White LED Lighting Increases the Root Productivity of Panax ginseng C. A. Meyer in a Hydroponic Cultivation System of a Plant Factory.

To identify effective light spectra for increasing the productivity of Panax ginseng, we conducted experiments in a controlled environment using a hydroponic cultivation system in a plant factory. We investigated the effect of single LEDs (red, blue, and yellow) and mixed LEDs (red + blue and red + blue + white). The relationships between four light spectra (red, blue, yellow, and white) and physiological responses (net photosynthetic rate, stomata conductance, transpiration rate, and intercellular CO2 partial pressure), as well as growth responses (shoot and root biomass), were analyzed using multivariate statistical analysis. Among the four physiological response variables, shoot biomass was not increased by any pathway, and root biomass was increased only by the intercellular CO2 partial pressure. Red and yellow light increased shoot biomass, whereas white light promoted an increase in the net photosynthetic rate and enhanced root biomass. In contrast, blue light was less effective than the other light spectra in increasing both shoot and root biomass. Therefore, red and yellow light are the most effective light spectra for increasing shoot biomass and white light is effective for increasing root biomass in a plant factory that uses artificial LED lighting. Furthermore, the intercellular CO2 partial pressure is an important physiological variable for increasing the root biomass of P. ginseng.

Korean Red Ginseng extract attenuates alcohol-induced addictive responses and cognitive impairments by alleviating neuroinflammation.

Background: Alcohol is one of the most commonly used psychoactive drugs. Due to its addictive characteristics, many people struggle with the side effects of alcohol. Korean Red Ginseng (KRG) is a traditional herbal medicine that is widely used to treat various health problems. However, the effects and mechanisms of KRG in alcohol-induced responses remain unclear. Therefore, the purpose of this study was to investigate the effects of KRG in alcohol-induced responses. Methods: We investigated two aspects: alcohol-induced addictive responses and spatial working memory impairments. To determine the effects of KRG in alcohol-induced addictive responses, we performed conditioned place preference tests and withdrawal symptom observations. To assess the effects of KRG in alcohol-induced spatial working memory impairment, Y-maze, Barnes maze, and novel object recognition tests were performed using mice after repeated alcohol and KRG exposure. To investigate the potential mechanism of KRG activity, gas chromatography-mass spectrometry and western blot analysis were performed. Results: KRG-treated mice showed dose-dependent restoration of impaired spatial working memory following repeated alcohol exposure. Furthermore, withdrawal symptoms to alcohol were reduced in mice treated with KRG and alcohol. The PKA-CREB signaling pathway was activated after alcohol administration, which was reduced by KRG. However, the levels of inflammatory cytokines were increased by alcohol and decreased by KRG. Conclusion: Taken together, KRG may alleviate alcohol-induced spatial working memory impairments and addictive responses through anti-neuroinflammatory activity rather than through the PKA-CREB signaling pathway.

Serotype Distribution and Antimicrobial Resistance of Streptococcus pneumoniae Causing Invasive Pneumococcal Disease in Korea Between 2017 and 2019 After Introduction of the 13-Valent Pneumococcal Conjugate Vaccine.

Background: Streptococcus pneumoniae is a serious pathogen causing various infections in humans. We evaluated the serotype distribution and antimicrobial resistance of S. pneumoniae causing invasive pneumococcal disease (IPD) after introduction of pneumococcal conjugate vaccine (PCV)13 in Korea and investigated the epidemiological characteristics of multidrug-resistant (MDR) isolates. Methods: S. pneumoniae isolates causing IPD were collected from 16 hospitals in Korea between 2017 and 2019. Serotyping was performed using modified sequential multiplex PCR and the Quellung reaction. Antimicrobial susceptibility tests were performed using the broth microdilution method. Multilocus sequence typing was performed on MDR isolates for epidemiological investigations. Results: Among the 411 S. pneumoniae isolates analyzed, the most prevalent serotype was 3 (12.2%), followed by 10A (9.5%), 34 (7.3%), 19A (6.8%), 23A (6.3%), 22F (6.1%), 35B (5.8%), 11A (5.1%), and others (40.9%). The coverage rates of PCV7, PCV10, PCV13, and pneumococcal polysaccharide vaccine (PPSV)23 were 7.8%, 7.8%, 28.7%, and 59.4%, respectively. Resistance rates to penicillin, ceftriaxone, erythromycin, and levofloxacin were 13.1%, 9.2%, 80.3%, and 4.1%, respectively. MDR isolates accounted for 23.4% of all isolates. Serotypes 23A, 11A, 19A, and 15B accounted for the highest proportions of total isolates at 18.8%, 16.7%, 14.6%, and 8.3%, respectively. Sequence type (ST)166 (43.8%) and ST320 (12.5%) were common among MDR isolates. Conclusions: Non-PCV13 serotypes are increasing among invasive S. pneumoniae strains causing IPD. Differences in antimicrobial resistance were found according to the specific serotype. Continuous monitoring of serotypes and antimicrobial resistance is necessary for the appropriate management of S. pneumoniae infections.

