A comparison of phenotypic and WGS drug susceptibility testing in Mycobacterium tuberculosis isolates from the Republic of Korea.

Background: WGS has significant potential to help tackle the major public health problem of TB. The Republic of Korea has the third highest rates of TB of all Organisation for Economic Cooperation and Development countries but there has been very limited use of WGS in TB to date. Objectives: A retrospective comparison of Mycobacterium tuberculosis (MTB) clinical isolates from 2015 to 2017 from two centres in the Republic of Korea using WGS to compare phenotypic drug susceptibility testing (pDST) and WGS drug susceptibility predictions (WGS-DSP). Methods: Fifty-seven MTB isolates had DNA extracted and were sequenced using the Illumina HiSeq platform. The WGS analysis was performed using bwa mem, bcftools and IQ-Tree; resistance markers were identified using TB profiler. Phenotypic susceptibilities were carried out at the Supranational TB reference laboratory (Korean Institute of Tuberculosis). Results: For first-line antituberculous drugs concordance for rifampicin, isoniazid, pyrazinamide and ethambutol was 98.25%, 92.98%, 87.72% and 85.96%, respectively. The sensitivity of WGS-DSP compared with pDST for rifampicin, isoniazid, pyrazinamide and ethambutol was 97.30%, 92.11%, 78.95% and 95.65%, respectively. The specificity for these first-line antituberculous drugs was 100%, 94.74%, 92.11% and 79.41%, respectively. The sensitivity and specificity for second-line drugs ranged from 66.67% to 100%, and from 82.98% to 100%, respectively. Conclusions: This study confirms the potential role for WGS in drug susceptibility prediction, which would reduce turnaround times. However, further larger studies are needed to ensure current databases of drug resistance mutations are reflective of the TB present in the Republic of Korea.

Electroplated core-shell nanowire network electrodes for highly efficient organic light-emitting diodes.

In this study, we performed metal (Ag, Ni, Cu, or Pd) electroplating of core-shell metallic Ag nanowire (AgNW) networks intended for use as the anode electrode in organic light-emitting diodes (OLEDs) to modify the work function (WF) and conductivity of the AgNW networks. This low-cost and facile electroplating method enabled the precise deposition of metal onto the AgNW surface and at the nanowire (NW) junctions. AgNWs coated onto a transparent glass substrate were immersed in four different metal electroplating baths: those containing AgNO3 for Ag electroplating, NiSO4 for Ni electroplating, Cu2P2O7 for Cu electroplating, and PdCl2 for Pd electroplating. The solvated metal ions (Ag+, Ni2+, Cu2+, and Pd2+) in the respective electroplating baths were reduced to the corresponding metals on the AgNW surface in the galvanostatic mode under a constant electric current achieved by linear sweep voltammetry via an external circuit between the AgNW networks (cathode) and a Pt mesh (anode). The amount of electroplated metal was systematically controlled by varying the electroplating time. Scanning electron microscopy images showed that the four different metals (shells) were successfully electroplated on the AgNWs (core), and the nanosize-controlled electroplating process produced metal NWs with varying diameters, conductivities, optical transmittances, and WFs. The metal-electroplated AgNWs were successfully employed as the anode electrodes of the OLEDs. This facile and low-cost method of metal electroplating of AgNWs to increase their WFs and conductivities is a promising development for the fabrication of next-generation OLEDs.

Clinical Features of Adult COVID-19 Patients without Risk Factors before and after the Nationwide SARS-CoV-2 B.1.617.2 (Delta)-variant Outbreak in Korea: Experience from Gyeongsangnam-do.

