1.Opacity proteins of neisseria gonorrhoeae in lipooligosaccharide mutants lost ability to interact with neutrophil-restricted CEACAM3 (CD66d).
Song ZHANG ; Ya-Ting TU ; Hua-Hua CAI ; Hong-Hui DING ; Qiao LI ; Ying-Xia HE ; Xin-Xin LIU ; Xin WANG ; Feng HU ; Tie CHEN ; Hong-Xiang CHEN
Journal of Huazhong University of Science and Technology (Medical Sciences) 2016;36(3):344-349
		                        		
		                        			
		                        			Lipooligosacharide (LOS) of Neisseria gonorrhoeae (gonococci, GC) is involved in the interaction of GC with host cells. Deletion of the alpha-oligosaccharide (alpha-OS) moiety of LOS (lgtF mutant) significantly impairs invasion of GC into epithelial cell lines. GC opacity (Opa) proteins, such as OpaI, mediate phagocytosis and stimulate chemiluminescence responses in neutrophils in part through interaction with members of the carcinoembryonic antigen (CEA) family, which includes CEACAM3 (CD66d), a human neutrophil specific receptor for phagocytosis of bacteria. In the present work, we examined the effects of OpaI-expressing lgtF mutant on phagocytosis by HeLa-CEACAM3 cells and chemiluminescence responses in neutrophils. The results showed that lgtF mutant even expressing OpaI completely lost the ability to promote either phagocytosis mediated by CEACAM3 interaction in HeLa cells or chemiluminescence responses in neutrophils. These data indicated that Opa proteins in the lgtF mutant, which might result from the conformational change, cannot be functional.
		                        		
		                        		
		                        		
		                        			Antigens, Bacterial
		                        			;
		                        		
		                        			chemistry
		                        			;
		                        		
		                        			genetics
		                        			;
		                        		
		                        			immunology
		                        			;
		                        		
		                        			metabolism
		                        			;
		                        		
		                        			Carbohydrate Sequence
		                        			;
		                        		
		                        			Carcinoembryonic Antigen
		                        			;
		                        		
		                        			genetics
		                        			;
		                        		
		                        			immunology
		                        			;
		                        		
		                        			Gene Expression Regulation
		                        			;
		                        		
		                        			HeLa Cells
		                        			;
		                        		
		                        			Host-Pathogen Interactions
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Lipopolysaccharides
		                        			;
		                        		
		                        			chemistry
		                        			;
		                        		
		                        			immunology
		                        			;
		                        		
		                        			Luminescent Measurements
		                        			;
		                        		
		                        			Mutation
		                        			;
		                        		
		                        			Neisseria gonorrhoeae
		                        			;
		                        		
		                        			genetics
		                        			;
		                        		
		                        			metabolism
		                        			;
		                        		
		                        			pathogenicity
		                        			;
		                        		
		                        			Neutrophils
		                        			;
		                        		
		                        			immunology
		                        			;
		                        		
		                        			microbiology
		                        			;
		                        		
		                        			Phagocytosis
		                        			
		                        		
		                        	
2.Correlations between the CagA Antigen and Serum Levels of Anti-Helicobacter pylori IgG and IgA in Children.
Ji Hyun SEO ; Chun Woo LIM ; Ji Sook PARK ; Jung Sook YEOM ; Jae Young LIM ; Jin Su JUN ; Hyang Ok WOO ; Hee Shang YOUN ; Seung Chul BAIK ; Woo Kon LEE ; Myung Je CHO ; Kwang Ho RHEE
Journal of Korean Medical Science 2016;31(3):417-422
		                        		