Clinical Usefulness of BACT Count and BACT-Info Flag of UF-5000 for Screening for Urinary Tract Infection and Prediction of Gram-Negative Bacteria.

BACKGROUND: A rapid and reliable screening test for urinary tract infection (UTI) is needed to reduce the turn-around time and to rule out negative results of urine culture. The aim of this study was to evaluate the performance of BACT count and BACT-Info flag of the UF-5000 for screening for UTI. METHODS: A total of 1,063 urine specimens from April to September 2019 were included in this study. We evaluated the diagnostic performance of white blood cell (WBC) count, BACT count, BACT-Info flag, and UTI flag in UF-5000 by comparing with the urine culture results. RESULTS: Of the urine specimens, 16.7% were culture-positive (≥ 105 CFU/mL) with 15 being yeast positive. A BACT count of > 685.3/µL showed the best diagnostic performance with 93.8% sensitivity and 90.2% specificity. We confirmed that the combination of BACT count (685.3/µL) and BACT-Info flag would be appropriate to use in a clinical laboratory (sensitivity 91.5%, specificity 90.5%). Based on this combination, the sensitivity and specificity of the Gram-negative flag were 95.5% and 94.8%. CONCLUSIONS: We recommend the use of a combination of BACT count (685.3/µL) and BACT-Info for UTI diagnosis. This combination is more appropriate for Gram-negative bacteria, and it would be useful for selecting empirical treatment.

Performance of MALDI-TOF Mass Spectrometry (VITEK MS) in the Identification of Salmonella Species.

Salmonella is a major pathogen causing foodborne infections in humans. Salmonella isolates are identified using biochemical and serological tests, including automated systems such as the VITEK2 system. However, there are few reports on Salmonella identification using VITEK MS. Therefore, we aimed to evaluate the usefulness of MALDI-TOF VITEK MS for Salmonella identification. A total of 1389 Salmonella isolates were identified using VITEK MS ver3.0 or ver3.2. All Salmonella isolates were confirmed by serotyping using the Kauffmann-White scheme, and the results were compared with the VITEK MS results. A total of 1389 Salmonella isolates, including 66 serotypes, were correctly identified at the genus level by VITEK MS. However, these systems failed to correctly identify typhoidal Salmonella. Among the five Salmonella enterica ssp. diarizonae isolates, only one was correctly identified, whereas one and three isolates were partially identified and misidentified, respectively. On the other hand, the VITEK2 system successfully identified all typhoidal Salmonella (Typhi and Paratyphi A) and Salmonella enterica ssp. diarizonae isolates. VITEK MS was useful for identifying Salmonella species isolated from clinical specimens; however, additional biochemical tests, such as the VITEK2 System, should be considered to accurately identify Salmonella ser. Typhi, and Salmonella ser. Paratyphi A.

Association of Carbapenemase-Producing Enterobacterales Detected in Stream and Clinical Samples.

