BACKGROUND: Nontuberculous mycobacteria (NTM) are considered opportunistic pathogens, and several species of NTM are associated with human diseases that typically involve the pulmonary, skin/soft tissue, or lymphatic systems; such infection may also cause disseminated diseases. Recent studies have reported increasing rates of NTM-induced disease worldwide. METHODS: Respiratory samples are being analyzed for acid-fast bacilli (AFB) culture and NTM identification at Dankook University Hospital in Cheonan, Korea, from September 2005 to September 2011. Identification is performed by using polymerase chain reaction-restriction fragment length polymorphism analysis targeting a novel region of the rpoB gene. RESULTS: A total of 25,133 specimens were received for AFB culture, of which 1,014 (4.0%) were NTM-positive. A total of 267 samples from 186 patients were tested for NTM identifications, and 232 samples from 157 patients were positive for NTM species. Among the patients who tested positive for NTM, 65.6% were men and the average age was 63.3 years. Mycobacterium avium complex, the most commonly detected NTM pathogen, was found in 65.9% of the 232 samples. The annual average percentage of NTM isolates from AFB culture-positive specimens was 31.3%: the highest rate was seen in 2011 (44.3%), followed by 2009 (37.4%) and 2010 (37.2%). An upward trend in NTM incidence was found during the study period. CONCLUSION: The prevalence of pulmonary NTM isolates continues to increase in Cheonan, suggesting that pulmonary NTM disease is becoming increasingly common.
Age Distribution ; Humans ; Incidence ; Korea ; Male ; Mycobacterium avium Complex ; Nontuberculous Mycobacteria ; Prevalence

BACKGROUND: Acute promyelocytic leukemia (APL) can be life threatening, necessitating emergency therapy with prompt diagnosis by morphologic findings, immunophenotyping, cytogenetic analysis, or molecular studies. This study aimed to assess the current routine practices in APL and the clinico-pathologic features of APL. METHODS: We reviewed the medical records of 48 Korean patients (25 men, 23 women; median age, 51 (20-80) years) diagnosed with APL in 5 university hospitals between March 2007 and February 2012. RESULTS: The WBC count at diagnosis and platelet count varied from 0.4 to 81.0 (median 2.0)x10(9)/L and 2.7 to 124.0 (median 54.5)x10(9)/L, respectively. The median values for prothrombin time and activated partial thromboplastin time were 14.7 (11.3-44.1) s and 29 (24-62) s, respectively. All but 2 patients (96%) showed a fibrin/fibrinogen degradation product value of >20 microg/mL. The D-dimer median value was 5,000 (686-55,630) ng/mL. The t(15;17)(q22;q12 and PML-RARA fusion was found in all patients by chromosome analysis and/or multiplex reverse transcriptase-polymerase chain reaction (RT-PCR), with turnaround times of 8 (2-19) d and 7 (2-13) d, respectively. All patients received induction chemotherapy: all-trans retinoic acid (ATRA) alone (N=11, 26%), ATRA+idarubicin (N=25, 58%), ATRA+cytarabine (N=3, 7%), ATRA+idarubicin+cytarabine (N=4, 9%). CONCLUSION: Since APL is a medical emergency and an accurate diagnosis is a prerequisite for prompt treatment, laboratory support to implement faster diagnostic tools to confirm the presence of PML-RARA is required.
Cytogenetic Analysis ; Emergencies ; Emergency Treatment ; Fibrin Fibrinogen Degradation Products ; Hospitals, University ; Humans ; Immunophenotyping ; Korea ; Leukemia, Promyelocytic, Acute ; Male ; Medical Records ; Partial Thromboplastin Time ; Platelet Count ; Prothrombin Time ; Tretinoin

BACKGROUND: Acute promyelocytic leukemia (APL) can be life threatening, necessitating emergency therapy with prompt diagnosis by morphologic findings, immunophenotyping, cytogenetic analysis, or molecular studies. This study aimed to assess the current routine practices in APL and the clinico-pathologic features of APL. METHODS: We reviewed the medical records of 48 Korean patients (25 men, 23 women; median age, 51 (20-80) years) diagnosed with APL in 5 university hospitals between March 2007 and February 2012. RESULTS: The WBC count at diagnosis and platelet count varied from 0.4 to 81.0 (median 2.0)x10(9)/L and 2.7 to 124.0 (median 54.5)x10(9)/L, respectively. The median values for prothrombin time and activated partial thromboplastin time were 14.7 (11.3-44.1) s and 29 (24-62) s, respectively. All but 2 patients (96%) showed a fibrin/fibrinogen degradation product value of >20 microg/mL. The D-dimer median value was 5,000 (686-55,630) ng/mL. The t(15;17)(q22;q12 and PML-RARA fusion was found in all patients by chromosome analysis and/or multiplex reverse transcriptase-polymerase chain reaction (RT-PCR), with turnaround times of 8 (2-19) d and 7 (2-13) d, respectively. All patients received induction chemotherapy: all-trans retinoic acid (ATRA) alone (N=11, 26%), ATRA+idarubicin (N=25, 58%), ATRA+cytarabine (N=3, 7%), ATRA+idarubicin+cytarabine (N=4, 9%). CONCLUSION: Since APL is a medical emergency and an accurate diagnosis is a prerequisite for prompt treatment, laboratory support to implement faster diagnostic tools to confirm the presence of PML-RARA is required.
Cytogenetic Analysis ; Emergencies ; Emergency Treatment ; Fibrin Fibrinogen Degradation Products ; Hospitals, University ; Humans ; Immunophenotyping ; Korea ; Leukemia, Promyelocytic, Acute ; Male ; Medical Records ; Partial Thromboplastin Time ; Platelet Count ; Prothrombin Time ; Tretinoin