		                        			
		                        			We tested correlations between anti-Helicobacter pylori IgG and IgA levels and the urease test, anti-CagA protein antibody, degree of gastritis, and age. In total, 509 children (0-15 years) were enrolled. Subjects were stratified as 0-4 years (n = 132), 5-9 years (n = 274), and 10-15 years (n = 103) and subjected to the urease test, histopathology, ELISA, and western blot using whole-cell lysates of H. pylori strain 51. The positivity rate in the urease test (P = 0.003), the degree of chronic gastritis (P = 0.021), and H. pylori infiltration (P < 0.001) increased with age. The median titer for anti-H. pylori IgG was 732.5 IU/mL at 0-4 years, 689.0 IU/mL at 5-9 years, and 966.0 IU/mL at 10-15 years (P < 0.001); the median titer for anti-H. pylori IgA was 61.0 IU/mL at 0-4 years, 63.5 IU/mL at 5-9 years, and 75.0 IU/mL at 10-15 years (P < 0.001). The CagA-positivity rate was 26.5% at 0-4 years, 36.5% at 5-9 years, and 46.6% at 10-15 years for IgG (P = 0.036), and 11.3% at 0-4 years, 18.6% at 5-9 years, and 23.3% at 10-15 years for IgA (P < 0.001). Anti-H. pylori IgG and IgA titers increased with the urease test grade, chronic gastritis degree, active gastritis, and H. pylori infiltration. Presence of CagA-positivity is well correlated with a high urease test grade and high anti-H. pylori IgG/IgA levels.
		                        		
		                        		
		                        		
		                        			Adolescent
		                        			;
		                        		
		                        			Antibodies, Bacterial/*blood
		                        			;
		                        		
		                        			Antigens, Bacterial/*analysis/immunology
		                        			;
		                        		
		                        			Bacterial Proteins/*analysis/immunology/metabolism
		                        			;
		                        		
		                        			Blotting, Western
		                        			;
		                        		
		                        			Child
		                        			;
		                        		
		                        			Child, Preschool
		                        			;
		                        		
		                        			Chronic Disease
		                        			;
		                        		
		                        			Enzyme-Linked Immunosorbent Assay
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Gastritis/pathology
		                        			;
		                        		
		                        			Helicobacter Infections/blood/microbiology/*pathology
		                        			;
		                        		
		                        			Helicobacter pylori/isolation & purification/*metabolism
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Immunoglobulin A/*blood
		                        			;
		                        		
		                        			Immunoglobulin G/*blood
		                        			;
		                        		
		                        			Infant
		                        			;
		                        		
		                        			Infant, Newborn
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Severity of Illness Index
		                        			;
		                        		
		                        			Urease/metabolism
		                        			
		                        		
		                        	
3.Clinical Evaluation of Rapid Diagnostic Test Kit Using the Polysaccharide as a Genus-Specific Diagnostic Antigen for Leptospirosis in Korea, Bulgaria, and Argentina.
Jin Woo LEE ; Sungman PARK ; Seung Han KIM ; Iva CHRISTOVA ; Paulina JACOB ; Norma B VANASCO ; Yeon Mi KANG ; Ye Ju WOO ; Min Soo KIM ; Young Jin KIM ; Min Kee CHO ; Yoon Won KIM
Journal of Korean Medical Science 2016;31(2):183-189
		                        		
		                        			
		                        			Leptospirosis, a zoonotic disease that is caused by many serovars which are more than 200 in the world, is an emerging worldwide disease. Accurate and rapid diagnostic tests for leptospirosis are a critical step to diagnose the disease. There are some commercial kits available for diagnosis of leptospirosis, but the obscurity of a species- or genus-specific antigen of pathogenic Leptospira interrogans causes the reduced sensitivity and specificity. In this study, the polysaccharide derived from lipopolysaccharide (LPS) of nonpathogenic Leptospira biflexa serovar patoc was prepared, and the antigenicity was confirmed by immunoblot and enzyme linked immunosorbent assay (ELISA). The performance of the rapid diagnostic test (RDT) kit using the polysaccharide as a diagnostic antigen was evaluated in Korea, Bulgaria and Argentina. The sensitivity was 93.9%, 100%, and 81.0% and the specificity was 97.9%, 100%, and 95.4% in Korea (which is a rare region occurring with 2 serovars mostly), Bulgaria (epidemic region with 3 serovars chiefly) and Argentina (endemic region with 19 serovars mainly) respectively. These results indicate that this RDT is applicable for global diagnosis of leptospirosis. This rapid and effective diagnosis will be helpful for diagnosis and manage of leptospirosis to use and the polysaccharide of Leptospira may be called as genus specific antigen for diagnosis.
		                        		
