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1.
Ann Lab Med ; 42(2): 249-257, 2022 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-34635616

RESUMEN

Background: Non-invasive clinical algorithms for the detection of liver fibrosis (LF) can reduce the need for liver biopsy (LB). We explored the implementation of two serum biomarkers, enhanced liver fibrosis (ELF) and Mac-2 binding protein glycosylation isomer (M2BPGi), in clinical algorithms for LF in chronic hepatitis B (CHB) patients. Methods: Two clinical algorithms were applied to 152 CHB patients: (1) transient elastography (TE) followed by biomarkers (TE/ELF and TE/M2GPGi); (2) biomarker test followed by TE (ELF/TE and M2BPGi/TE). Using the cut-off value or index for the detection of advanced LF (TE≥F3; 9.8 in ELF and 3.0 in M2BPGi), LB was expected to be performed in cases with discordant TE and biomarker results. Results: In both algorithms, the expected number of LBs was lower when using M2BPGi than when using ELF (TE/ELF or ELF/TE, 13.2% [N=20]; TE/M2BPGi or M2BPGi/TE, 9.9% [N=15]), although there was no statistical difference (P=0.398). In the TE low-risk group (TE≤F2), the discordance rate was significantly lower in the TE/M2BPGi approach than in the TE/ELF approach (1.5% [2/136] vs. 11.0% [15/136], P=0.002). In the biomarker low-risk group, there was no significant difference between the ELF/TE and M2BPGi/TE approaches (3.9% [5/126] vs. 8.8% [13/147], P=0.118). Conclusions: Both ELF and M2BPGi can be implemented in non-invasive clinical algorithms for assessing LF in CHB patients. Given the lowest possibility of losing advanced LF cases in the low-risk group when using the TE/M2BPGi approach, this combination seems useful in clinical practice.

2.
Ann Lab Med ; 42(1): 24-35, 2022 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-34374346

RESUMEN

Background: Laboratory parameter abnormalities are commonly observed in COVID-19 patients; however, their clinical significance remains controversial. We assessed the prevalence, characteristics, and clinical impact of laboratory parameters in COVID-19 patients hospitalized in Daegu, Korea. Methods: We investigated the clinical and laboratory parameters of 1,952 COVID-19 patients on admission in nine hospitals in Daegu, Korea. The average patient age was 58.1 years, and 700 (35.9%) patients were men. The patients were classified into mild (N=1,612), moderate (N=294), and severe (N=46) disease groups based on clinical severity scores. We used chi-square test, multiple comparison analysis, and multinomial logistic regression to evaluate the correlation between laboratory parameters and disease severity. Results: Laboratory parameters on admission in the three disease groups were significantly different in terms of hematologic (Hb, Hct, white blood cell count, lymphocyte%, and platelet count), coagulation (prothrombin time and activated partial thromboplastin time), biochemical (albumin, aspartate aminotransferase, alanine aminotransferase, lactate, blood urea nitrogen, creatinine, and electrolytes), inflammatory (C-reactive protein and procalcitonin), cardiac (creatinine kinase MB isoenzyme and troponin I), and molecular virologic (Ct value of SARS-CoV-2 RdRP gene) parameters. Relative lymphopenia, prothrombin time prolongation, and hypoalbuminemia were significant indicators of COVID-19 severity. Patients with both hypoalbuminemia and lymphopenia had a higher risk of severe COVID-19. Conclusions: Laboratory parameter abnormalities on admission are common, are significantly associated with clinical severity, and can serve as independent predictors of COVID-19 severity. Monitoring the laboratory parameters, including albumin and lymphocyte count, is crucial for timely treatment of COVID-19.


Asunto(s)
COVID-19 , Análisis de Datos , Humanos , Laboratorios , Masculino , Persona de Mediana Edad , República de Corea/epidemiología , Estudios Retrospectivos , SARS-CoV-2
3.
Mycopathologia ; 186(1): 15-26, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33180204

RESUMEN

With the increasing number of fungal infections and immunocompromised patients, rapid and accurate fungal identification is required in clinical microbiology laboratories. We evaluated the applicability of matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) system, MicroIDSys Elite (ASTA Corp., South Korea) for the identification of medically important filamentous fungi. A total of 505 strains comprising 37 genera and 90 species collected from 11 Korean hospitals were sent to the microbiology laboratory of International St. Mary's Hospital. All isolates were tested using MicroIDSys Elite, and data were analyzed using the MoldDB v.1.22 database (ASTA). Correct identification rates were compared with the multigene sequencing results. MicroIDSys Elite correctly identified 86.5% (437/505) and 88.9% (449/505) of all tested isolates at the species and genus level, respectively. About 98.2% of Aspergillus isolates were identified at the species level, including cryptic and rare species of A. calidoustus, A. tamarii, A. lentulus, A. versicolor and A. aculeatus. MicroIDSys Elite identified 75.0% of basidiomycetes, including Schizophyllum commune, and 84.3% of the dermatophytes. It also distinguished Sprothrix globosa at the species level. The mean scores of total isolates corresponding to correct species identification were significantly higher than those obtained for genus-level identification (253.5 ± 50.7 vs. 168.6 ± 30.3, P < 0.001). MicroIDSys Elite showed high accuracy for the identification of filamentous fungi, including cryptic and rare Aspergillus species. It is suitable for use in clinical laboratories as a rapid and efficient tool for clinical mold identification. Further evaluations are recommended for MicroIDSys Elite as a rapid and efficient tool for the identification of medically important filamentous fungi.

