1.Molecular Epidemiology of Extended-spectrum β-Lactamase-producing Escherichia coli in South Korea: A Korean Global Antimicrobial Resistance Surveillance System Report
Dokyun KIM ; SungYoung LEE ; Jun Sung HONG ; Min Hyuk CHOI ; Hyun Soo KIM ; Young Ree KIM ; Young Ah KIM ; Young UH ; Kyeong Seob SHIN ; Jeong Hwan SHIN ; Jeong Su PARK ; Kyoung Un PARK ; Soo Hyun KIM ; Jong Hee SHIN ; Jungsik YU ; Seok Hoon JEONG
Annals of Laboratory Medicine 2026;46(1):72-82
Background:
Extended-spectrum β-lactamase (ESBL)-producing Escherichia coli is among the most important multidrug-resistant pathogens causing bloodstream infections (BSIs).Cefotaximase (CTX-M) enzymes are the most common and highly diverse ESBL family in E.coli. CTX-M-15 in group CTX-M-1 and CTX-M-14 in group CTX-M-9 are the most extensively disseminated enzymes. Multidrug-resistant E. coli strains complicate empirical therapy and increase healthcare burden globally and in Korea. We investigated the molecular epidemiology, sequence types (STs), and ESBL genotypes of E. coli bloodstream isolates in Korea and identified clinical risk factors for cefotaxime resistance.
Methods:
We collected all non-duplicated isolates of E. coli and related clinical information from patients with BSIs at eight sentinel hospitals in the Korean Global Antimicrobial Resistance Surveillance System (Kor-GLASS) collection network during 2017–2021. Duplicate isolates were removed to ensure representativeness of the data. Antimicrobial susceptibility was tested using disk diffusion tests, and multilocus sequence typing and betalactamase genotyping were performed.
Results:
Among 9,232 E. coli blood isolates, resistance rates to cefotaxime and ceftazidime were 36.4% and 11.4%, respectively. Among the clinical factors, age > 65 yrs (adjusted odds ratio [aOR], 1.36), hospital-origin infection (aOR, 2.55), and admission type (intensive care unit [ICU] vs. general ward; aOR, 1.34) were significant cefotaxime resistance risk factors. ST131 was the most prevalent among cefotaxime-resistant E. coli (64.8%, 2,180/3,363), followed by ST1193 (5.3%, N = 177), and ST69 (5.1%, N = 170).ST131, ST648, ST405, and ST410 cefotaxime-resistant E. coli isolates frequently harbored blaCTX-M-15, whereas ST1193 and ST68 showed a high proportion of blaCTX-M-27 carriers, and most ST457 and ST5150 isolates carried blaCTX-M-55.
Conclusions
Continuous monitoring of ESBL-producing E. coli is required to prevent further dissemination, guide empirical therapy, inform infection control policies, and ensure early detection of multidrug-resistant clones with the potential for widespread transmission.
2.Performance Evaluation of the 2020 European Society of Cardiology 0-hour/1-hour Algorithm Using High-sensitivity Cardiac Troponin I for Non-ST-segment Elevation Acute Coronary Syndrome and Mortality Assessment Based on 1-year Real-world Data
Changhee HA ; Yeon Jae LEE ; Jong Do SEO ; Hanah KIM ; Hee-Won MOON ; Mina HUR ; Young Hwan LEE ; Sang O PARK ; Kyeong Ryong LEE ; Hyun-Joong KIM ; Yeo-Min YUN
Annals of Laboratory Medicine 2026;46(1):52-61
Background:
The 2020 European Society of Cardiology (ESC) 0-hr/1-hr algorithm using high-sensitivity cardiac troponin I (hs-cTnI) for non-ST-segment elevation acute coronary syndrome (NSTE-ACS) aims at early diagnosis and shorter emergency department (ED) stays. While this algorithm has been well-established in controlled studies, real-world implementation remains challenging. We evaluated the algorithm’s clinical performance and risk stratification capability in patients with chest pain or discomfort.
Methods:
We measured hs-cTnI in 4,678 patients suspected of NSTE-ACS between August 2022 and July 2023, using an Atellica IM Analyzer (Siemens Healthineers, Erlangen, Germany). We categorized patients into rule-in, observe, or rule-out groups according to the algorithm and assessed its diagnostic performance for NSTE-ACS. The final diagnosis of NSTE-ACS was adjudicated by two independent physicians. Additionally, we evaluated 30-day all-cause mortality, hazard risk, and ED length of stay across the three groups.
