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1.
Am J Infect Control ; 52(2): 214-219, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37406965

RESUMO

BACKGROUND: This study analyzed the validity of healthcare-associated infection (HAI) data of the Korean National healthcare-associated Infections Surveillance System. METHODS: The validation process consisted of external (EV) and internal (IV) validation phases. Of the 193 hospitals that participated from July 2016 through June 2017, EV was performed for 10 hospitals that were selected based on the HAI rate percentile. The EV team reviewed 295 medical records for 60 HAIs and 235 non-HAI control patients. IV was performed for both the 10 EV hospitals and 11 other participating hospitals that did not report any HAIs. RESULTS: In the EV, the diagnosis of urinary tract infections had a sensitivity of 72.0% and a specificity of 99.3%. The respective sensitivities of bloodstream infection and pneumonia were 63.2% and 70.6%; the respective specificities were 98.8% and 99.6%. The agreement (ĸ) between the EV and IV for 10 hospitals was 0.754 for urinary tract infections and 0.674 for bloodstream infections (P < .001, respectively). Additionally, IV found additional cases among 11 zero-report hospitals. DISCUSSION: This study demonstrates the need for ongoing validation and continuous training to maintain the accuracy of nationwide surveillance data. CONCLUSIONS: IV should be considered a validation method to supplement EV.


Assuntos
Infecções Relacionadas a Cateter , Doenças Transmissíveis , Infecção Hospitalar , Sepse , Infecções Urinárias , Humanos , Infecção Hospitalar/epidemiologia , Infecções Urinárias/epidemiologia , Sepse/epidemiologia , República da Coreia/epidemiologia , Atenção à Saúde , Infecções Relacionadas a Cateter/epidemiologia
2.
Infection ; 2023 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-37910310

RESUMO

PURPOSE: We aimed to explore the clinical characteristics of Campylobacter bacteraemia and identify the trends, risk factors for mortality, and antimicrobial susceptibility patterns from clinical samples. METHODS: This retrospective cohort study included patients confirmed to have Campylobacter bacteraemia from seven hospitals between January 2010 and June 2021. Data on demographics and underlying history, clinical manifestation, and antimicrobial susceptibility patterns were collected and analyzed. Annual cases of Campylobacter enteritis were extracted from a public database. RESULTS: A total of 108 patients were included, and five species were isolated. Campylobacter jejuni accounted for 54 (50.0%) cases and 17 (16%) patients had no symptoms other than fever. In-hospital mortality occurred in 14 (13.0%) patients. C. jejuni bacteraemia was associated with lower mortality compared to non-C. jejuni bacteraemia. Underlying cancer and septic shock were the significant factors associated with in-hospital mortality. Quinolone resistance was high (59%), whereas only 4% of isolates exhibited macrolide resistance. There has been a significant increase in the number of Campylobacter enteritis cases, which was strongly correlated with the number of Campylobacter bacteraemia cases (Pearson's coefficient: 0.953; p < 0.0001). CONCLUSION: The notably increasing incidence of Campylobacter bacteraemia and antibiotic resistance patterns can challenge the treatment, necessitating collective efforts of national surveillance and networks by many departments.

3.
Microorganisms ; 11(5)2023 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-37317095

RESUMO

BACKGROUND: Bloodstream infection (BSI) caused by carbapenem-resistant Enterobacteriaceae (CRE) significantly influences patient morbidity and mortality. We aimed to identify the characteristics, outcomes, and risk factors of mortality in adult patients with CRE bacteremia and elucidate the differences between carbapenemase-producing (CP)-CRE BSI and non-CP-CRE BSI. METHODS: This retrospective study included 147 patients who developed CRE BSI between January 2016 and January 2019 at a large tertiary care hospital in South Korea. The patient demographic characteristics and clinical and microbiological data including the Enterobacteriaceae species and carbapenemase type were obtained and analyzed. RESULTS: Klebsiella pneumoniae was the most commonly detected pathogen (80.3%), followed by Escherichia coli (15.0%). In total, 128 (87.1%) isolates were found to express carbapenemase, and most CP-CRE isolates harbored blaKPC. The 14-day and 30-day mortality rates for CRE BSI were 34.0% and 42.2%, respectively. Higher body mass index (odds ratio (OR), 1.123; 95% confidence interval (CI), 1.012-1.246; p = 0.029), higher sequential organ failure assessment (SOFA) score (OR, 1.206; 95% CI, 1.073-1.356; p = 0.002), and previous antibiotic use (OR, 0.163; 95% CI, 0.028-0.933; p = 0.042) were independent risk factors for the 14-day mortality. A high SOFA score (OR, 1.208; 95% CI; 1.081-0.349; p = 0.001) was the only independent risk factor for 30-day mortality. Carbapenemase production and appropriate antibiotic treatment were not associated with high 14- or 30-day mortality rates. CONCLUSIONS: Mortality from CRE BSI was related to the severity of the infection rather than to carbapenemase production or antibiotic treatment, showing that efforts to prevent CRE acquisition rather than treatment following CRE BSI detection would be more effective at reducing mortality.