4.
J Microbiol Methods ; 174: 105960, 2020 07.
Artículo en Inglés | MEDLINE | ID: mdl-32442656

RESUMEN

Real-time PCR tests have been widely used to detect mycobacterial infection. The quality of extracted DNA is crucial for obtaining accurate results of the real-time PCR tests, and automated extraction methods are faster and more effective than manual extraction. The novel Real-Prep automated extraction system has not yet been verified by direct comparisons to existing methods. In this study, we compared it with manual extraction, and the Nextractor system, an automated extraction method commonly used in Korea. From August to December 2018, 238 specimens, including sputum, bronchial washing, pericardial fluid, bronchial aspiration, pleural fluid, and closed pus samples, were collected and examined at Yeungnam University Hospital. After decontamination, smear microscopy, and culturing, DNA was extracted using the three methods. The DNA extraction efficiency (total amount of DNA [ng]/input specimen volume [µL]) and purity (A260/280 ratio), which indicates the presence of contaminants, were compared. Real-time PCR tests were conducted using the DNA extracted by each method. The cycle threshold, which is inversely related to the initial amount of mycobacterial DNA, and the percentage agreement between the PCR results of the three methods were evaluated. Our study revealed that the DNA extraction efficiency of the Real-Prep system was higher than that of manual extraction. There was no significant difference in DNA purity between the methods, and the percentage agreement for Mycobacterium tuberculosis and non-tuberculous mycobacteria among all three methods was almost perfect. The performance of the Real-Prep system was similar to that of the Nextractor system and superior to that of manual extraction. The Real-Prep system, a new automated nucleic acid extraction device, has a clear benefit because of its relative speed and low hands-on time. Therefore, the Real-Prep system is a useful substitute for manual DNA extraction, which has the potential to reduce workloads in laboratories and as a sensitive non-tuberculous mycobacteria detection method throughout the world.

5.
Exp Clin Transplant ; 18(1): 19-26, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31615382

RESUMEN

OBJECTIVES: Hepatic ischemia-reperfusion injury and transfusion of red blood cells in liver surgery are wellknown risk factors to induce acute tubular injury. Transfusion of stored red blood cells may affect hepatic ischemia-reperfusion injury-induced acute tubular injury. Here, we hypothesized whether preischemic (due to increased severity of hepatic injury) and postischemic (due to renal uptake of free heme and iron) transfusion of stored red blood cells may potentiate acute tubular injury in rats subjected to hepatic ischemia-reperfusion injury. MATERIALS AND METHODS: Sprague Dawley rats (n = 24) were divided into 4 groups: sham operation (sham group), hepatic ischemia-reperfusion injury only (injury-only group), red blood cell transfusion before hepatic ischemia-reperfusion injury (preinjury transfusion group), and red blood celltransfusion after hepatic ischemia-reperfusion injury (postinjury transfusion group). Partial hepatic ischemia was induced for 90 minutes, with reperfusion allowed for 12 hours. Hepatic and renal tubular injury markers, renal mRNA levels of oxidant stress markers, and inflammatory markers were assessed. Renal cortex samples were examined under hematoxylin and eosin staining for tubular histopathologic score and immunohistochemical staining forinflammatory cells. RESULTS: With regard to hepatic and renal tubular injury markers, serum alanine aminotransferase, serum urea nitrogen, and histopathologic scores were increased in the preinjury and postinjury transfusion groups versus injury-only group, with moderate to strong correlation between alanine aminotransferase and tubular injury markers. Renal oxidative stress markers (heme oxygenase-1 and neutrophil gelatinaseassociated lipocalin) were correlated with increased alanine aminotransferase, with upregulation of oxidant stress markers in the preinjury transfusion group versus sham group (all markers), as well as in the injury-only and postinjury transfusion groups (heme oxygenase-1 only). We observed no changes in renal inflammatory responses among the groups. CONCLUSIONS: Preischemic transfusion potentiated acute tubular injury without triggering renal inflammatory responses. Exacerbation of hepatic injury may induce acute tubular injury via renal oxidant stress.

