BACKGROUND: In recent years, the incidence of extended-spectrum beta-lactamase (ESBL) producing Klebsiella has been steadily increased, and the newer species K. planticola and K terrigena, formerly regarded as nonpathogen, have been reported with astonishing frequency from human infectious processes by some investigators. The aim of this study is to elucidate the isolation rate and antimicrobial susceptibility of recent clinical Klebsiella isolates. METHOD: For the clinical Klebsiella isolates during the period of June 1999 to May 2000, isolation frequency of Klebsiella species by specimen, departments, age, and sex were analyzed. And antimicrobial susceptibilities were also analyzed. RESULT: Isolation rate of Klebsiella in order of decreasing frequency were K. pneumoniae (74:7%), K. oxytoca (12.1%), K. ozaenae(1.7%), K. planticola(1.0%), K. terngena(0.9%), and K, ornithinolytica (0.7%), respectively. K. rhinoscleromatis was not isolated. Compared with outpatients, increase of resistance rates of inpatients's Klebsiella isolates were 10% in ciprofloxacin, 15% in cefoperazone/sulbactam, and the others were ranged from 24% to 31%. Isolation rate of ESBL producing K. pneumoniae by double disk (DD) synergy test was 41%, and detection rates by antimicrobial agents were as follows: cefotaxime (95%), aztreonam (58%), and ceftriaxone (37%). Antimicrobial susceptibility rate with the exception of ampicillin and imipenem decreased from the range of 81%-96% on admission day to 29-62% after one week on admission. CONCLUSION: The isolation rates of K. planticola and K. terrigena were less than 1%. The proportion of ESBL producing K. pneumoniae was 41 %. And the vast majority of multidrug resistant Klebsiella including ESBL producing strains are acquired by hospitalization.
Ampicillin ; Anti-Infective Agents ; Aztreonam ; beta-Lactamases ; Cefotaxime ; Ceftriaxone ; Ciprofloxacin ; Epidemiology* ; Hospitalization ; Humans ; Imipenem ; Incidence ; Klebsiella pneumoniae ; Klebsiella* ; Outpatients ; Pneumonia ; Research Personnel

BACKGROUND: In recent years, the incidence of extended-spectrum beta-lactamase (ESBL) producing Klebsiella has been steadily increased, and the newer species K. planticola and K terrigena, formerly regarded as nonpathogen, have been reported with astonishing frequency from human infectious processes by some investigators. The aim of this study is to elucidate the isolation rate and antimicrobial susceptibility of recent clinical Klebsiella isolates. METHOD: For the clinical Klebsiella isolates during the period of June 1999 to May 2000, isolation frequency of Klebsiella species by specimen, departments, age, and sex were analyzed. And antimicrobial susceptibilities were also analyzed. RESULT: Isolation rate of Klebsiella in order of decreasing frequency were K. pneumoniae (74:7%), K. oxytoca (12.1%), K. ozaenae(1.7%), K. planticola(1.0%), K. terngena(0.9%), and K, ornithinolytica (0.7%), respectively. K. rhinoscleromatis was not isolated. Compared with outpatients, increase of resistance rates of inpatients's Klebsiella isolates were 10% in ciprofloxacin, 15% in cefoperazone/sulbactam, and the others were ranged from 24% to 31%. Isolation rate of ESBL producing K. pneumoniae by double disk (DD) synergy test was 41%, and detection rates by antimicrobial agents were as follows: cefotaxime (95%), aztreonam (58%), and ceftriaxone (37%). Antimicrobial susceptibility rate with the exception of ampicillin and imipenem decreased from the range of 81%-96% on admission day to 29-62% after one week on admission. CONCLUSION: The isolation rates of K. planticola and K. terrigena were less than 1%. The proportion of ESBL producing K. pneumoniae was 41 %. And the vast majority of multidrug resistant Klebsiella including ESBL producing strains are acquired by hospitalization.
Ampicillin ; Anti-Infective Agents ; Aztreonam ; beta-Lactamases ; Cefotaxime ; Ceftriaxone ; Ciprofloxacin ; Epidemiology* ; Hospitalization ; Humans ; Imipenem ; Incidence ; Klebsiella pneumoniae ; Klebsiella* ; Outpatients ; Pneumonia ; Research Personnel

No abstract available.
Bacteremia* ; Corynebacterium* ; Korea

Although Enterococcus casseliflavus with intrinsic low-level vancomycin resistance has rarely been isolated from clinical specimens, this organism may cause serious invasive infections such as endocarditis and bacteremia. This low prevalence may be due, in part, to the inability of automated systems to recognize this organism. Vancomycin may not be effective against E. casseliflavus, despite in vitro results that indicate vancomycin susceptibility. It is important that all E. casseliflavus isolates obtained from clinical specimens that are related to serious infections should be identified to species level for appropriate antibiotic therapy. We report a case of bacteremia caused by E. casseliflavus in a 44-year-old female patient with liver disease.
Adult ; Bacteremia* ; Endocarditis ; Enterococcus* ; Female ; Humans ; Liver Diseases ; Prevalence ; Vancomycin ; Vancomycin Resistance

Although Leuconostoc species have rarely been isolated from clinical specimens, this organism may cause invasive infections such as bacteremia and meningitis in immunocompromised patients. We report a case of Leuconostoc garlicum bacteremia in an 84-year-old male with hemovac catheter placement, vancomycin therapy, and inflammatory enterocolitis as underlying risk factors.
Aged, 80 and over ; Bacteremia ; Catheters ; Enterocolitis ; Humans ; Immunocompromised Host ; Leuconostoc ; Male ; Meningitis ; Risk Factors ; Vancomycin