Background: The spread of carbapenem-resistant Enterobacterales (CRE) strains has caused treatment failure and is a worldwide threat to public health. However, there are limited reports on the prevalence of carbapenemase-producing Enterobacterales (CPE) in aquatic environments and its association with clinical isolates. This study aimed to investigate the prevalence of CPE in a stream environment and its genetic relationship with clinical isolates in Korea. Methods: A total of 4,582 water samples were collected from 94 streams. Multiplex PCR and sequencing were used to detect and identify six carbapenemase genes. Multi-locus sequence typing (MLST) was performed to investigate the genetic relatedness between the environmental strains and clinical isolates. Results: A total of 133 CRE strains were isolated from the streams. Klebsiella pneumoniae was the most common CRE (45.9%), followed by Enterobacter cloacae complex (29.3%), Escherichia coli (13.5%), Raoultella ornithinolytica (5.3%), and Citrobacter freundii (2.3%). Ninety (67.7%) isolates carried carbapenemase genes. K. pneumoniae carbapenemase-2 (36.7%) and New Delhi metallo-ß-lactamase-5 (32.2%) were the common carbapenemases detected. Sequence type (ST)307 and ST11 K. pneumoniae strains harboring the bla KPC-2 gene were the most prevalent in stream and patient samples. Conclusion: CPE was highly prevalent in streams and closely related to the isolates obtained from patients. Therefore, continuous monitoring of stream environments is required to control the spread of carbapenem resistance.

Association Between Unequal Division of Caregiving Work and South Korean Married Women's Depressive Symptoms.

Background: A disproportionate amount of family caregiving can negatively impact married women's mental health. This study aims to examine the relationship between depressive symptoms in South Korean women and the satisfaction with their husband's participation in family caregiving. Methods: Raw data from 1,515 of the participants in the 2014, 2016, and 2018 Korean Longitudinal Survey of Women and Families were analyzed. Satisfaction with husbands' participation in family caregiving was classified as satisfied, less satisfied, and not satisfied. The survey used the Center for Epidemiologic Studies Depression Scale to measure depressive symptoms. The association was examined using a generalized estimating equations model. Results: Results indicated 22.2% of the participating women reported depressive symptoms. Women who reported dissatisfaction with their husband's participation in caregiving were 2.54 times more likely to report depressive symptoms than the women who were satisfied. Subgroup analysis indicated that women with higher levels of education, were more likely to have depressive symptoms when they were not satisfied with their husbands' participation in caregiving. Conclusion: Married women who reported being dissatisfied with their husbands' participation in caregiving were more likely to report depressive symptoms. These results suggest the need to create environments with fair distribution of caregiving duties to minimize depressive symptoms in women.

Characteristics of Clonal Complex Changes and Quinolone Resistance-Determining Region Mutations of Levofloxacin-Resistant Streptococcus pneumoniae in South Korea.

Streptococcus pneumoniae is the most common causative agent of community-acquired pneumonia and invasive pneumococcal diseases with high mortality rates. The aims of this study were to evaluate clonal complex (CC) changes of levofloxacin-resistant S. pneumoniae (LRSP) strains and to investigate the relationship between levofloxacin resistance and pneumococcal serotypes. We analyzed the antimicrobial susceptibility of 145 LRSP strains to 18 antimicrobial agents and the quinolone resistance-determining region mutation. Multilocus sequence typing was performed to investigate the genetic relatedness among LRSP strains. Most LRSP strains (96.6%) were multidrug resistant and had simultaneous mutations in gyrA, parC, and parE (91.7%). The serotypes 11A (44.1%) and 13 (14.5%) accounted for 58.6% of LRSP strains, and 32.0% were nonvaccine serotypes. Most LRSP strains were grouped as CC8279 (N = 83; 57.2%), CC189 (N = 10; 6.9%), or CC320 (N = 5; 3.4%). CC8279 was commonly combined with serotypes 11A and 13. There were numerous changes of serotype and CC accompanying the emergence and spread of LRSP. Continuous monitoring of changes in the serotype and sequence type of LRSP is required to follow the spread of LRSP for public health monitoring.

Carbapenemase-producing Eenterobacterales from hospital environment and their relation to those from patient specimens.