		                        		
		                        		
		                        			Antigens, Bacterial/*immunology
		                        			;
		                        		
		                        			Argentina
		                        			;
		                        		
		                        			Bulgaria
		                        			;
		                        		
		                        			Enzyme-Linked Immunosorbent Assay
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Leptospira/isolation & purification/metabolism
		                        			;
		                        		
		                        			Leptospira interrogans/isolation & purification/metabolism
		                        			;
		                        		
		                        			Leptospirosis/*diagnosis/microbiology
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Polysaccharides/*immunology
		                        			;
		                        		
		                        			Reagent Kits, Diagnostic/*standards
		                        			;
		                        		
		                        			Republic of Korea
		                        			;
		                        		
		                        			Sensitivity and Specificity
		                        			
		                        		
		                        	
4.Clinical Evaluation of Rapid Diagnostic Test Kit Using the Polysaccharide as a Genus-Specific Diagnostic Antigen for Leptospirosis in Korea, Bulgaria, and Argentina.
Jin Woo LEE ; Sungman PARK ; Seung Han KIM ; Iva CHRISTOVA ; Paulina JACOB ; Norma B VANASCO ; Yeon Mi KANG ; Ye Ju WOO ; Min Soo KIM ; Young Jin KIM ; Min Kee CHO ; Yoon Won KIM
Journal of Korean Medical Science 2016;31(2):183-189
		                        		
		                        			
		                        			Leptospirosis, a zoonotic disease that is caused by many serovars which are more than 200 in the world, is an emerging worldwide disease. Accurate and rapid diagnostic tests for leptospirosis are a critical step to diagnose the disease. There are some commercial kits available for diagnosis of leptospirosis, but the obscurity of a species- or genus-specific antigen of pathogenic Leptospira interrogans causes the reduced sensitivity and specificity. In this study, the polysaccharide derived from lipopolysaccharide (LPS) of nonpathogenic Leptospira biflexa serovar patoc was prepared, and the antigenicity was confirmed by immunoblot and enzyme linked immunosorbent assay (ELISA). The performance of the rapid diagnostic test (RDT) kit using the polysaccharide as a diagnostic antigen was evaluated in Korea, Bulgaria and Argentina. The sensitivity was 93.9%, 100%, and 81.0% and the specificity was 97.9%, 100%, and 95.4% in Korea (which is a rare region occurring with 2 serovars mostly), Bulgaria (epidemic region with 3 serovars chiefly) and Argentina (endemic region with 19 serovars mainly) respectively. These results indicate that this RDT is applicable for global diagnosis of leptospirosis. This rapid and effective diagnosis will be helpful for diagnosis and manage of leptospirosis to use and the polysaccharide of Leptospira may be called as genus specific antigen for diagnosis.
		                        		
		                        		
		                        		
		                        			Antigens, Bacterial/*immunology
		                        			;
		                        		
		                        			Argentina
		                        			;
		                        		
		                        			Bulgaria
		                        			;
		                        		
		                        			Enzyme-Linked Immunosorbent Assay
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Leptospira/isolation & purification/metabolism
		                        			;
		                        		
		                        			Leptospira interrogans/isolation & purification/metabolism
		                        			;
		                        		
		                        			Leptospirosis/*diagnosis/microbiology
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Polysaccharides/*immunology
		                        			;
		                        		
		                        			Reagent Kits, Diagnostic/*standards
		                        			;
		                        		
		                        			Republic of Korea
		                        			;
		                        		
		                        			Sensitivity and Specificity
		                        			
		                        		
		                        	
