• Pediatric Infection and Vaccine
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• v.30 no.1
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• pp.33-38
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• 2023

A case of persistent Ralstonia mannitolilytica bacteremia in the neonatal intensive care unit prompted source investigation due to its rarity. After an extensive investigation, a contaminated ultrasonic nebulizer was identified as the source, and the infection was controlled by removing the source. This study emphasizes the importance of further investigations, even in single cases of rare pathogens.

• Pediatric Infection and Vaccine
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• v.23 no.2
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• pp.128-136
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• 2016

Purpose: This study was done to define clinical characteristics of fever without localizing signs (FWLS) in infants younger than 100 days of age with a goal of providing baseline data to establish a new diagnostic paradigm in the future. Methods: We reviewed medical records of 183 patients who admitted to Daegu Catholic University Medical Center for FWLS younger than 100 days of age from January 2013 to September 2015 retrospectively. Demographic, clinical features and laboratory findings were analyzed. Patients were divided into serious bacterial infection (SBI) and non-SBI groups, and then were compared between two groups to find risk factors for SBI. Results: Among 183 patients, lumbar puncture was performed in 98.9% and CSF pleocytosis was present in 35.9%. Sterile CSF pleocytosis was found in 43% of urinary tract infection (UTI) patients. None had concomitant bacterial meningitis in patients with UTI. As final diagnosis, febrile syndrome without source (25.7%) was most common. Among SBI, UTI was most common (99%). Birth weight, ESR, and CRP were significantly higher in SBI group compared to non-SBI group. Male sex (OR 4.93, 95% CI 1.60-15.24) and pyuria (OR 18.88, 95% CI 6.76-52.76) were identified as risk factors for SBI. Presence of sibling (OR 0.30, 95% CI 0.11-0.83) was significantly lower in SBI group. Conclusions: Our results showed UTI was the most common SBI in young infants with FWLS. Though aseptic meningitis can be coexisting with UTI, lumbar puncture may not be necessary in all patients having UTI.

• The Monthly Diabetes
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• s.216
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• pp.39-41
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• 2007

당뇨병환자에서의 감염증은 인슐린과 항균제의 사용으로 그 이환율과 사망률이 현저히 감소하였으나, 현재까지 당뇨병환자의 진료에 있어서 해결해야 할 중요한 문제로 남아있다. 당뇨병환자에서 감염증의 발생빈도는 대부분 일반인과 차이가 없다고 보고되고 있으나 일부 특정 감염증의 빈도는 현저하게 증가하고 감염증의 정도가 훨씬 심하며, 임상양상도 정상인과 다른 것으로 알려져 있다. 특히 인플루엔자, 세균뇨, 악성 외이도염, 비뇌모균증, 기종성 담낭염, 기종성 신우신염 또는 방광염, 급성 신유두괴사, 신주위 농양, 진균성 요로 감염증, 그람 음성균에 의한 폐렴, 괴사성 연조직 감염과 족부 궤양 관련 감염증 등은 당뇨병과의 관련성이 이미 입증된 감염질환들이다. 당뇨병 환자에서 감염증의 발생빈도는 약 14.4%에서 39.5%까지 보고되고 있으며, 국내에서는 폐결핵 20%, 요로 감염 20%, 폐렴 16%, 진균감염 7.6%, 균혈증 6.2%, 족부 궤양 관련 감염증 5.5%의 순으로 보고되고 있다. 당뇨병환자가 감염증에 대한 원인에 대해서는 확실히 밝혀지지는 않았지만 탈수, 영양실조, 다형 백혈구의 기능 장애, 혈액 순환장애 및 신경병증 등으로 설명되고 있다. 특히 당뇨병환자에서는 미세 혈관병증과 죽상경화증이 흔히 발생하기 때문에 각 조직으로의 혈액 공급이 감소되어 각 장기 조직에서는 정상적인 영양 및 산소 공급과 적절한 면역 반응을 유지하는 것이 어려워 결과적으로 감염증에 걸리기 쉽다. 이 글에서는 여러 가지 감염증 중 족부 궤양 감염증, 기종성 신우신염, 비대뇌모균증, 간농양에 대해 사례를 중심으로 알아보겠다.