6.
Ann Lab Med ; 39(6): 537-544, 2019 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31240881

RESUMEN

BACKGROUND: Several factors contribute to differences in Streptococcus pneumoniae serotype distribution. We investigated the serotype distribution and antimicrobial resistance of S. pneumoniae isolated between 2014 and 2016 in Korea. METHODS: We collected a total of 1,855 S. pneumoniae isolates from 44 hospitals between May 2014 and May 2016, and analyzed the serotypes by sequential multiplex PCR. We investigated the distribution of each serotype by patient age, source of the clinical specimen, and antimicrobial resistance pattern. RESULTS: The most common serotypes were 11A (10.1%), followed by 19A (8.8%), 3 (8.5%), 34 (8.1%), 23A (7.3%), and 35B (6.2%). The major invasive serotypes were 3 (12.6%), 19A (7.8%), 34 (7.8%), 10A (6.8%), and 11A (6.8%). Serotypes 10A, 15B, 19A, and 12F were more common in patients ≤5 years old, while serotype 3 was more common in patients ≥65 years old compared with the other age groups. The coverage rates of pneumococcal conjugate vaccine (PCV)7, PCV10, PCV13, and pneumococcal polysaccharide vaccine 23 were 11.8%, 12.12%, 33.3%, and 53.6%, respectively. Of the 1,855 isolates, 857 (46.2%) were multi-drug resistant (MDR), with serotypes 11A and 19A predominant among the MDR strains. The resistance rates against penicillin, cefotaxime, and levofloxacin were 22.8%, 12.5%, and 9.4%, respectively. CONCLUSIONS: There were significant changes in the major S. pneumoniae serotypes in the community. Non-PCV13 serotypes increased in patients ≤5 years old following the introduction of national immunization programs with the 10- and 13-polyvalent vaccines.


Asunto(s)
Antibacterianos/farmacología , Farmacorresistencia Bacteriana Múltiple/genética , Streptococcus pneumoniae/genética , Adolescente , Adulto , Anciano , Niño , ADN Bacteriano/genética , ADN Bacteriano/metabolismo , Farmacorresistencia Bacteriana Múltiple/efectos de los fármacos , Femenino , Hospitales , Humanos , Masculino , Persona de Mediana Edad , Reacción en Cadena de la Polimerasa Multiplex , República de Corea , Serogrupo , Streptococcus pneumoniae/efectos de los fármacos , Streptococcus pneumoniae/aislamiento & purificación , Adulto Joven
7.
Clin Lab ; 64(7): 1323-1326, 2018 Jul 01.
Artículo en Inglés | MEDLINE | ID: mdl-30146837

RESUMEN

BACKGROUND: IMP-4 class B metallo-ß-lactamase-producing Enterobacteriaceae are resistant to carbapenems. The aim of this study was to characterize of IMP-4 metallo-ß-lactamase (MBL)-producing Enterobacter aerogenes clinical isolate. METHODS: IMP-4 MBL-producing E. aerogenes clinical isolate was collected from a Korean Hospital in 2017. Antimicrobial susceptibility was determined by disk diffusion methods. Further, minimum inhibitory concentrations of ß-lactams were determined by Etest. Detection of bla genes was performed by PCR. The genetic organization of class 1 integron carrying the MBL gene cassette was investigated by PCR mapping and sequencing. RESULTS: E. aerogenes strain YN170501 exhibited resistance to penicillins, cephalosporins, and carbapenems and was susceptible to monobactam, aminoglycosides, fluoroquinolone, tigecycline, and trimethoprim-sulfamethoxazole. The blaIMP-4 gene was located in class 1 integron. CONCLUSIONS: The blaIMP-4 gene has never been reported in Enterobacter aerogenes clinical isolate from Korea.


Asunto(s)
Carbapenémicos/farmacología , Farmacorresistencia Bacteriana Múltiple/efectos de los fármacos , Enterobacter aerogenes/enzimología , beta-Lactamasas/metabolismo , Anciano , Anciano de 80 o más Años , Antibacterianos/farmacología , Farmacorresistencia Bacteriana Múltiple/genética , Enterobacter aerogenes/genética , Enterobacter aerogenes/fisiología , Infecciones por Enterobacteriaceae/microbiología , Femenino , Hospitales , Humanos , Integrones/genética , Masculino , Pruebas de Sensibilidad Microbiana , República de Corea , Análisis de Secuencia de ADN , beta-Lactamasas/genética
8.
J Surg Res ; 222: 26-33, 2018 02.
Artículo en Inglés | MEDLINE | ID: mdl-29273372

RESUMEN

BACKGROUND: Hepatic innate immune cells are considered to play a central role in the early phase of hepatic ischemia reperfusion (IR) injury. Transfusion of old red blood cells (RBCs) is known to prime immune cells, and transfusion before IR may exacerbate liver injury because of the expected hyperresponsiveness of immune cells. MATERIALS AND METHODS: Twenty-four Sprague-Dawley rats were divided into four groups: sham operation (Sham); hepatic IR only (IR Control); and two transfusion groups, preischemic (Pre-T) and postischemic (Post-T), in which allogeneic RBCs stored for 2 weeks were transfused before hepatic IR or after reperfusion, respectively. Partial hepatic ischemia was induced for 90 min, and reperfusion was allowed for 120 min. Serum alanine transaminase levels, area of necrosis, and apoptotic cells were then assessed. Inflammatory (tumor necrosis factor alpha, interleukin 1 beta [IL-1ß], IL-6, IL-10, and cyclooxygenase 2) and oxidative mediators (heme oxygenase 1, superoxide dismutase, and glutathione peroxidase 1) were assessed for elucidating the relevant mechanisms underlying the hepatic injury. RESULTS: Pre-T, but not Post-T, showed increased serum alanine transaminase levels than IR Control (P < 0.05). Area of necrosis was more severe in Pre-T than in IR Control or Post-T (P < 0.01), and apoptotic cells were also more abundant in Pre-T than in IR Control (P < 0.01). tumor necrosis factor alpha and IL-6 levels were higher in Pre-T than in IR Control or Post-T (P < 0.05), with no significant difference in cytoprotective protein levels. CONCLUSIONS: Preischemic transfusion of old RBCs aggravated hepatic injury. Inflammatory cytokines seemed to play a crucial role in liver injury exacerbation. Our results indicate that transfusion before hepatic ischemia may be detrimental.


