BACKGROUND: Aviators are tested for the antigens and antibodies of hepatitis viruses or tumor markers when they visit the Aerospace Medical Center (AMC) for regular checkups. Although various enzyme immunoassay (EIA) or chemiluminescence immunoassay (CLIA) are currently the standard quantitative methods and are widely used, the clinical laboratory of AMC is currently using the rapid qualitative immunochromatographic assays (ICA) for these tests due to the lack of necessary equipment and high cost. The aim of our study was to evaluate the rapid ICAs in comparison with standard methods. METHODS: With the cooperation of the Department of Laboratory Medicine in Seoul National University Bundang Hospital (SNUBH) where the standard methods (CLIA) had been used, serum specimens of SNUBH patients were collected and provided for AMC together with the results of six test items. The six items were HBsAg, anti-HBs, anti-HCV, alpha-fetoprotein (AFP), prostate-specific antigen (PSA), and carcinoembryonic antigen (CEA). The test results of these specimens by rapid ICAs were compared with those by the SNUBH methods. RESULTS: When the SNUBH methods were regarded as a standard, sensitivity/specificity of each rapid ICA was HBsAg 95.1%/100%, anti-HBs 90.6%/92.6%, anti-HCV 97.5%/ 100%, AFP 75%/100%, PSA 66%/100%, and CEA 47.7%/100%, respectively. CONCLUSION: The rapid ICA methods used at the AMC generally showed high specificity but low sensitivity which meant that the overall accuracy may be unsatisfactory. These ICAs were unsuitable for accurate confirmative diagnosis due to low negative predictive values. For several items whose sensitivities are particularly low, they could not be used as screening tests. If immunoassays are to be helpful for an accurate diagnosis, it is necessary to equip the AMC with an EIA or CLIA instrument.
alpha-Fetoproteins ; Antibodies ; Carcinoembryonic Antigen ; Hepatitis B Surface Antigens ; Hepatitis Viruses ; Humans ; Immunoassay ; Immunochromatography ; Immunoenzyme Techniques ; Luminescence ; Mass Screening ; Prostate-Specific Antigen ; Sensitivity and Specificity ; Biomarkers, Tumor

BACKGROUND: The Republic of Korea Air Force (ROKAF) makes its pilots undergo regular aero-medical checkups. About 15% of the pilots undergoing this check-up show increased serum bilirubin levels without any abnormality in other liver function test items, and even reexamination is required for those with a marked increase. In this study, we investigated the factors associated with increased serum bilirubin. METHODS: Questionnaires and blood tests were used for the ROKAF pilots who visited the Aerospace Medical Center for the aero-medical check-up. Various information from the questionnaire and blood test was statistically analyzed to identify the factors associated with increased bilirubin. RESULTS: In univariate analysis, age, fasting > or =12 hours, exercise in the last 3 days, and last alcohol intake > or = 120 g were statistically associated with increased serum bilirubin. In multivariate analysis, fasting > or =12 hours, exercise in the last 3 days, and last alcohol intake > or = 120 g were independent risk factors significantly associated with increased bilirubin. CONCLUSION: Prolonged fasting, recent exercise and drinking were associated with increased serum bilirubin as previously known. Pilots expecting regular aero-medical check-up should avoid intense exercise and drinking in order to get accurate blood test results.
Bilirubin ; Drinking ; Fasting ; Hematologic Tests ; Hyperbilirubinemia ; Liver Function Tests ; Multivariate Analysis ; Republic of Korea ; Risk Factors ; Surveys and Questionnaires

Methicillin-resistant Staphylococcus aureus (MRSA) is a typical pathogen of nosocomial infection, and has recently emerged as an important community-acquired pathogen. MRSA is notorious as a multidrug-resistant organism. Its resistance to all beta-lactams is mediated by PBP2a which is encoded by mecA, and it is also resistant to many antimicrobials of other classes due to frequently co-carrying resistance genes, which accounts for becoming a clinical and laboratory issue. This article reviews the microbiological characteristics, surveillance methods, and molecular epidemiology of MRSA.
Adenosine ; beta-Lactams ; Carrier State ; Cross Infection ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Molecular Epidemiology