• Journal of Korean Society of Environmental Engineers
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• v.35 no.7
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• pp.503-508
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• 2013

The aim of this study was to investigate the microbial communities in animal carcass disposal soils to examine the possible threat of pathogens from leachate. DNA extraction was performed for the soils in three carcass disposal sites located in Gyeonggi-do, Korea, and then 16S rRNA pyrosequencing was conducted to identify the microbial communities. Results indicate that, according to phylum classification, Proteobacteria (100%) was identified in soil A, Actinobacteria (66.4%) > Proteobacteria (31.1%) > Bacteriodetes (2.1%) > Acidobacteria (0.3%) in soil B, and Actinobacteria (63.1%) > Proteobacteria (36.9%) in soil C. According to genus classification, Pseudomonas was dominant in soil A (98%), Arthrobacter in soil B (68%) and C (61%). There were no detections of pathogens such as Salmonella, Campylobacter and Clostridium perfringens. However, high concentration of Ralstonia pickettii causing bacteremia was observed. Although carcass disposal soils examined in this study were not highly contaminated with pathogens, further monitoring is still needed to examine the potential threat of pathogens in leachate derived from carcass disposal sites.

• Pediatric Infection and Vaccine
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• v.8 no.2
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• pp.191-198
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• 2001

Purpose : The purpose of this study was to investigate clinical features of hospitalized infants 28~90 days of age with fever without source and to analyze those of young febrile infants using risk criteria for serious bacterial infection. Methods : The clinical features of 131 infants 28~90 days of age admitted to the Ulsan Dong-Kang General Hospital Pediatric Department because of fever(temperature ${\geq}38^{\circ}C$ rectally) without source, from January 2000 to December 2000, were investigated by retrospective chart review. The clinical features of 131 febrile infants were analyzed using Rochester criteria. Results : Among 131 cases, there were 60 cases(45.8%) of urinary tract infection, 33 cases (25.2%) of aseptic meningitis, 2 cases(1.5%) of bacteremia and 36 cases(27.5%) of no specific diagnosis. Among 131 cases, there were 57 cases(43.5%) in low risk group and 74 cases(56.5%) in not low risk one by Rochester criteria. A significant difference in the incidence of urinary tract infection, aseptic meningitis and no specific diagnosis was not found between both groups. Male to female ratio was 1.8 : 1. Sex ratio between both groups was not significantly different. Most febrile infant were noted in spring(35.1%) and the summer(36.7%). The peak incidence of aseptic meningitis was noted in May and June. The fever subsided mostly within 48~72 hours after administering antimicrobial agents(61.8~83.2%). A significant difference in duration of fever after administering antimicrobial agents was not found between both groups. Conclusion : A selected group of low risk infants 28~90 days of age with fever without source can be managed as outpatients provided that a thorough initial evaluation is performed, that parents can reliably monitor their infant closely at home and that careful follow up can be assured. Because bag collected specimens were more likely to yield indeterminate urine culture result, a suprapubic or catheter obtained urine specimen for culture is a necessary part of the evaluation of all febrile infants 28~90 days of age. The further prospective study on evaluation and management of young febrile infant should be performed in our hospital.

• Clinical and Experimental Pediatrics
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• v.49 no.3
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• pp.278-286
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• 2006

Purpose : Although suprapubic bladder aspiration(SBA) is the most reliable technique for identifying bacteriuria in young infant, no report has been published about the clinical manifestations of urinary tract infection(UTI) diagnosed by aspirated urine in Korea. This study was performed to examine clinical manifestations and related factors of UTI confirmed by a positive urine culture obtained by SBA in young infants. Methods : We reviewed medical records of 159 infants younger than six months of age, who had been admitted for UTI to Korea University Ansan Hospital from January 2002 to June 2005. Results : The male:female ratio was 5.1 : 1. The most common pathogen in urine culture was Escherichia coli(92.5 percent). Most of the gram-negative pathogens had high sensitivity to amikacin, or third generation cephalosporins and had low sensitivity to ampicillin, trimethoprim-sulfamethoxazole, or gentamicin. Hydronephrosis and vesicoureteral reflux(VUR) were present in 32.7 percent and 27.7 percent respectively. Renal cortical defects observed on DMSA scans were detected in 37.1 percent. Prolonged fever duration and hospital day, high erythrocyte sedimentation rate(ESR) and C-reactive protein(CRP) levels, hydronephrosis and VUR were related to the renal cortical defects(P<0.05). Rates of UTI-associated bacteremia and aseptic meningitis were 8.3 percent and 6.6 percent. Conclusion : Early differential diagnosis is very important in infants younger than 6 months of age with UTI because the clinical findings are non-specific and UTI-associated bacteremia and aseptic meningitis are concomitantly found. Because prolonged fever and higher ESR and CRP levels are risk factors of the renal cortical defects, radiologic evaluations and nephrologic follow-up were needed in identifying the predisposing congenital abnormalities and chronic renal scarring.