Asunto(s)
Transfusión de Eritrocitos/efectos adversos , Insuficiencia Hepática/inmunología , Daño por Reperfusión/inmunología , Animales , Antioxidantes/metabolismo , Senescencia Celular/inmunología , Eritrocitos/inmunología , Inmunidad Innata , Interleucina-10/metabolismo , Interleucina-6/metabolismo , Hígado/inmunología , Hígado/metabolismo , Masculino , Ratas Sprague-Dawley , Factor de Necrosis Tumoral alfa/metabolismo
9.
Blood Res ; 52(3): 167-173, 2017 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-29043231

RESUMEN

BACKGROUND: Invasive fungal infections (IFIs) are a life-threatening problem in immunocompromised patients. Despite timely diagnosis and appropriate antifungal therapy, clinical outcomes of IFIs remain unsatisfactory, necessitating treatment with a combination of antifungal agents. Therefore, childhood leukemic patients treated with voriconazole plus caspofungin were evaluated for the safety and efficacy of the combination antifungal therapy to treat IFIs. METHODS: In this retrospective study, medical records were retrieved for patients admitted to the Pediatric Department of Yeungnam University Hospital, Daegu, South Korea, between April 2009 and May 2013. Medical records of 22 patients were analyzed. RESULTS: Of the 22 patients studied, nine (41%) had been diagnosed with probable IFI, and 13 (59%) with possible IFI. All patients, except one, were already receiving antifungal monotherapy for the treatment of neutropenic fever. After a diagnosis of IFI was confirmed, antifungal monotherapy was replaced with combination therapy. The study's overall response rate was 90.9%, with complete responses in 86.3% of the patients. Two patients experienced a side effect of a small increase in liver enzyme levels. CONCLUSION: Voriconazole plus caspofungin combination therapy is an effective and safe treatment for serious IFI in pediatric patients with acute leukemia.

10.
Ann Clin Lab Sci ; 47(3): 328-333, 2017 May.
Artículo en Inglés | MEDLINE | ID: mdl-28667036

RESUMEN

Rotavirus is the most common cause of severe infectious diarrhea worldwide in children under 5 years of age. We have evaluated the performance of multiplex PCR [Seeplex® Diarrhea-V ACE Detection (V2.0) Kit] (the version 2.0 kit) for detecting rotaviruses in human stool specimens, in a comparison with ELISA (RIDASCREEN®) and the older Seeplex kit, namely Seeplex® Diarrhea-V ACE Detection Kit (the original kit). A total of 173 stool specimens, previously tested for rotavirus infection by ELISA from May 2014 to March 2016, were subjected to the two Seeplex® kits. The positive rate for the detection of rotavirus was 46.2% (80/173) by the version 2.0 kit. As compared with ELISA, the agreement rate of the original kit and the version 2.0 kit was 64.2% (positive agreement rate 23.1%, negative agreement rate 97.9%) and 97.7% (positive agreement rate 98.7%, negative agreement rate 96.8%), respectively. The agreement rate between the original kit and the version 2.0 kit was 65.3%. Thus, the Seeplex® Diarrhea-V ACE Detection (V2.0) Kit showed acceptable clinical performance and could be useful for detecting rotavirus infection with a performance superior to the original kit using the ELISA as the comparator.


Asunto(s)
Heces/virología , Gastroenteritis/virología , Infecciones por Rotavirus/diagnóstico , Adolescente , Niño , Preescolar , Ensayo de Inmunoadsorción Enzimática , Femenino , Humanos , Lactante , Recién Nacido , Masculino , Juego de Reactivos para Diagnóstico , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa/métodos , Rotavirus/genética , Rotavirus/patogenicidad
11.
Ann Lab Med ; 37(3): 231-239, 2017 May.
Artículo en Inglés | MEDLINE | ID: mdl-28224769

