• Neonatal Medicine
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• v.16 no.2
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• pp.172-181
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• 2009

Purpose: To identify trends in causative bacterial organisms for neonatal sepsis and antimicrobial susceptibilities over 10 years in one neonatal intensive care unit. Methods: We retrospectively reviewed the cases of culture-proven neonatal sepsis between January 1998 and December 2007. The 10-year period was divided into two phases (phase I, 1998-2002; phase II, 2003-2007) to distinguish the differences during the entire period. Results: Total 350 episodes of neonatal sepsis were identified in 315 neonates. The common pathogens of early-onset sepsis were S. epidermidis, S. aureus, P. aeruginosa, and E. cloacae in phase I, and S. epidermidis and E. cloacae in phase II. In cases of late-onset sepsis, coagulase negative Staphylococcus, S. aureus, and K. pneumoniae were isolated frequently in both phases. The incidence of sepsis caused by multi-drug resistant organisms decreased with strict infection control. Gram positive organisms showed 0-20% susceptibility to penicillin, ampicillin, and cefotaxime in both phases. Sensitivity to amikacin for Enterobacter spp. increased, whereas P. aeruginosa showed decreased sensitivity in phase II. Between 50% and 60% of other gram negative bacteria, except P. aeruginosa, were susceptible to cefotaxime in phase II in contrast to phase I. Greater than 80% of gram negative bacteria were sensitive to imipenem except P. aeruginosa and ciprofloxacin in both phases. Conclusion: The trend in causative microorganisms and antimicrobial susceptibilities can be used as a guideline for selection of appropriate antibiotics. A particular attention should be paid to infection control, especially to reduce sepsis caused by multi-drug resistant organisms.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.3
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• pp.85-93
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• 2017

The urinary tract infection (UTI) is one of the most important infections in hospital. The overuse and misuse of antimicrobial agents and the resulting emergence of resistant microorganisms have made choices regarding antimicrobial therapy more difficult. This study examined the changes in the antibiotic susceptibility to the causative organisms of urinary tract infections to provide useful information on the choice of adequate drugs in the treatment of urinary tract infections. The medical records of 2,707 patients with more than $10^5/ml$ microorganism in urine culture between January 2010 and December 2015 were reviewed retrospectively. The most common pathogenic organism was E. coli (28.1%). In the case of E.coli, there were no differences in frequency from 2010 to 2015 in men, but since 2014, the frequency decreased gradually since 2014 in women. For E. coli, the resistance rates to antibiotics were 72.2% in ampicillin, 44.9% in trimethoprim/sulfamethoxazole (TMP/SMX), and 41.3% in ciprofloxacin, but the 2nd, 3rd, and 4th cephalosporin (5%) had low antibiotic resistance rates. The pathogens of urinary tract infection are becoming diverse and their frequencies are also changing over time. These results suggest that the recommended drugs for UTI should be selected more carefully for in-patients and out-patients.

• Journal of Chest Surgery
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• v.37 no.2
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• pp.160-165
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• 2004

Successful treatment of multi-loculated pleural effusion or thoracic empyema requires effective drainage and definitive diagnosis of causative organism. The purpose of this study was to assess the efficacy of the video-assisted thoracoscopic surgery in the management of thoracic empyema or multi-loculated pleural effusion after chest tube drainage treatment had failed. Material and Method: Between April 2000 and July 2002, 20 patients with thoracic empyema or multi-loculated pleural effusion that failed to chest tube drainage or other procedures who underwent an operation. All patients were assessed by chest-computed tomogram and underwent video assisted thoracoscopic drainage, debridement, biopsy and irrigation of pleural cavity. Result: In 18 cases (90%), underwent successful video-assisted thoracoscopic surgery. In 2 cases, decortications by mini-thoracotomy were necessary. The ratio of sex was 4 : 1 (16 male: 4 female), mean age was 48.9 years old (range, 17∼72 years), mean duration of postoperative chest tube placement was 8.2 days (range, 4∼22 days), mean postoperative hospital stay was 15.2 days (range, 7∼33 days). Causative disease was tuberculosis, pneumonia, trauma and metastatic breast cancer, There were no major postoperative complications. Symptoms improved in all patients and were discharged with OPD follow up. Conclusion: In an early organizing phase of empyema or multi loculated pleural effusion, video-assisted thoracoscopic drainage and debridement are safe and suitable treatment.

• Journal of Chest Surgery
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• v.45 no.3
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• pp.171-176
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• 2012

Background: Deep neck infections (DNI) can originate from infection in the potential spaces and fascial planes of the neck. DNI can be managed without surgery, but there are cases that need surgical treatment, especially in the case of mediastinal involvement. The aim of this study is to identify clinical features of DNI and analyze the predisposing factors for mediastinal extension. Materials and Methods: We reviewed medical records of 56 patients suffering from DNI who underwent cervical drainage only (CD group) and those who underwent cervical drainage combined with mediastinal drainage for descending necrotizing mediastinitis (MD group) from August 2003 to May 2009 and compared the clinical features of each group and the predisposing factors for mediastinal extension. Results: Forty-four out of the 56 patients underwent cervical drainage only (79%) and 12 patients needed both cervical and mediastinal drainage (21%). There were no differences between the two groups in gender (p=0.28), but the MD group was older than the CD group (CD group, $44.2{\pm}23.2$ years; MD group, $55.6{\pm}12.1$ years; p=0.03). The MD group had a higher rate of co-morbidity than the CD group (p=0.04). The CD group involved more than two spaces in 14 cases (32%) and retropharyngeal involvement in 12 cases (27%). The MD group involved more than two spaces in 11 cases (92%) and retropharyngeal involvement in 12 cases (100%). Organism identification took place in 28 cases (64%) of the CD group and 3 cases of (25%) the MD group (p=0.02). The mean hospital stay of the CD group was $21.5{\pm}15.9$ days and that of the MD group was $41.4{\pm}29.4$ days (p=0.04). Conclusion: The predisposing factors of mediastinal extension in DNI were older age, involvement of two or more spaces, especially including the retropharyngeal space, and more comorbidities. The MD group had a longer hospital stay, higher mortality, and more failure to identify causative organisms of causative organisms than the CD group.

