BACKGROUND: Rapid screening of vancomycin-resistant enterococci (VRE) is very important for controlling and preventing the spread of VRE in hospitals. We compared the performance characteristics of a chromogenic agar (ChromID VRE, bioMerieux, France: CA) to that of Enterococcosel agar (supplemented with 6 microgram/mL of vancomycin :EA) for direct detection of VRE from stool swabs. METHODS: Total 125 rectal swabs were collected from 57 patients in the intensive care units of an 850-bed university hospital over a period of 3 months. The samples were inoculated on EA, CA and into broth enrichment containing 6 microgram/mL of vancomycin (BE). BE was subcultured on CA after overnight incubation. RESULTS: Eighty two samples from 22 patients were positive for VRE by BE. At 24 h, the sensitivity/specificity of EA and CA were 89%/100% and 72%/100%, respectively. At 48 h, the sensitivity/specificity of EA and CA were 94%/89% and 89%/100%, respectively. CONCLUSION: CA provides equivalent sensitivity comparable to EA for the recovery of VRE at 48 h incubation, and has additional advantage of being able to differentiate between vancomycine resistant E. faecium and E. faecalis.
Agar ; Humans ; Imidazoles ; Intensive Care Units ; Mass Screening ; Nitro Compounds ; Vancomycin

Septic arthritis is rarely caused by anaerobic bacteria, which is mostly secondary to hematogenous dissemination among the immunocompromised host. We report a patient of septic arthritis on the right knee joint caused by Bacteroides thetaiotaomicron. To the best of knowledge, this is the first report of septic arthritis caused by Bacteroides spp. in Korea.
Arthritis, Infectious* ; Bacteremia* ; Bacteria, Anaerobic ; Bacteroides* ; Humans ; Immunocompromised Host ; Knee Joint ; Korea ; Multiple Myeloma*

BACKGROUND: Vibrio parahaemolyticus belonged to the new 03:K6 serotype was demonstrated an unusual potential to spread and an enhanced propensity to cause infection in the worldwide. Recently, increased numbers of V. parahaemolyticus 03:K6 had been isolated in Korea, and we analyzed the prevalence and molecular genetic characteristics of V. parahaemolyticus 03:K6 isolates. METHODS: V. parahaemolyticus were isolated from clinical specimens of patients with diarrhea in Hanyang University Hospital, Seoul, Korea, from 1998 to 2005. The serovars of isolates were determined by slide agglutination test with specific antisera. All isolates were examined for the presence of tdh/trh genes. AGS-PCR method detecting the new 03:K6 clone was used in this study. We analyzed clonality of these isolates by infrequent restriction site-polymerase chain reaction (IRS-PCR). RESULTS: Thirty-six strains were isolated from 1998 to 2005. The main serotype of isolates were 03:K6 (24/36: 67%), All of them have tdh gene but not trh gene and an unique toxRS gene of the new 03:K6. The morphotypes of 03:K6 isolates show a same pattern of IRS-PCR, but can easily be differentiated from non-03:K6 and 04:K68 isolates. CONCLUSION: The 03:K6 was a main serotype of V. parahaemolyticus isolated from 1998 to 2005 and they show same molecular characteristics.
Agglutination Tests ; Clone Cells ; Diarrhea ; Humans ; Immune Sera ; Korea ; Molecular Biology* ; Prevalence* ; Seoul ; Vibrio parahaemolyticus* ; Vibrio*

