BACKGROUND: We monitored the prevalence of antimicrobial resistance and the pattern of multiple drug resistance in Escherichia coli isolated from healthy people in the community. METHODS: We performed antimicrobial susceptibility testing on 491 isolates of E. coli from 692 healthy people in Incheon from February to July in 2006. The results were interpreted according to the CLSI guidelines. RESULTS: The highest rate of resistance was observed against tetracycline (46.6%), ampicillin (41.1%), ticarcillin (37.9%), streptomycin (31.0%), and nalidixic acid (23.6%). Twenty six percent of isolates were observed to be resistant to five or more of the antimicrobials tested. CONCLUSION: In order to maintain a low level of antimicrobial use and resistance, the surveillance of antimicrobial resistance in the community would be very important, as it provides epidemical data to set up and control antibiotic guidelines and serves as an early warning for resistance in pathogenic bacteria.
Ampicillin ; Bacteria ; Drug Resistance, Multiple ; Escherichia coli* ; Escherichia* ; Healthy Volunteers* ; Incheon ; Nalidixic Acid ; Prevalence ; Streptomycin ; Tetracycline ; Ticarcillin

Skull base osteomyelitis (SBO) is difficult to diagnose when a patient presents with multiple cranial nerve palsies but no obvious infectious focus. There is no report about SBO with septic pulmonary embolism. A 51-yr-old man presented to our hospital with headache, hoarseness, dysphagia, frequent choking, fever, cough, and sputum production. He was diagnosed of having masked mastoiditis complicated by SBO with multiple cranial nerve palsies, sigmoid sinus thrombosis, and septic pulmonary embolism. We successfully treated him with antibiotics and anticoagulants alone, with no surgical intervention. His neurologic deficits were completely recovered. Decrease of pulmonary nodules and thrombus in the sinus was evident on the follow-up imaging one month later. In selected cases of intracranial complications of SBO and septic pulmonary embolism, secondary to mastoiditis with early response to antibiotic therapy, conservative treatment may be considered and surgical intervention may be withheld.
Anti-Bacterial Agents/therapeutic use ; Anticoagulants/therapeutic use ; C-Reactive Protein/analysis ; Cranial Nerve Diseases/complications/diagnosis ; Diagnosis, Differential ; Enterobacter aerogenes/isolation & purification ; Enterobacteriaceae Infections/diagnosis/drug therapy ; Humans ; Lung/pathology/radiography ; Magnetic Resonance Imaging ; Male ; Mastoiditis/complications/diagnosis ; Middle Aged ; Osteomyelitis/complications/*diagnosis/drug therapy ; Pulmonary Embolism/complications/*diagnosis/microbiology ; Sinus Thrombosis, Intracranial/complications/diagnosis ; Skull Base ; Sputum/microbiology ; Tomography, X-Ray Computed

Alveolar soft part sarcoma (ASPS) is a rare malignant soft-tissue neoplasm of unknown histogenesis. The two main sites of occurrence are the lower extremities in adults and the head and neck in children. We report the first case of pleural ASPS occurring in a 58-yr-old man who presented with progressive dyspnea. A computed tomographic scan of the thorax revealed a large enhancing pleural mass with pleural effusion in the left hemithorax. Wide excision of the pleural mass was performed. Histologically, the tumor consisted of organoid nests of large polygonal cells, the cytoplasm of which had eosinophilic and D-PAS positive granules. Immunohistochemical staining showed that the tumor cell nuclei were positive for transcription factor 3 (TFE3). The pleural ASPS with multiple bone metastases recurred 1 yr after surgery and the patient died of acute pulmonary embolism 1.5 yr after diagnosis.
Bone Neoplasms/diagnosis/secondary ; Dyspnea/etiology ; Humans ; Immunohistochemistry ; Male ; Middle Aged ; Pleura/physiopathology ; Positron-Emission Tomography and Computed Tomography ; Pulmonary Embolism/diagnosis ; Sarcoma, Alveolar Soft Part/*diagnosis/pathology/radiography ; Soft Tissue Neoplasms/*diagnosis/pathology/radiography ; Transcription Factor 3/metabolism

