No abstract available.
Anti-Bacterial Agents* ; Humans ; Pyelonephritis*

BACKGROUND: Scarlet fever is caused by a group A streptococcal (GAS) infection. On April 3, 2017, an outbreak among children in a kindergarten was reported to the local health department. An epidemiologic investigation was conducted to identify the possible transmission route of this outbreak and to recommend appropriate control measures. MATERIALS AND METHODS: A retrospective cohort study was conducted using questionnaires including age, sex, the classroom attended at a kindergarten, and date and type of symptoms developed. A case-patient is defined as a child having sore throat, fever, skin rash, or strawberry tongue with or without laboratory confirmation of GAS infection between March 28 and April 28, 2017. RESULTS: The index case-patients developed symptoms on March 28, 2017, and this outbreak persisted over a period of 16 days. The outbreak affected 21 out of 158 children (13.3%) in the kindergarten, with the mean age of 4.2 (range 3–5) years; 12 (57.1%) of them were boys. The common symptoms reported were fever (71.4%), sore throat (71.4%), reddened tonsil (57.1%), and skin rash (52.4%). The epidemiologic analysis showed that children attending one of the classrooms in the kindergarten were 14.12 times affected than the other classrooms (relative risk, 14.12; 95% confidence interval, 4.99–33.93; P < 0.01). All case-patients were recommended to stay away from the kindergarten and its social activities for > 24 hours after starting appropriate antibiotic treatment, and all the children in the kindergarten were instructed to keep strict personal hygiene practices. CONCLUSION: Our results suggest that the outbreak likely affected from the index case-patients who attended to one of the classrooms in the kindergarten. This highlights the importance of immediate notification of outbreak to prevent large number of patients.
Child ; Cohort Studies ; Exanthema ; Fever ; Fragaria ; Humans ; Hygiene ; Korea ; Palatine Tonsil ; Pharyngitis ; Retrospective Studies ; Scarlet Fever* ; Tongue

BACKGROUND: In many developing countries, shigellosis is endemic and also occurs in epidemics and treatment of multidrug-resistant (MDR) isolates are important. The aims of this study were to determine the antimicrobial susceptibility, prevalence of class 1 and 2 integrons and the clonal relatedness of isolates. MATERIALS AND METHODS: Antimicrobial susceptibility tests were performed by disc diffusion method. Polymerase chain reaction (PCR)-sequencing technique was employed for detection and characterization of integrons. The genetic relatedness was evaluated by using enterobacterial repetitive intergenic consensus (ERIC) PCR. RESULTS: There was a high percentage of resistance to trimethoprim-sulfamethoxazole (TMP/SMX) (93.7%), ampicillin (AMP) (87.3%), streptomycin (STR) (84.5%) and tetracycline (TET) (78.9%). Multidrug resistant phenotype was seen in 95.1% of total isolates. Most common MDR profile was TMP/SMX/STR/AMP resistant pattern. Among the 142 Shigella spp. analyzed in this study, 28 isolates were positive for class 1 integron with two types of gene cassette arrays (dfrA17/aadA5 = 31.7% and dfrA7 = 3.8%). The class 2 integron was more frequently detected among the isolates (94.7%) with dfrA1/sat1/aadA1 (69.4%) and dfrA1/sat1 (30.6%) gene cassettes. ERIC-PCR results showed 6, 5, 4 and 3 main genotypes among S. flexneri, S. sonnei, S. boydii and S. dysenteriae isolates, respectively. CONCLUSIONS: Our findings revealed that multidrug resistant Shigella species with high prevalence of class 2 integron were very common in Iran. In addition, ERIC-PCR patterns showed limited variety of clones are responsible for shigellosis in the region of the study.
Ampicillin ; Clone Cells ; Consensus ; Developing Countries ; Diffusion ; Dysentery, Bacillary ; Genotype ; Integrons ; Iran* ; Methods ; Phenotype ; Polymerase Chain Reaction ; Prevalence ; Shigella* ; Streptomycin ; Tetracycline ; Trimethoprim, Sulfamethoxazole Drug Combination

