Apolipoprotein E Genotype and Expression Correlated with Hepatitis C Virus Genotype and Infection

The hepatitis C virus (HCV) is a globally prevalent human pathogen that causes persistent liver infections in most infected individuals. Several studies reported that HCV particles are enriched in apolipoprotein E (apoE) and that apoE is required for HCV infectivity and production. However, the relationship between apoE gene polymorphisms and HCV genotypes in patients with HCV is less well understood. The aim of this study was to investigate the association between apoE gene polymorphism and HCV genotypes in patients. The HCV genotypes were identified among the 124 patients infected with HCV, and the genetic characteristics of the HCV genotype were analyzed. In addition, the results of the clinical laboratory test were comparatively analyzed according to the classified genotypes. Both HCV 1b (n=80) and 2a (n=42) patients had higher AFP, AST, ALT, ALP, γ-GTP, apoB, and apoE values compared with the normal control group. In particular, apoB and apoE levels were statistically significantly higher in the HCV 2a patients (P<0.05) and apoE levels were significantly higher in the HCV 1b patients (P<0.000). According to the results the patients with HCV genotype 1b showed higher values of liver damage related indicators and apoB expression than the patients with HCV genotype 2a. The fat related indicators and apoE expression were not different between the two major HCV genotypes (2a and 1b). We anticipate that the apoE ε3 allele is the most common type in HCV genotype 1b (89.2%) and 2a (91.7%). As a result of apoE genotyping, we confirmed an association with HCV infection and the apoE ε3 allele. However, the ratios of the apoE ε3 allele among the patients with genotype 1b and 2a were similar to each other.

Differences in Hematological Characteristics, Including Cholesterol and Apolipoprotein B and E, between Hepatitis B Virus and Hepatitis C Virus Patients in Korea

Hepatitis B virus (HBV) and hepatitis C virus (HCV) chronically cause hepatitis, liver cirrhosis, and hepatocellular carcinoma, and biomarkers related to liver damage are elevated in HBV and HCV patients. However, comparisons of biomarkers between HBV and HCV patients have not previously been reported. The aim of this study was to investigate differences in hematological biomarker in the sera of HBV and HCV patients and to find a key biomarker to differentiate between HBV and HCV infections. HBV (n=115) and HCV (n=128) samples (serum and whole blood) were collected and tested using a biochemical analysis system. The obtained data were analyzed with SPSS 18.0 statistical software. The mean age of the HCV group (60.3±14.1) was much higher than that of the HBV group (51.1±12.4). Male and female rates were 71.3% and 28.7% in the HBV group and 53.9% and 46.1% in the HCV group, respectively (p = 0.005). AST, ALT, and TG values were higher in the HCV group than in the HBV group. Although γ-GTP and LDL levels were higher in the HBV group than in the HCV group, apoB and apoE levels were much higher in HCV group than in HBV group (p < 0.001). There were no significant differences in the other hematological biomarkers between the HBV and HCV groups. In conclusion, HBV rates were higher in male patients, and HCV rates were higher in older patients. In particular, apoE and apoB were more highly expressed in HCV patients, and they might be key markers to differentiate HCV infection.

Synergistic Anti-bacterial Effects of Phellinus baumii Ethyl Acetate Extracts and beta-Lactam Antimicrobial Agents Against Methicillin-Resistant Staphylococcus aureus

BACKGROUND: The development of new drugs or alternative therapies effective against methicillin-resistant Staphylococcus aureus (MRSA) is of great importance, and various natural anti-MRSA products are good candidates for combination therapies. We evaluated the antibacterial activities of a Phellinus baumii ethyl acetate extract (PBEAE) and its synergistic effects with beta-lactams against MRSA. METHODS: The broth microdilution method was used to determine the minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) of the PBEAE. The PBEAE synergistic effects were determined by evaluating the MICs of anti-staphylococcal antibiotic mixtures, with or without PBEAE. Anti-MRSA synergistic bactericidal effects of the PBEAE and beta-lactams were assessed by time-killing assay. An ELISA was used to determine the effect of the PBEAE on penicillin binding protein (PBP)2a production. RESULTS: The MICs and MBCs of PBEAE against MRSA were 256-512 and 1,024-2,048 microg/mL, respectively. The PBEAE significantly reduced MICs of all beta-lactams tested, including oxacillin, cefazolin, cefepime, and penicillin. However, the PBEAE had little or no effect on the activity of non-beta-lactams. Time-killing assays showed that the synergistic effects of two beta-lactams (oxacillin and cefazolin) with the PBEAE were bactericidal in nature (Deltalog10 colony forming unit/mL at 24 hr: 2.34-2.87 and 2.10-3.04, respectively). The PBEAE induced a dose-dependent decrease in PBP2a production by MRSA, suggesting that the inhibition of PBP2a production was a major synergistic mechanism between the beta-lactams and the PBEAE. CONCLUSIONS: PBEAE can enhance the efficacy of beta-lactams for combined therapy in patients infected with MRSA.