5.Evaluation of adjuvant effects of fucoidan for improving vaccine efficacy.
Journal of Veterinary Science 2015;16(2):145-150
		                        		
		                        			
		                        			Fucoidan is a sulfated polysaccharide derived from brown seaweed, including Fucus vesiculosus. This compound is known to have immunostimulatory effects on various types of immune cells including macrophages and dendritic cells. A recent study described the application of fucoidan as a vaccine adjuvant. Vaccination is regarded as the most efficient prophylactic method for preventing harmful or epidemic diseases. To increase vaccine efficacy, effective adjuvants are needed. In the present study, we determined whether fucoidan can function as an adjuvant using vaccine antigens. Flow cytometric analysis revealed that fucoidan increases the expression of the activation markers major histocompatibility complex class II, cluster of differentiation (CD)25, and CD69 in spleen cells. In combination with Bordetella bronchiseptica antigen, fucoidan increased the viability and tumor necrosis factor-alpha production of spleen cells. Furthermore, fucoidan increased the in vivo production of antigen-specific antibodies in mice inoculated with Mycoplasma hyopneumoniae antigen. Overall, this study has provided valuable information about the use of fucoidan as a vaccine adjuvant.
		                        		
		                        		
		                        		
		                        			Adjuvants, Immunologic/pharmacology
		                        			;
		                        		
		                        			Animals
		                        			;
		                        		
		                        			Antigens, Bacterial/*immunology
		                        			;
		                        		
		                        			Bacterial Vaccines/administration & dosage/*immunology
		                        			;
		                        		
		                        			Biomarkers/metabolism
		                        			;
		                        		
		                        			Bordetella bronchiseptica/*immunology
		                        			;
		                        		
		                        			Cells, Cultured
		                        			;
		                        		
		                        			Cytokines/*metabolism
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Flow Cytometry
		                        			;
		                        		
		                        			Fucus/*chemistry
		                        			;
		                        		
		                        			Gene Expression Regulation/drug effects
		                        			;
		                        		
		                        			Mice
		                        			;
		                        		
		                        			Mice, Inbred BALB C
		                        			;
		                        		
		                        			Mycoplasma hyopneumoniae/*immunology
		                        			;
		                        		
		                        			Polysaccharides/*pharmacology
		                        			;
		                        		
		                        			Spleen/metabolism
		                        			
		                        		
		                        	
6.Phenotypic and Functional Analysis of HL-60 Cells Used in Opsonophagocytic-Killing Assay for Streptococcus pneumoniae.
Kyung Hyo KIM ; Ju Young SEOH ; Su Jin CHO
Journal of Korean Medical Science 2015;30(2):145-150
		                        		
		                        			
		                        			Differentiated HL-60 is an effector cell widely used for the opsonophagocytic-killing assay (OPKA) to measure efficacy of pneumococcal vaccines. We investigated the correlation between phenotypic expression of immunoreceptors and phagocytic ability of HL-60 cells differentiated with N,N-dimethylformamide (DMF), all-trans retinoic acid (ATRA), or 1alpha, 25-dihydroxyvitamin D3 (VitD3) for 5 days. Phenotypic change was examined by flow cytometry with specific antibodies to CD11c, CD14, CD18, CD32, and CD64. Apoptosis was determined by flow cytometry using 7-aminoactinomycin D. Function was evaluated by a standard OPKA against serotype 19F and chemiluminescence-based respiratory burst assay. The expression of CD11c and CD14 gradually increased upon exposure to all three agents, while CD14 expression increased abruptly after VitD3. The expression of CD18, CD32, and CD64 increased during differentiation with all three agents. Apoptosis remained less than 10% until day 3 but increased after differentiation by DMF or ATRA. Differentiation with ATRA or VitD3 increased the respiratory burst after day 4. DMF differentiation showed a high OPKA titer at day 1 which sustained thereafter while ATRA or VitD3-differentiated cells gradually increased. Pearson analysis between the phenotypic changes and OPKA titers suggests that CD11c might be a useful differentiation marker for HL-60 cells for use in pneumococcal OPKA.
		                        		