4.
J Thorac Dis ; 15(3): 1506-1516, 2023 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-37065603

RESUMO

Background: We aimed to develop integrative machine-learning models using quantitative computed tomography (CT) parameters in addition to initial clinical features to predict the respiratory outcomes of coronavirus disease 2019 (COVID-19). Methods: This was a retrospective study involving 387 patients with COVID-19. Demographic, initial laboratory, and quantitative CT findings were used to develop predictive models of respiratory outcomes. High-attenuation area (HAA) (%) and consolidation (%) were defined as quantified percentages of the area with Hounsfield units between -600 and -250 and between -100 and 0, respectively. Respiratory outcomes were defined as the development of pneumonia, hypoxia, or respiratory failure. Multivariable logistic regression and random forest models were developed for each respiratory outcome. The performance of the logistic regression model was evaluated using the area under the receiver operating characteristic curve (AUC). The accuracy of the developed models was validated by 10-fold cross-validation. Results: A total of 195 (50.4%), 85 (22.0%), and 19 (4.9%) patients developed pneumonia, hypoxia, and respiratory failure, respectively. The mean patient age was 57.8 years, and 194 (50.1%) were female. In the multivariable analysis, vaccination status and levels of lactate dehydrogenase, C-reactive protein (CRP), and fibrinogen were independent predictors of pneumonia. The presence of hypertension, levels of lactate dehydrogenase and CRP, HAA (%), and consolidation (%) were selected as independent variables to predict hypoxia. For respiratory failure, the presence of diabetes, levels of aspartate aminotransferase, and CRP, and HAA (%) were selected. The AUCs of the prediction models for pneumonia, hypoxia, and respiratory failure were 0.904, 0.890, and 0.969, respectively. Using the feature selection in the random forest model, HAA (%) was ranked as one of the top 10 features predicting pneumonia and hypoxia and was first place for respiratory failure. The accuracies of the cross-validation of the random forest models using the top 10 features for pneumonia, hypoxia, and respiratory failure were 0.872, 0.878, and 0.945, respectively. Conclusions: Our prediction models that incorporated quantitative CT parameters into clinical and laboratory variables showed good performance with high accuracy.

5.
Infect Chemother ; 55(3): 322-327, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36864765

RESUMO

BACKGROUND: Chryseobacterium indologenes is ubiquitous in nature and rarely causes infections. However, the clinical impact of C. indologenes has increased in recent years, especially in immunocompromised patients, and has resulted in high mortality rates. We aimed to investigate the clinical and microbiological characteristics of C. indologenes bacteremia. MATERIALS AND METHODS: We retrospectively reviewed medical records of a 642-bed university-affiliated hospital in Korea, dating from January 2001 to December 2020, to investigate C. indologenes bacteremia. RESULTS: A total of 22 C. indologenes isolates were identified from blood culture records. All patients were hospitalized at the time of bacteremia, and the most common manifestation was primary bacteremia. A sizable majority of the patients (83.3%) had underlying diseases, and all patients received intensive care unit care during their admission. The 14-day and 28-day mortality rates were 8.3% and 16.7%, respectively. Importantly, all C. indologenes isolates were 100% susceptible to trimethoprim-sulfamethoxazole. CONCLUSION: In our study, most of the infections were hospital-acquired, and the susceptibility pattern of the C. indologenes isolates showed multidrug resistance. However, trimethoprim-sulfamethoxazole is a potentially useful antibiotic for C. indologenes bacteremia treatment. More attention is required to identify C. indologenes as one of the most important nosocomial bacteria with detrimental effects in immunocompromised patients.