BACKGROUND: The hospital environment can be an important source for the transmission of pathogens, However, there are rare reports revealing the contamination of carbapenemase-producing enterobacterales (CPE) in the hospital environment. The aim of this study was to investigate the presence of CPE in hospital environments and their relation to clinical strains. METHODS: Environmental samples were collected from three tertiary university hospitals between June 2017 and August 2019. The environmental samples were inoculated on CHROMagar™ KPC plates. A multiplex PCR and sequencing were used for six carbapenemase genes. Multi-locus sequence typing (MLST) was performed for CPE of Klebsiella pneumoniae, Escherichia coli, and Enterobacter cloacae complex from the environmental and clinical specimens. RESULTS: 20 carbapenem-resistant Enterobacteriaceae (CRE) strains were detected in the beds of patients, toilet bowl, sink, patient's gown, electromanometer, and keyboard. K. pneumoniae was the most common, followed by Serratia marcescens, E. cloacae complex, E. coli, and Citrobacter freundii. Nineteen CRE were CPE. Eighteen of 19 CPEs produced KPC-2 carbapenemase, and one CPE (E. coli) produced NDM-5. We confirmed that the STs of K. pneumoniae-producing KPC-2 (ST 307 and ST11) and E. coli producing KPC-2 (ST648) from hospital environment were the same as those from patients. CONCLUSION: We believe that the hospital environment can be an important route for CPE transmission. Therefore, continuous surveillance and management are needed to prevent hospital-acquired infections (HAI) by transmission of CPE.

Association of Mixed Use of Electronic and Conventional Cigarettes and Exposure to Secondhand Smoke With Prediabetes.

CONTEXT: Despite previous studies regarding the association between smoking and diabetes, the effects of electronic cigarettes and secondhand smoke (SHS) on glucose metabolism and insulin sensitivity have not been fully elucidated. OBJECTIVE: To examine the association of mixed electronic and conventional cigarette use and exposure to SHS with prediabetes. DESIGN: Data from the 2014-2018 Korean National Health and Nutrition Examination Survey were analyzed. SETTING: Nationwide population-based. PARTICIPANTS: Of 39 199 participants, 22 385 participants (9490 men, 12 895 women) without diabetes were included. The main independent variables were smoking behaviors, including exposure to SHS. INTERVENTIONS: None. MAIN OUTCOME MEASURES: Prediabetes (hemoglobin A1C of 5.7-6.4%). RESULTS: Of 22 385 participants without diabetes, 6735 had prediabetes. Mixed cigarette use was associated with a 1.57-fold increase in the odds of prediabetes when compared with never-smoking [odds ratio (OR) = 1.57, 95% CI = 1.29-1.92] and a 1.27-fold increase when compared with conventional cigarette use only (OR = 1.27, 95% CI = 1.07-1.52). Participants who were current nonsmokers, but mixed users in the past had an increased risk of prediabetes (OR = 1.54, 95% CI = 1.04-2.13). There was no significant association between prediabetes and current nonsmoking in individuals with previous conventional cigarette use only. Among never-smokers, exposure to SHS significantly increased the risk of prediabetes (OR = 1.16, 95% CI = 1.04-1.30). CONCLUSIONS: Mixed use of electronic and conventional cigarettes and exposure to SHS increased the risk of prediabetes. Further studies are required to comprehensively investigate the molecular biology underlying the effects of previous and current mixed use of electronic cigarettes and SHS on glucose metabolism.

Serotype Distribution and Antimicrobial Resistance of Salmonella Isolates in Korea between 2016 and 2017.

Salmonella is one of the major causes of food-borne infections. We investigated the serotype distribution and antimicrobial resistance of Salmonella isolates collected in Korea between January 2016 and December 2017. In total, 669 Salmonella isolates were collected from clinical specimens at 19 university hospitals. Serotyping was performed according to the Kauffmann-White scheme, and antimicrobial susceptibility was tested using Sensititre EUVSEC plates or disk diffusion. Among the strains, C (39.8%) and B (36.6%) were the most prevalent serogroups. In total, 51 serotypes were identified, and common serotypes were S. enterica serovar I 4,[5],12:i:- (16.7%), S. Enteritidis (16.1%), S. Bareilly (14.6%), S. Typhimurium (9.9%), and S. Infantis (6.9%). The resistance rates to ampicillin, chloramphenicol, and trimethoprim-sulfamethoxazole were 32.6%, 12.1%, and 8.4%, respectively. The resistance rates to cefotaxime and ciprofloxacin were 8.1% and 3.0%, respectively, while 5.4% were multidrug-resistant. S. enterica serovar I 4,[5],12:i:- and S. Enteritidis were highly prevalent, and there was an increase in rare serotypes. Multidrug resistance and ciprofloxacin resistance were highly prevalent. Periodic investigations of Salmonella serotypes and antimicrobial resistance are needed.