		                        		
		                        		
		                        			Antibodies, Bacterial/immunology
		                        			;
		                        		
		                        			Antigens, CD11c/metabolism
		                        			;
		                        		
		                        			Antigens, CD14/metabolism
		                        			;
		                        		
		                        			Antigens, CD18/metabolism
		                        			;
		                        		
		                        			Apoptosis/*immunology
		                        			;
		                        		
		                        			Biological Assay
		                        			;
		                        		
		                        			Cell Differentiation
		                        			;
		                        		
		                        			Cell Line, Tumor
		                        			;
		                        		
		                        			Cholecalciferol/pharmacology
		                        			;
		                        		
		                        			Dimethylformamide/pharmacology
		                        			;
		                        		
		                        			Flow Cytometry
		                        			;
		                        		
		                        			HL-60 Cells
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Phagocytosis/*immunology
		                        			;
		                        		
		                        			Pneumococcal Vaccines/*immunology
		                        			;
		                        		
		                        			Receptors, IgG/metabolism
		                        			;
		                        		
		                        			Receptors, Immunologic/*biosynthesis
		                        			;
		                        		
		                        			Respiratory Burst/immunology
		                        			;
		                        		
		                        			Streptococcus pneumoniae/*immunology
		                        			;
		                        		
		                        			Tretinoin/pharmacology
		                        			
		                        		
		                        	
7.Phenotypic and Functional Analysis of HL-60 Cells Used in Opsonophagocytic-Killing Assay for Streptococcus pneumoniae.
Kyung Hyo KIM ; Ju Young SEOH ; Su Jin CHO
Journal of Korean Medical Science 2015;30(2):145-150
		                        		
		                        			
		                        			Differentiated HL-60 is an effector cell widely used for the opsonophagocytic-killing assay (OPKA) to measure efficacy of pneumococcal vaccines. We investigated the correlation between phenotypic expression of immunoreceptors and phagocytic ability of HL-60 cells differentiated with N,N-dimethylformamide (DMF), all-trans retinoic acid (ATRA), or 1alpha, 25-dihydroxyvitamin D3 (VitD3) for 5 days. Phenotypic change was examined by flow cytometry with specific antibodies to CD11c, CD14, CD18, CD32, and CD64. Apoptosis was determined by flow cytometry using 7-aminoactinomycin D. Function was evaluated by a standard OPKA against serotype 19F and chemiluminescence-based respiratory burst assay. The expression of CD11c and CD14 gradually increased upon exposure to all three agents, while CD14 expression increased abruptly after VitD3. The expression of CD18, CD32, and CD64 increased during differentiation with all three agents. Apoptosis remained less than 10% until day 3 but increased after differentiation by DMF or ATRA. Differentiation with ATRA or VitD3 increased the respiratory burst after day 4. DMF differentiation showed a high OPKA titer at day 1 which sustained thereafter while ATRA or VitD3-differentiated cells gradually increased. Pearson analysis between the phenotypic changes and OPKA titers suggests that CD11c might be a useful differentiation marker for HL-60 cells for use in pneumococcal OPKA.
		                        		
		                        		
		                        		
		                        			Antibodies, Bacterial/immunology
		                        			;
		                        		
		                        			Antigens, CD11c/metabolism
		                        			;
		                        		
		                        			Antigens, CD14/metabolism
		                        			;
		                        		
		                        			Antigens, CD18/metabolism
		                        			;
		                        		
		                        			Apoptosis/*immunology
		                        			;
		                        		
		                        			Biological Assay
		                        			;
		                        		
		                        			Cell Differentiation
		                        			;
		                        		
		                        			Cell Line, Tumor
		                        			;
		                        		
		                        			Cholecalciferol/pharmacology
		                        			;
		                        		
		                        			Dimethylformamide/pharmacology
		                        			;
		                        		
		                        			Flow Cytometry
		                        			;
		                        		