BACKGROUND: Data on severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) delta variant virulence are insufficient. We retrospectively compared the clinical features of adult coronavirus disease 2019 (COVID-19) patients without risk factors for severe COVID-19 who entered residential treatment centers (RTCs) before and after the delta variant outbreak. METHODS: We collected medical information from two RTCs in South Korea. On the basis of nationwide delta variant surveillance, we divided the patients into two groups: 1) the delta-minor group (diagnosed from December 2020-June 2021, detection rate < 10%) and 2) the delta-dominant group (diagnosed during August 2021, detection rate > 90%). After propensity-score matching, the incidences of pneumonia, hospital transfer and need for supplemental oxygen were compared between the groups. In addition, risk factors for hospital transfer were analysed. RESULTS: A total of 1,915 patients were included. The incidence of pneumonia (14.6% vs. 9.2%, P = 0.009), all-cause hospital transfer (10.4% vs. 6.3%, P = 0.020) and COVID-19-related hospital transfer (7.5% vs. 4.8%, P = 0.081) were higher in the delta-dominant group than those in the delta-minor group. In the multivariate analysis, the delta-dominant group was an independent risk factor for all-cause (adjusted odds ratio [aOR], 1.91; 95% confidence interval [CI], 1.16-3.13; P = 0.011) and COVID-19-related hospital transfer (aOR, 1.86; 95% CI, 1.04-3.32; P = 0.036). CONCLUSION: Hospitalization rates were increased in the adult COVID-19 patients during the delta variant nationwide outbreak. Our results showed that the delta variant may be more virulent than previous lineages.

Outcomes of Multidrug-Resistant Tuberculosis Treated With Bedaquiline or Delamanid.

BACKGROUND: Since 1 September 2016, bedaquiline and delamanid have been administered for the treatment of patients with multidrug-resistant/rifampicin-resistant tuberculosis after the official approval in South Korea. This study aimed to assess and compare the final treatment outcomes of patients who received bedaquiline with those of patients who received delamanid. METHODS: This is a nationwide cohort study of patients with multidrug-resistant/rifampicin-resistant tuberculosis in whom bedaquiline or delamanid was administered from 1 September 2016 to 28 February 2018, after receiving the official approval in South Korea. Patients were classified into the bedaquiline and delamanid group according to the first used drug. We evaluated and compared the final treatment outcomes between the groups. RESULTS: During the study period, 284 patients with multidrug-resistant/rifampicin-resistant tuberculosis were approved to use bedaquiline or delamanid and 260 were included in the final analysis; 119 (45.8%) and 141 patients (54.2%) were classified into bedaquiline and delamanid groups, respectively. Among them, 30 patients (11.5%) exhibited additional resistance to second-line injectable drugs, 94 patients (36.2%) had additional resistance to fluoroquinolones, and 37 patients (14.2%) had resistance to both drugs. The overall treatment success rate was 79.2%. Initiation of bedaquiline rather than delamanid was not associated with treatment success (adjusted odds ratio, .671; 95% confidence interval, .350-1.285). Frequencies of adverse events were not significantly different between the 2 groups. CONCLUSIONS: Initial choice of bedaquiline or delamanid did not make any significant difference in the final treatment outcome or the frequencies of adverse events among patients with multidrug-resistant/rifampicin-resistant tuberculosis.

Impact of Molecular Drug Susceptibility Testing on the Time to Multidrug-resistant Tuberculosis Treatment Initiation.

BACKGROUND: The purpose of this study was to evaluate the current status and trends in the coverage of molecular drug susceptibility testing (mDST), and the impact of mDST on the time to multidrug-resistant tuberculosis (MDR-TB) treatment initiation in Korea. METHODS: We included confirmed rifampin-resistant (RR)/MDR-TB patients who submitted application forms for novel drug uses to the National TB Expert Review Committee from September 1, 2016 to November 30, 2019. We retrospectively reviewed their medical records. RESULTS: Of the 621 MDR/RR-TB patients, mDST was performed in 442 (71.2%); Xpert MTB/RIF (Xpert) alone in 109 (17.6%), MTBDRplus line probe assay (LPA) alone in 199 (32.0%), and both Xpert and LPA in 134 (21.6%) patients. The coverage rate of mDST has gradually increased to 70% in 2015, 50.7% in 2016, 67.9% in 2017, 75.2% in 2018, and 79.4% in 2019 (P for trend < 0.001). Median time to MDR-TB treatment initiation was 35 days (interquartile range25-75 0-72), which has gradually decreased during the study period (P < 0.001). Independent predictors of shorter time to MDR-TB treatment initiation were retreatment case (adjusted hazard ratio [aHR], 1.30; 95% confidence interval [CI], 1.10-1.54), Xpert testing (aHR, 2.42; 95% CI, 2.03-2.88), and LPA testing (aHR, 1.83; 95% CI, 1.55-2.16). Transfer to another healthcare facility was inversely related to shorter time to treatment initiation (aHR, 0.74; 95% CI, 0.63-0.88). CONCLUSION: mDST coverage is gradually increasing and contributes to reducing the time to MDR-TB treatment initiation. Further efforts are needed to achieve universal access to mDST and to properly integrate mDST into routine clinical practice.