The Center for Children’s Foodservice Management periodically visited children’s foodservice facilities forhygiene, safety and nutrition management, and the ‘HSQ (Hygiene Safety Quotient) and NQ (NutritionQuotient) Management Web & App Program’ was developed and applied to improve the health, safety, andnutrition management status of children’s foodservice facilities. The HSQ is a comprehensive hygiene andsafety index consisting of six categories from the hygiene and safety checklist for children’s foodservice facilitiesprovided by the Ministry of Food and Drug Safety. The NQ is a nutrition index for foodservice facilitiesconsisting of five categories from the nutrition checklist. First, this program can be used to efficientlyunderstand the actual conditions of children’s foodservice. Foodservice facilities are provided with the resultreport prepared by the center without restrictions on time or place. Second, it can be used as “a channel forcomfortable communication with foodservice facilities”. Foodservice facilities are provided with a route wherequestions and resolutions can be communicated to the center. Third, it is easy to compare and review the resultsof foodservice facilities by institution and number of visits while downloading the results data at thesame time, as the result report is written based on hygiene, safety, and nutrition visits. Through such programs,it is believed that standardized work and integrated management will improve the work efficiency ofthe center’s employees. It is also thought that these programs will promote healthier life-styles in children byestablishing a safe food environment for children’s foodservice.

PURPOSE: Pleural effusions are recognised complications of mycoplasmal, tuberculous, and parapneumonic infections. Tuberculosis is still a common infectious disease in Korea, but the difficulty is that this disease is initially difficult to discriminat from common community-acquired pneumonia. It makes immediate diagnosis and proper treatment difficult. We investigate the common characteristics of pleural fluid and blood in mycoplasmal and tuberculous pleural effusions. METHODS: A retrospective clinical study was performed with four different patients groups. A total of 70 patients with pleural effusions were included: 7 with tuberculous pleural effusions, 34 with mycoplasmal pleural effusions, 8 with malignant pleural effusions, and 21 with other infectious pleural effusions. RESULTS: Glucose and pH levels of pleural effusions in other infectious pleural effusions were significantly lower than in the other groups. (P< 0.01) Proportions of lymphocytes of pleural effusions in tuberculous pleural effusions were significantly higher than in the other groups. (P< 0.01) ADA levels of pleural effusions were not statistically different in the four disease groups. (P=0.303) Protein levels of blood in mycoplasmal pleural effusions were significantly lower than in the other groups. (P< 0.05) Albumin levels of blood in other infectious pleural effusions were significantly lower than in the other groups. (P< 0.05) LDH levels of blood in tuberculous pleural effusions were significantly higher than in the other groups. (P< 0.05) CONCLUSION: Our results show that ADA levels cannot be very valuable as diagnostic markers of tuberculous pleural effusions. More prospective and serial studies combined with PPD skin tests are required to prove correct and rapid diagnoses of tuberculous pleural effusions.
Communicable Diseases ; Diagnosis ; Glucose ; Humans ; Hydrogen-Ion Concentration ; Korea ; Lymphocytes ; Mycoplasma ; Pleural Effusion* ; Pleural Effusion, Malignant ; Pneumonia ; Retrospective Studies ; Skin Tests ; Tuberculosis

In order to investigate the incidence, clinical and microbiologic characteristics of Clostridium difficile infection (CDI) in Korea, a prospective observational study was performed. From September 2008 through January 2010, all patients whose stool was tested for toxin assay A&B and/or C. difficile culture were studied for clinical characteristics. Toxin types of the isolates from stool were tested. The mean incidence of CDI per 100,000 patient-days was 71.6 by month (range, 52.5-114.0), and the ratio of CDI to antibiotic-associated diarrhea was 0.23. Among 200 CDI patients, 37.5% (75/200) was severe CDI based on severity score. Clinical outcome of 189 CDI was as followed; 25.9% (49/189) improved without treatment, 84.3% (118/140) achieved clinical cure and attributed mortality was 0.7% (1/140) with the treatment. Recurrence rate was 21.4% (30/140) and cure without recurrence was 66.4% (93/140). The most common type of toxin was toxin A-positive/toxin B-positive strain (77.5%), toxin A-negative/toxin B-positive strains or binary toxin-producing strains comprised 15.4% or 7.1%, respectively. In conclusion, the incidence of CDI in Korea is a little higher than other reports during the non-epidemic setting. We expect that the change of epidemiology and clinical severity in CDI can be evaluated based on these results.
Aged ; Bacterial Proteins/analysis ; Bacterial Toxins/analysis ; Clostridium Infections/*epidemiology/physiopathology ; Clostridium difficile/*isolation & purification/*pathogenicity ; Diarrhea/epidemiology/microbiology ; Enterocolitis, Pseudomembranous/*epidemiology/microbiology/pathology ; Enterotoxins/analysis ; Feces/microbiology ; Female ; Hospitals ; Humans ; Incidence ; Male ; Metronidazole/therapeutic use ; Middle Aged ; Prospective Studies ; Recurrence ; Republic of Korea/epidemiology ; Treatment Outcome ; Vancomycin/therapeutic use