Results:
The algorithm categorized 3,408 (72.9%), 573 (12.2%), and 697 (14.9%) patients into the rule-out, observe, and rule-in groups, respectively. Among 90 patients diagnosed as having NSTE-ACS, none were falsely categorized into the rule-out group. Survival analysis revealed significant differences (P < 0.001), with Cox hazard ratios of 2.38 (95% confidence interval: 1.20–4.71) and 6.39 (3.45–11.86) in the observe and rule-in groups, respectively. ED stays shortened in the order of rule-out, observe, and rule-in groups (P < 0.001).
Conclusions
The 2020 ESC 0-hr/1-hr algorithm demonstrates excellent diagnostic accuracy without false rule-outs and effective risk stratification, and contributes to efficient ED throughput, supporting its clinical utility in real-world emergency settings.
3.Myopia Management Consensus Statement in South Korean Children 2025 by the Korean Myopia Society for the Korean Association for Pediatric Ophthalmology and Strabismus
Yeon-Hee LEE ; Jae Yun SUNG ; Sun Young SHIN ; Young-Woo SUH ; Ungsoo Samuel KIM ; Hyunkyung KIM ; Kyung-Ah PARK ; Su Jin KIM ; MiRae KIM ; Hyun Jin SHIN ; Kyeong Wook LEE ; Haeng-Jin LEE ; So Young HAN ; Jinu HAN ; Eun Hee HONG ; Seung-Hee Hannah BAEK ; Hae Jung PAIK ;
Korean Journal of Ophthalmology 2026;40(2):185-205
Myopia, particularly high myopia, is a significant risk factor for several ocular pathologies including cataract, glaucoma, and retinal detachment. Excessive axial elongation associated with high myopia can induce biomechanical stretching, increasing the risk of serious complications like posterior staphyloma and myopic maculopathy. Global meta-analyses estimate that approximately 10 million people were visually impaired due to myopic maculopathy in 2015, with 3 million being blind. Recent nationwide surveys in South Korea revealed a prevalence of 65.4% for myopia and 6.9% for high myopia in children and adolescents, highlighting the urgent need for effective management. Delaying the onset and slowing the progression of myopia during childhood and adolescence is crucial for reducing the potential lifetime risk of these complications. This consensus statement, prepared by the Korean Myopia Society for the Korean Association for Pediatric Ophthalmology and Strabismus (KAPOS), reviews the current evidence for myopia control interventions and provides management strategies applicable to the South Korean clinical setting. Key interventions covered include lifestyle modifications (outdoor time, near work adjustment), optical methods (myopia-control spectacle lenses, dual-focus soft contact lenses, orthokeratology), and pharmacologic treatment (low-concentration atropine), as well as combination therapies. The statement also addresses patient selection, treatment outcome evaluation using spherical equivalent and axial length changes, and the crucial aspects related to treatment cessation and the rebound effect.
4.Dietary management of pediatric patients with kidney disease: recommendations by the Korean Society of Pediatric Nephrology and the Korean Society of Clinical Nutrition
Yo Han AHN ; Hee Gyung KANG ; Jiyoung SONG ; Sangmi HAN ; Eujin PARK ; Jin-Soon SUH ; Jeong Yeon KIM ; Min Ji PARK ; Keum Hwa LEE ; Seon Hee LIM ; Kyeong Hun SHIN ; Hyunji KO ; Hyun Joo LEE ; Eunyoung JEONG ; Jinsu KIM ; Sohyun PARK ; Eonju CHOI ; Yuri SEO ; Kyooyung OH ; Jin Kyoung KIM ; Hyun Kyung LEE
Childhood Kidney Diseases 2026;30(1):4-14
Pediatric kidney disease has a relatively lower prevalence than do other pediatric conditions and has a notably different etiology from kidney diseases observed in adults. Furthermore, the pediatric population is unique in that they experience ongoing growth and development, distinguishing them from adult patients. Consequently, pediatric patients with kidney disease require more specialized and meticulous nutritional management than do adults. To address this need and promote optimal dietary practices for pediatric patients with kidney disease, pediatric nephrologists from the Korean Society of Pediatric Nephrology and nutritionists from the Korean Society of Clinical Nutrition have collaborated to establish nutritional guidelines specifically tailored to Korean dietary patterns. These guidelines offer detailed, nutrient-specific recommendations covering energy, protein, calcium, phosphorus, and potassium consumption while providing practical, culturally relevant guidance intended to support both pediatric patients and their caregivers.
