1.Secondary transmission of severe fever with thrombocytopenia syndrome in a hospital setting in Republic of Korea: a retrospective observational study of personal protective equipment use and infection risk factors
Seongwoo PARK ; Hye Young LEE ; Jeong-ran KWON ; Yuna KIM
Osong Public Health and Research Perspectives 2026;17(2):155-164
Objectives:
This study investigated a cluster of secondary human-to-human transmission of severe fever with thrombocytopenia syndrome (SFTS) in a hospital setting, focusing on infection risk factors and the role of personal protective equipment (PPE).
Methods:
A descriptive epidemiological investigation was conducted following the death of anindex patient with laboratory-confirmed SFTS. A total of 27 close contacts, including healthcareworkers and a funeral director, were monitored for symptoms. Suspected cases underwent real-time reverse transcription polymerase chain reaction testing. Clinical features, PPE use, and exposure histories were analyzed. The Fisher exact test was used to assess associations between PPE use and infection. Viral genotyping and sequence analyses were performed to evaluate transmission routes.
Results:
The index patient deteriorated rapidly and died after repeated cardiopulmonaryresuscitation (CPR), during which 8 secondary cases occurred. Most infections were identifiedamong individuals involved in CPR or postmortem care without adequate PPE. Although notstatistically significant, infection rates were higher among those who did not wear masks or who used low-filtration masks. Proper use of gloves, gowns, and goggles was associated withlower infection rates. Cycle threshold values in secondary cases (range, 34–39) were higherthan in the index case (14.07), suggesting lower viral loads. Sequence analysis demonstrated99.6%–100% homology between the index and secondary cases; all isolates were genotype B, indicating direct transmission.
Conclusion
This study provides molecular and epidemiological evidence of nosocomial SFTS transmission. Inadequate PPE use during aerosol-generating procedures likely facilitated infection, underscoring the importance of strict adherence to PPE protocols and reinforced infection control practices.
2.Antibiotic resistance patterns of pathogenic Escherichia coli isolated from southeastern Korean patients with acute diarrhea from October 2023 to June 2024: a cross-sectional surveillance study
Suyeon JO ; Byoungkuk KIM ; Boyeong KWON ; Kwanghyun KIM ; Minhyeok KIM ; Kihyung PARK
Annals of Clinical Microbiology 2026;29(1):4-
Background:
Pathogenic Escherichia coli (PEC) is a leading cause of acute diarrhea worldwide. With increasing antibiotic use, antimicrobial resistance in PEC has become a significant public health concern. In this study, we investigated the distribution and antimicrobial susceptibility patterns of PEC isolated from patients with acute diarrhea in the Busan and Gyeongnam regions of South Korea.
Methods:
In this retrospective cross-sectional laboratory-based study, 272 PCR-positive residual stool or rectal swab specimens collected between October 2023 and June 2024 were screened; after exclusion of 80 specimens without recoverable or confirmable isolates, 192 pathogenic E. coli isolates were included for pathotype identification and antimicrobial susceptibility testing. Pathotypes were identified using multiplex real-time polymerase chain reaction, and antimicrobial susceptibility was tested against 18 agents using the VITEK II system.
Results:
Enteroaggregative E. coli (EAEC) was the most prevalent pathotype (44.8%), followed by enteropathogenic E. coli (34.9%). High resistance rates were observed for ampicillin (77.1%), cefazolin (55.2%), and amoxicillin/clavulanic acid (44.3%). EAEC demonstrated the highest multidrug resistance (MDR) rate (34.9%). Pediatric patients (< 18 years) exhibited significantly higher resistance rates and MDR frequencies compared with adults, particularly against β-lactam antibiotics.
Conclusion
EAEC was identified as the predominant and most resistant pathotype in this region. The elevated resistance levels in children and the prevalence of MDR EAEC underscore the need for continuous local surveillance and appropriate antibiotic stewardship.