PURPOSE: We evaluated epidemiological and clinical features of candidemia in neonates and children. MATERIALS AND METHODS: We retrospectively reviewed the medical charts of hospitalized neonates and children with positive blood cultures for Candida species from September 1, 2000 through August 31, 2006. RESULTS: Among 39 total neonates and children with candidemia, the median age was 4 months (interquartile range, 1-28) and overall mortality was 33%. Candida species included: Candida albicans (56%), Candida parapsilosis (23%) and Candida glabrata (15%). There was a tendency of proportional increase of candidemia due to non-albicans species (13% in 2001 vs 91% in 2006; P=0.01). Compared with children older than 1 month of age, the proportion of C. parapsilosis was significantly higher in neonates with candidemia (58% vs 7%; P=0.001). C. albicans was isolated more commonly from those who had undergone surgical intervention before candidemia (55% vs 18%; P<0.05). C. parapsilosis was isolated more commonly from premature neonates (78% vs 27%; P=0.015). C. glabrata was isolated more commonly from those who had neutropenia before candidemia (67% vs 12%; P=0.011). CONCLUSION: Candidemia by C. albicans was more commonly in surgical patients; by C. parapsilosis in premature neonates; by C. glabrata in neutropenic patients.
Candida ; Candida albicans ; Candida glabrata ; Candidemia* ; Candidiasis, Invasive ; Child* ; Epidemiology* ; Humans ; Infant, Newborn* ; Mortality ; Neutropenia ; Retrospective Studies ; Risk Factors

BACKGROUND: To provide useful information on the choice of adequate drugs in the treatment of urinary tract infection (UTI) in spinal cord injury patients. MATERIALS AND METHODS: The subjects were 34 spinal cord injured patients who were registered in Busan Spinal Cord Disabled Person Society and 111 patients with spinal cord injury who were admitted in 4 university hospitals in Busan between January 2004 and December 2005. We collected the patient's urine in July 2006 and performed comprehensive chart reviews of these patients. We studied the incidence of UTI, commonly cultured organisms, antimicrobial sensitivities, voiding methods and follow-up. RESULTS: The incidence of UTI was 48.3% of 145 patients. The most common causative organism of UTI was Escherichia coli (27.1%), followed by Pseudomonas aeruginosa (22.9%) and Klebsiella pneumoniae (8.3%). Antimicrobial sensitivities of imipenem, amikacin and ceftazidime to Escherichia coli were respectively 100%, 92.3%, 80.8%. The sensitivities of Pseudomonas to the same agents were 63.6%, 31.8 %, 45.5% respectively. Ciprofloxacin showed decreased sensitivities of 38.5%, 31.8% respectively for Escherichia coli and Pseudomonas aeruginosa. CONCLUSION: Our results implied decreasing susceptibility of ciprofloxacin, so it can be recommended to restrict the use of ciprofloxacin as a primary empirical antibiotic for UTI of spinal cord injured patients. Causative organisms of UTI are becoming more diverse. Also the incidence and antimicrobial sensitivities are changing as well. Therefore continuous observation with the appropriate treatment is needed.
Amikacin ; Busan ; Ceftazidime ; Ciprofloxacin ; Disabled Persons ; Escherichia coli ; Follow-Up Studies ; Hospitals, University ; Humans ; Imipenem ; Incidence ; Klebsiella pneumoniae ; Pseudomonas ; Pseudomonas aeruginosa ; Spinal Cord Injuries ; Spinal Cord* ; Urinary Tract Infections* ; Urinary Tract*