BACKGROUND: In this study, we evaluated the analytical performance and clinical potential of a one-step multiplex real-time PCR assay for the simultaneous detection of 14 types of respiratory viruses using the AdvanSure RV real-time PCR Kit (LG Life Sciences, Korea). METHODS: Three hundred and twenty clinical specimens were tested with the AdvanSure RV real-time PCR Kit and conventional multiplex reverse transcription (RT)-PCR assay. The assay results were analyzed and the one-step AdvanSure RV real-time PCR Kit was compared with the conventional multiplex RT-PCR assay with respect to the sensitivity and specificity of the detection of respiratory viruses. RESULTS: The limit of detection (LOD) was 1.31 plaque-forming units (PFU)/mL for human rhinoviruses (hRVs), 4.93 PFU/mL for human coronavirus HCoV-229E/NL63, 2.67 PFU/mL for human coronavirus HCoV-OC43, 18.20 PFU/mL for parainfluenza virus 1 (PIV)-1, 24.57 PFU/mL for PIV-2, 1.73 PFU/mL for PIV-3, 1.79 PFU/mL for influenza virus group (Flu) A, 59.51 PFU/mL for FluB, 5.46 PFU/mL for human respiratory syncytial virus (hRSV)-A, 17.23 PFU/mL for hRSV-B, 9.99 PFU/mL for human adenovirus (ADVs). The cross-reactivity test for this assay against 23 types of non-respiratory viruses showed negative results for all viruses tested. The agreement between the one-step AdvanSure multiplex real-time PCR assay and the conventional multiplex RT-PCR assay was 98%. CONCLUSIONS: The one-step AdvanSure RV multiplex real-time PCR assay is a simple assay with high potential for specific, rapid and sensitive laboratory diagnosis of respiratory viruses compared to conventional multiplex RT-PCR.

BACKGROUND: Rapid identification of the causative agent among potential bacterial and viral pathogens is important for the management of acute respiratory disease. In this study, we evaluated the analytical performance and clinical usefulness of a recently-introduced multiplex PCR assay, Seeplex(TM)Pneumobacter detection kit (Seegene Inc., Korea) for the identification of respiratory bacterial pathogens. METHODS: One hundred and eighty one nasopharyngeal aspirates were collected from pediatric patients with respiratory symptoms and analysed by multiplex PCR for the detection of Streptococcus pneumoniae (S.P), Haemophilus influenzae (H.I), Mycoplasma pneumoniae (M.P), Chlamydophila pneumoniae (C.P), Bordetella pertussis (B.P) and Legionella pneumophila (L.P). A comparison of multiplex PCR with conventional culture for the isolation of S.P and H.I was performed on 112 specimens. The cross reactivity of multiplex PCR was also evaluated. RESULTS: Of 181 cases, 81 cases were positive by multiplex PCR (44.8%): 52 cases for S.P (28.7%), 47 cases for H.I (26.0%), 9 cases for M.P (5.0%), 3 cases for B.P (1.7%) and 1 case for C.P (0.6%) including multiple infection cases. The agreement rates between multiplex PCR and culture for S.P and H.I were 92.9% (kappa index=0.84, P<0.001) and 91.1% (kappa index=0.75, P<0.001), respectively. There was no cross reactivity with common bacterial and viral pathogens. CONCLUSIONS: Seeplex(TM) Pneumobacter detection kit could be a useful screening tool for the rapid detection of respiratory bacterial pathogens. Further studies with lower respiratory tract specimens would be needed for the clinical evaluation of S. pneumoniae and H. influenzae detected by multiplex PCR.
Adolescent ; Bacterial Infections/*diagnosis ; Child ; Child, Preschool ; DNA, Bacterial/analysis ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Mycoplasma pneumoniae/*isolation & purification ; Pneumonia, Mycoplasma/diagnosis ; *Polymerase Chain Reaction ; Reagent Kits, Diagnostic ; Respiratory Tract Infections/*diagnosis/microbiology ; Sensitivity and Specificity