6.
Medicine (Baltimore) ; 102(4): e32704, 2023 Jan 27.
Artigo em Inglês | MEDLINE | ID: mdl-36705390

RESUMO

Stenotrophomonas maltophilia is a Gram-negative opportunistic pathogen that can cause serious infection. We aimed to analyze the prevalence and susceptibility rates to trimethoprim/sulfamethoxazole of S. maltophilia. We conducted a retrospective study of S. maltophilia isolates from a university hospital from 2001 to 2020. Clinical information, the numbers of isolates and susceptibility rates were analyzed by year. Susceptibility rates and changes in respiratory and non-respiratory samples were compared. 1805 S. maltophilia isolates were identified, of which 81.4% (1469/1805) were from respiratory samples. There was a male predominance and 52% of the isolates were from general wards. The average susceptibility rate was 87.7% and there was no significant annual trend (P = .519). The susceptibility rate was 88.7% in respiratory samples and 84.1% in non-respiratory samples (P = .018). Susceptibility analyses using clinical data over long periods can guide the choice of antimicrobials especially for pathogen whose treatment options are limited.


Assuntos
Infecções por Bactérias Gram-Negativas , Stenotrophomonas maltophilia , Combinação Trimetoprima e Sulfametoxazol , Feminino , Humanos , Masculino , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Infecções por Bactérias Gram-Negativas/tratamento farmacológico , Infecções por Bactérias Gram-Negativas/epidemiologia , Hospitais Universitários , Testes de Sensibilidade Microbiana , Prevalência , República da Coreia/epidemiologia , Estudos Retrospectivos , Atenção Secundária à Saúde , Stenotrophomonas maltophilia/efeitos dos fármacos , Combinação Trimetoprima e Sulfametoxazol/farmacologia , Combinação Trimetoprima e Sulfametoxazol/uso terapêutico
7.
Infect Chemother ; 54(4): 781-786, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36226346

RESUMO

Regdanvimab is the only monoclonal antibody available in Korea that targets severe acute respiratory syndrome coronavirus 2. We retrospectively evaluated the clinical characteristics of 374 adults hospitalized with coronavirus disease 2019 (COVID-19) who were treated with regdanvimab from September through December 2021. In total, 322 (86.1%) patients exhibited risk factors for disease progression. Most patients (91.4%) improved without additional treatment. No patient died or was transferred to intensive care. This study shows that regdanvimab prevented disease progression in high-risk patients with mild to moderate COVID-19 infections during Delta variant predominance.

8.
Malar J ; 21(1): 289, 2022 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-36217154

RESUMO

BACKGROUND: Primaquine is activated by CYP2D6 in the hepatocytes. In Korea, primaquine is the only hypnozoitocidal agent used for patients with vivax malaria. Thus, patients with poor CYP2D6 activity could have an increased risk of primaquine failure and subsequent relapse. The study sought to identify the association between CYP2D6 phenotype and recurrence of malaria in Korean patients. METHODS: A total of 102 patients with vivax malaria were prospectively enrolled from eight institutions in Korea. An additional 38 blood samples from patients with recurred vivax malaria were provided by the Korea Disease Control and Prevention Agency. Malaria recurrence was defined as more than one episode of vivax malaria in the same or consecutive years. CYP2D6 star alleles, phenotypes, and activity scores were examined. RESULTS: Genotyping for CYP2D6 was successful in 101 of the prospectively enrolled patients and 38 samples from the Korea Disease Control and Prevention Agency, of which 91 were included in the no-recurrence group and 48 were included in the recurrence group. Reduced CYP2D6 activity (intermediate metabolizer) phenotype was more common in the recurrence group than in the no-recurrence group (OR, 2.33 (95% CI, 1.14-4.77); p = 0.02). Patients with lower CYP2D6 activity had a higher probability of recurrence (p = 0.029). CONCLUSION: This study suggests that CYP2D6 polymorphism may affect primaquine efficacy and thus Plasmodium vivax recurrence in Korea.