3.The Korean Rectal Cancer Multidisciplinary Committee Clinical Practice Guidelines for Rectal Cancer version 2.0
Hyo Seon RYU ; Hyun Jung KIM ; Dong Hyun KANG ; Yoo-Kang KWAK ; Han Deok KWAK ; Yoon-Hye KWON ; Dalyon KIM ; Baek-Hui KIM ; Jae Hyun KIM ; Ji Hun KIM ; Jin Won KIM ; Tae Hyung KIM ; Hae Young KIM ; Soo Min NAM ; Gyoung Tae NOH ; Jun Woo BONG ; Nak Song SUNG ; Seon Hui SHIN ; Kil-Yong LEE ; Sung Chul LEE ; Sea-Won LEE ; Jung Won LEE ; Jong Min LEE ; Myung Hoon IHN ; Joo Han LIM ; Woong Bae JI ; Dae Hee PYO ; Young Ki HONG ; Jung-Myun KWAK ;
Annals of Coloproctology 2026;42(1):4-33
Rectal cancer, which accounts for approximately 40% of colorectal cancers, remains a major clinical concern. Recent advances in diagnostic imaging, surgical techniques, radiotherapy, and systemic treatment have steadily improved rectal cancer outcomes. Considering this, the Korean Rectal Cancer Multidisciplinary (KRCM) Committee has aimed to provide clinicians and policymakers with up-to-date, evidence-based clinical practice guidelines to support optimal decision-making, reflecting current evidence, the Korean healthcare context, and patient values and preferences. The Clinical Practice Guidelines for Rectal Cancer version 2.0 were developed through multidisciplinary collaboration with related academic societies, building upon and updating the KRCM Clinical Practice Guidelines version 1.0 (titled “Multidisciplinary guidelines for the management of rectal cancer”). These consensus guidelines of the KRCM were established based on a comprehensive literature review, evidence synthesis, with recommendation development guided by the GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology, and consideration of applicability in real-world clinical practice under the national health insurance system. Each recommendation has been presented with its strength and level of evidence.
4.Association Between Statin Use and Non-Melanoma Skin Cancer Risk:A Distributed Network Analysis of 11 Real-World Databases
Jiyoon AN ; Man S KIM ; Yoonsung LEE ; Bark-Lynn LEW ; Soon-Hyo KWON
Annals of Dermatology 2026;38(2):117-122
Background:
Given the dual potential of statins to act as both carcinogenic and antineoplastic agents, evidence from previous investigations into statin use and the risk of nonmelanoma skin cancer (NMSC) remains inconclusive.
Objective:
To demonstrate the impact of statin exposure on the NMSC risk in Korean patients.
Methods:
We carried out a multicenter cohort study based on electronic health record data aggregated from 11 Korean hospitals. Patients with hyperlipidemia who had been taking antilipidemic agents, including statins were included in this study. We applied 1:1 propensity score matching to create balanced cohorts and used Cox regression to assess the hazard ratio (HR) for NMSC.
Results:
A total of 18,579 statin users and a matched number of non-users were included across 11 databases. Statin use showed no significant association with an increased risk of NMSC (HR, 1.03; 95% confidence interval, 0.75–1.43). Subgroup analyses of drug exposure, age, and sex depicted no significant HR trends.
Conclusion
Statin exposure demonstrated no significant association with NMSC development in Korean patients with hyperlipidemia.
5.Assessing Laser Safety in Dermatology:Eye Protection and Infection Control Practices Among Board-Certified Korean Dermatologists
Sejin OH ; Yeong Ho KIM ; Bo Ri KIM ; Hyun-Min SEO ; Soon-Hyo KWON ; Hoon CHOI ; Hae Woong LEE ; Jung-Im NA ; Chun Pill CHOI ; Joo Yeon KO ; Hwa Jung RYU ; Suk Bae SEO ; Jong Hee LEE ; Chang-Hun HUH ; Hei Sung KIM
Annals of Dermatology 2026;38(1):69-74
Background:
Laser procedures are integral to dermatologic practice, yet safety measures- particularly regarding ocular protection and plume control- are poorly studied in real-world settings.