5.Oral Health-Related Functional Factors Associated with Different Levels of Obstructive Sleep Apnea Risk in Korean Adults: Analysis of a National Survey
Hee-Kyeong BAK ; Na-Young LEE ; Han-Na KIM
Journal of Dental Hygiene Science 2026;26(1):20-32
Background:
This study aimed to investigate the association between oral health-related functional and symptomatic factors andrisk of obstructive sleep apnea (OSA) among Korean adults aged ≥40 years, with a focus on identifying oral health indicators associated with different levels of OSA risk.
Methods:
Data from the Eighth Korea National Health and Nutrition Examination Survey (2019∼2021) were analyzed. Among 22,559 participants, 8,603 adults aged ≥40 years with complete data were included. OSA risk was assessed using a modified STOP-B28 questionnaire (Snoring, Tiredness, Observed apnea, high blood Pressure, and body mass index >28 kg/m 2 ).Participants were categorized into normal, low-risk, and high-risk OSA groups, enabling a risk-stratified analysis. Associations between OSA risk levels and multiple oral health-related factors reflecting oral function and symptom history were examined using complex sample cross-tabulation and multivariable logistic regression analyses.
Results:
Male sex was associated with a higher likelihood of belonging to the low-risk (odds ratio [OR]=1.244) and high-risk(OR=1.587) OSA groups than the normal group (p<0.05). Several oral health-related factors showed graded associations with increasing OSA risk. Individuals with masticatory discomfort had 1.349-fold and 1.595-fold higher odds of belonging to the low-risk and high-risk groups, respectively (p<0.05). In the high-risk group, moderate speaking discomfort (OR=1.482) and a history of toothache within the past year (OR=1.487) were independently associated with an elevated OSA risk (p<0.05).
Conclusion
Oral health-related functional discomfort and symptom history were significantly associated with increasing OSA risklevels among middle-aged and older adults. By adopting a risk-based, stratified approach rather than focusing on diagnosed OSA or single oral symptoms, this study revealed that oral health indicators may serve as accessible markers for identifying individuals at elevated risk of OSA, underscoring the potential role of dental and oral healthcare settings in early screening and prevention.
6.Association between preoperative oxygen reserve index and postoperative pulmonary complications: a prospective observational study
Sangho LEE ; Halin HONG ; Hyojin CHO ; Sang-Wook LEE ; Ann Hee YOU ; Hee Yong KANG ; Sung Wook PARK ; Mi Kyeong KIM ; Jeong-Hyun CHOI
Korean Journal of Anesthesiology 2025;78(3):224-235
Background:
The oxygen reserve index (ORi) noninvasively measures oxygen levels within the mild hyperoxia range. To evaluate whether a degree of increase in the ORi during preoxygenation for general anesthesia is associated with the occurrence of postoperative pulmonary complications (PPCs).
Methods:
We enrolled 154 patients who underwent preoperative pulmonary function tests and were scheduled for elective surgery under general anesthesia. We aimed to measure the increase in ORi during preoxygenation before general anesthesia and analyze its association with PPCs.
Results:
PPCs occurred in 76 (49%) participants. Multivariate logistic regression analysis revealed that the three-minute preoxygenation ORi was significantly associated with PPCs (Odds ratio [OR]: 0.02, 95% CI [0.00–0.16], P < 0.001). The areas under the curve (AUC [95% CI]) in the receiver operating characteristic curve analysis for the three-minute preoxygenation ORi for PPCs were 0.64 (0.55–0.73). After a subgroup analysis, multivariate logistic regression showed that the three-minute preoxygenation ORi was significantly associated with PPCs among patients who underwent thoracic surgery (OR: 0.01, 95% CI [0.00–0.19], P = 0.006). The AUC of the three-minute preoxygenation ORi for PPCs was 0.72 (0.57–0.86) in patients who underwent thoracic surgery.