Association between sedentary time and sleep quality based on the Pittsburgh Sleep Quality Index among South Korean adults.

BACKGROUND: Sleep problems increase the risk of premature illness and death. We evaluated the association between sedentary time and sleep quality among South Korean adults. METHODS: The data of adults (aged ≥ 19 years) from the 2018 Korea Community Health Survey were analyzed. Sedentary time, which included hours spent sitting or lying down daily, was categorized into four standardized groups. Poor sleep quality was defined using the global cutoff point (> 5 points) of the Pittsburg Sleep Quality Index. Multiple logistic regression analyses were performed to identify the association between sedentary time (≤ 3.9, 4.0-5.9, 6.0-7.9, and ≥ 8 hours /day) and sleep quality, by sex. RESULTS: Of the 224,118 participants, 35,784/100,454 men (35.6%) and 58,271/123,664 women (47.1%) had poor sleep quality. Compared with ≤ 3.9 h/day, sedentary times 4.0-5.9, 6.0-7.9, and ≥ 8 h/day were associated with worse sleep quality among men (odds ratio [OR]: 1.12, 95% confidence interval [CI]: 1.08-1.16; OR: 1.19, 95% CI: 1.14-1.25; OR: 1.30, 95% CI: 1.25-1.34, respectively) and women (OR: 1.06, 95% CI: 1.03-1.10; OR: 1.12, 95% CI: 1.08-1.16; OR: 1.22, 95% CI: 1.18-1.26, respectively). In subgroup analyses of sleep quality, subjective sleep quality, latency, disturbance, use of sleeping medication, and daytime dysfunction showed a strong dose-response relationship with increasing sedentary time in both sexes. CONCLUSIONS: Regardless of sex, the longer the sedentary time, the stronger the association with poor sleep quality. Nationwide efforts are required to recommend standards for sedentary time and develop evidenced-based healthy behavior guidelines.

Gestational diabetes mellitus and the role of intercurrent type 2 diabetes on long-term risk of cardiovascular events.

Recent studies have shown that gestational diabetes mellitus (GDM) is associated with an increased risk for cardiovascular disease. GDM has also been shown to be a risk factor for type 2 diabetes (T2DM) after pregnancy. However, there is limited evidence regarding the role of intercurrent T2DM on the relationship between GDM and future CVD. Thus, we investigated the risks of incident cardiovascular events among women with GDM during pregnancy compared to women without GDM and whether the increased CVD risk is dependent on intercurrent development of T2DM. We conducted a population-based retrospective cohort study using the Korean National Health Insurance Service claims database. Outcomes were the first occurrence of any CVD (myocardial infarction, treatment with coronary revascularization, heart failure, and cerebrovascular disease). Cox proportional hazard models were used to assess the association between GDM and incident CVD events, using landmark analysis at 4 years. A total of 1,500,168 parous women were included in the analysis, of which 159,066 (10.60%) had GDM. At a median follow-up of 12.8 years, 13,222 incident cases of total CVD were observed. Multivariable-adjusted hazard ratio for total CVD among women with prior GDM, compared with those without GDM, was 1.08 (95% CI 1.02-1.14). Further classifying GDM by progression to T2DM in relation to total CVD risk indicated a positive association for GDM with progression to T2DM vs no GDM or T2DM (HR 1.74; 95% CI 1.40-2.15), and no statistically significant association for GDM only (HR 1.06; 95% CI 1.00-1.12). GDM with subsequent progression to T2DM were linked with an increased risk of cardiovascular diseases. These findings highlight the need for more vigilant postpartum screening for diabetes and the implementation of diabetes interventions in women with a history of GDM to reduce future CVD risk.

A Keyword Analysis Study on Postpartum Obesity Using Big Data.

This study selected Google and Naver, the most recognizable Internet portals in Korea, as subjects for analysis. "Postpartum obesity" and "postpartum depression" were used as keywords for data collection. This study aimed to provide basic data for solving maternal problems using big data. Keywords related to postpartum obesity were collected from the portal site Google from 1 January 2019 to 31 December 2019. The collected data were analyzed through simple frequency analysis, N-gram analysis, and keyword network. This study can be used as basic data for postpartum obesity-related programs or academic research. It is also expected to be used for research on the development of a mobile-based customized healthcare system focused on maternal health. Previous papers and data are still insufficient at solving the physical and mental problems related to postpartum obesity and depression. It is necessary to find ways to continuously integrate and collect data from mothers across the country.

