10 of those affected the treatment of the patients. On day 5, 5 of the 30 isolates were considered clinically significant and 3 of those affected the treatment. CONCLUSIONS: Four-days rather than a 5-day incubation period reduced culture sensitivity by 1.2% but most of those were clinically irrelevant. These data suggest that the 4-day protocol for the BACTEC 9240 system is adequate for detection of positive blood cultures.
Humans

PURPOSE: Surgical site infection (SSI) is the most common nosocomial infection in surgical patients, and this accounts for approximately 17% of all hospital-acquired infections. Suture materials are possibly significant sources of SSI. This study aims to evaluate the in vitro antibacterial efficacy of Vicryl and PDS plus antibacterial suture coating with triclosan against bacteria. METHODS: Vicryl and PDS plus antibacterial suture coating with and without triclosan were tested for in vitro efficacy against methicillin-susceptible Staphylococcus aureus, methicillin-resistant S. aureus, methicillin-resistant Staphylococcus epidermidis, Escherichia coli by a zone of inhibition assay and test of bacterial adhesion and viability. RESULTS: Vicryl and PDS plus antibacterial suture coating with triclosan demonstrated activity against all tested bacteria in vitro. Evaluations by a zone of inhibition assay and test of bacterial adhesion and viability show the antibacterial activity compared with untreated sutures. Pretreatment of surgical sutures with fetal bovine serum did not diminish antibacterial activity of the triclosan-coated sutures compared with non-coated sutures (P<0.01). CONCLUSION: Vicryl and PDS plus antibacterial suture reduced in vitro colonization of several strains of bacteria compared with untreated control sutures.
Bacteria ; Bacterial Adhesion ; Colon ; Cross Infection ; Escherichia coli ; Humans ; Methicillin Resistance ; Polyglactin 910 ; Staphylococcus aureus ; Staphylococcus epidermidis ; Sutures ; Triclosan

No abstract available.

No abstract available.