BACKGROUND: The annual prevalence of foot ulcer in Korea is 99.5 per 100,000 people with diabetes and 49.8 cases among them go through amputation. Moreover, amputation due to uncontrolled infection accounts for 50% of all non-traumatic limb amputations. Therefore, reliable microbiological documentation is important. MATERIALS AND METHODS: We enrolled 74 patients with diabetic foot infection, who referred to Korea University Hospital from September 2006 to March 2007. Deep tissue biopsies were taken from the base of ulcer after surgical debridement and cleansing at admission. We analyzed the microbiological differences according to the sex, age, type and duration of diabetes, glycemic control, presence of neuropathy or angiopathy, diabetic nephropathy, osteomyelitis, transcutaneous oxygen tension and prior antibiotic use. RESULTS: Gram-positive aerobic bacteria were the most common organisms isolated (76.4%), followed by Gram-negative aerobic bacteria (33.3%) and fungus (2.0%). Of the Gram-positive aerobes, methicillin-resistant Staphylococcus aureus (MRSA) was found most frequently (29.4%). The clinical and laboratory findings showed no significant clinical differences between gram-positive and gram-negative infections. Moreover, there was no difference in clinical findings between methicillin-susceptible and methicillin-resistant S. aureus infections. Mixed infection was not common (average, 1.2 organisms with each diabetic foot infection). Of note, mixed infection was more frequently found in patients with prior antibiotic use. CONCLUSION: MRSA was the most common pathogen in diabetic foot infection among patients referred to tertiary hospital. There was no significant difference of clinical and laboratory findings with regard to gram stain results and methicillin resistance in S. aureus. Mixed infection was not common, but broad spectrum antibiotics are recommended for severe diabetic foot infection with prior antibiotic exposure.
Amputation ; Anti-Bacterial Agents ; Bacteria, Aerobic ; Biopsy* ; Coinfection ; Debridement ; Diabetic Angiopathies ; Diabetic Foot* ; Extremities ; Foot Ulcer ; Fungi ; Gram-Negative Aerobic Bacteria ; Humans ; Korea ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Osteomyelitis ; Oxygen ; Prevalence ; Tertiary Care Centers ; Ulcer

No abstract available.
Asian Continental Ancestry Group* ; Humans

No abstract available.
Anti-Infective Agents* ; Compliance*

Mycobacterium genavense, first identified in 1990, is known as a pathogen that mimics disseminated Myocobacterium avium-intracellulare complex (MAC) infection with particular propensity for the gastrointestinal tract. In Korea, no case with the organism has been reported. Herein we report a case of Mycobacterium genavense infection that manifested with erosive lesion of duodenum in a patient with acquired immune deficiency syndrome. The patient presented with epigastric pain and fever, diarrhea. Duodenal biopsy showed histiocytic infiltration with numerous acid-fast bacilli. Identification of the mycobacterial isolate by the polymerase chain reaction restriction analysis of 16S rRNA gene revealed Mycobacterium genavense.
Acquired Immunodeficiency Syndrome ; Biopsy ; Diarrhea ; Duodenum* ; Fever ; Gastrointestinal Tract ; Genes, rRNA ; HIV Infections* ; HIV* ; Humans ; Korea ; Mycobacterium* ; Polymerase Chain Reaction

Vivax malaria reemerged in the Republic of Korea in 1993. Vivax malaria is generally a benign disease with few severe complications. Even in the worldwide literature, there is only a small number of case reports on severe complications in vivax malaria. We report a unique case of P. vivax infection complicated by seizure and shock. A 58 year-old male showed generalized tonic-clonic seizure and shock after P. vivax infection. The species of malarial parasite was identified using peripheral blood film examination and polymerase chain reaction (PCR). He successfully recovered after treatment with hydroxychloroquine.
Humans ; Hydroxychloroquine ; Malaria ; Malaria, Cerebral ; Malaria, Vivax* ; Male ; Middle Aged ; Parasites ; Plasmodium vivax ; Polymerase Chain Reaction ; Republic of Korea ; Seizures* ; Shock*