• Pediatric Infection and Vaccine
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• v.19 no.3
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• pp.157-161
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• 2012

Streptococcus anginosus is a member of Streptococcus milleri group, and is found in the oral mucosa, respiratory tract, and gastrointestinal tract as normal flora. It can develop into a disease in patients with deteriorating clinical condition or with clinical risk factors. A previously healthy 15-year-old boy was admitted due to fever, abdominal discomfort and vomiting which lasted for 7 days. He had a history of dental procedure 1 day before the development of fever. He was diagnosed with acute acalculous cholecystitis based on the clinical, laboratory, and imaging finding, and S. anginosus was isolated from the blood culture. The patient was successfully treated with antibiotic therapy.

• Microbiology and Biotechnology Letters
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• v.34 no.1
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• pp.52-57
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• 2006

For the purpose of production of a novel antihyperlipemial HMG-CoA reductase inhibitor from bacteria, a bacterium which showed the highest HMG-CoA reductase inhibitory activity was isolated from traditional Doenjang. This strain was identified as Bacillus cereus (D-3) based on its microbiological characteristics and 165 rRNA sequence analysis. The maximal HMG-CoA reductase inhibitor production from Bacillus cereus D-3 was obtained by cultivation in a Glucose-CSL broth containing 2% glucose, 0.6% corn steep liquor, $0.04%\;K_{2}HPO_4$ and $0.05%\;KH_{2}PO_4$ at $30^{\circ}C$ for 36 h. The final HMG-CoA reductase inhibitory activity under the above conditions was 39.4%.

• Clinical and Experimental Pediatrics
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• v.49 no.10
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• pp.1116-1119
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• 2006

Pyomyositis is a primary bacterial infection of the skeletal muscles. Although infection can affect any skeletal muscle, the large muscle groups such as the quadriceps or gluteal muscles are most often the focus of this disease, and most commonly the inflammation is focal, involving a single muscle. The mechanism of pyomyositis is poorly understood. The local mechanical trauma at the time of an incidental bacteremia is frequently postulated as a mechanism that could explain the high incidence of the disease in tropical areas and its male preponderance. Staphylococcus aureus is the most common organism responsible for pyomyositis. Mycobacterium tuberculosis primarily affects the lungs, and the prevalence of active pulmonary tuberculosis co-existing with musculoskeletal tuberculosis has been about 30 percent. We report here on a case of an otherwise healthy 17-month-old girl, who had tuberculous pyomyositis at the upper arm after the hepatitis A vaccination with no evidence of any coexistent active tuberculosis.

• Pediatric Infection and Vaccine
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• v.9 no.1
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• pp.100-103
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• 2002

Streptococcus milleri Goup Bacteria(SMG) comprise three species, Streptococcus anginosus, Streptococcus intermedius, Streptococcus constellatus. Although they are commensal organism, they can be pathogenic. SMG can be aggressive pathogen in the head and neck with a propensity for abscess formation and local extension of the infection. SMG is culturally and biochemically variable, which makes it hard for the clinicians to recognize it. Hence, it seems that this organism has been relatively neglected. Most of the Lancefield F streptococci are SMG. We report one patient who had Group F streptococcal bacteremia and subdural abscess. According to his medical history, he was diagnosed as membranoproliperative glomerulonephritis three years ago. He complained headache although he was treated by appropiate antibiotics. Brain CT was used as a tool to identify the brain abscess. He had surgical drainage and was treated with IV antibiotics postoperatively.