Electroplated Silver-Nickel Core-Shell Nanowire Network Electrodes for Highly Efficient Perovskite Nanoparticle Light-Emitting Diodes.

The low sheet resistance and high optical transparency of silver nanowires (AgNWs) make them a promising candidate for use as the flexible transparent electrode of light-emitting diodes (LEDs). In a perovskite LED (PeLED), however, the AgNW electrode can react with the overlying perovskite material by redox reactions, which limit the electroluminescence efficiency of the PeLED by causing the degradation of and generating defect states in the perovskite material. In this study, we prepared Ag-Ni core-shell NW electrodes using the solution-electroplating technique to realize highly efficient PeLEDs based on colloidal formamidinium lead bromide (FAPbBr3) nanoparticles (NPs). Solvated Ni ions from the NiSO4 source were deposited onto the surface of AgNW networks in three steps: (i) cathodic cleaning, (ii) adsorption of the Ni-ion complex onto the AgNW surface, and (iii) uniform electrodeposition of Ni. An ultrathin (∼3.5 nm) Ni layer was uniformly deposited onto the AgNW surface, which exhibited a sheet resistance of 16.7 Ω/sq and an optical transmittance of 90.2%. The Ag-Ni core-shell NWs not only increased the work function of the AgNW electrode, which facilitated hole injection into the emitting layer, but also suppressed the redox reaction between Ag and FAPbBr3 NPs, which prevented the degradation of the emitting layer and the generation of defect states in it. The resulting PeLEDs based on FAPbBr3 NPs with the Ag-Ni core-shell NWs showed high current efficiency of 44.01 cd/A, power efficiency of 35.45 lm/W, and external quantum efficiency of 9.67%.

Interim treatment outcomes in multidrug-resistant tuberculosis patients treated sequentially with bedaquiline and delamanid.

OBJECTIVES: The objective of this study was to evaluate the efficacy and safety of the sequential use of bedaquiline (Bdq) and delamanid (Dlm) in patients with multidrug-resistant tuberculosis (MDR-TB) and limited treatment options. METHODS: This study evaluated 74 MDR-TB patients treated between March 2016 and December 2018 with Bdq followed by Dlm (n = 22), or vice versa (n= 52), combined with optimized background regimens. RESULTS: The mean age of the participants was 49.0 ± 15.8 years. Fifty-one (68.9%) of the participants were male. Fluoroquinolone resistance was identified in 54 (72.9%) patients, including 20 (27.0%) with extensively drug-resistant TB. Of the 47 (63.5%) patients with positive cultures at the commencement of the first new drug, culture conversion occurred in 44 (93.6%). The interim treatment outcome after 12 months was favourable in 68/74 patients (91.9%). Twenty-four weeks of treatment were completed in 137 of 148 episodes of new drug use (92.3%). Regarding the 11 early discontinuation events, six patients stopped using a new drug due to adverse drug reactions that were not life-threatening, including one (1.4%) who stopped Bdq due to QT-prolongation. CONCLUSIONS: Sequential use of the two new drugs appears to be an effective and safe option for MDR-TB patients with few treatment options.

Interim treatment outcomes in multidrug-resistant tuberculosis using bedaquiline and/or delamanid in South Korea.

PURPOSE: The Korea Centers for Disease Control & Prevention has implemented a review process for the approval of new drugs used to treat patients with multidrug-resistant tuberculosis (MDR-TB) since September 2016. Therefore, this study aimed to evaluate the efficacy and safety of these new drugs bedaquiline (Bdq) and delamanid (Dlm). METHODS: A total of 318 patients with MDR-TB were reviewed by the committee from September 2016 to February 2018; 282 (88.7%) of them were treated with the new drugs (Bdq, 107 patients; Dlm, 108 patients; and both concurrently or sequentially, 67 patients) and retrospectively evaluated. Culture conversion rates, interim treatment outcomes at 12 months, and predictors of unfavorable outcomes were analyzed. Treatment efficacy was also compared between Bdq and Dlm. RESULTS: The mean age of the patients was 49.3 years, and 197 (69.9%) were male. Three patients were HIV seropositive and 151 (53.5%) were quinolone resistant. The culture conversion rates at 2 and 6 months were 57.4% (81/141) and 89.4% (126/141), respectively. A favorable outcome at 12 months was achieved in 84.8% of patients (239/282). Differences in the culture conversion rate or interim treatment outcomes were not statistically significant among the drug susceptibility test patterns or new drugs used. Multivariable analysis showed that age >60 years and body mass index of <18.5 kg/m2 were significant risk factors for unfavorable outcomes at 12 months. CONCLUSIONS: The use of new drugs resulted in satisfactory interim treatment results, without significant differences between them.

