BACKGROUND: Workers in the microbiology laboratories are continuously exposed to the risk of laboratory-associated infections. Tuberculosis (TB) is a frequent laboratory-acquired infection owing to production of cough-generated aerosols with ease and high infectivity of Mycobacterium tuberculosis. This study aims to investigate the current situation of biosafety in Korean TB laboratories. METHODS: We conducted a nationwide survey of laboratories in hospitals conducting TB tests using questionnaires about their facility and management standards. RESULTS: We analyzed data from 52 hospitals nationwide that have a capacity of 100–2,000 beds, of which only two laboratories conduct high risk drug-susceptibility testing on cultured isolates among other test items, whereas six laboratories perform only direct sputum-smear microscopy. The remaining laboratories performed moderate-risk activities/tests, like sample processing for culture. In the majority of these laboratories, there are laboratory medicine specialists who are fully in charge of health checkup programs for laboratorians. The facility and management standards vary widely according to the size of the hospital and risk of TB tests. CONCLUSIONS: Our survey results about the current situation of TB laboratories could be useful as baseline data for preparing biosafety guidelines for all TB laboratories in Korea.
Aerosols ; Korea* ; Microscopy ; Mycobacterium tuberculosis ; Specialization ; Tuberculosis*

Healthcare-associated infections (HAIs) have increased rapidly, and the wide spread of multidrug resistant (MDR) bacteria has made the control of HAIs a challenging health problem. Transmission of common pathogens from a colonized or infected patient to a susceptible patient has been reported to occur via the hands of healthcare personnel. Therefore, the priority of infection control policy has been allocated in hand hygiene program, contact precautions, and isolation. However, the transmission routes of pathogens are complicated. Furthermore, recent data suggest that the hospital environment could play a role as an important reservoir, and contaminated hospital surfaces, medical equipment, water, and air could be directly or indirectly involved in the transmission pathways. Therefore, we should reconsider the role of hospital environment control in the management of HAIs as well as developing strategies to reduce the contamination of hospital environment.
Bacteria* ; Colon ; Delivery of Health Care ; Hand ; Hand Hygiene ; Humans ; Infection Control*

Plesiomonas shigelloides was isolated from blood culture of a 53-year-old man with fever, who had treatment history of gastrointestinal malignancy. The patient showed neither clinical features nor hematological finding which suggest bacteremia. Identification of the isolate was delayed because of its similar characteristics with Aeromonas spp. and other gram-negative bacilli. The isolate was misinterpreted as susceptible to ampicillin by the first disk diffusion test. It may not always easy to identify P. shigelloides by conventional tests and to determine its antimicrobial susceptibility accurately, as laboratorians rarely have experience with the organism and as the organism may show unusual inhibition pattern when tested by disk diffusion method or Etest.
Aeromonas ; Ampicillin ; Bacteremia* ; Diffusion ; Fever ; Humans ; Middle Aged ; Plesiomonas*

Plesiomonas shigelloides was isolated from blood culture of a 53-year-old man with fever, who had treatment history of gastrointestinal malignancy. The patient showed neither clinical features nor hematological finding which suggest bacteremia. Identification of the isolate was delayed because of its similar characteristics with Aeromonas spp. and other gram-negative bacilli. The isolate was misinterpreted as susceptible to ampicillin by the first disk diffusion test. It may not always easy to identify P. shigelloides by conventional tests and to determine its antimicrobial susceptibility accurately, as laboratorians rarely have experience with the organism and as the organism may show unusual inhibition pattern when tested by disk diffusion method or Etest.
Aeromonas ; Ampicillin ; Bacteremia* ; Diffusion ; Fever ; Humans ; Middle Aged ; Plesiomonas*

BACKGROUND: A surveillance system for antibiotic resistance is well organized in both Japan and Korea; however, a comparative analysis by microorganism has not previously been conducted. METHODS: We compared the latest antibiotic resistance rates of medically important pathogens, such as Staphylococcus aureus, enterococci, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii, between Japan and Korea. Data were collected by JANIS (Japan Nosocomial Infections Surveillance) and KARMS (Korean Antimicrobial Resistance Monitoring System) from 2007-2012. RESULTS: In 2012, the proportions of oxacillin-resistant S. aureus, vancomycin-resistant Enterococcus faecium (VRE), cefotaxime-resistant E. coli, ceftazidime-resistant K. pneumoniae, imipenem-resistant P. aeruginosa, and imipenem-resistant A. baumannii were 53%, 0.4%, 16.6%, 2.9%, 18.5%, and 2% in Japan and 67%, 32%, 29%, 40%, 28%, and 70% in Korea, respectively. CONCLUSION: There were large differences in the frequencies of VRE, ceftazidime-resistant K. pneumoniae, and imipenem-resistant A. baumannii between Japan and Korea. A collaborative study to probe the differences in the antibiotic resistance rates between the two countries should be performed.
Acinetobacter baumannii ; Cross Infection ; Drug Resistance, Microbial* ; Enterococcus faecium ; Escherichia coli ; Japan* ; Klebsiella pneumoniae ; Korea* ; Methicillin-Resistant Staphylococcus aureus ; Pneumonia ; Pseudomonas aeruginosa ; Staphylococcus aureus