Aspergillus tracheobronchitis is one form of invasive pulmonary aspergillosis which is characterized by ulcers and pseudomembrane formation in tracheobronchial tree. In Aspergillus tracheobronchitis, the infection is often limited to the mucosa and it accounts for less than 10 percents of invasive disease. Invasive aspergillosis mainly occurs in immunocompromized patients with prolonged neutropenia, advanced AIDS, organ transplantation, high-dose glucocorticoid therapy or cytotoxic therapy although it can occur in less immunocompromised patients, such as after influenza, COPD, old age, and diabetes. We report a case of Aspergillus tracheobronchitis in a 61 year-old patient with diabetes and Child Pugh class A liver cirrhosis. He presented with cough and purulent sputum for 10 days. He was diagnosed by bronchoscopy and successfully treated with antifungal therapy.
Aspergillosis ; Aspergillus ; Bronchitis ; Bronchoscopy ; Child ; Cough ; Diabetes Mellitus ; Humans ; Immunocompromised Host ; Influenza, Human ; Invasive Pulmonary Aspergillosis ; Liver Cirrhosis ; Mucous Membrane ; Neutropenia ; Organ Transplantation ; Pulmonary Disease, Chronic Obstructive ; Sputum ; Transplants ; Ulcer

Malaria is a potent burden on public healthcare worldwide due to requiring rapid diagnosis and treatment. Nowadays, prompt diagnosis with rapid diagnostic tests (RDTs) has been widely accepted as an effective diagnostic technique in malaria-endemic countries, primarily due to their easy operation, fast output, and straightforward interpretation. The global availability and use of RDTs have gradually grown over recent decades as field-applicable diagnostic tests for the reliable confirmation of malaria infection and proper case management. This study was conducted to evaluate diagnostic performance of 3 commercially available malaria RDT kits : BIOCREDITTM Malaria Ag Pf(pLDH), Malaria Ag Pf(pLDH/pHRPII), and Malaria Ag Pf/Pv(pLDH/pLDH) (where pLDH and pHRPII stand for plasmodium lactate dehydrogenase and histidine-rich protein 2, respectively) for the specific detection of Plasmodium falciparum. A total of 1,129 blood samples including 95 blood samples, confirmed as vivax malaria infection by microscopic examinations and a nested-PCR method, were tested for falciparum malaria infection. The overall sensitivity and specificity of Malaria Ag Pf(pLDH/pHRPII), Malaria Ag Pf/Pv(pLDH/pLDH), and Pf(pLDH) for P. falciparum were 99.0% and 100%, 95.8% and 100%, and 100% and 100%, respectively. It is proposed that the 3 RDT kits perform reliable level of diagnostic accuracy of detection for P. falciparum parasites.

In this article, the ethical statement was missing.

Background: Humidifier disinfectant-related lung injury (HDLI) is a severe form of toxic inhalational pulmonary parenchymal damage found in residents of South Korea previously exposed to specific guanidine-based compounds present in humidifier disinfectants (HD). HD-associated asthma (HDA), which is similar to irritant-induced asthma, has been recognized in victims with asthma-like symptoms and is probably caused by airway injury. In this study, diffusing capacity of the lung for carbon monoxide (DL CO ) in individuals with HDA was compared to that in individuals with pre-existing asthma without HD exposure. Methods: We retrospectively compared data, including DLCO values, of 70 patients with HDA with that of 79 patients having pre-existing asthma without any known exposure to HD (controls). Multiple linear regression analysis and logistic regression analysis were performed to confirm the association between HD exposure and DL CO after controlling for confounding factors. The correlation between DLCO and several indicators related to HD exposure was evaluated in patients with HDA.Result: The mean DLCO was significantly lower in the HDA group than in the control group (81.9% vs. 88.6%; P = 0.021). The mean DLCO of asthma patients with definite HD exposure was significantly lower than that of asthma patients with lesser exposure (P for trend = 0.002). In multivariable regression models, DLCO in the HDA group decreased by 5.8%, and patients with HDA were 2.1-fold more likely to have a lower DLCO than the controls. Pathway analysis showed that exposure to HD directly affected DLCO values and indirectly affected its measurement through a decrease in the forced vital capacity (FVC). Correlation analysis indicated a significant inverse correlation between DLCO % and cumulative HD exposure time. Conclusion DLCO was lower in patients with HDA than in asthma patients without HD exposure, and decreased FVC partially mediated this effect. Therefore, monitoring the DL CO may be useful for early diagnosis of HDA in patients with asthma symptoms and history of HD exposure.