		                        			HL-60 Cells
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Phagocytosis/*immunology
		                        			;
		                        		
		                        			Pneumococcal Vaccines/*immunology
		                        			;
		                        		
		                        			Receptors, IgG/metabolism
		                        			;
		                        		
		                        			Receptors, Immunologic/*biosynthesis
		                        			;
		                        		
		                        			Respiratory Burst/immunology
		                        			;
		                        		
		                        			Streptococcus pneumoniae/*immunology
		                        			;
		                        		
		                        			Tretinoin/pharmacology
		                        			
		                        		
		                        	
8.Identification of Outer Membrane Vesicles Derived from Orientia tsutsugamushi.
Sun Myoung LEE ; Hea Yoon KWON ; Jae Hyong IM ; Ji Hyeon BAEK ; Jae Seung KANG ; Jin Soo LEE
Journal of Korean Medical Science 2015;30(7):866-870
		                        		
		                        			
		                        			Orientia tsutsugamushi, a causative pathogen of Scrub typhus, is a gram-negative intracellular bacterium. Outer membrane vesicles (OMVs) are produced from the membrane of bacteria and play many roles related to the survival of the pathogen. However, there have been no reports confirming whether O. tsutsugamushi indeed produce OMVs. O. tsutsugamushi boryong was cultured in ECV-304 cells for the purification of OMVs. Western blot analysis and immunoenrichment using anti-O. tsutsugamushi monoclonal antibody and electron microscopy were employed for identification and characterization of OMVs. We confirm the presence of OMVs derived from O. tsutsugamushi, and also found that those OMVs contain a major surface antigen of 56-kDa protein and variant immunogenic antigens.
		                        		
		                        		
		                        		
		                        			Antibodies, Monoclonal/*immunology
		                        			;
		                        		
		                        			Antigens, Bacterial/*immunology
		                        			;
		                        		
		                        			Antigens, Surface/*immunology
		                        			;
		                        		
		                        			Cell Line
		                        			;
		                        		
		                        			Cell Membrane/immunology
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Microscopy, Electron
		                        			;
		                        		
		                        			Orientia tsutsugamushi/*immunology/metabolism
		                        			;
		                        		
		                        			Scrub Typhus/diagnosis/microbiology
		                        			;
		                        		
		                        			Secretory Vesicles/*immunology
		                        			
		                        		
		                        	
9.Isolation, in vitro propagation, genetic analysis, and immunogenic characterization of an Ehrlichia canis strain from southeastern Brazil.
Rosiane Nascimento ALVES ; Susana Elisa RIECK ; Carlos UEIRA-VIEIRA ; Marcelo Bahia LABRUNA ; Marcelo Emilio BELETTI
Journal of Veterinary Science 2014;15(2):241-248
		                        		
		                        			
		                        			Amplification of the 16S rRNA gene from a blood sample obtained from a dog in southeastern Brazil was used to confirm a naturally acquired Ehrlichia (E.) canis infection. Following isolation and culturing of the new bacterial strain called Uberlandia, partial sequences of the dsb and p28 genes were obtained. The dsb partial sequence of the novel strain was 100% similar to dsb gene sequences of E. canis obtained from different geographic areas around the world. Conversely, the p28 partial sequence for the E. canis Uberlandia strain differed at several nucleotides from other sequences available in GenBank. To confirm the antigenic profile of the Uberlandia strain, an indirect immunofluorescence assay against E. canis antigens was performed using dog sera collected from two different areas in Brazil (Uberlandia and Sao Paulo). The results suggest that both antigens were able to identify animals seropositive for E. canis in Brazil since these Brazilian strains appear to be highly conserved.
		                        		