Direct Detection of Methicillin-Resistant Staphylococcus aureus from Blood Cultures Using Three Non-Molecular Methods: PBP2a Latex Agglutination, PBP2a Rapid Immunochromatographic Assay and MRSA-Chromogenic Medium / 대한임상미생물학회지

BACKGROUND: This study compared three non-molecular methods for the detection of methicillin-resistance directly from blood cultures containing Staphylococcus aureus: penicillin-binding protein (PBP) 2a latex agglutination (LA), PBP2a immunochromatographic assay (ICA) and MRSA chromogenic medium (CM). METHODS: Fifty methicillin-resistant S. aureus (MRSA) and 50 methicillin-susceptible S. aureus (MSSA) were seeded into blood-culture bottles. When isolates returned a positive signal, 5 mL of culture was added to serum separator tubes and centrifuged at 1,300 g for 10 min. The pellets were then used as the inoculum for the PBP2a LA, MRSA-CM and PBP2a ICA. The pure colony was used for PBP2a LA test, additionally. RESULTS: The respective sensitivities and specificities were 98 and 100% for PBP2a ICA, and 100 and 100% for MRSA-CM in direct detection of MRSA from positive blood culture. The results of PBP2a LA test using pure colony were entirely compatible with those by mecA gene PCR but the PBP2a LA test using the pellets directly isolated from positive blood culture showed sometimes ambiguous agglutination; its sensitivity and specificity were 78 and 100%, if ambiguous results were scored as negative, and were 90 and 92%, if ambiguous results were scored as positive, respectively. CONCLUSION: For direct detection of MRSA in positive blood culture, MRSA-CM and PBP2a ICA provided excellent results. The PBP2a LA test using pure colony also gave excellent results but the PBP2a LA test by the direct method using pellet of positive blood culture was slightly less sensitive than the other two methods.

Characterization of Acinetobacter baumannii Co-producing Carbapenemases OXA-23 and OXA-66, and armA 16S Ribosomal RNA Methylase at a University Hospital in South Korea / 대한임상미생물학회지

BACKGROUND: In the present study, the resistance mechanisms against carbapenems and aminoglycosides for 23 strains of multi-drug-resistant Acinetobacter baumannii isolated at a university hospital were investigated. METHODS: The minimal inhibitory concentrations (MICs) were determined via broth microdilution or Etest. The genes encoding OXA-type carbapenemases and 16S rRNA methylase were identified using multiplex PCR, and the amplified products were sequenced. Conjugation experiments were conducted, and an epidemiologic study was performed using enterobacterial repetitive intergenic consensus (ERIC)-PCR. RESULTS: In the isolates, the MICs of the tested aminoglycosides, including arbekacin, were >1024 microg/mL; the MICs of aztreonam, cefepime, ceftazidime, and ciprofloxacin ranged from 64 to 128 microg/mL; and the MICs of carbapenem ranged from 32 to 64 microg/mL, as determined through the broth microdilution test. According to the E-test, the MICs of ampicillin/sulbactam and colistin were 8 and 0.25 to 0.38 microg/mL, respectively. Sequence analysis confirmed that all of the isolates expressed carbapenemases OXA-23 and OXA-66, as well as armA 16S rRNA methylase. In addition, ISAba1 was identified upstream of the gene encoding OXA-23. OXA-23 and armA were not transferred to Escherichia coli J53 cells in the transconjugation experiments. ERIC-PCR molecular fingerprinting produced a single pattern in all cases. CONCLUSION: The co-production of OXA-23 and armA 16S rRNA methylase may be attributed to the multidrug resistance of the A. baumannii isolates in the present study. Stricter surveillance and more rapid detection are necessary to prevent the spread of this type of resistance in the future.

A Case of Catheter-Related Bacteremia by Arthrobacter woluwensis / 대한진단검사의학회지

Arthrobacter woluwensis, a catalase-positive coryneform bacterium recognized as an opportunistic pathogen, was repeatedly isolated from the blood of a 56-year-old male patient with metastatic colon cancer. The isolate was identified by various phenotypic tests and by sequencing analysis of 16S rRNA. Antimicrobial susceptibility testing was performed by E-test; the MICs to vancomcyin, cefotamine, and penicillin were 1.5 microgram/mL, >64 microgram/mL, and 4 microgram/mL, respectively. The patient was treated with vancomycin, and the subclavian catheter, which was presumed to be the source of the infection, was removed. Thereafter, repeated blood cultures did not grow the organism. The infections of human caused by A. woluwensis have not been reported previously in Korea, probably because of the difficulty of identifying Arthrobacter strains by conventional biochemical tests.

A Case of Bacteremia Caused by Arcobacter butzleri / 대한진단검사의학회지

Arcobacter butzleri, a gram-negative, slightly curved bacterium previously described as an aerotolerant Campylobacter, was isolated from the blood of a 53-year-old male patient with alcoholic cirrhosis. The isolate was identified by various phenotypic tests and 16S rRNA sequencing analysis. The patient was treated with amikacin and recovered uneventfully. To our knowledge, this is the first case of A. butzleri bacteremia reported in Korea.

