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A Case of Enterococcus casseliflavus Bacteremia.

Young UH ; Hyeun Gyeo LEE ; Gyu Yel HWANG ; Kap Jun YOON ; Hyo Youl KIM

Korean Journal of Clinical Microbiology.2001;4(2):146-149.

Although Enterococcus casseliflavus with intrinsic low-level vancomycin resistance has rarely been isolated from clinical specimens, this organism may cause serious invasive infections such as endocarditis and bacteremia. This low prevalence may be due, in part, to the inability of automated systems to recognize this organism. Vancomycin may not be effective against E. casseliflavus, despite in vitro results that indicate vancomycin susceptibility. It is important that all E. casseliflavus isolates obtained from clinical specimens that are related to serious infections should be identified to species level for appropriate antibiotic therapy. We report a case of bacteremia caused by E. casseliflavus in a 44-year-old female patient with liver disease.
Adult ; Bacteremia* ; Endocarditis ; Enterococcus* ; Female ; Humans ; Liver Diseases ; Prevalence ; Vancomycin ; Vancomycin Resistance

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A Case of Septicemia by Plesiomonas shigelloides.

Hyun Mi CHO ; Young UH ; Kap Jun YOON ; Won Yeon LEE ; Hyo Youl KIM

Korean Journal of Clinical Microbiology.2001;4(2):142-145.

Plesiomonas shigelloides is an oxidase-positive, fermentative, gram-negative rod currently classified as a member of the family Vibrionaceae. P. shigelloides has been implicated as the causative agents of gastroenteritis as well as extraintestinal infections such as septicemia, neonatal meningitis, cellulitis, and cholecystitis. Septicemia due to P. shigelloides is very rare but is severe and has been associated with a high mortality rate. We report a case of septicemia caused by P. shigelloides in a 66-year-old male with diabetes mellitus who had diagnosed as liver cirrhosis 7 years before.
Aged ; Cellulitis ; Cholecystitis ; Diabetes Mellitus ; Gastroenteritis ; Humans ; Liver Cirrhosis ; Male ; Meningitis ; Mortality ; Plesiomonas* ; Sepsis* ; Vibrionaceae

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A Case of Hafnia alvei Peritonitis with Septicemia.

Wonkeun SONG ; Taek Kyung KIM ; Min Jeong PARK ; Kyu Man LEE

Korean Journal of Clinical Microbiology.2001;4(2):139-141.

Hafnia alvei is gram-negative bacilli that is rarely isolated from human specimens and is rarely considered to be pathogenic. It has been associated with gastroenteritis, pneumonia, meningitis, bacteremia, and nosocomial wound infections. But, no case of extraintestinal H. alvei infection was documented in Korea to our knowledge. A 50-year-old man with hepatocellular carcinoma was admitted to our hospital via emergecy department because of abdominal pain. The peritoneal fluid and 3 consecutive blood cutures yielded H. alvei. The organism was susceptible to all antimicrobial agents tested, except cefazolin. Despite treatment with intravenous cefotaxime, the patient was expired after 4 days due to septicemia.
Abdominal Pain ; Anti-Infective Agents ; Ascitic Fluid ; Bacteremia ; Carcinoma, Hepatocellular ; Cefazolin ; Cefotaxime ; Gastroenteritis ; Hafnia alvei* ; Hafnia* ; Humans ; Korea ; Meningitis ; Middle Aged ; Peritonitis* ; Pneumonia ; Sepsis* ; Wound Infection

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Analysis of Enterovirus Genotypes Using Single-Strand Conformational Polymorphism.

Jung Hyun KIM ; Jung Hee LEE ; Je Kue LEE ; Won Ki BANG ; Jung Yon HONG ; Eui Chong KIM

Korean Journal of Clinical Microbiology.2001;4(2):134-138.