		                        		
		                        		
		                        			Animals
		                        			;
		                        		
		                        			Antigens, Bacterial/blood/*diagnostic use
		                        			;
		                        		
		                        			Bacterial Outer Membrane Proteins/genetics/metabolism
		                        			;
		                        		
		                        			Bacterial Proteins/*genetics/metabolism
		                        			;
		                        		
		                        			Base Sequence
		                        			;
		                        		
		                        			Brazil
		                        			;
		                        		
		                        			Dog Diseases/diagnosis/*microbiology
		                        			;
		                        		
		                        			Dogs
		                        			;
		                        		
		                        			Ehrlichia canis/*genetics/*immunology/isolation & purification
		                        			;
		                        		
		                        			Ehrlichiosis/diagnosis/microbiology/*veterinary
		                        			;
		                        		
		                        			Fluorescent Antibody Technique, Indirect/veterinary
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Molecular Sequence Data
		                        			;
		                        		
		                        			Polymerase Chain Reaction/veterinary
		                        			;
		                        		
		                        			RNA, Ribosomal, 16S/genetics/metabolism
		                        			;
		                        		
		                        			Sequence Alignment/veterinary
		                        			
		                        		
		                        	
10.The Association between Influenza Treatment and Hospitalization-Associated Outcomes among Korean Children with Laboratory-Confirmed Influenza.
Jacqueline K LIM ; Tae Hee KIM ; Paul E KILGORE ; Allison E AIELLO ; Byung Min CHOI ; Kwang Chul LEE ; Kee Hwan YOO ; Young Hwan SONG ; Yun Kyung KIM
Journal of Korean Medical Science 2014;29(4):485-493
		                        		
		                        			
		                        			There are limited data evaluating the relationship between influenza treatment and hospitalization duration. Our purpose assessed the association between different treatments and hospital stay among Korean pediatric influenza patients. Total 770 children < or = 15 yr-of-age hospitalized with community-acquired laboratory-confirmed influenza at three large urban tertiary care hospitals were identified through a retrospective medical chart review. Demographic, clinical, and cost data were extracted and a multivariable linear regression model was used to assess the associations between influenza treatment types and hospital stay. Overall, there were 81% of the patients hospitalized with laboratory-confirmed influenza who received antibiotic monotherapy whereas only 4% of the patients received oseltamivir monotherapy. The mean treatment-related charges for hospitalizations treated with antibiotics, alone or with oseltamivir, were significantly higher than those treated with oseltamivir-only (P < 0.001). Influenza patients treated with antibiotics-only and antibiotics/oseltamivir combination therapy showed 44.9% and 28.2%, respectively, longer duration of hospitalization compared to those treated with oseltamivir-only. Patients treated with antibiotics, alone or combined with oseltamivir, were associated with longer hospitalization and significantly higher medical charges, compared to patients treated with oseltamivir alone. In Korea, there is a need for more judicious use of antibiotics, appropriate use of influenza rapid testing.
		                        		
		                        		
		                        		
		                        			Adolescent
		                        			;
		                        		
		                        			Anti-Bacterial Agents/*therapeutic use
		                        			;
		                        		
		                        			Antigens, Viral/analysis/immunology
		                        			;
		                        		
		                        			Antiviral Agents/*therapeutic use
		                        			;
		                        		
		                        			Child
		                        			;
		                        		
		                        			Child, Preschool
		                        			;
		                        		
		                        			Cohort Studies
		                        			;
		                        		
		                        			Demography
		                        			;
		                        		
		                        			Drug Therapy, Combination
		                        			;
		                        		
		                        			Female
		                        			;
		                        		
		                        			Hospitalization
		                        			;
		                        		
		                        			Humans
		                        			;
		                        		
		                        			Infant
		                        			;
		                        		
		                        			Infant, Newborn
		                        			;
		                        		
		                        			Influenza A virus/metabolism
		                        			;
		                        		
		                        			Influenza B virus/metabolism
		                        			;
		                        		
		                        			Influenza, Human/*drug therapy
		                        			;
		                        		
		                        			Male
		                        			;
		                        		
		                        			Oseltamivir/*therapeutic use
		                        			;
		                        		
		                        			Republic of Korea
		                        			;
		                        		
		                        			Retrospective Studies
		                        			
		                        		
		                        	
            
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