Roll-to-roll redox-welding and embedding for silver nanowire network electrodes.

We developed a continuous roll-to-roll redox-welding and embedding method for the fabrication of electrodes of silver nanowire (AgNWs) networks. The roll-to-roll welding method involved a sequence of oxidation and reduction reactions in an aqueous solution. The redox-welding significantly decreased the sheet resistance of the AgNW film owing to the strong fusion and interlocking at the nanowire junction, while the optical transmittance was maintained. The first oxidation step using HNO3 generated ionized silver (Ag+) which got re-deposited onto the nanowire junctions via an autocatalytic reaction. The oxide layers, which formed on the nanowire surface by both air exposure and the first step of oxidation, were removed by the second reduction step using NaBH4. The redox-welded AgNW electrodes exhibited a sheet resistance of 11.3 Ω sq-1 at the optical transmittance of 90.5% at 550 nm. Furthermore, redox-welding of the AgNWs significantly enhanced their mechanical robustness compared to that of the as-coated AgNWs. The redox-welded AgNWs embedded in a UV curable resin, using a roll-to-roll embedding process, were successfully applied as anode electrodes for large-area and flexible organic light emitting diodes (OLEDs). The device performance is superior to that of a device based on the as-coated AgNW electrode, and is also comparable to that of a device using commercial ITO as the electrode. The redox-welding and embedding processes provide a facile and reliable method for fabricating large-area transparent flexible electrodes for next-generation flexible optoelectronic devices.

Epitaxial-Growth-Induced Junction Welding of Silver Nanowire Network Electrodes.

In this study, we developed a roll-to-roll Ag electroplating process for metallic nanowire electrodes using a galvanostatic mode. Electroplating is a low-cost and facile method for deposition of metal onto a target surface with precise control of both the composition and the thickness. Metallic nanowire networks [silver nanowires (AgNWs) and copper nanowires (CuNWs)] coated onto a polyethylene terephthalate (PET) film were immersed directly in an electroplating bath containing AgNO3. Solvated silver ions (Ag+ ions) were deposited onto the nanowire surface through application of a constant current via an external circuit between the nanowire networks (cathode) and a Ag plate (anode). The amount of electroplated Ag was systematically controlled by changing both the applied current density and the electroplating time, which enabled precise control of the sheet resistance and optical transmittance of the metallic nanowire networks. The optimized Ag-electroplated AgNW (Ag-AgNW) films exhibited a sheet resistance of ∼19 Ω/sq at an optical transmittance of 90% (550 nm). A transmission electron microscopy study confirmed that Ag grew epitaxially on the AgNW surface, but a polycrystalline Ag structure was formed on the CuNW surface. The Ag-electroplated metallic nanowire electrodes were successfully applied to various electronic devices such as organic light-emitting diodes, triboelectric nanogenerators, and a resistive touch panel. The proposed roll-to-roll Ag electroplating process provides a simple, low-cost, and scalable method for the fabrication of enhanced transparent conductive electrode materials for next-generation electronic devices.

Interim outcomes of delamanid for the treatment of MDR- and XDR-TB in South Korea.