PURPOSE: A number of countries have experienced an increase in pertussis during the past decade. In particular, there has been an increase in the incidence rate among adolescents and adults. To learn more about the current epidemiology of pertussis, we studied the prevalence and clinical characteristics of pertussis in children in Cheonan, South Korea. METHODS: We collected nasopharyngeal aspirates of 118 patients who were treated for respiratory symptoms at Dankook Univeristy Hospital between March 2008 and September 2009. We performed multiplex PCR for detection of Bordetella pertussis in those aspirates. RESULTS: Of the 118 patients, 10 (8%) were positive by PCR for B. pertussis. Six episodes occurred during the period July to September 2009. Nine of the 10 patients were less than 3 months old. Seven of them had not received DTaP vaccine. The mean duration of coughing before diagnosis was 10.9+/-5.2 days. Ten patients (100%) had paroxysmal cough and 8 (80%) had post-tussive vomiting. Only one patient had fever. One who had complications that include pneumonia, atelectasis and pneumomediastinum developed an absolute increase in leukocyte count (84,400/mm3). There was a statistically significant relation between vaccine being received and development of complications (P=0.033). CONCLUSION: We suspect that there was an epidemic of pertussis between July and September 2009. Further investigation by a pediatric or nationwide surveillance system is needed to monitor the changing epidemiology for pertussis.
Adolescent ; Adult ; Bordetella pertussis ; Child ; Cough ; Diphtheria-Tetanus-acellular Pertussis Vaccines ; Fever ; Humans ; Incidence ; Korea ; Leukocyte Count ; Mediastinal Emphysema ; Multiplex Polymerase Chain Reaction ; Organothiophosphorus Compounds ; Pneumonia ; Polymerase Chain Reaction ; Prevalence ; Pulmonary Atelectasis ; Republic of Korea ; Vomiting ; Whooping Cough

PURPOSE: This study was conducted to assess the current(2003-2005) prevalence of anti-HBs and immunologic memory for Hepatitis B vaccine in children from the central area of Korea. METHODS: Subjects were chosen from children and adolescents who received tests for hepatitis B surface antigen(HBsAg) and anti-HBs at Dankook University Hospital from March 2003 to May 2005. Among these, antibodies to hepatitis B core antigen(IgG anti-HBc) were checked. A single booster vaccination was performed on children whose anti-HBs titers were under 10 mIU/mL. One month after booster vaccination we rechecked the anti-HBs titer. RESULTS: A total of 3,277 subjects were tested for HBsAg/anti-HBs, and 1,913(58.4 percent) of them were positive for anti-HBs. Of these, 29 subjects(0.9 percent) were positive for HBsAg. Positive results for anti-HBs by age were 78.6 percent for 6-12 months of age, 62.7 percent for 1-3 years of age, 51.9 percent for 4-6 years of age, 49.5 percent for 7-12 years of age, 63.4 percent for 13-15 years of age and 72.2 percent for 16-18 years of age. The 80 subjects who were tested negative for HBsAg/anti-HBs received a single booster vaccine, 71 subjects were tested positive for antibodies. IgG anti-HBc titer was checked for 169 of the subjects, 5 subjects were positive. CONCLUSION: In our study, a significant anamnestic response was observed in 88.8 percent of children. This is believed to be a result of the relatively long immunologic memory effect of the hepatitis B vaccination in children from the central area of Korea.
Adolescent ; Antibodies ; Child* ; Hepatitis B Surface Antigens ; Hepatitis B Vaccines* ; Hepatitis B* ; Hepatitis* ; Humans ; Immunoglobulin G ; Immunologic Memory* ; Korea* ; Prevalence* ; Vaccination