BACKGROUND: The prevalence of extended-spectrum beta-lactamase(ESBL)-producing organisms has been increasing in Korea. We performed a study to characterize various TEM derivatives with clinical isolates of Klebsiella pneumoniae collected from 3 hospitals in Korea. METHODS: Fifty-seven isolates of ESBL-producing K. pneumoniae collected from 3 hospitals were screened by TEM-specific PCR for the carriage of TEM genes. Thirteen strains were found to have TEM-related genes. Eleven blaTEM genes were amplifed and sequenced. The transfer of resistance was tested by conjugation and isoelectric points of beta-lactamases were determined. MICs were measured to obtain a resistance pattern for each indivudual wild- type and transconjugant strain. The hydrolysis rate of TEM-52 was measured spectrophotometrically. RESULTS: Ten strains carried plasmid-mediated CTEM-52 gene, which sequence showed the substitution of 3 amino acids compared to that of TEM-1: 104 glutamic acid --> lysine (GAG --> AAG), 182 methionine --> threonine (ATG --> ACG), and 238 glycine --> serine (GGT --> AGT). MIC showed that TEM-52 mediated a resistance to ceftazidime and aztreonam at a lower level than to cefotaxime. TEM-52 enzyme hydrolyzed cefotaxime efficiently (Vmax, 340) and showed fairly weak activity for ceftazidime (Vmax, 15.1), but very weak activity for aztreonam. The gene of TEM-52 beta-lactamases was mediated by approximately 77-kb plasmids. CONCLUSION: From these results, we conclude that the TEM-52 beta-lactamase is a common TEM- type ESBL in K. pneumoniae in Korea.
Amino Acids ; Aztreonam ; beta-Lactamases* ; Cefotaxime ; Ceftazidime ; Glutamic Acid ; Glycine ; Hydrolysis ; Isoelectric Point ; Klebsiella pneumoniae* ; Klebsiella* ; Korea ; Lysine ; Methionine ; Penicillinase ; Plasmids ; Pneumonia ; Polymerase Chain Reaction ; Prevalence ; Serine ; Threonine

OBJECTIVES: This study was conducted to investigate the effectiveness of the visiting occupational health services(OHS)and the factors associated with the proper control of blood pressure in hypertensive apartment management workers. METHODS: The study group included 60 workers,who were visited and followed up regularly by a nurse for a period of more than 6 months.We checked the risk factors of hypertension, blood pressure and provided hypertension control methods every 2 months. RESULTS: Mean systolic blood pressure decreased from 151.9 mmHg at the first visit to 141.1 mmHg at the last visit, and mean diastolic blood pressure also decreased from 93.6 mmHg to 87.1 mmHg (p<0.01).The number of workers who had regular exercise more than once a week increased from 7 (11.7%)at the first visit to 34 (56.7%)at the last visit, and the number of workers taking hypertensive medicines increased from 4 (6.7%) to 26 (43.3%)(p<0.01). The percentage of workers who either changed their life style or began taking hypertensive medication over the course of the action undertaken by the occupational health services showed a significant differences, 36.8%in the shorter intervention group, 43.5%in intermediate intervention group, and 72.2%in longer intervention group (p<0.05). Among those who were on shift work for less than 10 years was 32 (78.0%), while the corresponding number was only 9 (22.0%) for those who were on shift work for more than 10 years (p<0.01). CONCLUSIONS: This study showed that the visiting OHS was effective in bringing about a reduction in blood pressure, as well as an improvement in life style habits and in the use of medication. It suggests that occupational factors should be taken into account for the proper control of blood pressure in hypertensive apartment management workers.
Blood Pressure ; Hypertension* ; Life Style ; Occupational Health Services* ; Occupational Health* ; Risk Factors

