• Pediatric Infection and Vaccine
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• v.27 no.2
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• pp.83-89
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• 2020

Purpose: Group A streptococcus (GAS) is a common pathogen in pediatric patients and often causes acute pharyngotonsillitis and skin and soft tissue infections. In addition, bacteremia with significant morbidity and mortality can also occur. This study was conducted to describe the clinical manifestations and treatment outcomes of pediatric GAS bacteremia patients in Korea. Methods: This was a single-center, retrospective study. From January 2000 to December 2016, pediatric patients aged ≤18 years with GAS bacteremia were studied. Clinical manifestations, underlying diseases, intensive care unit stay, and antibiotic susceptibility were evaluated. Results: During the study period, 19 patients had GAS bacteremia. Ten (53%) were male, and the median age was 7.4 years (range, 0.3-17.4 years). Fourteen (74%) had chronic underlying diseases. Five (26%) were immunocompromised (leukemia and chronic kidney disease). Eight (42%) had lymphatic or vascular malformations, of which seven had lesions with signs of inflammation. Three (16%) developed pneumonia, and two of them received ventilator care. The 30-day mortality rate was 6% (1/19), and the cause of death was bacteremic pneumonia. All GAS isolates were sensitive to penicillin. Fifteen (79%) were sensitive to both erythromycin and clindamycin. Conclusions: This study identified various clinical manifestations of GAS bacteremia. GAS should be considered as a potential pathogen that can cause bacteremia and result in a serious clinical course.

• Pediatric Infection and Vaccine
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• v.25 no.1
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• pp.45-49
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• 2018

Group B streptococcus (GBS) is the leading cause of neonatal morbidity and mortality. Late-onset GBS disease commonly manifests as occult bacteremia or meningitis. Approximately 50% of survivors of late-onset meningitis have long-term neurologic sequelae. Cerebrovascular complications are often associated with unfavorable clinical outcomes of GBS meningitis. There have been a few reports of cerebral infarction accompanied by GBS meningitis. We report a 29-day-old girl with severe, widespread cerebral infarction due to late-onset GBS meningitis. Isolated GBS strain from this patient was serotype III, ST-19. Currently, she has cortical blindness and significant developmental delay.

• Clinical and Experimental Pediatrics
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• v.51 no.6
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• pp.622-628
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• 2008

Purpose : The purpose of this study was to evaluate the immunogenicity of the booster immunization with pneumococcal conjugate vaccine in Korean children. Methods : Thirty-nine children aged 12-23 months who visited Kangnam CHA Hospital between September 2006 and December 2006 were enrolled. The children were divided into primary and booster groups depending on their vaccination status for the 7-valent pneumococcal conjugate vaccine. The anti-pneumococcal antibody levels of each serotype included in the vaccine (4, 6B, 9V, 14, 18C, 19F, 23F) were determined by third-generation ELISA. Results : The geometric mean titer (GMT) of antibodies to each pneumococcal serotype in the booster group was higher than in the primary group (P<.05). The percentage of subjects with pneumococcal antibodies ${\geq}0.35{\mu}g/mL$ was 90.5-100% for all serotypes in both the primary and booster groups. The percentage of subjects with pneumococcal antibodies ${\geq}1.0g/mL$ in the booster group was 94.4-100%, which was higher than the primary group except for serotypes 6B and 14 (P<.05). The percentage of subjects with pneumococcal antibodies ${\geq}5.0{\mu}g/mL$ in the booster group was 50.0-94.4% which was higher than the primary group for all serotypes (P<0.05). Conclusion : The immunogenicity of a booster dose of the pneumococcal conjugate vaccine in Korean children was high and the immunogenicity of a primary series was also relatively high. To determine the feasibility of the introduction of the pneumococcal conjugate vaccine and the appropriate schedule for Korean children, further prospective investigation of the immunogenicity of the booster immunization is needed.

• Pediatric Infection and Vaccine
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• v.24 no.3
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• pp.183-187
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• 2017

Group A streptococcus is a common cause of upper respiratory infection in children; however, it is a rare cause of pseudoaneurysm in pediatrics with only limited reports of cases associated with cardiac surgery and underlying disease. We report a case of infectious pseudoaneurysm of the right internal iliac artery caused by group A streptococcus in a previously healthy 5-year-old boy who presented with scarlet fever and group A streptococcal bacteremia. He was admitted to the hospital with fever, rash on the whole body, and sore throat, accompanied by severe leg pain. He was treated with surgical removal and antibiotics. Because a pseudoaneurysm may develop in children without vascular-related underlying diseases, we should consider the possibility of this important clinical diagnosis in patients with scarlet fever.

• Pediatric Infection and Vaccine
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• v.22 no.2
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• pp.113-116
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• 2015

Posterior reversible leukoencephalopathy syndrome is a clinical radiographic syndrome of many causative factors. Sudden onset headache, vomiting, altered mental status, blurred vision and seizures are main symptoms shown in posterior reversible leukoencephalopathy syndrome. In addition, it typically shows radiological findings of edema in the white matter of posterior cerebrum, being in commonly bilateral but asymmetric. We report a case of poststreptococcal glomerulonephritis (PSGN) presenting as posterior reversible leukoencephalopathy syndrome. Immediate control of hypertension resulted in rapid and complete neurological recovery.