Assuntos
Antimaláricos , Citocromo P-450 CYP2D6 , Malária Vivax , Antimaláricos/uso terapêutico , Citocromo P-450 CYP2D6/genética , Família 2 do Citocromo P450 , Humanos , Malária Vivax/tratamento farmacológico , Malária Vivax/genética , Fenótipo , Plasmodium vivax , Primaquina/uso terapêutico , Recidiva , República da Coreia
9.
Sci Rep ; 12(1): 13934, 2022 08 17.
Artigo em Inglês | MEDLINE | ID: mdl-35978016

RESUMO

We aimed to estimate the socioeconomic burden of pneumonia due to multidrug-resistant Acinetobacter baumannii (MRAB) and Pseudomonas aeruginosa (MRPA). We prospectively searched for MRAB and MRPA pneumonia cases and matched them with susceptible-organism pneumonia and non-infected patients from 10 hospitals. The matching criteria were: same principal diagnosis, same surgery or intervention during hospitalisation, age, sex, and admission date within 60 days. We calculated the economic burden by using the difference in hospital costs, the difference in caregiver costs, and the sum of productivity loss from an unexpected death. We identified 108 MRAB pneumonia [MRAB-P] and 28 MRPA pneumonia [MRPA-P] cases. The estimated number of annual MRAB-P and MRPA-P cases in South Korea were 1309-2483 and 339-644, with 485-920 and 133-253 deaths, respectively. The annual socioeconomic burden of MRAB-P and MRPA-P in South Korea was $64,549,723-122,533,585 and $15,241,883-28,994,008, respectively. The results revealed that MRAB-P and MRPA-P occurred in 1648-3127 patients, resulted in 618-1173 deaths, and caused a nationwide socioeconomic burden of $79,791,606-151,527,593. Multidrug-resistant organisms (MDRO) impose a great clinical and economic burden at a national level. Therefore, controlling the spread of MDRO will be an effective measure to reduce this burden.


Assuntos
Infecções por Acinetobacter , Acinetobacter baumannii , Pneumonia , Infecções por Acinetobacter/tratamento farmacológico , Infecções por Acinetobacter/epidemiologia , Antibacterianos/farmacologia , Farmacorresistência Bacteriana Múltipla , Humanos , Testes de Sensibilidade Microbiana , Pneumonia/tratamento farmacológico , Pneumonia/epidemiologia , Pseudomonas aeruginosa , Fatores Socioeconômicos
10.
J Glob Antimicrob Resist ; 31: 45-51, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-35981691

RESUMO

OBJECTIVES: Although many deaths due to carbapenem-resistant Acinetobacter baumannii (CRAB) bacteraemia occur within a few days after the onset of bacteraemia, risk factors for early mortality (EM) have not been deeply investigated. We aimed to determine the risk factors for EM and the difference between risk factors associated with EM and late mortality (LM) in CRAB bacteraemia. METHODS: Clinical information on all patients with CRAB bacteraemia in 10 hospitals during a 1-year period was collected. Among the cases with mortality within 30 days, EM and LM were defined as death within 3 and more than 5 calendar days from the first positive blood culture, respectively. RESULTS: In total, 212 CRAB bacteraemia cases were included in the analysis. Of 122 (57.5%) patients with 30-day mortality, EM was observed in 75 (61.5%) patients and LM in 39 (32.0%) patients. The proportion of severe sepsis or septic shock, Pitt score, and Sequential Organ Failure Assessment (SOFA) score was significantly higher in patients with EM than those with LM. Although urinary tract infection as the site of infection and the severity of illness were independent predictors of LM, only factors representing the severity of illness were independent risk factors for EM. CONCLUSION: Our results suggest that a large proportion of CRAB bacteraemia with high severity progresses to a rapidly fatal course, regardless of the underlying diseases or source of infection. Further studies might be needed to investigate the microbiological factors associated with CRAB and pathogen-host interaction in patients with EM.