Molecular Epidemiologic Study of Urinary Tract Infection by Myroides species (Flavobacterium odoratum) / 감염과화학요법

BACKGROUND: Myroides species are widely distributed in nature, but clinical infection by these organisms are extremely rare. We report herein prolonged outbreak of urinary tract infection by Myroides species. METHODS: Forty-four Myroides spp. were isolated from urine samples from 25 patients over a period of nine months, and random amplified polymorphic DNA (RAPD) method was performed to characterize the genotype of these isolates. RESULTS: All of the subjects were hospitalized patients with indwelling urinary catheter. Five of the patients showed concomitant pyuria, which could be considered as evidence of urinary tract infection, and isolation of these organisms in the remainder of the patients could be considered as simple colonization. All the isolates were resistant to antimicrobial agents tested. RAPD analysis showed identical DNA fingerprinting patterns in all the isolates. CONCLUSION: This study revealed that all the Myroides spp. isolated from urinary specimens of prolonged outbreak were genotypically the same. Because of its resistance to multiple antimicrobial agents, prevention of dissemination of this strain is clinically important.

Molecular Epidemiologic Study of Urinary Tract Infection by Myroides species (Flavobacterium odoratum) / 감염과화학요법

BACKGROUND: Myroides species are widely distributed in nature, but clinical infection by these organisms are extremely rare. We report herein prolonged outbreak of urinary tract infection by Myroides species. METHODS: Forty-four Myroides spp. were isolated from urine samples from 25 patients over a period of nine months, and random amplified polymorphic DNA (RAPD) method was performed to characterize the genotype of these isolates. RESULTS: All of the subjects were hospitalized patients with indwelling urinary catheter. Five of the patients showed concomitant pyuria, which could be considered as evidence of urinary tract infection, and isolation of these organisms in the remainder of the patients could be considered as simple colonization. All the isolates were resistant to antimicrobial agents tested. RAPD analysis showed identical DNA fingerprinting patterns in all the isolates. CONCLUSION: This study revealed that all the Myroides spp. isolated from urinary specimens of prolonged outbreak were genotypically the same. Because of its resistance to multiple antimicrobial agents, prevention of dissemination of this strain is clinically important.

Evaluation of the HM-JACK Automatic Analyzer for Fecal Occult Blood Test / 임상검사와정도관리

BACKGROUND: Fecal occult blood test is a useful method for mass screening of colorectal cancer. HM-JACK is automatic analyzer for detecting fecal occult blood with latex agglutination methods. We evaluated its apparatus for compatibility for clinical testing. METHODS: The linearity, precision and effect of temperature and container in stool storage were evaluated. The comparison study with OC-Hemodia and prozone phenomenon were evaluated. RESULTS: The linearity was good(R(2)=0.997) and coeffiecinet variation(CV) of within-day precision were 4.6% and 2.6% in low concentration and high concentration. The CV of between-day precision were 4.8% and 3.5%. The hemoglobin concentration of 0.1 g/dL(1x10(6) ng/mL) was measured to 651 ng/mL for Antigen excess zone. The hemoglobin were more decreased in room temperature storage and usual container storage than in low temperature storage and HM-JACK container storage. The concordance rate between HM-JACK and OC-Hemodia was 90%. CONCLUSION: HM-JACK showed good performance for linearity, precision and comparison study. Therefore, it can be used effectively in clinical laboratory due to convenience, and possibility of quantitation and fast reporting.

Application of random amplified polymorphic DNA (RAPD) for the epidemiological study of an outbreak of Candida albicans septicemia in neonatal intensive care units / 대한임상병리학회지

BACKGROUND: The opportunistic imperfect fungus Candida albicans causing life-threatening infections in immunocompromised patients is recognized to be one of important nosocomial pathogens. Recently, an outbreak of septicemia caused by C. albicans was occured in neonatal intensive care unit (NICU) of Chungbuk university hospital. To investigate the molecular epidemiology of these infections, we analyzed genotypes of C. albicans isolates from NICU and non-NICU. METHODS: Fourteen isolates of C. albicans were used for intraspecies genotyping, which were composed of 9 isolates from NICU and 5 isolates from non-NICU from January to April 1998. Each three isolates of C. albicans, C. parapsilosis and C. tropicalis were used for interspecies genotyping. The genotyping were analyzed by RAPD with four random primers. RESULTS: The genotypes of C. albicans isolates from immature neonates in NICU were identical with those from medical persons in NICU but different with those from patients in non-NICU. Interspecies RAPD profiles were more distinctive than intraspecies RAPD profiles. The reproducibility of RAPD showed good result. CONCLUSION: These results show that C. albicans isolated from NICU disclose the same RAPD genotype, which suggests the clonal origin, and RAPD can be the useful method for the epidemiological study of nosocomial infection caused by C.albicans.