RESUMEN

BACKGROUND: National surveillance of antimicrobial resistance becomes more important for the control of antimicrobial resistance and determination of treatment guidelines. We analyzed Korean Antimicrobial Resistance Monitoring System (KARMS) data collected from 2013 to 2015. METHODS: Of the KARMS participants, 16 secondary or tertiary hospitals consecutively reported antimicrobial resistance rates from 2013 to 2015. Data from duplicate isolates and institutions with fewer than 20 isolates were excluded. To determine the long-term trends, previous KARMS data from 2004 to 2012 were also considered. RESULTS: The prevalence of methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococcus faecium from 2013 to 2015 was 66-72% and 29-31%, respectively. The resistance rates of Escherichia coli to cefotaxime and cefepime gradually increased to 35% and 31%, respectively, and fluoroquinolone resistance reached 48% in 2015. The resistance rates of Klebsiella pneumoniae to cefotaxime, cefepime, and carbapenem were 38-41%, 33-41%, and <0.1-2%, respectively, from 2013 to 2015. The carbapenem susceptibility rates of E. coli and K. pneumoniae decreased from 100% and 99.3% in 2011 to 99.0% and 97.0% in 2015, respectively. The resistance rate of Pseudomonas aeruginosa to carbapenem increased to 35% and the prevalence of carbapenem-resistant Acinetobacter baumannii increased from 77% in 2013 to 85% in 2015. CONCLUSIONS: Between 2013 and 2015, the resistance rates of E. coli to third- and fourth-generation cephalosporins increased continuously, while carbapenem-susceptibility gradually decreased, particularly in K. pneumoniae. The prevalence of carbapenem-resistant P. aeruginosa and A. baumannii increased significantly; therefore, few treatment options remain for these resistant strains.


Asunto(s)
Antibacterianos/farmacología , Farmacorresistencia Bacteriana , Bacterias Gramnegativas/efectos de los fármacos , Klebsiella pneumoniae/efectos de los fármacos , Grupo de Ascendencia Continental Asiática , Carbapenémicos/farmacología , Cefalosporinas/farmacología , Bases de Datos Factuales , Fluoroquinolonas/farmacología , Bacterias Gramnegativas/aislamiento & purificación , Bacterias Grampositivas/efectos de los fármacos , Bacterias Grampositivas/aislamiento & purificación , Humanos , Klebsiella pneumoniae/aislamiento & purificación , Pruebas de Sensibilidad Microbiana , República de Corea , Centros de Atención Secundaria , Centros de Atención Terciaria
12.
Front Microbiol ; 8: 2343, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-29326660

RESUMEN

The worldwide dissemination of carbapenemase-producing Enterobacteriaceae (CPE) has become a major therapeutic concern in clinical settings. Enterobacter cloacae is a major pathogen that causes serious hospital-acquired infections. We investigated the clinical characteristics and molecular mechanisms of the first IMP-4-producing E. cloacae clinical isolates in Korea. Five carbapenemase-producing E. cloacae strains out of 792 E. cloacae clinical isolates, which have been identified at a university hospital in Korea between March 2014 and February 2016, were included in this study. Antimicrobial susceptibilities to imipenem, meropenem, and ertapenem were tested using E-test. Carbapenemase determinant screening, genetic environment, and multilocus sequence typing were conducted using PCR and sequencing analysis. All isolates were not susceptible to at least one of the tested carbapenems and presented highly similar pulsed-field gel electrophoresis (PFGE) patterns, evidencing hospital-wide clonal dissemination. Among all isolates harboring the blaIMP-4 carbapenemase gene, four isolates identified as predominant ST74, also contained blaCMY-2. One strain, designated as rare ST194, carried blaCMY-1. The E. cloacae strain, harboring both blaIMP-4 and blaCMY-1, was resistant to all three tested carbapenems. The blaIMP-4 gene was located on a highly mobile class 1 integron, showing a new form of the blaIMP-4-qacG-aacA4 array. This is the first description of IMP-4-producing E. cloacae strains in Korea. This observation implicates the widespread of blaIMP-4 in Enterobacteriaceae clinical isolates and provides insights into the epidemic potential and clinical therapeutic importance of IMP-4-producing E. cloacae for healthcare-associated infections.

13.
Jpn J Infect Dis ; 66(4): 284-9, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-23883837

RESUMEN

The study aimed to investigate the prevalence of various serotypes and extended-spectrum ß-lactamase-producing features of Salmonella strains and to determine the antimicrobial susceptibility of 256 Salmonella strains other than Salmonella serotype Typhi, which were isolated at 12 university hospitals in Korea. We identified 46 serotypes of Salmonella spp. Serogroup D was the most common (39.5%), followed by B (32.4%), C (22.7%), E (2.7%), A (2.3%), and G (0.4%). The three most common Salmonella serotypes were Enteritidis (36.3%), Typhimurium (16.8%), and Infantis (7.8%). Six strains that belonged to serotype Paratyphi A and nine that belonged to serotype Paratyphi B were also detected. The 256 Salmonella strains had a 38.7% rate of resistance to ampicillin, 23.0% to chloramphenicol, 8.2% to cefotaxime, 8.6% to ceftriaxone, and 6.3% to trimethoprim-sulfamethoxazole. The antimicrobial resistance rates of Salmonella serogroups B and D were higher than those of the other serogroups. Seven isolates carried blaCTX-M: four CTX-M-15, two CTX-M-14, and one CTX-M-3.