Echinostoma cinetorchis is an oriental intestinal fluke causing significant pathological damage to the small intestine. The aim of this study was to determine a full-length cDNA sequence of E. cinetorchis endoribonuclease (RNase H; EcRNH) and to elucidate its molecular biological characters. EcRNH consisted of 308 amino acids and showed low similarity to endoribonucleases of other parasites (<40%). EcRNH had an active site centered on a putative DDEED motif instead of DEDD conserved in other species. A recombinant EcRNH produced as a soluble form in Escherichia coli showed enzymatic activity to cleave the 3′-O-P bond of RNA in a DNA-RNA duplex, producing 3′-hydroxyl and 5′-phosphate. These findings may contribute to develop antisense oligonucleotides which could damage echinostomes and other flukes.
Amino Acids ; Catalytic Domain ; DNA, Complementary ; Echinostoma* ; Endoribonucleases ; Escherichia coli ; Intestine, Small ; Oligonucleotides, Antisense ; Parasites ; Ribonuclease H* ; Ribonucleases* ; RNA ; Trematoda

BACKGROUND: Bacterial pneumonia occurring after respiratory viral infection is common. However, the predominant bacterial species causing pneumonia secondary to respiratory viral infections other than influenza remain unknown. The purpose of this study was to know whether the pathogens causing post-viral bacterial pneumonia vary according to the type of respiratory virus. METHODS: Study subjects were 5,298 patients, who underwent multiplex real-time polymerase chain reaction for simultaneous detection of respiratory viruses, among who visited the emergency department or outpatient clinic with respiratory symptoms at Ulsan University Hospital between April 2013 and March 2016. The patients' medical records were retrospectively reviewed. RESULTS: A total of 251 clinically significant bacteria were identified in 233 patients with post-viral bacterial pneumonia. Mycoplasma pneumoniae was the most frequent bacterium in patients aged <16 years, regardless of the preceding virus type (p=0.630). In patients aged ≥16 years, the isolated bacteria varied according to the preceding virus type. The major results were as follows (p<0.001): pneumonia in patients with influenza virus (type A/B), rhinovirus, and human metapneumovirus infections was caused by similar bacteria, and the findings indicated that Staphylococcus aureus pneumonia was very common in these patients. In contrast, coronavirus, parainfluenza virus, and respiratory syncytial virus infections were associated with pneumonia caused by gram-negative bacteria. CONCLUSION: The pathogens causing post-viral bacterial pneumonia vary according to the type of preceding respiratory virus. This information could help in selecting empirical antibiotics in patients with post-viral pneumonia.
Ambulatory Care Facilities ; Anti-Bacterial Agents ; Bacteria ; Coronavirus ; Emergency Service, Hospital ; Gram-Negative Bacteria ; Humans ; Influenza, Human ; Medical Records ; Metapneumovirus ; Mycoplasma pneumoniae ; Orthomyxoviridae ; Paramyxoviridae Infections ; Pneumonia ; Pneumonia, Bacterial ; Pneumonia, Mycoplasma ; Pneumonia, Staphylococcal ; Real-Time Polymerase Chain Reaction ; Respiratory Syncytial Virus Infections ; Retrospective Studies ; Rhinovirus ; Ulsan

We hereby report a case on bronchogenic cyst which is initially non-infected, then becomes infected after bronchoscopic ultrasound (US)-guided transesophageal fine-needle aspiration (FNA). The non-infected bronchogenic cyst appears to be filled with relatively echogenic materials on US, and the aspirate is a whitish jelly-like fluid. Upon contrast-enhanced MRI of the infected bronchogenic cyst, a T1-weighted image shows low signal intensity and a T2-weighted image shows high signal intensity, with no enhancements of the cyst contents, but enhancements of the thickened cystic wall. The patient then undergo video-assisted thoracic surgery 14 days after the FNA. The cystic mass is known to be completely removed, and the aspirate is yellowish and purulent. To understand the image findings that pertain to the gross appearance of the cyst contents will help to diagnose bronchogenic cysts in the future.
Biopsy, Fine-Needle ; Bronchogenic Cyst* ; Humans ; Magnetic Resonance Imaging ; Thoracic Surgery, Video-Assisted ; Ultrasonography