Assuntos
Infecções por Acinetobacter , Acinetobacter baumannii , Bacteriemia , Humanos , Infecções por Acinetobacter/microbiologia , Carbapenêmicos/farmacologia , Testes de Sensibilidade Microbiana , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Bacteriemia/microbiologia , Fatores de Risco
11.
Front Med (Lausanne) ; 9: 914098, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35669915

RESUMO

Background: Chest computed tomography (CT) scans play an important role in the diagnosis of coronavirus disease 2019 (COVID-19). This study aimed to describe the quantitative CT parameters in COVID-19 patients according to disease severity and build decision trees for predicting respiratory outcomes using the quantitative CT parameters. Methods: Patients hospitalized for COVID-19 were classified based on the level of disease severity: (1) no pneumonia or hypoxia, (2) pneumonia without hypoxia, (3) hypoxia without respiratory failure, and (4) respiratory failure. High attenuation area (HAA) was defined as the quantified percentage of imaged lung volume with attenuation values between -600 and -250 Hounsfield units (HU). Decision tree models were built with clinical variables and initial laboratory values (model 1) and including quantitative CT parameters in addition to them (model 2). Results: A total of 387 patients were analyzed. The mean age was 57.8 years, and 50.3% were women. HAA increased as the severity of respiratory outcome increased. HAA showed a moderate correlation with lactate dehydrogenases (LDH) and C-reactive protein (CRP). In the decision tree of model 1, the CRP, fibrinogen, LDH, and gene Ct value were chosen as classifiers whereas LDH, HAA, fibrinogen, vaccination status, and neutrophil (%) were chosen in model 2. For predicting respiratory failure, the decision tree built with quantitative CT parameters showed a greater accuracy than the model without CT parameters. Conclusions: The decision tree could provide higher accuracy for predicting respiratory failure when quantitative CT parameters were considered in addition to clinical characteristics, PCR Ct value, and blood biomarkers.

12.
Emerg Microbes Infect ; 11(1): 1316-1324, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35465831

RESUMO

Fully vaccinated people remain at risk of Coronavirus Disease 2019 (COVID-19). We examined association between prior vaccination and clinical outcomes in patients with COVID-19. Overall, 387 patients with mild-to-severe COVID-19 were enrolled. Patients were considered fully vaccinated at least 14, 7, and 14 days after receiving the second dose of ChAdOx1 nCoV-19 or mRNA-1273, second dose of BNT162b2, or single dose of Ad26.COV2.S, respectively. The primary outcomes (risk of pneumonia, requirement of supplemental oxygen, and progression to respiratory failure) were compared between vaccinated and unvaccinated patients. Logistic regression analysis was performed to identify factors associated with the outcomes. There were 204 and 183 patients in the vaccinated and unvaccinated groups, respectively. The vaccinated group was significantly older and had more comorbidities than the unvaccinated group. Patients in the unvaccinated group were significantly more likely to develop pneumonia (65.6% vs. 36.8%) or require supplemental oxygen (29.0 vs. 15.7%) than the vaccinated group. The vaccinated group had a significantly shorter time from symptom onset to hospital discharge than the unvaccinated group (10 vs. 11 days; p<0.001). The proportion of patients who progressed to respiratory failure did not differ significantly between groups. In multivariable analyses, vaccination was associated with an approximately 70% and 82% lower likelihood of pneumonia and supplemental oxygen requirement, respectively. Being vaccinated was associated with a significantly lower risk of pneumonia and severe disease when breakthrough infection developed. Our findings support continuous efforts to increase vaccine coverage in populations.


Assuntos
COVID-19 , Insuficiência Respiratória , Ad26COVS1 , Vacina BNT162 , COVID-19/prevenção & controle , Vacinas contra COVID-19 , ChAdOx1 nCoV-19 , Humanos , Oxigênio , SARS-CoV-2 , Vacinação
13.
Korean J Parasitol ; 60(1): 39-43, 2022 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-35247953

RESUMO

Plasmodium vivax exhibits dormant liver-stage parasites, called hypnozoites, which can cause relapse of malaria. The only drug currently used for eliminating hypnozoites is primaquine. The antimalarial properties of primaquine are dependent on the production of oxidized metabolites by the cytochrome P450 isoenzyme 2D6 (CYP2D6). Reduced primaquine metabolism may be related to P. vivax relapses. We describe a case of 4 episodes of recurrence of vivax malaria in a patient with decreased CYP2D6 function. The patient was 52-year-old male with body weight of 52 kg. He received total gastrectomy and splenectomy 7 months before the first episode and was under chemotherapy for the gastric cancer. The first episode occurred in March 2019 and each episode had intervals of 34, 41, and 97 days, respectively. At the first and second episodes, primaquine was administered as 15 mg for 14 days. The primaquine dose was increased with 30 mg for 14 days at the third and fourth episodes. Seven gene sequences of P. vivax were analyzed and revealed totally identical for all the 4 samples. The CYP2D6 genotype was analyzed and intermediate metabolizer phenotype with decreased function was identified.