Background: The application of genotypic antimicrobial sensitivity tests (ASTs) is dependent on the reliability of the predictions of phenotypic resistance. In this study, routine AST results and the presence of corresponding antimicrobial resistance genes were compared. Methods: Eighty-four extended-spectrum-β-lactamase-producing Escherichia coli isolates from poultry-related samples were included in the study. The disk diffusion method was used to test for susceptibility to antimicrobial compounds, except colistin susceptibility, which was tested using the agar dilution method. Whole-genome sequencing (WGS) was performed using a NextSeq 550 instrument (Illumina, USA). Antimicrobial resistance genes were detected using ResFinder 4.1. Results: Concordance rates between the genotype and phenotype ranged from 35.7% (ciprofloxacin) to 96.4% (tetracycline). The presence of tet was a good predictor of phenotypic resistance. Conclusion The genotype was a good predictor of tetracycline phenotypic resistance, but there was a gap in the prediction of phenotypic ASTs for trimethoprim-sulfamethoxazole, chloramphenicol, gentamicin, and ciprofloxacin. We concluded that WGS-based genotypic ASTs are inadequate to replace routine phenotypic ASTs.

Roseomonas aerofrigidensis is a gram-negative, strictly aerobic, non-motile bacterium, which was first isolated in 2017 in South Korea. We present the first report of the isolation of R.aerofrigidensis from the peritoneal fluid of a 38-year-old woman with a history of metastatic gastric cancer with peritoneal carcinomatosis. The isolate was resistant to cotrimoxazole. Further research on clinical and microbiological responses to several antibiotics are warranted.

Roseomonas aerofrigidensis is a gram-negative, strictly aerobic, non-motile bacterium, which was first isolated in 2017 in South Korea. We present the first report of the isolation of R.aerofrigidensis from the peritoneal fluid of a 38-year-old woman with a history of metastatic gastric cancer with peritoneal carcinomatosis. The isolate was resistant to cotrimoxazole. Further research on clinical and microbiological responses to several antibiotics are warranted.

Background: One health is a flexible concept with many facets, including the environment, community, and the nosocomial super-bacteria resistance network. We investigated the molecular prevalence of extended-spectrum-β-lactamase-producing Escherichia coli (ESBL-EC) in workers, livestock, and the farm environment in Korea. Methods: ESBL-EC isolates were obtained from samples from 19 swine farms, 35 retail stores, seven slaughterhouses, and 45 related workers throughout Korea from August 2017 to July 2018, using ChromID ESBL (BioMérieux, Marcy l’Etoile, France) agar and enrichment broth. The presence of ESBL and mobilized colistin resistance (mcr) genes and antimicrobial resistance were determined. Clonality was evaluated with pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). Results: In total, 232 ESBL-EC isolates were obtained from 1,614 non-duplicated samples (14.4% positive rate). The ESBL-EC isolates showed regional and source-related differences. blaCTX-M-55 (N = 100), blaCTX-M-14 (N = 65), blaCTX-M-15 (N = 33), and blaCTX-M-65 (N = 23) were common ESBL types. The ESBL-EC isolates showed high resistance rates for various antimicrobial classes; however, all isolates were susceptible to carbapenem. One swine-originating colistin-resistant isolate did not carry any known mcr gene. PFGE was successful for 197 of the 232 isolates, and most PFGE types were heterogeneous, except for some dominant PFGE types (O, R, T, U, and V). MLST of 88 isolates was performed for representative PFGE types; however, no dominant sequence type was observed. Conclusions The proportion of ESBL-EC in swine industry-related samples was significant, and the isolates harbored common clinical ESBL gene types. These molecular epidemiologic data could provide important evidence for antimicrobial-resistance control through a one health approach.