BACKGROUND: As tuberculous and nontuberculous mycobacterial infections are increasing, it is very important to differentiate the myobacterial species. High performance liquid chromatography (HPLC) method has been proven to be a useful technique for the identification of mycobacteria. The purpose of this study was to investigate the identification rate using HPLC and to know nontuberculous mycobacterial distribution in Ulsan University Hospital. METHOD: Mycobacteria grew in 959 clinical specimens, which were analyzed by HPLC, and their distribution was reviewed by retrospective studies. RESULTS: The patterns of HPLC were divided into single, double, and triple cluster groups which consist of 9, 20, and 4 species of mycobacteria respectively. The identification rate of mycobacteria by HPLC was 98.9%, And the rate of nontuberculous mycobacteria in mycobacterial culture positive specimens was 12.2%. CONCLUSION: HPLC is an excellent tool for mycobacterial identification. And the culture rate of nontuberculous mycobacteria in clinical specimens is increasing in Korea.
Chromatography, High Pressure Liquid ; Chromatography, Liquid* ; Korea ; Mycobacterium tuberculosis ; Nontuberculous Mycobacteria ; Retrospective Studies ; Ulsan

BACKGROUND: Mycobacterial disease is still greatly concerned in the developing and industrialized countries. Ogawa media has been used to diagnose mycobacterial disease in Korea in spite of a low sensitivity and long incubation time. Mycobacterium Growth Indicator Tube (MGIT) 960 system has been developed to overcome the pitfalls of Ogawa media. So, we investigated improvement in dectection rate and the detection time of mycobacteria using the MGIT 960 system along with 3% Ogawa media. METHODS: A total of 8,045 clinical specimens referred to the department of laboratory medicine in Ulsan University Hospital from January in 2001 to June in 2002 were cultured for mycobacteria. Specimens were processed with the NALC-NAOH (final concentration of NaOH: 1%) and inoculated into both MGIT and Ogawa media. Mycolic acid in the cultured products were analyzed by High performance liquid chromatography to discriminate between Mycobacterium tuberculosis and nontuberculous mycobacteria. RESULTS: Of 8,045 clinical specimens cultured, mycobacteria grew in 957 (11.9%) specimens, 840 (87.8%) M. tuberculosis and 117 (12.2%) nontuberculous mycobacteria. Mycobacteria were detected in 939 specimens (98.1%) by MGIT and 771 (80.6%) specimens by Ogawa media; 753 (78.7%) were detected by both media, 186 (19.4%) by MGIT only, and 18 (1.9%) by Ogawa media only. Mycobacteria were detected in 11.7 days by MGIT 960 and 28.4 days by Ogawa media. CONCLUSIONS: The detection rate and detection time of mycobacteri are improved considerably by the MGIT system; however a combined use of MGIT system and Ogawa media is the most ideally recommended for increasing the detection rate and shortening the detection time.
Chromatography, Liquid ; Developed Countries ; Korea ; Mycobacterium tuberculosis ; Mycobacterium* ; Mycolic Acids ; Nontuberculous Mycobacteria ; Tuberculosis ; Ulsan

BACKGROUND: Non-O157 human isolates among enterohemorrhagic Escherichia coli (EHEC) serogroup have been reported with increasing frequency in recent years; the serotype O26 is the most common among the non-O157 isolates. We performed serotyping of E. coli isolates with O157, O26, and O111 antisera at Ulsan University Hospital and identified 27 isolates of O26. The purpose of this study was to investigate the clinical significance of E. coli O26 isolates. METHODS: During the 24-month period from January 2002 to December 2003, E. coli isolates were serotyped when requested by the physician because of bloody diarrhea or when blood was noted in the stool specimen at the laboratory. The isolates were identified biochemically by Vitek 1 (BioMerieux Vitek Inc., Mo., USA) and serotyped using diagnostic antisera of O157, O26, and O111 (NIH, Korea). When a positive agglutination reaction was shown, the patient's was reviewed retrospectively. RESULTS: Of 4,921 isolates of E. coli during the 2-year period, 200 isolates were serotyped and 27 (13.5%) were identified as serotype O26. These were isolated from stool (13 isolates), urine (9), pus (1), blood (1), and bile (1). Among the 13 patients whose stool specimens grew E. coli O26, 12 had watery diarrhea and 7 bloody diarrhea; two patients had thrombocytopenia and purpura simultaneously. Two patients with watey diarrhea, two with bloody diarrhea, and one with TTP were among the 7 patients with E. coli O26 in the urine. Finally, one patient each with blood isolate and bile isolate of E. coli O26 both had acute gastroenteritis. CONCLUSIONS: Most of the patients infected with E. coli O26 had clinical manifestations consistent with EHEC infections. E. coli isolates from patients with boody diarrhea should be serotyped with O157 and O26 antisera.
Agglutination ; Bile ; Diarrhea ; Enterohemorrhagic Escherichia coli ; Escherichia coli* ; Escherichia* ; Gastroenteritis ; Humans ; Immune Sera ; Purpura ; Retrospective Studies ; Serotyping ; Suppuration ; Thrombocytopenia ; Ulsan

Escherichia coli O26 is the most common serotype among the non-O157 E. coli strains producing shiga-toxin (ST) and the cases infected by ST-producing E. coli O26 has been reported with increasing frequency. The infection of ST-producing E. coli O26 can manifest mainly as an acute gastroenteritis and a hemorrhagic colitis, but rarely a hemolytic uremic syndrome or a thrombotic thrombocytopenic purpura (TTP). We reported the first case of TTP associated with E. coli O26 in Korea.
Colitis ; Escherichia coli* ; Gastroenteritis ; Hemolytic-Uremic Syndrome ; Korea ; Purpura, Thrombotic Thrombocytopenic*