Objectives: Delamanid is a new anti-TB drug, but few data exist on its use outside clinical trials. The purpose of this study was to evaluate the efficacy as well as the safety and tolerability of a delamanid-containing regimen for 24 weeks in the treatment of MDR- and XDR-TB. Methods: We performed a retrospective cohort study among patients with MDR/XDR-TB who were treated with a delamanid-containing regimen in seven hospitals in South Korea. Results: A total of 32 patients with MDR-TB, of which 6 (18.8%) were XDR-TB, were included and all completed 24 weeks of delamanid treatment. Of 19 patients (59.4%) who had positive culture sputum at the initiation of delamanid treatment, the proportion of culture conversion at 8 weeks was 72.2% (13 of 18) in solid medium and 50.0% (7 of 14) in liquid medium. The proportion of culture conversion at 24 weeks was 94.4% (17 of 18) in solid medium and 92.9% (13 of 14) in liquid medium. The median time to culture conversion was 33 days (range = 5-81) using solid medium and 57 days (range = 8-96) using liquid medium. Of the 32 patients, there was no serious adverse event or death. Three patients developed a transient QTcF of > 500 ms. Conclusions: The use of delamanid combined with optimized background regimens has the potential to achieve high culture conversion rates at 24 weeks with an acceptable safety and tolerability profile in patients with MDR/XDR-TB.

Halide Welding for Silver Nanowire Network Electrode.

We developed a method of chemically welding silver nanowires (AgNWs) using an aqueous solution containing sodium halide salts (NaF, NaCl, NaBr, or NaI). The halide welding was performed simply by immersing the as-coated AgNW film into the sodium halide solution, and the resulting material was compared with those obtained using two typical thermal and plasmonic welding techniques. The halide welding dramatically reduced the sheet resistance of the AgNW electrode because of the strong fusion among nanowires at each junction while preserving the optical transmittance. The dramatic decrease in the sheet resistance was attributed to the autocatalytic addition of dissolved silver ions to the nanowire junction. Unlike thermal and plasmonic welding methods, the halide welding could be applied to AgNW films with a variety of deposition densities because the halide ions uniformly contacted the surface or junction regions. The optimized AgNW electrodes exhibited a sheet resistance of 9.3 Ω/sq at an optical transmittance of 92%. The halide welding significantly enhanced the mechanical flexibility of the electrode compared with the as-coated AgNWs. The halide-welded AgNWs were successfully used as source-drain electrodes in a transparent and flexible organic field-effect transistor (OFET). This simple, low-cost, and low-power consumption halide welding technique provides an innovative approach to preparing transparent electrodes for use in next-generation flexible optoelectronic devices.

Positively-charged reduced graphene oxide as an adhesion promoter for preparing a highly-stable silver nanowire film.

An ultrathin conductive adhesion promoter using positively charged reduced graphene oxide (rGO-NH3(+)) has been demonstrated for preparing highly stable silver nanowire transparent conductive electrodes (AgNW TCEs). The adhesion promoter rGO-NH3(+), spray coated between the substrate and AgNWs, significantly enhances the chemical and mechanical stabilities of the AgNW TCEs. Besides, the ultrathin thickness of the rGO-NH3(+) ensures excellent optical transparency and mechanical flexibility for TCEs. The AgNW films prepared using the adhesion promoter are extremely stable under harsh conditions, including ultrasonication in a variety of solvents, 3M Scotch tape detachment test, mechanical bending up to 0.3% strain, or fatigue over 1000 cycles. The greatly enhanced adhesion force is attributed to the ionic interactions between the positively charged protonated amine groups in rGO-NH3(+) and the negatively charged hydroxo- and oxo-groups on the AgNWs. The positively charged GO-NH3(+) and commercial polycationic polymer (poly allylamine hydrochloride) are also prepared as adhesion promoters for comparison with rGO-NH3(+). Notably, the closely packed hexagonal atomic structure of rGO offers better barrier properties to water permeation and demonstrates promising utility in durable waterproof electronics. This work offers a simple method to prepare high-quality TCEs and is believed to have great potential application in flexible waterproof electronics.

Prevalence of and risk factors for resistance to second-line drugs in people with multidrug-resistant tuberculosis in eight countries: a prospective cohort study.