Objective:
To evaluate current practices in eye protection, infection control, and occupational risk awareness among Korean dermatologists performing laser treatments.
Methods:
A cross-sectional survey was conducted among board-certified dermatologists at the 2024 Korean Society for Dermatologic Laser Surgery meeting. The questionnaire covered demographics, laser frequency, use of goggles and masks, infection control strategies, ophthalmologic monitoring, and history of warts or cancer.
Results:
Seventy-nine respondents completed the survey. All reported using protective goggles, but only 26.6% and 22.8% did so for CO 2 and erbium-doped yttrium aluminium garnet lasers, respectively. Only 24.1% underwent regular eye exams, and 13.9% reported eye conditions after starting laser practice. While 89.9% used masks, 40.8% used dental masks, which are inadequate for plume protection. Suction devices were used by 94.9%, though performance specifications were unclear. Warts were reported by 46.8% of respondents; two reported cancer diagnoses after initiating laser work.
Conclusion
Despite high overall adherence to basic safety practices, critical gaps remain. Our findings highlight the need for standardized guidelines and long-term occupational health monitoring to ensure safe laser practice.
6.Current Clinical Perspectives on Rosacea Management: Insights From a Korean Multicenter Expert Opinion Survey
Bo Ri KIM ; Sejin OH ; Ju Hee HAN ; Jimyung SEO ; Hyun-Min SEO ; Soon-Hyo KWON ; Hoon CHOI ; Jung U SHIN ; Jae We CHO ; Boncheol Leo GOO ; Jung-Im NA ; Dong Hun LEE ; Chun Pill CHOI ; HaeWoong LEE ; Joo Yeon KO ; Hwa Jung RYU ; Nark-Kyoung RHO ; Hyunjo KIM ; Ga-Young LEE ; Jong Hee LEE ; Nala SHIN ; Sang Ju LEE ; Suk Bae SEO ; Geun Soo LEE ; Hei Sung KIM ; Chang-Hun HUH
Annals of Dermatology 2026;38(1):42-50
Background:
Rosacea is a chronic inflammatory skin disorder characterized by erythema, papules, ocular symptoms, and heightened sensitivity. Patients with neurogenic symptoms such as burning or stinging remain particularly difficult to manage. Current guidelines often underrepresent energy-based devices (EBDs), pigmentary sequelae, psychosocial burden, and ocular comorbidities.
Objective:
To examine Korean dermatologists’ expert perspectives on rosacea management, focusing on skin sensitivity, neurogenic symptoms, pigmentary changes, psychosocial impact, ocular involvement, and EBD use.
Methods:
A web-based, 29-item survey was administered to 25 board-certified Korean dermatologists (May–June 2025). Quantitative and qualitative responses were analyzed.
Results:
Erythematotelangiectatic and papulopustular phenotypes with sensitivity skin predominated. EBDs (pulsed dye laser, intense pulsed light) were frequently used but limited by cost and sensitivity issues. Neurogenic symptoms were recognized but rarely treated with neuromodulators. Post-inflammatory hyperpigmentation was infrequent, yet monitoring was inconsistent.Psychosocial and ocular aspects were acknowledged but seldomly systematically addressed.Respondents expressed interest in emerging adjunctive treatments such as cold plasma, skin boosters, and holistic care approaches.
Conclusion
Korean dermatologists adopt individualized strategies for rosacea, yet practice gaps remain regarding neurogenic symptoms, pigmentary complications, and psychosocial and ocular comorbidities. Findings support the need for updated multidisciplinary, phenotype-driven guidelines aligned with real-world practice.