Conclusions
A low ORi measured after 3 min of preoxygenation for general anesthesia was associated with an increased risk of PPCs, including those undergoing thoracic surgery. This study demonstrated the potential of ORi, measured after oxygen administration, as a tool for evaluating lung function that complements traditional lung function tests and scoring systems.
7.Association between preoperative oxygen reserve index and postoperative pulmonary complications: a prospective observational study
Sangho LEE ; Halin HONG ; Hyojin CHO ; Sang-Wook LEE ; Ann Hee YOU ; Hee Yong KANG ; Sung Wook PARK ; Mi Kyeong KIM ; Jeong-Hyun CHOI
Korean Journal of Anesthesiology 2025;78(3):224-235
Background:
The oxygen reserve index (ORi) noninvasively measures oxygen levels within the mild hyperoxia range. To evaluate whether a degree of increase in the ORi during preoxygenation for general anesthesia is associated with the occurrence of postoperative pulmonary complications (PPCs).
Methods:
We enrolled 154 patients who underwent preoperative pulmonary function tests and were scheduled for elective surgery under general anesthesia. We aimed to measure the increase in ORi during preoxygenation before general anesthesia and analyze its association with PPCs.
Results:
PPCs occurred in 76 (49%) participants. Multivariate logistic regression analysis revealed that the three-minute preoxygenation ORi was significantly associated with PPCs (Odds ratio [OR]: 0.02, 95% CI [0.00–0.16], P < 0.001). The areas under the curve (AUC [95% CI]) in the receiver operating characteristic curve analysis for the three-minute preoxygenation ORi for PPCs were 0.64 (0.55–0.73). After a subgroup analysis, multivariate logistic regression showed that the three-minute preoxygenation ORi was significantly associated with PPCs among patients who underwent thoracic surgery (OR: 0.01, 95% CI [0.00–0.19], P = 0.006). The AUC of the three-minute preoxygenation ORi for PPCs was 0.72 (0.57–0.86) in patients who underwent thoracic surgery.
Conclusions
A low ORi measured after 3 min of preoxygenation for general anesthesia was associated with an increased risk of PPCs, including those undergoing thoracic surgery. This study demonstrated the potential of ORi, measured after oxygen administration, as a tool for evaluating lung function that complements traditional lung function tests and scoring systems.
8.Association between preoperative oxygen reserve index and postoperative pulmonary complications: a prospective observational study
Sangho LEE ; Halin HONG ; Hyojin CHO ; Sang-Wook LEE ; Ann Hee YOU ; Hee Yong KANG ; Sung Wook PARK ; Mi Kyeong KIM ; Jeong-Hyun CHOI
Korean Journal of Anesthesiology 2025;78(3):224-235
Background:
The oxygen reserve index (ORi) noninvasively measures oxygen levels within the mild hyperoxia range. To evaluate whether a degree of increase in the ORi during preoxygenation for general anesthesia is associated with the occurrence of postoperative pulmonary complications (PPCs).
Methods:
We enrolled 154 patients who underwent preoperative pulmonary function tests and were scheduled for elective surgery under general anesthesia. We aimed to measure the increase in ORi during preoxygenation before general anesthesia and analyze its association with PPCs.
Results:
PPCs occurred in 76 (49%) participants. Multivariate logistic regression analysis revealed that the three-minute preoxygenation ORi was significantly associated with PPCs (Odds ratio [OR]: 0.02, 95% CI [0.00–0.16], P < 0.001). The areas under the curve (AUC [95% CI]) in the receiver operating characteristic curve analysis for the three-minute preoxygenation ORi for PPCs were 0.64 (0.55–0.73). After a subgroup analysis, multivariate logistic regression showed that the three-minute preoxygenation ORi was significantly associated with PPCs among patients who underwent thoracic surgery (OR: 0.01, 95% CI [0.00–0.19], P = 0.006). The AUC of the three-minute preoxygenation ORi for PPCs was 0.72 (0.57–0.86) in patients who underwent thoracic surgery.
Conclusions
A low ORi measured after 3 min of preoxygenation for general anesthesia was associated with an increased risk of PPCs, including those undergoing thoracic surgery. This study demonstrated the potential of ORi, measured after oxygen administration, as a tool for evaluating lung function that complements traditional lung function tests and scoring systems.