Associations of Handgrip Strength and Handgrip Strength Asymmetry With Depression in the Elderly in Korea: A Cross-sectional Study.

OBJECTIVES: Recent studies have suggested that assessing handgrip strength (HGS) asymmetry together with HGS may be helpful for evaluating problems in geriatric patients. This study aimed to identify whether HGS asymmetry, weakness, or both were associated with depression in Korean older adults. METHODS: This study included 4274 subjects from the sixth and seventh Korea National Health and Nutrition Examination Survey. Depression was measured using the Patient Health Questionnaire-9. The maximum HGS of the dominant hand was used as a representative value. HGS symmetry was categorized by the ratio of the HGS of the dominant hand to that of non-dominant hand. The odds ratio (OR) for depression was calculated according to the HGS and its symmetry. RESULTS: In total, 240 (12.5%) men and 534 (22.7%) women had depression. HGS or HGS asymmetry showed no statistically significant associations with depression in elderly men. Elevated odds of depression were observed in elderly women with low HGS (OR, 1.93; 95% confidence interval [CI], 1.33 to 2.81) or prominent HGS asymmetry (OR, 1.46; 95% CI, 1.02 to 2.08). There was a positive additive interaction between asymmetric HGS and weakness, as women with low and prominently asymmetric HGS showed higher odds of depression (OR, 3.77; 95% CI, 2.16 to 6.59) than women with high and symmetric HGS. CONCLUSIONS: Depression in elderly Korean women was associated with both low and asymmetric HGS. Our findings support the potential value of HGS asymmetry as an indicator of HGS.

Uric acid level and kidney function: a cross-sectional study of the Korean national health and nutrition examination survey (2016-2017).

Kidney disease is expected to become the fifth leading cause of premature death globally by 2040. Uric acid level is a risk factor for kidney disease. The current study aims to investigate the association between uric acid levels and kidney function in the Korean population. The data of 11,042 participants of the 2016-2017 Korea National Health and Nutrition Examination Survey were analysed. The estimated glomerular filtration rate was calculated using the modification of diet in renal disease formula for Koreans. For each sex, uric acid levels were divided into five subsequent categories of increasing levels (Q1, Q2, Q3, Q4, and hyperuricemia). The association between uric acid level and kidney function was investigated using multiple logistic regression. The results showed that the higher the uric acid levels, the greater the odds of reduced kidney function in both sexes. In men, the adjusted odds ratios (95% confidence intervals) for reduced eGFR comparing the hyperuricemia group to the lowest serum uric acid quartile was 5.55 (3.27-9.44), and in women, the odds ratios (95% confidence intervals) was 7.52 (4.39-12.87). Normal weight or underweight in men and overweight in women, as well as diabetes mellitus, hypertension, and physical inactivity were highly associated with reduced kidney function. Our study revealed a dose-response relationship between uric acid levels and kidney function. Therefore, high uric acid level should be considered as a factor that is potentially related to kidney dysfunction in the Korean population.

Synergistic Effects and Sex Differences in Anthropometric Measures of Obesity and Elevated High-Sensitivity C-Reactive Protein Levels.