Assuntos
Antimaláricos , Malária Vivax , Antimaláricos/uso terapêutico , Citocromo P-450 CYP2D6/genética , Citocromo P-450 CYP2D6/metabolismo , Citocromo P-450 CYP2D6/uso terapêutico , Humanos , Malária Vivax/tratamento farmacológico , Malária Vivax/parasitologia , Masculino , Pessoa de Meia-Idade , Plasmodium vivax/genética , Plasmodium vivax/metabolismo , Primaquina/uso terapêutico , Recidiva
14.
Clin Case Rep ; 9(12): e05177, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34938553

RESUMO

Yokenella regensburgei is a Gram-negative, oxidase-negative motile rod which is rarely isolated from human caused a few opportunistic infections in immunocompromised patients so far. We report the first case of otitis media combined with externa caused by Y. regensburgei in an immunocompetent patient. A 56-year-old male patient visited the outpatient clinic of the Otolaryngology Department due to otorrhea of the right ear started after diving in mountain valley in Korea 3 days ago. He was immunocompetent adult and clinical examination revealed swelling and debris accumulation in the right external auditory canal with an intact, erythematous tympanic membrane, and clear, odorless otorrhea. Microbiological culture of otorrhea revealed Y. regensburgei by matrix-assisted laser desorption/ionization time-of-flight and PCR-based 16S rRNA gene sequencing. His otorrhea persisted, and a pinpoint perforation occurred in the inferior anterior portion of the tympanic membrane. 50% acetic acid irrigation and 500 mg of oral ciprofloxacin were prescribed, and his infection was cured after 4 weeks. This is the first case of otitis media combined with externa caused by Yokenella regensburgei in an immunocompetent patient. Given that Yokenella species infections are rare, especially in immunocompetent patients, this case highlights the importance of history taking and communication between clinicians and laboratory physicians. Molecular identification methods assist in identifying rare pathogens.

15.
BMC Infect Dis ; 21(1): 1184, 2021 Nov 25.
Artigo em Inglês | MEDLINE | ID: mdl-34823480

RESUMO

BACKGROUND: Human granulocytic anaplasmosis (HGA) is a systemic inflammatory response caused by the rickettsial bacterium Anaplasma phagocytophilum. Rhabdomyolysis and acute kidney injury (AKI) are rare complications of HGA. Here, we report a case of HGA concurrent with rhabdomyolysis and AKI in an elderly patient. CASE PRESENTATION: An 84-year old woman with a medical history of hypertension was hospitalised after two days of fever, dizziness, whole body pain, and general weakness. Laboratory investigations showed severe thrombocytopenia, leukopenia, impaired renal function, and elevated cardiac enzyme and myoglobin levels. On the day after admission, peripheral blood smear revealed morula inclusions in neutrophils, a suggestive finding of HGA. Real-time polymerase chain reaction (PCR) results indicated the presence of A. phagocytophilum. Antibiotics were de-escalated to doxycycline monotherapy. After 10 days of antibiotic treatment, laboratory tests showed complete recovery from HGA complicated with rhabdomyolysis and AKI. CONCLUSIONS: HGA can lead to serious complications in patients with associated risk factors. Therefore, in patients with HGA accompanied by rhabdomyolysis, management with antibiotics and hydration should be initiated immediately, and not delayed until diagnostic confirmation.


Assuntos
Anaplasma phagocytophilum , Anaplasmose , Rabdomiólise , Idoso , Idoso de 80 Anos ou mais , Anaplasma phagocytophilum/genética , Anaplasmose/complicações , Anaplasmose/diagnóstico , Anaplasmose/tratamento farmacológico , Animais , Antibacterianos/uso terapêutico , Doxiciclina/uso terapêutico , Feminino , Humanos , Rabdomiólise/complicações , Rabdomiólise/tratamento farmacológico
16.
Infect Chemother ; 53(3): 557-561, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34405593

RESUMO

Vaccination is an important strategy for controlling the coronavirus disease 2019 (COVID-19) pandemic. We conducted a web-based cross-sectional survey based on Google Forms to collect data on adverse events (AEs) after the first dose of the ChAdOx1 nCoV-19 vaccine for healthcare workers (HCWs). Among the 1,676 vaccinated HCWs, 59.5% (998/1,676) responded to the survey. In total, 809 (81.1%) respondents reported experiencing AEs. There were no serious AEs, such as anaphylaxis. The most common AE was pain at the injection site (76.2%), followed by fatigue (75.9%), myalgia (74.9%), and fever (58.4%). HCWs in the younger age group experienced significantly more AEs than in the older age group.

