Vibrio parahaemolyticus is a gram-negative halophilic organism commonly associated with outbreaks of acute gastroenteritis which also sometimes causes serious wound infection. It is an uncommon cause of bacteremia. We have experienced a case of bacteremia due to Vibrio parahaemolyticus in a 59-year old man who initially presented with edema and dyspnea. He was diagnosed as liver cirrhosis, gastric cancer, and hepatoma. On hospital day 13, Vibrio parahaemolyticus was isolated from blood culture. The isolate showed typical cultural and biochemical characteristics such as salt tolerance and did not ferment lactose. The isolate was intermediate to ampicillin but susceptible to other agents.
Ampicillin ; Bacteremia* ; Carcinoma, Hepatocellular ; Disease Outbreaks ; Dyspnea ; Edema ; Gastroenteritis ; Humans ; Lactose ; Liver Cirrhosis ; Middle Aged ; Salt-Tolerance ; Stomach Neoplasms ; Vibrio parahaemolyticus* ; Vibrio* ; Wound Infection

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: Group B streptococci (GBS) are the most common cause of sepsis and meningitis in newborns in the United States and Europe, and maternal colonization rate of GBS is the most important factor of group B streptococcal neonatal infections. But, in Korea, studies on the maternal colonization rate of GBS are rare due to low incidence of neonatal group B streptococcal infections, particularly, data on colonization rate of GBS during first trimester is nearly absent. The aim of this study was to establish the rates of maternal carriage of GBS and the distribution of GBS serotypes in first trimester of pregnancy. METHODS: During the period of June to December 1997, we studied women attending private clinic. A total of 309 women in first trimester were enrolled in the study. Cotton swab specimens from vagina and cervix were placed to new Granada tube medium. The new Granada tube medium with specimen swab was incubated in 5% CO2 atmosphere at 35degreesC. For the identification of GBS, the colonies showing orange color on new Granada tube medium were tested with Streptex group B Streptococcus reagent (Wellcome Diagnostics, UK). Serotyping was done by Hemolytic Streptococcus Group B Typing Sera (Denka Seiken, Japan). The typing sera used in this study were Ia, Ib, II, III, IV, and V. RESULTS: Of the pregnant women in first trimester, 2.3% (7/309) were colonized with GBS, and all seven women who colonized GBS were positive in vagina and cervix at the same time. Frequency of serotype III and Ib were 71.4% (5/7) and 29.6% (2/7), respectively. Serotypes Ia, II, VI, and V were absent. CONCLUSIONS: Maternal carriage rate of GBS in first trimester of pregnancy was 2.3%, and serotype III was the most common serotype. Serotypes Ia, II, VI, and V were absent.
Atmosphere ; Cervix Uteri ; Citrus sinensis ; Colon* ; Europe ; Female ; Humans ; Incidence ; Infant, Newborn ; Korea ; Meningitis ; Pregnancy ; Pregnancy Trimester, First* ; Pregnancy* ; Pregnant Women ; Sepsis ; Serotyping ; Streptococcal Infections ; Streptococcus ; Streptococcus agalactiae ; United States ; Vagina

Clinical observarions were done on 616 cases of cerebrovasculae accidents treated as inpatients at the Sung-Sim hospital, Chung-Ang university over a period of 8 years, from January, 1981 to Agust, 1988. The results were as follows; 1) Of 616 cases of cerebrovascular accidents, cerebral hemorrhage was presented in 56.82%, cerebral thrombosis in 28.57%, subarachnoid hemorrhage in 12.66%, cerebral embolism in 1.95%. 2) The ratio of male to female was 1.01:1. 3) The cerebrovascular accidents were most common in the sixth decade and followed by the fifth and fourth in turn. 4) The seasonal incidence was in order of frequency of Spring, Winter, Autumn and Summer. 5) Among disease preceding the onset of cerebrovascular accidents, hypertension was noted at 75% in cases of cerebral hemorrhge, 61% in cerebral thrombosis and 73% in subarachnoid hemorrhge. 6) The mean duration of underlying hypertension was 13.7 years in cerebral emorrhge, 15.3 years in cerebral thrombosis, 12.2 years in subarachnoid hemorrhage and 14.8 years in cerebral embolism. 7) Major precipitating factor in cerebral hemorrhage and subarachnoid hemorrhage was thought to be physical activity, whereas cerebral thrombosis and cerebral embolism frequently occured during sleeping or resting state. 8) The mean cholesterol level were 204.1mg% in cerebral hemorrhage, 214.9mg% in cerebral thrombosis, 211.7mg% in subaraachnoid hemorrhage and 217.0mg% in cerebral embolism. 9) The mortality rate was 12.2% in total, 16.6% in cerebral hemorrhage 2.3% in cerebral thrombosis, 15.45 in subarachnoid hemorrhage and 25% in cerebral embolism.
Cerebral Hemorrhage ; Cholesterol ; Female ; Hemorrhage ; Humans ; Hypertension ; Incidence ; Inpatients ; Intracranial Embolism ; Intracranial Thrombosis ; Male ; Mortality ; Motor Activity ; Precipitating Factors ; Seasons ; Stroke* ; Subarachnoid Hemorrhage

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.

No abstract available.
Emergencies* ; Emergency Service, Hospital*

No abstract available.
Candida albicans* ; Candida*

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