Asunto(s)
Antibacterianos/farmacología , Infecciones por Salmonella/microbiología , Salmonella/clasificación , Salmonella/efectos de los fármacos , Farmacorresistencia Bacteriana , Hospitales Universitarios , Humanos , Pruebas de Sensibilidad Microbiana , Reacción en Cadena de la Polimerasa , Prevalencia , República de Corea/epidemiología , Salmonella/aislamiento & purificación , Infecciones por Salmonella/epidemiología , Serotipificación , beta-Lactamasas/genética
14.
Microb Drug Resist ; 17(4): 507-12, 2011 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-21830908

RESUMEN

The aims of the current study were to investigate the prevalence and molecular characteristics of plasmid-mediated quinolone resistance (PMQR) genes from colonizing fecal organisms and to compare the incidence and subtype of these genes according to bacterial species and hospital at five tertiary-care hospitals in Korea. A total of 500 nonduplicated clinical isolates of Enterobacteriaceae were obtained from fecal specimens at five tertiary-care hospitals between March and May 2008. The PMQR genes (qnrA, qnrB, qnrS, aac(6')-Ib-cr, and qepA) were amplified by PCR and confirmed by direct sequencing of the PCR products. A total of 83 (16.6%) qnr-positive isolates were detected. The prevalence rates of qnrA, qnrB, and qnrS were 1.4%, 13.6%, and 1.6%, respectively. The species distributions of qnrB-positive isolates were Klebsiella pneumoniae (37/109; 33.9%), Citrobacter freundii (10/34; 29.4%), Citrobacter braakii (8/13; 61.5%), and Escherichia coli (8/275; 2.9%). Sixteen subtypes of qnrB were detected, including seven novel variants. The prevalences of aac(6')-Ib-cr and qepA were 15.6% (n=78) and 0.6% (n=3), respectively. The aac(6')-Ib-cr gene was detected in 39 (47.0%) of 83 qnr-positive isolates and 39 (9.4%) of 417 qnr-negative isolates There was one qepA variant containing a novel mutation (Ala231Val). The prevalence of PMQR genes was high in Enterobacteriaceae from stool specimens in Korea, and there was a close relation between qnr and aac(6')-Ib-cr.


Asunto(s)
Farmacorresistencia Bacteriana/genética , Infecciones por Enterobacteriaceae/epidemiología , Enterobacteriaceae/aislamiento & purificación , Heces/microbiología , Plásmidos/genética , Quinolonas/farmacología , Antibacterianos/farmacología , Proteínas Bacterianas/genética , Conjugación Genética , Enterobacteriaceae/clasificación , Enterobacteriaceae/efectos de los fármacos , Enterobacteriaceae/genética , Infecciones por Enterobacteriaceae/microbiología , Hospitales Universitarios , Humanos , Pruebas de Sensibilidad Microbiana , Reacción en Cadena de la Polimerasa , República de Corea/epidemiología
15.
Microb Drug Resist ; 17(4): 551-7, 2011 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-21830947

RESUMEN

BACKGROUND: The aim of this study was to investigate the prevalence of plasmid-mediated quinolone resistance (PMQR) and mutations in quinolone resistance-determining regions (QRDRs) of Salmonella and their association with fluoroquinolone susceptibility in Korea. METHODS: A total of 284 nonduplicated clinical isolates of Salmonella were collected from various clinical specimens at 12 tertiary-care hospitals in Korea. The qnrA, qnrB, and qnrS genes were detected by multiplex polymerase chain reaction (PCR). The qepA and aac(6')-Ib-cr genes were amplified by PCR. The QRDRs of gyrA, gyrB, parC, and parE were amplified by PCR from the DNA of selected nalidixic acid-resistant and qnr-positive isolates. RESULTS: We detected six qnr-positive Salmonella (four qnrS1 and two qnrB19) and one aac(6')-Ib-cr-positive strain. A mutation in the QRDR of gyrA only (N=46) was the most common, followed by gyrA+parC (N=9), parC (N=7), gyrA+parE (N=3), parC+parE (N=3), gyrA+gyrB (N=2), and parE (N=1). There were seven novel mutations in the QRDR regions of gyrB, parC, and parE. Six of seven PMQR-positive isolates had high-level resistance to nalidixic acid, and all six strains had reduced susceptibility to ciprofloxacin. One qnrS1-positive isolate was resistant to ciprofloxacin, norfloxacin, and nalidixic acid. The resistant rates to nalidixic acid, ciprofloxacin, norfloxacin, and levofloxacin were 49.3%, 1.1%, 0.7%, and 0.4%, respectively. CONCLUSION: We report the first detection of PMQR in Salmonella isolates from Korea. It is essential to continue surveillance and to watch for the spread of PMQR in Salmonella for public health control.


