Four Gram-positive cocci were isolated from the cerebrospinal fluid or blood of four different patients, but they could not be identified by an automated conventional identification system, so they were identified using cellular fatty acid (CFA) composition analysis and 16S rRNA gene sequencing analysis. Of these, two strains (SMC-A2662 and SMC-A5889), which were previously supposed to be Rothia dentocariosa according to the API Coryne system, were identified as Rothia aeria by the 16S rRNA gene analysis. SMC-A608, which was unidentified by both the VITEK2 and API Coryne systems, was identified as Rothia mucilaginosa. The one remaining SMC-2244T was distinguished from the other Rothia species by its biochemical profile, its CFA composition and its 16S rRNA gene sequence. Phylogenetic analysis showed that it was closely related to Rothia nasimurium but the 16S rRNA gene sequence dissimilarity of 1.8% was enough to differentiate it from R. nasimurium. Based on both the phenotypic and phylogenetic evidence, we propose a new species name for this bacterium, Rothia arfidiae sp. nov. The results of this study show that several Rothia species were isolated from human and we have identified them using 16S rRNA gene sequences.
Genes, rRNA ; Gram-Positive Cocci ; Humans

BACKGROUND: In Korea, methicillin-resistant Staphylococcus aureus (MRSA) is the most common nosocomial pathogen, which is particularly prevalent in ICU. We performed this study to investigate the modes of transmission of MRSA and the role of nasal carriage of11RSA to subsequent MRSA infections in medical ICU. METHODS: All patients admitted to the medical lCU during 10 months were studied prospectively. Nasal swabs were done in all patients within 24 hours of admission and weekly thereafter. For patients who developed MRSA infections, additional cultures were done before start of antibiotics. Surveillance cultures of nostril, hands of health care workers and environment were done once at the end of the study. Bacterial typing was performed with pulsed-field gel electrophoresis (PFGE) using Smal. RESULTS: Among 138 patients enrolled, 24 patients (17.4 %) were nasal colonizers, and 9 patients (6.5%) were already infected with MRSA prior to admission. New nasal colonization among patients, in whom follow up nasal cultures were done at the interval of 3 days or more, developed at 36.2 % (21/58 patients). New infections of MRSA in patients who were admitted for more than 3 days, developed at 11.7 % (13/111 patients). Patients in isolation room were infected with MRSA less frequently (P <0.05). No other risk factors for nasal colonization of MRSA or MRSA infections were found. There were no significant differences between nasal colonizers and non-colonizers in the incidence of MRSA infections. PFGE analysis of MRSA isolates from patients showed several major patterns, which were similar in both MRSA isolates obtained prior to admission and those acquired after admission. PFGE patterns of MRSA isolates from health care workers and environment were different from those of patients. CONCLUSION: Patients who were infected or colonized with MRSA seemed to be a major source for transmission of MRSA in medical ICU. In medical lCU, where MRSA were prevalent, nasal colonization was not related to the increased incidence of MRSA infections.
Anti-Bacterial Agents ; Bacterial Typing Techniques ; Colon ; Cross Infection ; Delivery of Health Care ; Electrophoresis, Gel, Pulsed-Field ; Follow-Up Studies ; Hand ; Humans ; Incidence ; Intensive Care Units ; Korea ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Prospective Studies ; Risk Factors ; Staphylococcus aureus