BACKGROUND: The prevalence of extensively drug-resistant (XDR) tuberculosis is increasing due to the expanded use of second-line drugs in people with multidrug-resistant (MDR) disease. We prospectively assessed resistance to second-line antituberculosis drugs in eight countries. METHODS: From Jan 1, 2005, to Dec 31, 2008, we enrolled consecutive adults with locally confirmed pulmonary MDR tuberculosis at the start of second-line treatment in Estonia, Latvia, Peru, Philippines, Russia, South Africa, South Korea, and Thailand. Drug-susceptibility testing for study purposes was done centrally at the Centers for Disease Control and Prevention for 11 first-line and second-line drugs. We compared the results with clinical and epidemiological data to identify risk factors for resistance to second-line drugs and XDR tuberculosis. FINDINGS: Among 1278 patients, 43·7% showed resistance to at least one second-line drug, 20·0% to at least one second-line injectable drug, and 12·9% to at least one fluoroquinolone. 6·7% of patients had XDR tuberculosis (range across study sites 0·8-15·2%). Previous treatment with second-line drugs was consistently the strongest risk factor for resistance to these drugs, which increased the risk of XDR tuberculosis by more than four times. Fluoroquinolone resistance and XDR tuberculosis were more frequent in women than in men. Unemployment, alcohol abuse, and smoking were associated with resistance to second-line injectable drugs across countries. Other risk factors differed between drugs and countries. INTERPRETATION: Previous treatment with second-line drugs is a strong, consistent risk factor for resistance to these drugs, including XDR tuberculosis. Representative drug-susceptibility results could guide in-country policies for laboratory capacity and diagnostic strategies. FUNDING: US Agency for International Development, Centers for Disease Control and Prevention, National Institutes of Health/National Institute of Allergy and Infectious Diseases, and Korean Ministry of Health and Welfare.

Pulmonary resection combined with isoniazid- and rifampin-based drug therapy for patients with multidrug-resistant and extensively drug-resistant tuberculosis.

OBJECTIVE: To evaluate the clinical efficacy of pulmonary resection and postoperative use of a first-line drug regimen for patients with well-localized, cavitary pulmonary multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB). METHODS: This was a prospective case study set in the National Masan Tuberculosis Hospital in Masan, Republic of Korea. From February 1998 to May 2004, 19 patients with well-localized, cavitary pulmonary MDR-TB or XDR-TB were enrolled and followed prospectively through April 2007. After radical surgical resection, patients were treated with anti-tuberculous therapy consisting of isoniazid (H), rifampin (R), ethambutol (E), pyrazinamide (Z), and streptomycin (S) (3HREZS/3HRES/6HRE). RESULTS: All recovered isolates of Mycobacterium tuberculosis were resistant to isoniazid and rifampin, and to a mean of 4.7 anti-tuberculous drugs (range 2-8 drugs). Seventeen patients had MDR-TB and two had XDR-TB. Surgical procedures included: lobectomy (14 patients), lobectomy plus segmentectomy or wedge resection (four patients), and pneumonectomy (one patient). The median time to postoperative sputum smear and culture conversion was 2 days (range 1-23 days). Fifteen (78.9%) subjects, including both with XDR-TB, had durable cures (mean follow-up period 53.2 months). One patient failed to convert her sputum and was successfully switched to second-line therapy. Another patient developed active disease again 68 months after cure, likely due to re-infection with a new M. tuberculosis strain. Two patients were lost to follow-up after hospital discharge. CONCLUSION: Resectional lung surgery combined with isoniazid- and rifampin-based anti-tuberculous chemotherapy can be an effective treatment strategy for patients with well-localized, cavitary pulmonary MDR-TB and XDR-TB.

Allergens causing atopic diseases in canine.

Canine atopic skin disease is seasonal or sometimes non-seasonal immune-mediated skin disease which occurs commonly in Korea. The definite clinical sign is systemic pruritus, especially on periocular parts, external ear, interdigit spaces and lateral flank. For diagnosis of this dermatitis, complete history taking followed by intradermal skin test and serum in vitro IgE test needs to be performed. Allergen selection for the diagnosis and treatment of atopic dermatitis should be varied geographically. In this study, with intradermal skin test(IDST) the prevalence of atopic disease and what allergens are involved in are researched. Allergens used for IDST included 26 allergen extracts from six allergen groups: grasses, trees, weeds, molds, epidermal allergens and environmental allergens. The number of allergens was 42 in which the positive and negative controls are included. The most common positive allergen reaction was the house dust mites on IDST(22/35, 63%). The other positive allergen reactions were to flea(3/35, 9%), molds(1/35, 3%), house dusts(2/35, 6%), feathers (1/35, 3%), cedar/juniper(1/35, 3%), timothy grass(1/35, 3%) and dandelion(1/35, 3%). In this study, the most prevalent allergen causing atopic dermatitis in dogs in Korea was the house dust mites followed by the flea.