9.Association between preoperative oxygen reserve index and postoperative pulmonary complications: a prospective observational study
Sangho LEE ; Halin HONG ; Hyojin CHO ; Sang-Wook LEE ; Ann Hee YOU ; Hee Yong KANG ; Sung Wook PARK ; Mi Kyeong KIM ; Jeong-Hyun CHOI
Korean Journal of Anesthesiology 2025;78(3):224-235
Background:
The oxygen reserve index (ORi) noninvasively measures oxygen levels within the mild hyperoxia range. To evaluate whether a degree of increase in the ORi during preoxygenation for general anesthesia is associated with the occurrence of postoperative pulmonary complications (PPCs).
Methods:
We enrolled 154 patients who underwent preoperative pulmonary function tests and were scheduled for elective surgery under general anesthesia. We aimed to measure the increase in ORi during preoxygenation before general anesthesia and analyze its association with PPCs.
Results:
PPCs occurred in 76 (49%) participants. Multivariate logistic regression analysis revealed that the three-minute preoxygenation ORi was significantly associated with PPCs (Odds ratio [OR]: 0.02, 95% CI [0.00–0.16], P < 0.001). The areas under the curve (AUC [95% CI]) in the receiver operating characteristic curve analysis for the three-minute preoxygenation ORi for PPCs were 0.64 (0.55–0.73). After a subgroup analysis, multivariate logistic regression showed that the three-minute preoxygenation ORi was significantly associated with PPCs among patients who underwent thoracic surgery (OR: 0.01, 95% CI [0.00–0.19], P = 0.006). The AUC of the three-minute preoxygenation ORi for PPCs was 0.72 (0.57–0.86) in patients who underwent thoracic surgery.
Conclusions
A low ORi measured after 3 min of preoxygenation for general anesthesia was associated with an increased risk of PPCs, including those undergoing thoracic surgery. This study demonstrated the potential of ORi, measured after oxygen administration, as a tool for evaluating lung function that complements traditional lung function tests and scoring systems.
10.Application of cooked meat codes to improve the validity of nutrient content estimation in a recipe-based food ingredient database
Seo-Young YUN ; Hee Joe LEE ; Taenam LEE ; Ga-Eun CHOI ; Minseo CHOI ; Mi-Kyeong CHOI ; Nami JOO ; Mi-Hyun KIM ; Cho-il KIM
Nutrition Research and Practice 2025;19(6):1002-1010
BACKGROUND/OBJECTIVES:
Accurate estimation of nutrient intake from food consumption requires reliable food composition data. However, since nutrient content changes during cooking, the application of raw ingredient composition may lead to overestimation, particularly for energy and fat in meat dishes. In this study, the suitability of applying cooked food codes for meat dishes to improve the validity of recipe-based nutrient content estimation was evaluated.MATERIALS/METHODS: Pork (thin-sliced and thick-cut belly and shoulder butt) and beef (tenderloin, loin, rib meat, and brisket point) were examined for cooking yield after grilling and their nutrient contents were estimated. Each cut was portioned to 100 g of raw meat and cooked in triplicate. Nutrient content was calculated using both raw and cooked meat codes from the Korean Standard Food Composition Table, and differences in energy, fat, and protein content were compared.
RESULTS:
When grilled under standardized conditions, the average cooking yield was approximately 65% for pork and 80% for beef (P < 0.0001). Thin slices of pork belly had a lower yield (62.6%) than thicker cuts (68.0%), while beef brisket point had the lowest yield among beef cuts (63.6%). Applying cooked meat codes and measured cooking yields resulted in overall decreases in energy (−10% to −50%) and fat (−20% to −60%) content, with slight increase in protein (up to +34%, P < 0.0001). For beef tenderloin, additional comparisons using matched raw and grilled data from the United States Department of Agriculture SR Legacy Database showed smaller percent differences in energy, fat, and protein than those obtained from the Korean database.
CONCLUSION
Incorporating measured cooking yields and corresponding cooked meat codes into recipe-based databases can improve the accuracy of nutrient intake estimation. The development of nutrient databases that reflect differences in cooking conditions—including temperature, duration, and doneness—should be prioritized to enhance the validity of national dietary surveys.

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