BACKGROUND: Cryptococcal meningitis is an opportunistic infection common among patients with AIDS. Because of the low incidence of cryptococcal meningitis in Korea, there have been insufficient data on the clinical features of cryptococcal meningitis in non-AIDS Korean patients, particularly in patients with liver cirrhosis (LC). We evaluated the clinical manifestations of cryptococcal meningitis in non-AIDS patients admitted at the Samsung Medical Center and assessed the relationship between LC and cryptococcal meningitis. METHODS: The medical records of 25 non-AIDS patients with cryptococcal meningitis admitted between May 1995 and March 1999 were reviewed. Cryptococcal meningitis was confirmed by positive culture of CSF or compatible clinical features plus a positive cry-ptococcal latex test. The mean age of the 25 patients was 55 years and the median duration of follow-up was 95.5 days. Underlying conditions were:use of immunosuppressants (including steroids) (47.8%), LC (34.8%), diabetes mellitus (34.8%), malignancy (17.4%), alcoholism (8.7%), and none (21.7%, five patients). RESULTS: There were no differences in the clinical manifestations between the LC and non-LC groups, with the exception of mental deterioration, which was more frequent in patients with LC than without LC (P= 0.026). The outcomes were:complete cure in six cases, cure with sequelae in five, and treatment failure in ten. The crude and attributable mortality rates of cryptococcal meningitis were 62.5% (15/24) and 50.0% (12/24), respectively. LC was a significant risk factor for a poor survival rate among patients with cryptococcal meningitis (OR:3.25, 95% CI, 1.02~10.40) (P=0.045). CONCLUSION: In Korea, liver cirrhosis is an important risk factor for cryptococcal meningitis and an attributable factor for its high mortality. Because it is possible to confuse mental obtundation in cirrhotic patients with that of hepatic encephalopathy, cryptococcal meningitis should be considered in any patients with altered consciousness and liver cirrhosis.
Alcoholism ; Consciousness ; Cryptococcosis ; Diabetes Mellitus ; Follow-Up Studies ; Hepatic Encephalopathy ; Humans ; Immunosuppressive Agents ; Incidence ; Korea ; Latex ; Liver Cirrhosis ; Medical Records ; Meningitis, Cryptococcal* ; Mortality ; Opportunistic Infections ; Risk Factors ; Survival Rate ; Treatment Failure

Right-sided infective endocarditis (RIE) occurs predominantly in intravenous drug users in western countries, and it has a relatively good prognosis. Clinical features and prognosis of RIE occurring in non-drug users are not well known. We investigated the clinical findings of RIE in non-drug users. We retrospectively reviewed 345 cases diagnosed with IE. Cases with RIE or left-sided infective endocarditis (LIE) defined by the vegetation site were included and cases having no vegetation or both-side vegetation were excluded. Clinical findings and in-hospital outcome of RIE were compared to those of LIE. Among the 245 cases, 39 (16%) cases had RIE and 206 (84%) cases had LIE. RIE patients were younger (40+/-19 yr vs 50+/-18 yr, P=0.004), and had a higher incidence of congenital heart disease (CHD) (36% vs 13%, P<0.001) and central venous catheter (CVC) (21% vs 4%, P=0.001) compared to LIE patients. A large vegetation was more common in RIE (33% vs 9%, P<0.001). Staphylococcus aureus was the most common cause of RIE, while Streptococcus viridans were the most common cause of LIE. In-hospital mortality and cardiac surgery were not different between the two groups. CHD and use of CVC were common in non-drug users with RIE. The short-term clinical outcome of RIE is not different from that of LIE.
Adult ; Aged ; Central Venous Catheters/microbiology ; Echocardiography ; Endocarditis, Bacterial/*diagnosis/microbiology/mortality ; Female ; Heart Defects, Congenital/complications/epidemiology ; Hospital Mortality ; Humans ; Incidence ; Male ; Middle Aged ; Prognosis ; Retrospective Studies ; Staphylococcus aureus/isolation & purification ; Viridans Streptococci/isolation & purification ; Young Adult

We isolated non-O1, non-O139 Vibrio cholerae from pleural effusion in a patient with recurred advanced gastric caner after total gastrectomy. We also recovered the organism from the patient's stool culture. The patient did not experience gastrointestinal symptoms such as diarrhea except heartburn and epigastric discomfort from stomach cancer before admission. The suspected route of infection is directly from the gastrointestinal tract through the previous surgical wounds. After antibiotic treatment, no more V. cholerae was isolated and the patient was well discharged from the hospital. This is the first report of V. cholerae infection associated with pleural effusion in a long-term latent carrier of the organism.
Vibrio cholerae non-O1/*isolation & purification ; Stomach Neoplasms/microbiology/surgery ; Pleural Effusion/*microbiology ; Middle Aged ; Male ; Humans ; *Gastrectomy ; Carrier State

