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First Case of Psychrobacter sanguinis Bacteremia in a Korean Patient.

Sangeun LIM ; Hui Jin YU ; Seungjun LEE ; Eun Jeong JOO ; Joon Sup YEOM ; Hee Yeon WOO ; Hyosoon PARK ; Min Jung KWON

Annals of Clinical Microbiology.2017;20(3):74-79. doi:10.5145/ACM.2017.20.3.74

Psychrobacter sanguinis has been described as a Gram-negative, aerobic coccobacilli originally isolated from environments and seaweed samples. To date, 6 cases of P. sanguinis infection have been reported. A 53-year-old male was admitted with a generalized tonic seizure lasting for 1 minute with loss of consciousness and a mild fever of 37.8℃. A Gram stain revealed Gram-negative, small, and coccobacilli-shaped bacteria on blood culture. Automated microbiology analyzer identification using the BD BACTEC FX (BD Diagnostics, Germany) and VITEK2 (bioMérieux, France) systems indicated the presence of Methylobacterium spp., Aeromonas salmonicida, and the Moraxella group with low discrimination. The GenBank Basic Local Alignment Search Tool and an Ez-Taxon database search revealed that the 16S rRNA gene sequence of the isolate showed 99.30% and 99.88% homology to 859 base-pairs of the corresponding sequences of P. sanguinis, respectively (GenBank accession numbers JX501674.1 and HM212667.1). To the best of our knowledge, this is the first human case of P. sanguinis bacteremia in Korea. It is notable that we identified a case based on blood specimens that previously had been misidentified by a commercially automated identification analyzer. We utilized 16S rRNA gene sequencing as a secondary method for correctly identifying this microorganism.
Aeromonas salmonicida ; Bacteremia* ; Bacteria ; Databases, Nucleic Acid ; Discrimination (Psychology) ; Fever ; Genes, rRNA ; Humans ; Korea ; Male ; Methods ; Methylobacterium ; Middle Aged ; Moraxella ; Psychrobacter* ; RNA, Ribosomal, 16S ; Seaweed ; Seizures ; Unconsciousness

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Comparison of Multilocus Sequence Typing Change Patterns of Vancomycin-Resistant Enterococcus faecium from 2015 to 2017.

Joon KIM ; Young Ihn KWON ; Wee Gyo LEE

Annals of Clinical Microbiology.2017;20(3):67-73. doi:10.5145/ACM.2017.20.3.67

BACKGROUND: Multilocus sequence typing (MLST) is useful in determining the long-term evolutionary process and minimizes differences in experimental results across individuals and laboratories. It is also useful in determining evolutionary origins and backgrounds of bacterial species. This study carries out MLST analysis on VanA-type vancomycin-resistant Enterococcus faecium isolated from patient specimens in a single university hospital over nine years in order to observe changes in genetic evolution over time. METHODS: During the years from 2007 to 2015, 44 clinical isolates of vanA-containing E. faecium were collected from Ajou University Hospital in Korea. Species were identified by the VitekII system (bio-Merieux, USA), and antibiotic susceptibility testing was performed by disk diffusion and E-test according to Clinical and Laboratory Standards Institute (CLSI) guidelines. To determine genetic relatedness, matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF M/S) was employed. To characterize clonal diversity, MLST analysis was used. RESULTS: All isolates were highly resistant to ampicillin, ciprofloxacin, and vancomycin but showed variable levels of resistance to teicoplanin. The 44 clinical isolates were genetically unrelated according to MALDI-TOF M/S analysis. MLST showed that the clinical isolates harbored 6 sequence types (ST), with ST17 (n=19) being the most common, followed by ST78 (n=13), ST192 (n=6), ST64 (n=4), ST262 (n=1), and ST414 (n=1). CONCLUSION: The MLST analysis showed that the sequence types of most isolates belonged to clonal complex 17 This is consistent with outbreaks in hospitals. We had single observations for ST262 and ST414, suggesting that they were random occurrences. MLST can be useful for speculating the genetic evolution of VanA-containing E. faecium isolates.
Ampicillin ; Ciprofloxacin ; Diffusion ; Disease Outbreaks ; Enterococcus faecium* ; Enterococcus* ; Evolution, Molecular ; Humans ; Korea ; Mass Spectrometry ; Multilocus Sequence Typing* ; Teicoplanin ; Vancomycin

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High Prevalence of Rotavirus G4P6 Genotypes among Neonates in Two Korean Hospitals.