BACKGROUND: Epidemics of aseptic meningitis due to enteroviruses has occurred annually in the late spring and early summer season. The early detection of such epidemics is important for the prevention of further infection. Enteroviruses consist of 67 serotypes but one or two serotypes may be the causative agents of epidemics in the year and several different serotypes involve sporadic cases. In order to discriminate epidemics from sporadic infection, the serotype should be determined. We evaluated the significance of the single-strand conformational polymorphism (SSCP) of reverse transcription-polymerase chain reaction (RT-PCR) products of 5'-untranslated region (UTR) for the determination of serotypes. METHODS: The specimens of patients were cultured with RD cell and the RT-PCR was performed in case of the positive cytopathic effect. For the amplification of 153-bp of 5'-UTR, primers (EN1: 5'-CTC CGG CCC CTG AAT GCG GCT AAT-3'; EN2: 5'-ATT GTC ACC ATA AGC AGC CA-3') were used. The RT-PCR products were denatured with 95% formamide at 95degrees C for 5 min and SSCP was performed. 12.5% polyacrylamide gel (49/1 acrylamide/bis) was made by using Mighty SmallTM SE245 Dual Gel Caster (Hoefer Scientific Instruments Inc., USA). Electrophoresis was done at 10 mA for 1.5 h, and silver nitrate stain was performed. The SSCP patterns were compared with serotypes determined by sequence analysis of VP1 region. RESULTS: Coxsackievirus A9 (two strains), coxsackievirus A16 (10), coxsackievirus B2 (two), coxsackievirus B3 (two), echovirus 3 (two), echovirus 11 (two), echovirus 16 (seven), echovirus 19 (two), echovirus 30 (three), and enterovirus 71 (six) showed the different SSCP patterns according to their serotypes. The same pattern was observed in the same serotype, except echovirus 30 showing two different patterns. CONCLUSIONS: The SSCP of RT-PCR products of 5'-UTR may be helpful to determine the serotype and discriminate epidemics from sporadic cases. This has the advantage to be able to test the specimens directly without the viral culture. But the serotype should be determined by other method such as neutralization or sequence analysis in case of the first isolate in the epidemic season and the stains showing the new SSCP patterns.
Coloring Agents ; Electrophoresis ; Enterovirus B, Human ; Enterovirus* ; Genotype* ; Humans ; Meningitis, Aseptic ; Polymorphism, Single-Stranded Conformational ; Seasons ; Sequence Analysis ; Silver Nitrate ; Natural Resources

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Utility of 293 Cells in Culture of Enteroviruses.

Han Sung KIM ; Wonkeun SONG ; Kyu Man LEE

Korean Journal of Clinical Microbiology.2001;4(2):129-133.

BACKGROUND: Viral isolation in cell culture remains as a reference method for diagnosis of enteroviral infection. Enteric adenoviruses are cultivated in 293 cells. Enteroviral and enteroadenovrial tropisms for the gastrointestinal tract lead to the assumption that 293 cells would be useful in enteroviral isolation. We evaluated usefulness of 293 cells in the diagnosis of enteroviral infection. METHODS: Human embryonic lung fibroblasts (HEL), HeLa, RD and 293 cells were used to evaluate viral isolation from clinical specimens, susceptibilities of the cell lines to reference enteroviral strains and influence to stool extracts on the viral isolation. Forty-four stool specimens collected from patients during the epidemic period of type 9 echoviral aseptic meningitis and type 30 echoviral culture-positive 33 stool and 58 cerebrospinal fluid (CSF) specimens were inoculated onto cell lines. RESULTS: Echovirus type 9 was isolated from 31 of 44 stool specimens. Of 31 echovirus 9 isolates, 22 (71.0%), 21 (67.7%), 6 (19.4%) and 3 (9.7%) were detected in HEL, 293, RD and HeLa, respectively. Of 33 echovirus 30 isolates from stool specimens, 32 (97.0%) were detected in 293; 17 (51.5%) were detected in RD. Of 58 echovirus 30 isolates from CSF specimens, 39 (67.2%) were detected in 293; 30 (51.7%) were detected in RD. 293 cells were sensitive for coxsackievirus A9 reference strain and echovirus 7 reference strain. Stool extracts induced enhanced cytopathic effect by echovirus 9 infection in 293 and HEL. CONCLUSIONS: 293 cells are useful in the diagnosis of echoviral and some enteroviral infection.
Adenoviridae ; Cell Culture Techniques ; Cell Line ; Cerebrospinal Fluid ; Diagnosis ; Echovirus 9 ; Enterovirus B, Human ; Enterovirus* ; Fibroblasts ; Gastrointestinal Tract ; Humans ; Lung ; Meningitis, Aseptic ; Tropism

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Laboratory Experience in Phenotypic and Molecular Identification of Blastomyces dermatitidis First Isolated in Korea.