Background: It remains unclear which anthropometric measure best predicts elevated high-sensitivity C-reactive protein (hs-CRP) levels. This study investigated the association and synergistic interaction of two obesity indices with elevated hs-CRP levels in a national sample of Korean adults, stratified by sex. Methods: The present cross-sectional study used data from the 2015-2018 Korea National Health and Nutrition Examination Survey of 18,610 subjects aged ≥20 years after excluding those with missing variables. Multiple logistic regression analyses and chi-squared tests were performed to investigate the association between body mass index (BMI) and waist circumference (WC) with elevated hs-CRP levels. Interaction analysis was used to examine the synergistic effect between BMI and WC on the risk of having elevated hs-CRP levels. Results: Elevated hs-CRP levels exceeding 3 mg/L were present in 9.3% and 7.5% of men and women, respectively. The relationship between each obesity index and elevated hs-CRP levels was significant in women (high WC (odds ratio [OR] = 1.77, 95% confidence interval [CI] = 1.24-2.54), high BMI (OR = 2.08, 95% CI = 1.58-2.74)) but not in men (high WC (OR = 1.19, 95% CI = 0.86-1.64), high BMI (OR = 0.99, 95% CI = 0.77-1.29)). Furthermore, combined measures of the two obesity indices and interaction analysis results revealed a synergistic association in men (OR = 1.57, 95% CI = 1.33-1.85; relative excess risk due to interaction (RERI) = 0.39, 95% CI = -0.09-0.86), and women (OR = 3.70, 95% CI = 3.09-4.43; RERI = 0.85, 95% CI = -0.06-1.75). Conclusion: BMI and WC were significantly associated with a risk of elevated hs-CRP levels in women but not in men. Nevertheless, significant synergistic interactions were seen in combined measures of BMI and WC, regardless of sex. These findings emphasize the need to use both measures of adiposity concurrently in the assessment of obesity and when identifying cardiovascular risk.

Synergistic association of high-sensitivity C-reactive protein and body mass index with insulin resistance in non-diabetic adults.

Epidemiological evidence has indicated that inflammatory markers and obesity are strongly correlated with insulin resistance (IR). However, there is a paucity of studies assessing the complex interaction between elevated hs-CRP and body mass index (BMI), particularly among Asians. This study investigated the additive interaction between hs-CRP and BMI on IR, using cross-sectional data from the 7th Korea National Health and Nutrition Examination Survey (2016-2018). A total of 5706 men and 6707 women aged 20 years or older were evaluated, and a multiple logistic regression analysis was used to assess the association of serum hs-CRP and BMI with IR, as measured by the triglyceride-glucose index (TyG index). Sex-specific median values were used to dichotomise the continuous TyG index variable into insulin-sensitive and IR categories. Biological interaction was evaluated using the Relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP), and synergy index (SI). The joint effects of high hs-CRP and overweight/obesity on IR were greater than would be expected from the effects of the individual exposures alone. Relative to those with low hs-CRP and BMI < 23, having both exposures was related to increased IR with an adjusted OR of 2.97 (95% CI 2.50-3.52) in men and 3.08 (95% CI 2.67-3.56) in women with significant additive interactions. These findings demonstrate that IR prevention strategies that reduce both systematic inflammation and BMI may exceed the expected benefits based on targeting these risk factors separately.

Prevalence and Characteristics of Carbapenemase-Producing Enterobacteriaceae in Three Tertiary-Care Korean University Hospitals between 2017 and 2018.

The aim of this study was to evaluate the prevalence and characteristics of carbapenemase-producing Enterobacteriaceae (CPE) from 3 tertiary-care Korean university hospitals between 2017 and 2018. Non-duplicated clinical isolates of Enterobacteriaceae showing resistance to any carbapenem agents were collected prospectively from 3 tertiary university hospitals between 2017 and 2018. The presence of carbapenemase genes was detected by multiplex PCR and sequencing for blaKPC, blaVIM, blaNDM, blaIMP, blaOXA, and blaGES was performed. Among the 690 potential carbapenem-resistant Enterobacteriaceae (CRE) isolates, 66.8% (N = 461) were CPE. The species distribution of CPE was as follows: Klebsiella pneumoniae was most common (75.9%), followed by Escherichia coli (15.0%), Citrobacter freundii (4.6%), Enterobacter cloacae (2.6%), Klebsiella. aerogenes (0.7%), and Klebsiella. oxytoca (0.4%). All 11 CPE genes were detected, particularly K. pneumoniae carbapenemase (KPC)-2 (87.6%), New Delhi metallo-ß-lactamase (NDM)-1 (7.4%), NDM-5 (1.7%), KPC-3 (1.3%), oxacillinase (OXA)-232 (1.1%), and OXA-181 (1.1%). Six isolates produced 2 or 3 carbapenemases. The majority of the carbapenemase-producing C. freundii tested positive for NDM-1. We confirmed a high proportion of CPE among the CRE isolates with a high prevalence of KCP-2-producing K. pneumoniae and E. coli. Therefore, there is a need for undertaking continuous surveillance to monitor the prevalence of CPE.