• Korean Journal of Microbiology
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• v.44 no.4
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• pp.289-292
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• 2008

Trisodium phosphate 12 hydrate and citric acid monohydrate mixture showed the strong anti-sticking effect on Streptococcus mutans, Streptococcus mitis, and Streptococcus salivarius, which are adhered to glass beads. Each Streptococcus species was shaking-cultured in brain heart infusion broth containing three glass beads. After 18 hr, glass beads were slightly washed into normal saline by three-pin-pointed pincette. Each three glass-beads set was put into reagent -containing tubes, which have 40 mg of bits of weighing paper for gaining brushing effect as similar as brushing one's teeth. The tubes were shaken by vortex mixer for 10 min except non-oral microbe, Streptococcus agalactiae (5 min). The samples were colony-counted by serial agar dilution method. Experiment was repeated three times for each Streptococcus species. The relative ratios of bacterial de-adherence by reagents were calculated in comparison with normal saline control. The de-adherence degree of citric acid-trisodium phosphate-saline mixture (CTS, pH 6.0) against Streptococcus mutans came to an average of 12.5 times compared with normal saline control. Trisodium-saline (TS, pH 8.4) showed the average of 7.5 times, and citric acid-saline (CS, pH 4.6) showed 6.0 times compared to the control group. The bacterial de-adherence degree against Streptococcus salivarius was each 7.2,2.6 and 2.8 times in above reagent sequence in comparison with saline control. CTS and TS showed 2.4 and 3.4 times of anti-sticking effect on Streptococcus mitis respectively, but CS had no anti-sticking effect on this bacterium. CTS, TS and CS showed 0.7, 0.6, and 0.6 times on non-oral microbe, Streptococcus agalactiae, separately compared with saline control. These results show that oral Streptococcus mutans, Streptococcus salivarius, and Streptococcus mitis, which are causative of dental caries or subacute endocarditis, may be easily removed from oral cavity by CTS mixture. It is conceivable that our experimental results will enable the development of a new conceptive toothpaste to prevent dental caries or subacute endocarditis after drawing teeth.

• 보건세계
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• v.54 no.2 s.606
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• pp.44-47
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• 2007

폐렴은 아주 다양한 원인으로 생긴다. 그 중 세균, 곰팡이, 바이러스, 기생충과 같은 미생물이 폐렴을 일으키는 일이 흔하다. 폐렴을 일으키는 미생물이 100여 가지가 넘지만 폐렴을 가장 흔히 일으키는 것은 세균이다. 세균 중에서도 폐렴사슬알균은 폐렴의 가장 흔한 원인이다. 그 외에도 유기용제, 구토물 등이 폐에 들어가 폐렴을 일으키기도 한다.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.12 no.11
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• pp.4951-4958
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• 2011

The purpose of this study was availability for the classical test method. The test were called CLSI(Clinical and Laboratory Standards Institute) that was disk diffusion method, the newly designed E-test(made use disk diffusion method) can estimate the MIC and modified broth microdilution method that was standardized. Those tests were observed by MicroScan MicroSTREP plus panel. Target strains were 53 strains of S.pneumoniae and 51 strains of ${\alpha}$-hemolytic streptococci which were separated from the inpatient in university hospital for 6 months from February to August, 2009. The 9 antimicrobial agent of target evaluation were cefotaxime, chloramphenicol, clindamycin, erythromycin, levofloxacin, penicillin, tetracycline, trimethoprim/sulfamethoxazole, and vancomycin. researched comparative analysis both S.pneumoniae and ${\alpha}$-hemolytic streptococci. The result of the high concordance rates in ${\alpha}$-hemolytic streptococci was recognized formally in clinical microbiology laboratory.

• Clinical and Experimental Pediatrics
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• v.48 no.7
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• pp.716-722
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• 2005

Purpose : A full view of the spectrum of all bacterial diseases in healthy children is essential to the establishment of public health priorities. Accurate information on the relative importance of the various pathogens in terms of the age of the affected patients, the site of infection and the case fatality rate are valuable to the clinician in choosing antimicrobial treatments. Methods : Fifty-nine episodes of bacteremia were analysed. Data were collected at Ilsan Paik Hospital from January 2000 to December 2003. Analysis of each collected episode included isolating pathogen from blood culture, diagnosis, hospital course, isolating pathogens from other tissue sites, and studying results of antimicrobial sensitivity tests. Results : Fifty-nine cases of community-acquired bacteremia were reviewed. The most common pathogen was Staphylococcus aureus(11 cases, 18.6 percent), followed by Salmonella(10 cases, 16.9 percent), E. coli(7 cases, 11.9 percent), Streptococcus pneumoniae(five cases, 8.5 percent), Streptococcus viridans(5 cases 8.5 percent). The most common diagnosis was bacteremia without an indentified focus(61 percent), followed by meningitis(12 percent), bacteremia with enteritis(10.2 percent) and bacteremia with urinary tract infection(8.5 percent). Salmonella was still an important causative agent of bacteremia. The relative importance of Haemophilus influenza and Streptococcus pneumoniae was lower than in other studies. The most common organism responsible for bacteremia without an identified focus was Staphylococcus aureus. The case-fatality was 3.4 percent for all cases of bacteremia. Conclusion : We reviewed the etiology of community-acquired bacteremia. These data may be useful in the establishment of public health priorities and serve as a reference for selection of antibiotics in the empirical therapy of suspected invasive bacterial infection.

• Pediatric Infection and Vaccine
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• v.16 no.2
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• pp.210-214
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• 2009

Group A streptococcus (GAS) rarely causes meningoencephalitis in children without risk factors. A previously healthy 8 year-old child presented with lethargy, high fever, and vomiting. The clinical course was unusual including intractable seizures, disseminated intravascular coagulation (DIC), and left hemiparesis in spite of the appropriate and timely administration of antibiotics and corticosteroids. The microbiologic studies revealed that the pathogen was susceptible to penicillin and GAS M18 strains. This case showed the importance of the GAS vaccine in addition to appropriate antibiotics.