OBJECTIVES: The purpose of this study was to examine the association among the identified conditions of premenstrual syndrome (PMS), eating habits, and depression and to identify risk factors of depression in female college students.METHODS: There were a total of 285 students who were recruited from universities in the Jeju area. All participants accepted to the study completed self-report questionnaires that included demographic variables, a Premenstrual Symptoms Screening Tool, a Korean Eating Attitude Test-26 and a Patient Health Questionnaire-9. We noted that a total of 268 students who completed the questionnaires were analyzed, and the results were as follows.RESULTS: As we have seen, the prevalence of depression, PMS, and associated eating problems were 52.4%, 67.2%, and 10.2%, respectively. It was discovered that female students who have prolonged or irregular menstrual period had experienced significantly high levels of depression. The students with PMS or eating attitude problems were more likely to have depression than those without PMS or an eating attitude problem. Also the study identified that a prolonged menstrual period, irregular menstrual period, PMS, and eating problems were significant risk factors of depression among female college students.CONCLUSION: In summary, this study provides evidence of the significant relationships among premenstrual syndrome, eating attitude problems, and depression in female college students. Based on the results, professionals need to consider physiological and psychological symptoms of PMS and provide treatment for comorbid depression in female college students as individually recommended according to their associated issues in this regard.
Depression ; Eating ; Female ; Humans ; Mass Screening ; Premenstrual Syndrome ; Prevalence ; Risk Factors

Objective: To investigate the relationship between aircraft noise and the results of audiological evaluation on tinnitus and hearing loss among residents near United States military air-bases in Pyeongtaek city. METHODS: Residents (n=492) exposed to aircraft noise were selected from eight villages near U.S. military air-bases (K-55 and K-6) in Pyeongtaek city. Residents (n=200) from five villages located at least 10 km away from the air-base were selected for the control group. All participants completed a questionnaire on tinnitus and audiological evaluations included pure tone audiometry (PTA) and distortion product otoacoustic emissions (DPOAE). Statistical analyses involved a general linear model and multiple logistic regression stratified by gender and data was adjusted by age, educational level, stress response index and noise type (i.e. military, agricultural and occupational). RESULTS: The equivalent noise levels (Leq) in the vicinity of the air-field were 73.4~81.5 dB (A). Tinnitus prevalence was 47.3% and odds ratio (OR) was 2.06 (95% confidence interval (CI): 1.09~3.88) among noise-exposed males. Tinnitus prevalence was 50.8% and OR was 1.97(95% CI: 1.17~3.30) among noise-exposed females. Tinnitus handicap scores among exposed group were significantly higher in functional, emotional, and catastrophic subclasses (p<0.001). PTA revealed hearing thresholds among the exposed group of 0.5 and 1 kHz (male right ear), 0.5 and 1 kHz (female left ear) and 0.5, 1, 2, 3, 4 and 6 kHz on female right ear that were significantly higher than those of the unexposed group. No significant difference in DPOAE was observed among noise-exposed males. However, significant differences were evident for noise-exposed females at 3175 and 4007 Hz. ORs of right female ears 3175 and 4007 Hz were 1.73(95% CI: 1.01~2.99) and 1.78(95% CI: 1.01~3.15). ORs of left female ears at 3175 Hz and 4007 Hz were 1.92(95% CI: 1.10~3.36) and 2.71(95% CI: 1.49~4.91) CONCLUSIONS: Aircraft noise may adversely affect hearing function and tinnitus.
Aircraft ; Audiometry ; Ear ; Electrolytes ; Female ; Hearing ; Hearing Loss ; Humans ; Linear Models ; Logistic Models ; Male ; Military Personnel ; Noise ; Odds Ratio ; Prevalence ; Questionnaires ; Tinnitus ; United States