Jae Seok KIM ; Sung Mi KIM ; Hyun Soo KIM

Annals of Clinical Microbiology.2017;20(3):63-66. doi:10.5145/ACM.2017.20.3.63

BACKGROUND: The introduction of rotavirus vaccines has decreased the prevalence of rotavirus infections and might have changed the distribution of rotavirus genotypes. However, neonates are not eligible for vaccination and, therefore, are at risk for rotavirus infection while in the hospital nursery or neonatal intensive care unit. Our aim was to evaluate the shift of genotypes of group A rotavirus strains among neonates cared for in two geographically distant hospitals in Korea. METHODS: Analysis of rotavirus P and G genotypes was performed for 63 neonates (27 neonates in Seoul and 36 neonates in Busan) admitted to two hospitals between 2011 and 2013. RESULTS: Among the 63 tested neonates less than one month of age, 61 (96.8%) were infected with genotype G4P[6]. CONCLUSION: This study identified G4P[6] as the most frequently isolated genotypes among neonates in Korea; therefore, prevention of the G4P[6] genotype should be considered for neonates.
Genotype* ; Humans ; Infant, Newborn* ; Intensive Care, Neonatal ; Korea ; Nurseries ; Nurseries, Hospital ; Prevalence* ; Rotavirus Infections ; Rotavirus Vaccines ; Rotavirus* ; Seoul ; Vaccination

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Trend of Prevalence and Antifungal Drug Resistance of Candida Species Isolated from Candidemia Patients at a Tertiary Care Hospital During Recent Two Decades.

Dongkyun KIM ; Gyu Yel HWANG ; Gilsung YOO ; Juwon KIM ; Young UH

Annals of Clinical Microbiology.2017;20(3):53-62. doi:10.5145/ACM.2017.20.3.53

BACKGROUND: Candidemia has increased with an increasing number of people in the high risk group and so has become more important. This study was conducted to investigate the isolation rate of Candida species from candidemia patients and the change in rate of antifungal resistance. METHODS: At a single tertiary care hospital, 1,120 blood cultures positive for Candida species from 1997 to 2016 were investigated according to date of culture, gender, age, and hospital department. RESULTS: During the investigation period, the number of candidemia patients increased from 14 in 1997 to 84 in 2016. The most common organism identified during the two decades was Candida albicans (40.8%), followed by Candida parapsilosis (24.1%), Candida tropicalis (13.2%), and Candida glabrata (12.8%). C. glabrata was relatively common in females (45.5%) compared to males. The age group 40-89 years was more frequently infected than other age groups, and the most frequent isolates according to age group were C. albicans in neonate (66.7%), C. parapsilosis in 1-9-year-olds (41.7%), and C. glabrata in those aged ≥60 years (range; 13.3%–20.0%). According to the visited departments, C. albicans, C. glabrata, and Candida haemulonii were more common in medical departments, while C. parapsilosis was more common in surgical departments. In the antifungal susceptibility test, a rising trend of azole resistance among C. albicans and C. glabrata was observed in recent years. CONCLUSION: In this study, it was confirmed that the isolation rate of Candida species in blood is different by age, gender, and hospital department, and the distribution of isolated Candida species changed over time. The resistance patterns of antifungal agents are also changing, and continuous monitoring and proper selection of antifungal agents are necessary.
Antifungal Agents ; Candida albicans ; Candida glabrata ; Candida tropicalis ; Candida* ; Candidemia* ; Danazol ; Drug Resistance, Fungal* ; Female ; Hospital Departments ; Humans ; Infant, Newborn ; Male ; Prevalence* ; Tertiary Healthcare*

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Late Prosthetic Joint Infection and Bacteremia by Bacillus cereus Confirmed by 16S rRNA Sequencing and Hip Joint Tissue Pathology.

Jihye HA ; Yu Jin PARK ; Yee Jeong KIM ; Hyun Cheol OH ; Young Ah KIM

Annals of Clinical Microbiology.2016;19(2):54-57. doi:10.5145/ACM.2016.19.2.54

Bacillus cereus is a widespread organism in nature and a member of the B. cereus group of catalasepositive, aerobic, spore-forming, Gram-positive bacilli. B. cereus found in blood is often dismissed as a contaminant in the absence of repeated isolation from multiple cultures. Soft tissue and bone infection due to B. cereus have been associated with trauma, intravenous drug use, and an immunocompromised state. We report a very late prosthetic joint infection of the hip joint and consequent bacteremia caused by B. cereus, which occurred 13 years after total hip replacement surgery in the absence of recent trauma or intervention.
Arthritis ; Arthroplasty, Replacement, Hip ; Bacillus cereus* ; Bacillus* ; Bacteremia* ; Hip Joint* ; Hip* ; Joints* ; Pathology* ; Prostheses and Implants

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Distribution and Antimicrobial Resistance of Streptococcus pneumoniae at Four University Hospitals in Busan and Gyeongnam.