7.Applying National Whole-genome Sequencing Findings for Rare Diseases in Clinical Practice: The Imperative of a Multidisciplinary Approach
Kyung Sun PARK ; Sunghwan SHIN ; Jong-Ho PARK ; Young-Eun KIM ; Won Kyung KWON ; Min-Kyung SO ; Changhee HA ; Ja-Hyun JANG ; Taeheon LEE ; Chang-Seok KI ; Yoonjung KIM ; Kyung-A LEE ; Inho PARK ; Sejoon LEE ; Hong-Hee WON ; ; Jong-Won KIM
Annals of Laboratory Medicine 2026;46(1):94-103
Background:
As nationwide government-led whole-genome sequencing (WGS) projects progress, optimizing the clinical integration of large-scale WGS results is crucial. We explored how the initial analysis from Korea’s First WGS Pilot Study for Rare Diseases was applied in clinical practice, and then we reanalyzed the data comprehensively at Samsung Medical Center (SMC) Seoul, Korea.
Methods:
A prospective cohort study designed to collect WGS data under a Korean national initiative was conducted from August 2020 to December 2021. We focused on patients with rare diseases recruited from 16 university hospitals. The participants included 5,000 individuals (2,200 probands and 2,800 family members). The initial WGS data and diagnostic reference reports (from 682 probands and 484 family members), generated based on the First Korean WGS Pilot Study for Rare Diseases, were subsequently reanalyzed by SMC.
Results:
The initial analysis of the First Korean WGS Pilot Study data revealed a diagnostic rate of 17%. Upon receiving these results, the SMC conducted two rounds of reanalysis, increasing the diagnostic rate from 15% in the first analysis, to 18% in the second, and finally to 24% in the third (P = 1.6 × 10 −5 ). Key factors in improving the genetic diagnosis included increased detection of novel (likely) pathogenic variants (P = 1.0 × 10 −4 ), improved diagnostic rates with larger family recruitment (P = 0.004), and refined clinical information for more precise genotype–phenotype correlation analysis (40%).
Conclusions
Although national WGS projects lay a foundation for rare disease diagnosis, hospital-level reanalysis and multidisciplinary collaborations are crucial for optimizing diagnostic outcomes.
8.Optimization of Natural Killer Cell Expansion with K562-mbIL-18/-21 Feeder Cells and Assurance of Feeder Cell-Free Products
Hantae JO ; Yujung JO ; Seung Kwon KOH ; Mijeong LEE ; Jinho KIM ; SoonHo KWEON ; Jeehun PARK ; Hyun‑Young KIM ; Duck CHO
Annals of Laboratory Medicine 2026;46(2):180-189
Background:
Cancer cell line-derived feeder cells enhance natural killer (NK) cell expansion; however, concerns regarding viable residual feeder cells in the final product limit their use. Evidence supporting the safety of NK-sensitive K562-based feeders, even when irradiated, is scarce. We optimized an NK cell expansion protocol using genetically engineered K562-mbIL-18/-21 (GE-K562) feeder cells and clinical-grade media and confirmed the absence of residual feeder cells.
Methods:
NK cell expansion efficiency was compared between feeder-free and feederbased systems using CTS NK-Xpander Medium. To achieve optimal NK expansion, various peripheral blood mononuclear cell (PBMC)-to-feeder ratios and re-stimulation frequencies were tested over 21 days. Flow cytometry and BCR::ABL1 quantitative reverse transcription PCR (RT-qPCR) were used to confirm the absence of feeder cells in the final NK cell product.
Results:
Feeder-based systems showed superior NK cell fold expansion compared with that of feeder-free systems. Among feeder-based conditions, NK cells expanded 5,224-fold at a 2:1 PBMC-to-feeder ratio after 3 weeks, relative to 1,450-fold at a 6:1 ratio (P < 0.05).Re-stimulation on days 7 and 14 further increased expansion up to 261,457-fold. Irradiated feeder cells showed no proliferation and were eliminated within 3–6 days. On day 21, flow cytometry and BCR::ABL1 RT-qPCR results confirmed the absence of residual feeder cells.
Conclusions
Our optimized NK cell expansion protocol using irradiated GE-K562 feeder cells and clinical-grade media offers a safe and scalable approach to generating large numbers of NK cells, supporting its potential use in clinical immunotherapy applications.