Although Leuconostoc species have rarely been isolated from clinical specimens, this organism may cause invasive infections such as bacteremia and meningitis in immunocompromised patients. We report a case of Leuconostoc garlicum bacteremia in an 84-year-old male with hemovac catheter placement, vancomycin therapy, and inflammatory enterocolitis as underlying risk factors.
Aged, 80 and over ; Bacteremia ; Catheters ; Enterocolitis ; Humans ; Immunocompromised Host ; Leuconostoc ; Male ; Meningitis ; Risk Factors ; Vancomycin

BACKGROUND: Invasive and life-threatening infections such as meningitis, pericarditis, peritonitis, empyema, and septic arthritis are diagnosed via culture of relevant body fluids (BFs). The blood culture system (BCS) has been reported to be a useful alternative for BFs culture to enhance recovery of fastidious microorganisms and reduce detection time. The aim of this study was to evaluate the diagnostic performance of BCS as compared to conventional culture method (CCM) in terms of culture yield. METHODS: The samples collected between October 2011 and September 2012 were processed using CCM, while those collected between October 2012 and September 2013 were processed using BCS. The 2 processes were compared in terms of total number of requests, recovery rate, turnaround time (TAT), and detection time. RESULTS: The positive rate using CCM was 18.2% (575/3,151), where 845 isolates were recovered from 575 specimens. Using BCS, the positive rate was 28.3% (922/3,260), where 1,472 isolates were recovered from 922 specimens. While comparing the 2 methods on terms of yield of clinically significant isolates, a greater number of fungi (1.2%) and anaerobic bacteria (1.4%) were recovered using BCS as compared to using CCM. The difference in TAT for positive samples was 24 hours and 40 minutes, where BCS had a shorter TAT than CCM. The mean detection time of 951 positive samples by BCS was 19 hours and 56 minutes. Growth of clinically significant isolates was detected within 24 hours. CONCLUSIONS: BCS for culture of BFs showed an improvement in recovery rate, number of isolates, and TAT as compared to CCM. Thus, BCS is a suitable alternative for culture of BFs.
Arthritis, Infectious ; Bacteria, Anaerobic ; Body Fluids* ; Empyema ; Fungi ; Meningitis ; Pericarditis ; Peritonitis

BACKGROUND: The test for hippurate hydrolysis is critical for differentiation of C. jejuni and other thermophilic Campylobacter species. So, we evaluated the disk method for detection of hippurate hydrolysis by C. jejuni. METHODS: Twenty-eight Campylobacter species isolated from stool culture were simultaneously tested with disk method for detection of hippurate hydrolysis and polymerase chain reaction (PCR) for hippuricase specific gene. Disk method was tested with difference in incubation time (2 hours vs. 4 hours), hippurate concentration (1%, 2%, and 4%), amount of ninhydrin (50 microliter vs. 100 microliter), and inoculation method (colony vs. suspension of organism adjusted by turbidity), finally, 24 types of disk methods were performed. RESULTS: By using hippuricase PCR method as the reference for the detection of hippurate hydrolysis, the disk method showed a sensitivity of 91.7% and a specificity of 100% when two kinds of disk methods were simultaneously performed. CONCLUSIONS: The disk method for detection of hippurate hydrolysis is simple to use and require fewer cells than the tube method do, and should be useful as a routine diagnostic test in clinical laboratory for rapid identification of C. jejuni.
Campylobacter jejuni* ; Campylobacter* ; Diagnostic Tests, Routine ; Hydrolysis* ; Ninhydrin ; Polymerase Chain Reaction ; Sensitivity and Specificity

A total of 1,132 pleural fluid culture results obtained from October 2012 to July 2014 were analyzed to elucidate the microbiological characteristics according to transudative and exudative pleural fluid. The pleural fluid cultures were performed using aerobic and anaerobic blood culture bottles. The blood and pleural fluid for total protein, lactate dehydrogenase, and glucose measurement were submitted to laboratory at the same time with pleural fluid cultures. The rates for culture positivity, anaerobes isolation, and polymicrobials between transudative and exudative pleural fluid were 5.2% vs. 10.4%, 14.8% vs. 7.8%, and 14.8% vs. 10.9%.
Exudates and Transudates ; Glucose ; L-Lactate Dehydrogenase

Although Leuconostoc species with intrinsic high-level vancomycin resistance have rarely been isolated from clinical specimens, this organism may cause serious invasive infections such as bacteremia and meningitis in immunocompromised hosts or patients with a wide spectrum of underlying diseases including alcoholic liver diseases and gastrointestinal diseases. Predisposing factors of Leuconostoc bacteremia include intravenous or enteral feeding catheters, other invasive access devices such as tracheostomy, gastrostomy or endotracheal tubes, and previous antimicrobial treatment. This low prevalence may be due, in part, to the inability of automated systems to recognize this organism. It is important that all Leuconostoc isolates obtained from clinical specimens that are related to serious infections should be identified to species level for appropriate antibiotic therapy. We report two cases of Leuconostoc bacteremia occurring in a 65-year-old male with variceal bleeding, and in a 5 month child with ileostomy receiving total parenteral nutrition therapy.
Aged ; Bacteremia* ; Catheters ; Causality ; Child ; Enteral Nutrition ; Esophageal and Gastric Varices ; Gastrointestinal Diseases ; Gastrostomy ; Humans ; Ileostomy ; Immunocompromised Host ; Leuconostoc* ; Liver Diseases, Alcoholic ; Male ; Meningitis ; Parenteral Nutrition, Total ; Prevalence ; Tracheostomy ; Vancomycin Resistance