BACKGROUND/AIMS: The aim of our study was to compare the characteristics of nosocomial infective endocarditis (NIE) with community-acquired infective endocarditis (CIE) and to determine independent risk factors for in-hospital death. METHODS: We retrospectively reviewed the medical records of 560 patients diagnosed with infective endocarditis. NIE was defined by a diagnosis made > 72 hours after hospital admission or within 2 months of hospital discharge. RESULTS: Among the 560 cases reviewed, 121 were classified as NIE. Compared with patients with CIE, patients with NIE were older (mean ± SD, 51.30±18.01 vs. 59.76±14.87, p < 0.001). The in-hospital death rate of the NIE group was much higher than that of the CIE group (27.3% vs. 5.9%, p < 0.001). More patients with NIE had central intravenous catheters, and were undergoing hemodialysis (p < 0.001). Methicillin-resistant Staphylococcus aureus (MRSA) was the most common causal microorganism of NIE, and MRSA (p < 0.001) and fungus (p = 0.002) were more common in NIE compared with CIE. On multiple analysis, age, liver cirrhosis, cancer chemotherapy, central intravenous catheter, hemodialysis, and genitourinary tract manipulation were independent clinical risk factors for NIE. Among the patients with NIE, 33 died during their hospital admission. The independent risk factors for in-hospital death were older age (adjusted odds ratio [OR], 1.04; 95% confidence interval [CI], 1.01 to 1.07; p = 0.037) and chemotherapy for malignancy (adjusted OR, 3.89; 95% CI, 1.18 to 12.87; p = 0.026). CONCLUSIONS Because of the considerable incidence of NIE and its poor prognosis, we should pay attention to early diagnosis and active management of NIE, especially for older patients and patients receiving chemotherapy.

Tixagevimab/cilgavimab is a monoclonal antibody used to prevent coronavirus disease 2019 among immunocompromised hosts and maintained neutralizing activity against early omicron variants. Omicron BN.1 became a dominant circulating strain in Korea early 2023, but its susceptibility to tixagevimab/cilgavimab is unclear. We conducted plaque reduction neutralization test (PRNT) against BN.1 in a prospective cohort (14 patients and 30 specimens). BN.1 PRNT was conducted for one- and three-months after tixagevimab/ cilgavimab administration and the average PRNT ND 50 of each point was lower than the positive cut-off value of 20 (12.9 ± 4.5 and 13.2 ± 4.2, respectively, P = 0.825). In the paired analyses, tixagevimab/cilgavimab-administered sera could not actively neutralize BN.1 (PRNT ND 50 11.5 ± 2.9, P = 0.001), compared with the reserved activity against BA.5 (ND 50 310.5 ± 180.4). Unlike virus-like particle assay, tixagevimab/cilgavimab was not active against BN.1 in neutralizing assay, and would not be effective in the present predominance of BA.2.75 sublineages.

BACKGROUND: This study was to evaluate a nationwide nosocomial infection rate and antimicrobial resistance in intensive care units(ICUs) in Korea. METHODS: The study was carried out at 16 university-affiliated teaching hospitals from July through October 2004. We performed a prospective multicenter study to investigate nosocomial infection rates, device-associated infection rated, and causative pathogens and their antimicrobial resistance. RESULTS: The urinary tract was the most commonly involved site. Nosocomial infection rate was 12.48 in medical. ICU (MICU), 9.59 in medical surgical ICU (MSICU), 14.76 in surgical ICU (MSICU), and 11.60 in other lCU. Device-associated infection rates were as follow: 1) rates of urinary catheter-associated urinary tract infection were 4.26 in MICU, 3.17 in SICU, 4.88 in MSICU, and 5.87 in other ICU; 2) rates of central line-associated bloodstream infection were 3.24 in MICU, 1.56 in SlCU, 2.36 in MSICU, and 1.78 in other ICU; 3) rates of ventilator-associated pneumonia were 3.61 in MlCU, 13.05 in SICU, 1.68 in MSICU, and 4.84 in other lCU. Staphylococcus aureus was the most frequently identified microorganism in this study; 93% of S. aurues were resistant to methicillin; 17% of Pseudomonas aeruginosa isolated were resistant to imipenem; 11% of Enterococcus faecium and 18% of Enterococcus faecalis showed resistance to vancomycin. Over a half of Acinetobacter spp, Stenotrophomonas maltophilia, Klebsiella pneumoniae, and Escherichia coli showed resistant to fluoroquinolone. Conclusion: This study shows the seriousness of antimicrobial resistance and the importance of infection control in the lCU in Korea. This study should provide a theoretical strategy to enforce the infection control.
Acinetobacter ; Cross Infection* ; Enterococcus faecalis ; Enterococcus faecium ; Escherichia coli ; Hospitals, Teaching ; Hospitals, University* ; Imipenem ; Infection Control ; Intensive Care Units* ; Critical Care* ; Klebsiella pneumoniae ; Korea* ; Methicillin ; Pneumonia, Ventilator-Associated ; Prospective Studies ; Pseudomonas aeruginosa ; Staphylococcus aureus ; Stenotrophomonas maltophilia ; Urinary Tract ; Urinary Tract Infections ; Vancomycin