Non-tuberculous mycobacteria (NTM) are being recognized increasingly as the causative agents of opportunistic infections in humans. This study investigated the epidemiologic trends of NTM recovery from various clinical specimens in 2 Korean tertiary-care hospitals. We reviewed the laboratory records of patient samples cultured for mycobacteria between 2009 and 2015 at 2 tertiary-care hospitals in Korea. The medical records for patients with positive NTM samples were also reviewed. During the study period, 144,540 specimens were cultured for mycobacteria. The proportion of NTM-positive samples increased from 23.3% in 2009 to 48.2% in 2015. The 2 most frequently isolated NTM were Mycobacterium intracellulare (38.3%) and M. avium (23.1%). The number of clinically significant diseases caused by NTM in inpatients and outpatients increased from 6.8 to 12.9 per 100,000 patients over the same period. The rates of recovery of NTM from clinical specimens and the number of patients with NTM infections increased significantly (P < 0.001, testing for trend) between 2009 and 2015.
Humans ; Inpatients ; Korea ; Medical Records ; Mycobacterium avium ; Mycobacterium avium Complex ; Mycobacterium tuberculosis ; Opportunistic Infections ; Outpatients

BACKGROUND: A hand hygiene policy has been introduced by the Joint Commission International Accreditation Standards for Hospitals (JCI); the purpose of this policy is to ensure that systematic standards are continuously practiced at hospitals in order to improve the quality of medical care and the safety of patients and health care workers. This policy requires that phlebotomists wear new gloves and disinfect their hands before attending a patient to prevent nosocomial infections and to protect the phlebotomists. This study aimed to assess the responses of patients and guardians regarding the hand hygiene procedures. METHODS: Between January and February 2010, a questionnaire survey was performed at our hospital for 310 outpatients, 93 inpatients, and 189 guardians. RESULTS: In all, 70.8% of respondents answered that phlebotomists did not require considerable time to remove and wear gloves, and 69.9% responded that phlebotomists could readily detect veins even with their gloves on. Besides, 81.9% respondents thought that it was sanitarily important for phlebotomists to remove their gloves and disinfect their hands after a venipuncture, whereas only 2.8% thought that this practice caused discomfort. CONCLUSION: The patients and guardians recognized that the hand hygiene procedures were important for their own safety and encouraged their application rather than considering them uncomfortable or inappropriate. Introduction and maintenance of the hand hygiene policy of JCI would not be difficult because patients or guardians recognized its importance.
Accreditation ; Cross Infection ; Surveys and Questionnaires ; Delivery of Health Care ; Dietary Sucrose ; Gloves, Protective ; Hand ; Hand Disinfection ; Hand Hygiene ; Humans ; Inpatients ; Joints ; Outpatients ; Phlebotomy ; Veins

The authors regret that there were errors in the article. The errors were in one co-author's affiliation and funding source.

BACKGROUND: Cefroxadine is an oral first-generation cephalosporin, which has been used for several years. But, the susceptibility data of cefroxadine were rarely reported in Korea. The current study attempted to determine the antibacterial activity of cefroxadine against the major clinical isolates. METHODS: According to the NCCLS recommendations, antibacterial activities of cefroxadine were measured against total 500 major clinical isolates. MICs were determined by the agar dilution method, a series of doubling dilutions from 128 to 0.03 /mL, on Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, Citrobacter freundii, Serratia marcescens, Proteus mirabilis, and Staphylococcus spp. In case of Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella catarrhalis, broth microdilution method, a series of doubling dilutions from 16 to 0.015 /mL, was performed. RESULTS: Cefroxadine had variable activity against Enterobacteriaceae. MIC cumulative curves showed that cefroxadine had relatively low MIC distributions against E. coli, K. pneumoniae and P. mirabilis, showing MIC50 were 4, 4, and 8 /mL, respectively. Against E. cloacae, C. freundii, and S. marcescens, cefroxadine 's MIC50 values ranged from 128 to >128 /mL. For clinical isolates of methicillin-susceptible Staphylococcus aureus and methicillin-susceptible Staphylococcus epidermidis, cefroxadine had MIC90 values were 4 /mL and 8 /mL, respectively. Cefroxadine had MIC50 values of 1 /mL and >16 /mL for penicillin-susceptible and penicillin-not-susceptible strains of S. pneumoniae, respectively. Cefroxadine had MIC50 values of 8 /mL and 4 /mL against H. influenzae and M. catarrhalis, respectively. CONCLUSION: Cefroxadine had good activity against gram-positive bacteria, except penicillin-resistant S. pneumoniae, and showed moderate antimicrobial activity against M. catarrhalis, E. coli, P. mirabilis, and K. pneumonaie. Cefroxadine had variable activity against Enterobacteriaceae other than the above-mentioned species.
Agar ; Citrobacter freundii ; Cloaca ; Enterobacter cloacae ; Enterobacteriaceae ; Escherichia coli ; Gram-Positive Bacteria ; Haemophilus influenzae ; Influenza, Human ; Klebsiella pneumoniae ; Korea ; Mirabilis ; Moraxella (Branhamella) catarrhalis ; Pneumonia ; Proteus mirabilis ; Serratia marcescens ; Staphylococcus ; Staphylococcus aureus ; Staphylococcus epidermidis ; Streptococcus pneumoniae