9.Molecular and Microbiological Characteristics of Uropathogenic Escherichia coli Harboring CTX-M-55
Heejeong KWON ; Jeoungyeon KIM ; Jinnam KIM ; Se Yoon PARK ; Choseok YOON ; Yangsoon LEE ; Bongyoung KIM
Annals of Laboratory Medicine 2026;46(3):345-350
The extended-spectrum β-lactamase (ESBL) CTX-M-55, a CTX-M-15 variant distinguished by an amino-acid substitution (Ala77Val), has enhanced enzymatic activity due to higher structural stability. In Korea, CTX-M-55 remains insufficiently characterized, particularly in the context of urinary tract infections (UTIs). We identified CTX-M-55 among uropathogenic Escherichia coli isolates and compared its microbiological characteristics with those of CTX-M-15. In total, 247 E. coli isolates were collected from patients with acute pyelonephritis at Hanyang University Seoul Hospital, an 860-bed tertiary-care hospital, between July 2019 and December 2021. ESBL production was confirmed using a double-disk synergy test, and minimum inhibitory concentrations (MICs) were determined. Resistance genes were detected using PCR, and CTX-M-15 sequences were analyzed. Among 38 isolates detected using PCR, eight were confirmed as CTX-M-55 using further sequence analysis. CTXM-55 showed (P > 0.05) a trend toward increased resistance to aztreonam, cefotaxime, ceftazidime, and cefepime, while showing decreased resistance to amoxicillin/clavulanate and piperacillin/tazobactam. CTX-M-55 had higher MIC 50 values than CTX-M-15 for ceftazidime ( > 16 vs. 8 µg/mL), cefepime (32 vs. 1 µg/mL), and piperacillin/tazobactam (0.5 vs.0.25 µg/mL). Virulence factors and coexisting resistance genes did not significantly differ.Our findings suggest that, given its increased resistance to ceftazidime and cefepime, CTXM-55 should be considered when treating UTIs in Korea.
10.Work-life balance and effort-reward imbalance, and their interaction, associated with presenteeism among Korean wage workers: Based on 6th Korean working conditions survey
Sang-Hyeon KIM ; Eun-Chul JANG ; Soon-Chan KWON ; In-ho LEE ; Jisuk YUN ; Ui Chan JUNG ; Young-Sun MIN
Annals of Occupational and Environmental Medicine 2026;38(1):e1-
Background:
This study investigated the relationship between work-life balance (WLB), effort-reward imbalance (ERI), and presenteeism among Korean wageworkers through two models used simultaneously.
Methods:
Data from the 6th Korean Working Conditions Survey for 28,669 Korean workers, including 13,513 men and 15,156 women, were analyzed. All analyses were performed with pre-designed weight. Multiple logistic regression analysis was used to analyze the association between WLB, ERI, and presenteeism among Korean workers. The participants were classified into the following four groups: group 1, status of both WLB and ERI is “balanced”; group 2, WLB and ERI status are “imbalanced” and “balanced”, respectively; group 3, WLB and ERI status are “balanced” and “imbalanced”, respectively; group 4: status of both WLB and ERI is “imbalanced.”
Results:
We found that WLB and ERI were associated with presenteeism in both men and women. Depending on their WLB and ERI status, women generally had a higher tendency of presenteeism than men. Multiple logistic regression shows that, in most models and groups, there is an increased odds ratio (OR) for presenteeism in both men and women compared to the reference value. Moreover, the OR in both men and women gradually increased in groups 2, 3, and 4 compared with group 1. When considering both WLB and ERI status simultaneously, ERI had a greater impact on presenteeism than WLB. Furthermore, it was found that a synergistic effect of presenteeism manifests when both WLB and ERI are in a state of imbalance simultaneously.
Conclusions
Using the two models simultaneously, we found an association between WLB, ERI, and presenteeism according to sex with a synergistic effect among Korean workers. Our research suggests that active interventions targeting WLB and ERI are necessary to reduce presenteeism, which ultimately leads to decreased productivity.

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