Kyung Sun PARK ; Chang Seok KI ; Nam Yong LEE

Korean Journal of Clinical Microbiology.2012;15(3):114-116. doi:10.5145/KJCM.2012.15.3.114

Blastomycosis, endemic in North America, has been hardly reported in Korea. We describe laboratory experience in phenotypic and molecular identification of Blastomyces dermatitidis first isolated in Korea. The patient was a 45-year-old male with pulmonary blastomycosis mimicking pulmonary tuberculosis. Diagnosis was based on culture and dimorphism combined with DNA target sequencing of internal transcribed spacers (ITS) and D1/D2 regions.
Blastomyces ; Blastomycosis ; DNA ; Humans ; Korea ; Male ; Middle Aged ; North America ; Tuberculosis, Pulmonary

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A Case of Bacteremia Due to Microbacterium oleivorans Identified by 16S rRNA Sequencing Analysis.

Bo Hyun KIM ; Mi Kyung LEE

Korean Journal of Clinical Microbiology.2012;15(3):110-113. doi:10.5145/KJCM.2012.15.3.110

Microbacterium oleivorans is a gram-positive, coryneform rod bacterium. The pathogenic potential of the Microbacterium species has recently been reported to be increasing. Microbacterium comprises approximately 50 species. The differences in regards to the biochemical characteristics of Microbacterium species are unclear, and is why molecular investigations (e.g., using 16S rRNA gene sequencing) are the best method to identify the species. We report a case of bacteremia that was caused by Microbacterium oleivorans in a 4-year-old boy, who had no specific medical history. This represents the first report of M. oleivorans bacteremia in Korea.
Bacteremia ; Genes, rRNA ; Korea ; Preschool Child

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Detection of Trichomonas vaginalis, Gardnerella vaginalis, and Candida Species in Affirm VPIII, Papanicolaou Smear Test and Gram Stain.

Kye Hyun KIM ; Tae Hyoung KIM ; Jun Hyung LEE ; Tae Jin LEE ; Mi Kyung LEE

Korean Journal of Clinical Microbiology.2012;15(3):104-109. doi:10.5145/KJCM.2012.15.3.104

BACKGROUND: Infectious vaginitis is caused primarily by three different groups of microbial pathogens (Trichomonas vaginalis, Candida spp., and Gardnerella vaginalis). The objective of this study was to compare the Affirm VPIII assay using a DNA hybridization technique with the Papanicolaou (Pap) smear test and the Gram stain in the detection and identification of these three organisms. METHODS: A total of 300 vaginal samples were collected from women that were either symptomatic for vaginitis or asymptomatic women that were being seen for routine obstetric or gynecological care. The presence of T. vaginalis, Candida spp., and G. vaginalis was evaluated by using the Affirm VIII assay (Becton Dickinson, USA), Pap smear test, and Gram stain method, respectively. RESULTS: With the Affirm VPIII assay, 1 (0.3%) patient tested positive for T. vaginalis, 99 (33.0%) patients were positive for G. vaginalis, and 18 (6.0%) were positive for Candida spp. The detection rates of Trichomonas infection, bacterial vaginosis and candidiasis by the Pap smear test and Gram stain method were 0.7% versus 0%, 16.3% versus 35.7%, and 1.7% versus 9.7%, respectively. The differences between the detection rates of the above three organisms between the Pap smear test and the Gram stain method were statistically significant (p<0.05). CONCLUSION: The Affirm VPIII assay was more sensitive than the Pap smear test and more specific than the Gram stain method for the detection and identification of these three organisms. In addition, the results of the Affirm VPIII assay are quick to obtain and are simple and easy to interpret.
Candida ; Candidiasis ; Chimera ; DNA ; Female ; Gardnerella ; Gardnerella vaginalis ; Humans ; Trichomonas ; Trichomonas Infections ; Trichomonas vaginalis ; Vaginal Smears ; Vaginitis ; Vaginosis, Bacterial

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Evaluation of a 16S rDNA PCR Assay for Detection of Bacterial Pathogens in Blood Culture Broth.

Sook Jin JANG ; Jin Hee KIM ; Young Sook KIM ; Jong Hee SHIN ; Geon PARK ; Bidur Prasad CHAULAGAIN ; Dae Soo MOON ; Young Jin PARK

Korean Journal of Clinical Microbiology.2006;9(1):64-70.