BACKGROUND: Cefditoren is an oral cephalosporin with excellent activity against Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella catarrhalis, which are the predominant bacterial causes of community-acquired respiratory tract infections. The current study attempted to determine the antibacterial activity of cefditoren against the major clinical isolates. METHODS: According to the NCCLS recommendations, antibacterial activities of cefditoren were measured against total 504 major clinical isolates. MICs were determined by the agar dilution method, a series of doubling dilutions from 128 to 0.03 microgram/mL, on E. coli, K. pneumoniae, E. cloacae, C. freundii, S. marcescens, P. mirabilis, and Staphylococcus spp. In case of H. influenzae, S. pneumoniae, and M. catarrhalis, broth microdilution method, a series of doubling dilutions from 16 to 0.015 microgram/mL, was performed. RESULTS: Cefditoren had variable activity against Enterobacteriaceae. MIC cumulative curves showed that cefditoren had low MIC distributions against E. coli and P. mirabilis, and MIC90 were 8 and 0.5 microgram/mL, respectively. Against K. pneumoniae, E. cloacae, C. freundii, and S. marcescens, cefditoren's MIC90 values ranged from 32 to >128 microgram/mL. For clinical isolates of methicillin-susceptible S. aureus and methicillin-susceptible S. epidermidis, cefditoren had MIC90 values of 1 microgram/mL and 0.5 microgram/mL, respectively. Cefditoren had MIC90 values of 1 microgram/mL for penicillin-susceptible and penicillin-not-susceptible strains of S. pneumoniae. Cefditoren had MIC90 values of 0.03 microgram/mL and 0.5microgram/mL against H. influenzae and M. catarrhalis, respectively. CONCLUSION: Cefditoren had excellent activity against S. pneumoniae, H. influenzae, and M. catarrhalis. Cefditoren had variable activity against Enterobacteriaceae. The results of this study confirm the excellent activity of cefditoren against the major respiratory tract pathogens and suggest that cefditoren could be a good antibiotic for empiric oral treatment of community-acquired respiratory tract infections.
Agar ; Cloaca ; Enterobacteriaceae ; Haemophilus influenzae ; Influenza, Human ; Mirabilis ; Moraxella (Branhamella) catarrhalis ; Pneumonia ; Respiratory System ; Respiratory Tract Infections ; Staphylococcus ; Streptococcus pneumoniae

BACKGROUND: Cefditoren is an oral cephalosporin with excellent activity against Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella catarrhalis, which are the predominant bacterial causes of community-acquired respiratory tract infections. The current study attempted to determine the antibacterial activity of cefditoren against the major clinical isolates. METHODS: According to the NCCLS recommendations, antibacterial activities of cefditoren were measured against total 504 major clinical isolates. MICs were determined by the agar dilution method, a series of doubling dilutions from 128 to 0.03 microgram/mL, on E. coli, K. pneumoniae, E. cloacae, C. freundii, S. marcescens, P. mirabilis, and Staphylococcus spp. In case of H. influenzae, S. pneumoniae, and M. catarrhalis, broth microdilution method, a series of doubling dilutions from 16 to 0.015 microgram/mL, was performed. RESULTS: Cefditoren had variable activity against Enterobacteriaceae. MIC cumulative curves showed that cefditoren had low MIC distributions against E. coli and P. mirabilis, and MIC90 were 8 and 0.5 microgram/mL, respectively. Against K. pneumoniae, E. cloacae, C. freundii, and S. marcescens, cefditoren's MIC90 values ranged from 32 to >128 microgram/mL. For clinical isolates of methicillin-susceptible S. aureus and methicillin-susceptible S. epidermidis, cefditoren had MIC90 values of 1 microgram/mL and 0.5 microgram/mL, respectively. Cefditoren had MIC90 values of 1 microgram/mL for penicillin-susceptible and penicillin-not-susceptible strains of S. pneumoniae. Cefditoren had MIC90 values of 0.03 microgram/mL and 0.5microgram/mL against H. influenzae and M. catarrhalis, respectively. CONCLUSION: Cefditoren had excellent activity against S. pneumoniae, H. influenzae, and M. catarrhalis. Cefditoren had variable activity against Enterobacteriaceae. The results of this study confirm the excellent activity of cefditoren against the major respiratory tract pathogens and suggest that cefditoren could be a good antibiotic for empiric oral treatment of community-acquired respiratory tract infections.
Agar ; Cloaca ; Enterobacteriaceae ; Haemophilus influenzae ; Influenza, Human ; Mirabilis ; Moraxella (Branhamella) catarrhalis ; Pneumonia ; Respiratory System ; Respiratory Tract Infections ; Staphylococcus ; Streptococcus pneumoniae