Asunto(s)
Girasa de ADN/genética , Topoisomerasa de ADN IV/genética , Farmacorresistencia Bacteriana/genética , Mutación/genética , Plásmidos/genética , Quinolonas/farmacología , Infecciones por Salmonella/epidemiología , Salmonella/efectos de los fármacos , Antibacterianos/farmacología , Proteínas Bacterianas , Conjugación Genética , Fluoroquinolonas/farmacología , Hospitales Universitarios , Humanos , Pruebas de Sensibilidad Microbiana , Prevalencia , República de Corea/epidemiología , Salmonella/enzimología , Salmonella/genética , Salmonella/aislamiento & purificación , Infecciones por Salmonella/microbiología , Salmonella typhimurium/efectos de los fármacos , Salmonella typhimurium/enzimología , Salmonella typhimurium/genética , Salmonella typhimurium/aislamiento & purificación
16.
Diagn Microbiol Infect Dis ; 71(2): 171-3, 2011 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-21840672

RESUMEN

A total of 49 consecutive nonduplicate Salmonella isolates collected in a nationwide survey performed in 2009 in Korea were included in this study. Resistance gene, sizes, and replicon sequence types (RSTs) of R plasmids, and sequence types (STs) and XbaI-macrorestriction patterns of extended-spectrum ß-lactamase (ESBL)-producing isolates were determined. Six Salmonella enterica serovar Enteritidis isolates of ST11 showed ESBL phenotypes, and the isolates harbored an incompatibility group FII plasmid of RST S1:A-:B- carrying the bla(CTX-M-15) gene.


Asunto(s)
Plásmidos/genética , Salmonella enteritidis/genética , beta-Lactamasas/genética , ADN Bacteriano/genética , Electroforesis en Gel de Campo Pulsado/métodos , Genes Bacterianos , Sitios Genéticos , Humanos , Pruebas de Sensibilidad Microbiana/métodos , Replicón , República de Corea , Salmonella enteritidis/clasificación , Análisis de Secuencia de ADN
17.
J Antimicrob Chemother ; 66(6): 1263-8, 2011 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-21415040

RESUMEN

OBJECTIVES: The purpose of this study was to investigate the molecular epidemiology of CTX-M-14-producing Escherichia coli clinical isolates from Korea. METHODS: A total of 138 non-duplicate E. coli clinical isolates showing reduced susceptibility or resistance to ceftazidime and/or cefotaxime were included in the study. Resistance genes, genetic environment, R plasmid size and replicon type, sequence type (ST) and XbaI-macrorestriction patterns were determined. RESULTS: Among 138 isolates, 35 were found to carry the bla(CTX-M-14) gene. The ISEcp1 element was identified in the upstream region of the bla(CTX-M-14) gene in 32 isolates. The bla(CTX-M-14) gene was located on an IncF plasmid in 21 isolates, on an IncA/C plasmid in 1 isolate, on the chromosome in 8 isolates and on both the chromosome and an IncF plasmid in 5 isolates. The most prevalent ST was ST405 (n = 8), followed by ST354 (n = 4), ST38 (n = 3), ST69 (n = 3) and the intercontinental ST, ST131 (n = 3). PFGE and multilocus sequence typing experiments demonstrated no major clonal relationship among the CTX-M-14-producing isolates. CONCLUSIONS: The bla(CTX-M-14) gene was probably mobilized by IncF plasmids, which can readily spread in E. coli, causing horizontal dissemination of the resistance gene in Korea.


Asunto(s)
Infecciones por Escherichia coli/epidemiología , Infecciones por Escherichia coli/microbiología , Escherichia coli/enzimología , Escherichia coli/aislamiento & purificación , Plásmidos , beta-Lactamasas/genética , Antibacterianos/farmacología , Técnicas de Tipificación Bacteriana , Cefotaxima/farmacología , Ceftazidima/farmacología , ADN Bacteriano/química , ADN Bacteriano/genética , ADN Bacteriano/metabolismo , Desoxirribonucleasas de Localización Especificada Tipo II/metabolismo , Escherichia coli/clasificación , Escherichia coli/genética , Transferencia de Gen Horizontal , Corea (Geográfico)/epidemiología , Epidemiología Molecular , Datos de Secuencia Molecular , Tipificación Molecular , Polimorfismo de Longitud del Fragmento de Restricción , Análisis de Secuencia de ADN , Resistencia betalactámica
18.
Korean J Lab Med ; 30(6): 585-90, 2010 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-21157143

RESUMEN

In B lymphoblastic leukemia/lymphoma (B-ALL/LBL), t(9;22)(q34;q11.2) and t(1;19)(q23;p13.3) are recurrent cytogenetic abnormalities. The concurrent occurrence of both abnormalities is very rare, and only 3 cases have been previously reported. Here, we report a case of adult B-ALL with ider(9)(q10)t(9;22)(q34;q11.2) and der(19)t(1;19)(q23;p13.3). A literature review revealed that ider(9) (q10)t(9;22) is a rare variant of t(9;22) with a deletion of the short arm of chromosome 9. Fifteen cases of ider(9)(q10)t(9;22) have been reported. This abnormality is specific to precursor B-lymphoid neoplasms, such as B-ALL or B-lymphoid blast phase of CML, and is associated with disease progression or short survival. The cytogenetic abnormality t(1;19) is also specific to B-ALL. In most instances of t(1;19), TCF3 is fused to PBX1; however, a few cases have identical translocations but no TCF3-PBX1 fusion, as was observed in our patient. We describe the first case of ider(9)(q10)t(9;22) in combination with TCF3-PBX1 negative t(1;19). The patient underwent imatinib therapy in addition to intensive chemotherapy, but failed to achieve remission.