BACKGROUND: Enterococci have become increasingly predominant as causative agents of nosocomial infections. Infections due to multi-drug resistant enterococci have drawn increasing attention during the past two decades. The purpose of the present study was to evaluate the occurrence of virulence factors and antimicrobial resistance in enterococci isolated from patients with bacteremia or urinary tract infection. METHODS: A total of 209 strains of enterococi (102 Enterococcus faecalis and 107 E. facium) isolated during 8 months of 2005 were collected from 10 university hospitals in Korea. Disk diffusion susceptibility tests were performed using Mueller-Hinton agar. The antimicrobial resistance genes and virulence factors were determined using PCR. RESULTS: In E. faecalis, the rate of resistance to ciprofloxacin, tetracycline, and quinupristindalfopristin was 27.4%, 83.3%, and 85.2%, respectively; no isolates were resistant to ampicillin, vancomycin, teicoplanin, or linezolid. In E. faecium, the rate of resistance to ampicillin, ciprofloxacin, tetracycline, vancomycin, and teicoplanin was 86.9%, 87.9%, 8.4%, 19.6%, and 6.5%, respectively; no strains were resistant to quinupristin-dalfopristin or linezolid. All the E. faecalis strains tested were found to harbor multiple virulence factors, but E. faecium strains were generally without virulence factors except esp. The prevalence of the esp gene was significantly higher in enterococci isolated from urinary tract infection than in those from bacteremia. CONCLUSION: A similar pattern of resistance to antimicrobial agents and prevalence of virulence factors was observed in both the enterococci isolated from bacteremia and urinary tract infection. Our study indicates that host factors are more likely than bacterial properties to influence the development of bacteremia.
Agar ; Ampicillin ; Anti-Infective Agents ; Bacteremia* ; Ciprofloxacin ; Cross Infection ; Diffusion ; Enterococcus faecalis ; Hospitals, University ; Humans ; Korea ; Polymerase Chain Reaction ; Prevalence ; Teicoplanin ; Tetracycline ; Urinary Tract Infections* ; Urinary Tract* ; Vancomycin ; Virulence Factors* ; Virulence* ; Linezolid

BACKGROUND: Intestinal alkaline phosphatase (ALP) is more prevalent in individuals of blood group B or O secretors and increases after a meal, especially, high-fat diet. The purpose of this study was to evaluate the prevalence and clinical significance of intestinal ALP in the sera of healthy adults. METHODS: Whole blood specimens were obtained from 42 healthy adults after fasting for at least 8 hours, and again at 2 hours after a regular meal. ALP was measured by TBA-200FR and analyzed for isoenzymes by Helena REP system. We also tested their ABO blood groups using GENEDIA anti-A and anti-B sera. RESULTS: The levels of fasting ALP, postprandial ALP, and the difference between the fasting and postprandial ALP (ALP difference) were 57.6+/-20.8 (12-111) IU/L, 62.3+/-17.4 (27-120) IU/L, and 4.6+/-15.4 (-8~63) IU/L, respectively. Delta (delta) ALP was 27.6+/-86.3 (-11.4~312.5)%. Among the 42 subjects, 6 were blood group A, 16 group B, 10 group AB, and 10 group O. Intestinal isoenzyme of ALP was detected in two subjects, both of whom were blood group O. The differences in fasting ALP, postprandial ALP, ALP difference, and delta ALP between ABO blood groups were statistically not significant. CONCLUSIONS: Intestinal ALP was detected in 5% of healthy adults, especially, in 20% of blood group O. Intestinal ALP has been known to be of no specific clinical significance. However, when ALP is measured in a non-fasting sample, the presence of intestinal ALP could result in an abnormally high ALP and subsequent unnecessary tests. Therefore, it is recommended that ALP should be measured only after fasting.
Adult* ; Alkaline Phosphatase* ; Blood Group Antigens ; Diet, High-Fat ; Fasting ; Humans ; Isoenzymes ; Meals ; Prevalence*

BACKGROUND: A few recent studies have been conducted to analyzing the blood usage with regard to diagnosis of Korean recipients. We performed a study to analyze the usage of blood components. METHODS: Transfused components such as packed red blood cells (RBC), whole blood (WB), fresh frozen plasma (FFP), and platelet components (PLT) were estimated by the principal diagnoses of the patients, who were discharged from February 1998 to January 1999, according to the International Statistical Classification of Diseases (ICD)-10. RESULTS: Eleven percentage (2,227/20,650) of inpatients were transfused. The transfusion rate of hospitalized patients for RBCs, WBs, FFPs, and PLTs was 10.1%, 0.4%, 4.0% and 16.2 %, respectively. There was a difference in the sex ratio (1.6 male/female) in all blood components transfused. Of all investigated blood components (22,523 units), 10,729 units (47.6%) of RBCs, 240 units (1.1%) of WBs, 5,355 units (23.8%) of FFPs, and 6,199 units (27.5%) of PLTs were transfused. The hospitalized patients who received 1 unit of RBCs was 12.9%, and 2 units were most frequent transfused units (25.6%). Seventy-four percent of all 22,523 units were used in four diagnostic categories of highest blood usage; injury and poisoning (29.2%), nonhematologic neoplasms (16.3%), digestive system disease (16.1%) and circulatory system disease (12.5%). CONCLUSION: We performed usage analysis of blood components with regard to diagnosis, comparing the previous studies in other hospitals. This study could provide baseline transfusion information in relation to diagnosis, and help improve the quality control of blood utilization and transfusion practice.
Blood Platelets ; Classification* ; Diagnosis ; Digestive System Diseases ; Erythrocytes ; Humans ; Inpatients ; Plasma ; Poisoning ; Quality Control ; Sex Ratio