Si Hyun KIM ; Sae Am SONG ; Jongyoun YI ; Duyeal SONG ; Chulhun Ludgerus CHANG ; Dong Chul PARK ; Sang Hwa URM ; Hye Ran KIM ; Jeong Hwan SHIN

Annals of Clinical Microbiology.2016;19(2):48-53. doi:10.5145/ACM.2016.19.2.48

BACKGROUND: Streptococcus pneumoniae is the most common human pathogen causing community-acquired pneumonia. There is little information on the recent antimicrobial susceptibility patterns of S. pneumoniae in Busan and Gyeongnam of Korea. The aim of this study was to investigate the distribution and antimicrobial resistance of S. pneumoniae at 4 university hospitals in Busan and Gyeongnam. METHODS: We collected and analyzed the antimicrobial susceptibility results of 850 S. pneumoniae strains isolated from regional 4 university hospitals during the last 2 years from July 2013 through June 2015. RESULTS: Among 850 S. pneumoniae strains, 635 strains were isolated from respiratory specimens, followed by blood (N=121), CSF (N=13), and others (N=81). Antimicrobial susceptibility rates to penicillin, cefotaxime and ceftriaxone were 79.4%, 76.6% and 83.6%, respectively. The resistant rates to erythromycin and clindamycin were 80.9% and 68.2%, respectively. The resistant rates to levofloxacin were 9.2%. There were some differences in resistant rates by age groups, years, and specimen types. CONCLUSION: We found the changes of antimicrobial resistance of S. pneumoniae during the last 2 years. It is necessary to monitor the antimicrobial susceptibility of S. pneumoniae regularly for empirical therapy and for early detection of the changes of resistance.
Busan* ; Cefotaxime ; Ceftriaxone ; Clindamycin ; Drug Resistance ; Erythromycin ; Hospitals, University* ; Humans ; Korea ; Levofloxacin ; Penicillins ; Pneumonia ; Streptococcus pneumoniae* ; Streptococcus*

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Molecular Epidemiology and Characterization of Carbapenemase-Producing Enterobacteriaceae Isolated at a University Hospital in Korea during 4-Year Period.

Sunyoung AHN ; Ji Yeon SUNG ; Hyunsoo KIM ; Myung Sook KIM ; Younjee HWANG ; Sori JONG ; Younghee SEO ; Eunjin HA ; Eun Suk PARK ; Jun Yong CHOI ; Dongeun YONG ; Kyungwon LEE

Annals of Clinical Microbiology.2016;19(2):39-47. doi:10.5145/ACM.2016.19.2.39

BACKGROUND: Carbapenemase-producing Enterobacteriaceae (CPE) has been increasingly reported worldwide in the past 10 years, which is an important infection control concern. Since the epidemiology and characteristics of these CPEs vary according to institutes, we aimed to characterize CPEs in a university hospital during the recent 4 years. METHODS: From October 2011 to September 2015, CPE isolates from clinical specimens and hospital surveillance cultures were collected. Carbapenem resistance was confirmed by disk diffusion method and Minimal Inhibitory Concentration (MIC) was determined by agar dilution method. Carbapenemase production was tested by double disk test using aminophenylboronic acid and dipicolic acid. PCR and sequence analysis were performed to detect bla(KPC), bla(IMP-1), bla(VIM-2), bla(NDM-1)-like genes and bla(OXA-48) gene. Pulsed-field gel electrophoresis (PFGE) and Multilocus sequence typing (MLST) were conducted for KPC-producing Klebsiella pneumoniae isolates. RESULTS: Twenty-five isolates (11%) of CPE were identified among 222 carbapenem-resistant Enterobacteriacae isolates during the study period. The most prevalent CPE was KPC-producing K. pneumonia and others were IMP-1, VIM-2, NDM-1 type and OXA-48 producing CPEs. Most of these CPEs showed resistance to carbapenems with variable MICs. The sequence types (STs) of KPC-producing K. pneumoniae were ST307 and ST11. The PFGE of ST11 and ST307 showed clonality in each group suggesting the possibility of in-hospital outbreak. CONCLUSION: The prevalence of CPE has been increasing. In our institute, KPC-producing K. pneumoniae was the most frequently isolated CPE in the recent 4 years. CPE including KPC producers can easily transfer their resistance. Therefore continuous monitoring and more intensified infection control for CPE should be considered.
Academies and Institutes ; Agar ; Carbapenems ; Diffusion ; Drug Resistance, Bacterial ; Electrophoresis, Gel, Pulsed-Field ; Enterobacteriaceae* ; Epidemiology ; Infection Control ; Klebsiella pneumoniae ; Korea* ; Methods ; Molecular Epidemiology* ; Multilocus Sequence Typing ; Pneumonia ; Polymerase Chain Reaction ; Prevalence ; Sequence Analysis

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Correction: Comparison of Multilocus Sequence Typing Change Patterns of Vancomycin-Resistant Enterococcus faecium from 2015 to 2017.