BACKGROUND: Rapid detection of pathogens in blood is important in patient management, because the mortality rate associated with bloodstream infections is very high. We evaluated the efficiency of a 16S rDNA PCR assay for the detection of various pathogens in blood culture broth in METHODS: 16S rDNA PCR was performed on 221 blood culture bottles consisting of 99 culturepositive and 122 culture-negative samples. The results were compared with conventional culture methods. We also compared the efficiency of three DNA extraction and purification methods using proteinase K, triton X-100, and benzyl alcohol-guanidine DNA extraction of blood culture broths. RESULTS: The 16S rDNA PCR method detected 95 (12 Staphylococcus aureus, 27 coagulase negative staphylococci, 10 enterococci, 5 streptococci, 37 gram negative bacilli, 4 corynebacteria) of 99 positive culture bottles. Four false-negative results were obtained for bottles containing 2 Corynebacterium, 1 Escherichia coli, and 1 S. aureus species. All 122 bottles that showed no blood culture growth were negative by 16S rDNA PCR. Overall, the sensitivity, specificity, positive predictive values and negative predictive values of 16S rDNA PCR relative to the culture results were 96.0%, 100%, 100%, and 96.8%, respectively. Among the three DNA extraction methods, the benzyl alcohol-guanidine method was most effective. CONCLUSION: The 16S rDNA PCR assay is a rapid and efficient means of detecting various pathogens in the blood and has great potential for use in the clinical microbiology laboratory.
Coagulase ; Corynebacterium ; DNA ; DNA, Ribosomal* ; Endopeptidase K ; Escherichia coli ; Humans ; Mortality ; Octoxynol ; Polymerase Chain Reaction* ; Sensitivity and Specificity ; Sepsis ; Staphylococcus aureus

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Evaluation of the Phoenix System for the Detection of Methicillin-Resistent Staphylococcus aureus.

Kyung Ran JUN ; Hong Seon JEON ; Heungsup SUNG ; Mi Na KIM

Korean Journal of Clinical Microbiology.2006;9(1):58-63.

BACKGROUND: We evaluated the BD Phoenix Automated Microbiology System (Phoenix) for its ability to detect methicillin resistant Staphylococcus aureus (MRSA) and compared the results to those obtained by the Clinical and Laboratory Standards Institute (CLSI) agar dilution method, a mecA gene PCR method, and the MicroScan WalkAway 96 System (MicroScan). METHODS: One hundred seventy S. aureus strains (Group I) isolated from blood and urine cultures were collected from eight university hospitals and 58 strains (Group II) including 20 blood isolates among Group I and 38 isolates from skin lesions of atopic patients were collected from Asan Medical Center. All 208 isolates were tested with Phoenix using PMIC/ID-53 panels, and the tests were repeated when the results were indeterminate. The results by Phoenix were compared to the susceptibility results obtained by reference methods: the CLSI method for oxacillin MIC for Group I strains, and a PCR assay method for detection of the mecA gene and MicroScan tests for oxacillin susceptibility for Group II strains. RESULTS: One hundred strains (58.8%) in Group I were MRSA and 28 strains (48.3%) were mecA positive in Group II. Compared to the CLSI method, Phoenix showed the sensitivity and specificity of 100% and MIC agreement of 99.4% for Group I strains. The level of agreement between Phoenix and MicroScan for oxacillin MIC and their interpretation were 98.3% and 100%, respectively, for Group II strains. Both MicroScan and Phenix failed to detect one mecA-positive strain: its MIC was shown as 2 microgram/mL twice by MicroScan and 2 microgram/mL twice and > 2 microgram/mL once by Phoenix. The frequency of the indeterminate results was 5.5% and the mean time to completion of the tests was 12.8 (10.2-16) hours in Phoenix. CONCLUSION: Phoenix showed a high level of sensitivity and specificity for the detection of MRSA with an excellent correlation with MicroScan. Further evaluation is required for detection of heterogeneous MRSA.
Agar ; Chungcheongnam-do ; Hospitals, University ; Humans ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Oxacillin ; Polymerase Chain Reaction ; Sensitivity and Specificity ; Skin ; Staphylococcus aureus* ; Staphylococcus*

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