Asunto(s)
Leucemia-Linfoma Linfoblástico de Células Precursoras B/diagnóstico , Translocación Genética , Células de la Médula Ósea/citología , Células de la Médula Ósea/patología , Deleción Cromosómica , Cromosomas Humanos Par 1 , Cromosomas Humanos Par 19 , Cromosomas Humanos Par 22 , Cromosomas Humanos Par 9 , Femenino , Proteínas de Fusión bcr-abl/genética , Proteínas de Fusión bcr-abl/metabolismo , Humanos , Hibridación Fluorescente in Situ , Cariotipificación , Persona de Mediana Edad , Leucemia-Linfoma Linfoblástico de Células Precursoras B/genética
19.
Yonsei Med J ; 51(6): 901-11, 2010 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-20879058

RESUMEN

PURPOSE: Antimicrobial resistance monitoring could be a useful source of information for treating and controlling nosocomial infections. We analyzed antimicrobial resistance data generated by Korean Hospitals and by a commercial laboratory in 2005 and 2007. MATERIALS AND METHODS: Susceptibility data for 2005 and 2007 were collected from 37 and 41 hospitals, respectively, and from one commercial laboratory. Intermediate susceptibility was not included in the calculation of resistance rates. RESULTS: Methicillin-resistant Staphylococcus aureus (MRSA) (64%), third-generation cephalosporin-resistant Klebsiella pneumoniae (29%), fluoroquinolone-resistant Escherichia coli (27%), Pseudomonas aeruginosa (33%), and Acinetobacter spp. (48%), and amikacin-resistant P. aeruginosa (19%) and Acinetobacter spp. (37%) were prevalent in hospitals in 2007. A gradual increase of vancomycin-resistant Enterococcus faecium and imipenem-resistant Acinetobacter spp. was observed. Higher incidences of thirdgeneration cephalosporin-resistant E. coli and K. pneumoniae and imipenemresistant P. aeruginosa were found in the commercial laboratory than in the hospitals. CONCLUSION: Methicillin-resistant S. aureus, third-generation cephalosporin- resistant K. pneumoniae, and fluoroquinolone-resistant E. coli, P. aeruginosa and Acinetobacter spp. remain prevalent in Korea, while the incidence of vancomycin-resistant E. faecium and imipenem-resistant Acinetobacter spp. has increased gradually. The higher prevalences of third-generation cephalosporinresistant E. coli and K. pneumoniae, and imipenem-resistant P. aeruginosa in the commercial laboratory are a new concern.


Asunto(s)
Acinetobacter/metabolismo , Infecciones Bacterianas/epidemiología , Ceftazidima/farmacología , Infección Hospitalaria/epidemiología , Farmacorresistencia Bacteriana , Fluoroquinolonas/farmacología , Imipenem/farmacología , Infecciones por Klebsiella/tratamiento farmacológico , Klebsiella pneumoniae/metabolismo , Infecciones Bacterianas/tratamiento farmacológico , Infección Hospitalaria/tratamiento farmacológico , Escherichia coli/metabolismo , Humanos , Staphylococcus aureus Resistente a Meticilina/metabolismo , Pseudomonas aeruginosa/metabolismo , República de Corea , Vancomicina/farmacología
20.
Korean J Lab Med ; 28(3): 174-8, 2008 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-18594167

RESUMEN

Trisomy 19 is frequently encountered in cases of chronic myeloid leukemia (CML) as a secondary abnormality: however, trisomy 19 rarely occurs as a sole chromosomal abnormality and, to date, it has only been reported in 48 hematopoietic malignancies, 1 case of adenocarcinoma and 1 case of astrocytic tumor. Here, we report two additional cases of trisomy 19 as a sole karyotypic aberration in myeloid malignancies. One of these cases involved a 6-month-old male who was diagnosed with acute myeloid leukemia minimally differentiated. His karyotype was 47,XY,+19[20]. He expired 5 days after diagnosis. Another case occurred in an 80-yr-old female who had refractory anemia with excess blasts. Her karyotype was 47,XX,+19[16]/46,XX[4]. Four months later, her peripheral blood smears suggested that the disease had progressed, but she refused further evaluation. Based on a review of the existing literature and the results of this report, trisomy 19 not only as a secondary abnormality but also as a sole karyotypic aberration is strongly associated with myeloid disorder; however, it is not preferentially found in specific FAB subgroups of myelodysplasic syndrome or acute myeloid leukemia.


Asunto(s)
Anemia Refractaria/diagnóstico , Anemia Refractaria/genética , Cromosomas Humanos Par 19 , Leucemia Mieloide/diagnóstico , Leucemia Mieloide/genética , Trisomía , Enfermedad Aguda , Anciano de 80 o más Años , Femenino , Humanos , Lactante , Cariotipificación , Masculino
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