Joon KIM ; Young Ihn KWON ; Wee Gyo LEE

Annals of Clinical Microbiology.2017;20(4):109-109. doi:10.5145/ACM.2017.20.4.109

The period of study in title should have been listed as ‘in the Past Nine Years’. Therefore, we ask to correct ‘from 2015 to 2017’ with ‘from 2007 to 2015’.

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Rapid Detection of Group B Streptococcus Using ChromID STRB and PCR in the Pregnant Women.

Dong Hyun LEE ; Hyoshim SHIN ; Sunjoo KIM

Annals of Clinical Microbiology.2017;20(4):103-108. doi:10.5145/ACM.2017.20.4.103

BACKGROUND: Group B Streptococcus (GBS) can be transmitted to neonates during delivery through the birth canal. As awareness of neonatal GBS infections is increasing, more rapid and efficient screening tests are required. The aim of this study was to evaluate the performance of ChromID STRB (bioMérieux, France) and PCR compared with the standard culture method. METHODS: Recto-vaginal swabs were collected from 775 pregnant women from April 2016 to March 2017. Cotton swab cultures were grown in LIM broth overnight and then subcultured onto blood agar plates and ChromID STRB. PCR was carried out to detect atr genes specific for GBS. RESULTS: The carrier rate of GBS was 5.9% (46/775). The sensitivity, specificity, positive predictive value, and negative predictive value were 83.8%, 99.3%, 86.1%, and 99.2%, respectively, for ChromID STRB and 89.2%, 99.6%, 91.7%, and 99.5%, respectively for PCR. Both ChromID STRB and PCR detected 6 more cases compared to the standard culture. CONCLUSION: Chromogenic agar, ChromID STRB, and PCR using the atr gene showed excellent performance to screen for GBS. To administer prophylactic antibiotics efficiently, either selective chromogenic agar or PCR could be used in addition to the standard culture.
Agar ; Anti-Bacterial Agents ; Female ; Humans ; Infant, Newborn ; Mass Screening ; Methods ; Parturition ; Polymerase Chain Reaction* ; Pregnancy ; Pregnant Women* ; Sensitivity and Specificity ; Streptococcus agalactiae ; Streptococcus*

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Evaluation of EuDx™-PN MLC Detection Kit for Detection of Mycoplasma pneumoniae, Chlamydophila pneumoniae, and Legionella pneumophila in Respiratory Specimens.

Mi Kyung LEE ; Heungsup SUNG ; Ah Ra CHO ; Hyun Young CHI

Annals of Clinical Microbiology.2017;20(4):97-102. doi:10.5145/ACM.2017.20.4.97

BACKGROUND: Infection by the intracellular bacteria Mycoplasma pneumoniae, Chamydophila pneumoniae, and Legionella pneumophila are common causes of community-acquired pneumonia (CAP). This study describes the evaluation of a new multiplex real-time PCR test, EuDx™-PN MLC Detection Kit (EUDIPIA), which allows the simultaneous detection of M. pneumoniae, C. pneumoniae, and L. pneumophila in respiratory samples. METHODS: A total of 353 samples were tested using three PCR kits: multiplex PCR (Seeplex PneumoBacter ACE Detection Kit) and two multiplex real-time PCR (EuDx™-PN MLC Detection Kit and Anyplex™ II RB5 Detection Kit). The results were considered true positives (expanded standard) for M. pneumoniae, C. pneumoniae, and L. pneumophila if they were positive according to any of the three tests. RESULTS: The sensitivity and specificity of EuDx™-PN MLC Detection Kit were 93.3–100% and 100%, respectively. The agreement rate and Cohen's kappa coefficient (value) between EuDx™-PN MLC Detection Kit and Anyplex™ II RB5 Detection Kit for M. pneumoniae, C. pneumoniae, and L. pneumophila were 70–100% and 0.82–1, respectively. CONCLUSION: These results demonstrate that the EuDx™-PN MLC Detection Kit is a sensitive, specific, and useful screening tool for the detection of atypical pathogens in respiratory samples and can be helpful in selecting appropriate antimicrobial therapy for patients with respiratory infection.
Bacteria ; Chlamydial Pneumonia* ; Chlamydophila pneumoniae* ; Chlamydophila* ; Humans ; Legionella pneumophila* ; Legionella* ; Mass Screening ; Multiplex Polymerase Chain Reaction ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pneumonia ; Pneumonia, Mycoplasma* ; Polymerase Chain Reaction ; Real-Time Polymerase Chain Reaction ; Respiratory Tract Infections ; Sensitivity and Specificity

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