17.
Oxf Med Case Reports ; 2021(11-12): omab131, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34987857

RESUMO

Shewanella are Gram-negative rods and marine pathogens. Here, we report a case of bacterial keratitis caused by Shewanella algae without marine exposure. A 66-year-old man with suspected pneumonia was sent to the emergency department from a nursing hospital. He had been in there for 2 years in a vegetative state and could not close his eyes voluntarily. Neither the patient nor his family had experienced any marine exposure. Keratitis was suspected in his right eye. Gram-negative rods grew from swab culture and identified as S. algae by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry and 16S rRNA sequencing. The patient was treated with topical tobramycin, moxifloxacin and ofloxacin as well as steroids for 14 days, and the keratitis improved. S. algae is a rare human pathogen, and most human infections involve marine exposure. This is the second report of bacterial keratitis caused by S. algae worldwide and the first in Asia.

18.
Pathogens ; 9(11)2020 Nov 14.
Artigo em Inglês | MEDLINE | ID: mdl-33202553

RESUMO

Extrapulmonary nontuberculous mycobacteria (NTM) infections contribute to morbidity and mortality worldwide. However, studies about extrapulmonary NTM infections have been limited. Therefore, we aim to describe the diversity of extrapulmonary NTM infections and identify predictors for species. Information regarding diversity of NTM isolates, antimicrobial susceptibility testing, treatment regimens, and outcomes were collected from four tertiary care centers in South Korea. Comparisons were made between patients with rapidly growing mycobacteria (RGM) and slowly growing mycobacteria (SGM) infections. A total of 117 patients (46 males vs. 71 females) were included. Skin and soft tissue infections (SSTIs) predominated (34.2%), followed by bone and joint infections (28.2%). In SSTIs, RGM species were predominantly identified (26/28, 92.9%), whereas SGM species were mainly identified in bone and joint infections (18/26, 69.2%), and the difference of isolated sites was verified by a post hoc test (p < 0.001). Multivariable regression analysis revealed that male sex (vs. female sex; OR 5.30, CI 1.35-24.26, p = 0.020) and bone and joint infections (vs. SSTIs; OR 18.10, CI 3.28-157.07, p = 0.002) were predictors of SGM infections, whereas the opposite was observed for RGM infections. Bone and joint infections and male sex were predictors for SGM infections, whereas SSTIs and female sex were predictors for RGM infections.

19.
Emerg Infect Dis ; 26(8): 1852-1855, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32687027

RESUMO

We reviewed the clinical efficacy of chloroquine for Plasmodium vivax malaria, the changing trend of parasite clearance time, and fever clearance time during 2000-2016 in South Korea. Median parasite clearance time and fever clearance time increased significantly over the study period. Chloroquine was mostly underdosed when used to treat P. vivax malaria.


Assuntos
Antimaláricos , Malária Vivax , Malária , Parasitos , Animais , Antimaláricos/uso terapêutico , Cloroquina/uso terapêutico , Quimioterapia Combinada , Malária/tratamento farmacológico , Malária Vivax/tratamento farmacológico , Malária Vivax/epidemiologia , Plasmodium vivax , Primaquina/uso terapêutico , República da Coreia/epidemiologia , Resultado do Tratamento
20.
Infect Chemother ; 52(1): 93-97, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31997601

RESUMO

We performed a point seroprevalence survey of measles among healthcare workers (HCWs) at two Korean teaching hospitals in 2019. A total of 2,830 HCWs underwent an antibody test. The overall seropositivity of measles was 93.1%. The seroprevalence of measles was lowest in HCWs aged 20 - 24 years (81.2%), followed by those aged 25 - 29 years (90.1%). The rates of anti-measles IgG positivity were significantly different between the two hospitals (97.0% vs. 89.4%, P <0.001). These results suggest that the seropositivity of measles in HCWs may differ depending on the hospital's vaccination policy.

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