• Korean Journal of Fisheries and Aquatic Sciences
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• v.28 no.3
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• pp.364-372
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• 1995

On the outbreak of paralytic shellfish poisoning in April 1993 in most of shellfish harvesting areas in Jinhae Bay, Korea, to clarify the toxin production of causative organism Alexandrium species, 19 axenic clonal isolates established from the benthic resting cysts in three different stations of those culture grounds were subjected to PSP toxin analysis by HPLC. Individual toxin content per cell was highly variable among the strains isolated from a sampling area and originated from an individual cyst. Average toxin contents in those areas revealed higher values of 54-70 fmol/cell. Toxin profiles included C1/C2(epiGTX8/GTX8), GTX1/GTX4 and neoSTX as the major components, and GTX2/GTX3, GTX5, C4, dcSTX and STX as the minor or sporadic ones. neoSTX on the dominant toxins showed not only most diverse compositional changes comprising $5-54 mol\%$ ranges but also no detection on the half of the strains examined, which were implicated in arising of heterogeneity with a genetic trait within a geographical region. When average toxin composition was compared, carbamate toxins comprised large proportions of $57\%,\;54\%\;and\;67\%$ as total toxin in St. 1, St. 2 and St. 4, respectively. These results suggested that an extensive paralytic shellfish toxification in Jinhae Bay could be largely due to the production of highly potent carbamate toxins in the causative dinoflagellate Alexandrium species.

• The Journal of the Korean Society for Microbiology
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• v.22 no.3
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• pp.209-218
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• 1987

Leptospira interrogans, the causative organism of leptospirosis, is characterized by a fine helical morphology, and the helix is almost always right-handed. However, one of the striking features of recent isolates of L. interrogans in Korea was the heterogeneity in their morphology. Even under optimal culture conditions($30^{\circ}C$, EMJH medium), rods, spiral forms with right or left-handed helices, and even spherical forms of L. interrogans were present. Although the literature notes the presence of left-handed helices, long rods, and spherical forms in cultures of L. interrogans isolates, little is known about the cause of this morphologic heterogeneity. In an attempt to answer this question, this study was initiated to examine the effects of culture conditions, especially temperature and medium, on the morphology of L. interrogans. Four temperatures($5^{\circ}C$, $15^{\circ}C$, $30^{\circ}C$, and $37^{\circ}C$) and two types of media(Fletcher and EMJH) were used; one strain from Korean isolates and L. interrogans serovar canicola obtained from the Pasteur Institute(Paris, France) were employed throughout the study. The findings are as follows: 1. The L. interrogans isolated in Korea(UM-19) had a larger cell diameter($0.25{\sim}0.30\;{\mu}m$: $0.10{\sim}0.15\;{\mu}m$), and helix diameter($0.10{\sim}0.60\;{\mu}m$: $0.10{\sim}0.15\;{\mu}m$) than that obtained from the Pasteur Institute, but they varied in their distances between the helices($0.31{\sim}1.00\;{\mu}m$: $0.50{\sim}0.70\;{\mu}m$). 2, When UM-19 was grown at $37^{\circ}C$ after months or longer preincubation at $5^{\circ}C$ or $15^{\circ}C$, the majority of the organisms were spiral forms; however, they became rods when subcultured at $30^{\circ}C$ or $37^{\circ}C$. No significant morphological differences were found between Fletcher and EMJH media. 3. When L. interrogans serovar canicola was subcultured more than ten times at $37^{\circ}C$, some of the organism lost their motility as well as the hooks at either one or both ends, but only in Fletcher medium. The number of variants increased with the frequency of subculturing. These findings suggested that L. interrogans strain (UM-19) is different, in their morphology, from that of the Pasteur Institute, and its various morphologies may represent stages of the life cycle and vary with incubation temperature.

• Clinical and Experimental Pediatrics
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• v.51 no.10
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• pp.1077-1084
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• 2008

Purpose : Despite the seriousness of bacterial meningitis in children, there is little information on the incidence, causative organisms, mortality rate and age distribution. We studied the frequency by age group and causal pathogens, and clinical characteristics in children with bacterial meningitis in the private sector in Korea. Methods : The medical records containing the data on bacterial meningitis patients under 18 years of age confirmed by cerebrospinal fluid (CSF) findings were retrospectively analyzed from September, 1993 to August, 2006 at Ewha Womans University Mokdong Hospital. Results : Eighty-one cases of bacterial meningitis were observed. Overall the most common organism was Streptococcus agalactiae (group B streptococcus, GBS) (30 cases, 37.0%) followed by Haemophilus influenzae (22 cases, 27.2%), Streptococcus pneumoniae (12 cases, 14.8%), Escherichia coli (3 cases, 3.7%), Neisseria meningitidis (1 case, 1.2%) and others (13 cases, 16.0%). In neonates and young infants under 2 months, the most common organism was GBS. In children between 3 months, and 5 years, the most common organism was H. influenzae. S. pneumoniae was the most common organism in children over 5 years of age. Thirty-one patients (38.3%) had complications. Of all ages, the mortality rate of bacterial meningitis markedly decreased compared with the previously reported rate. Conclusion : In neonates, GBS meningitis was most common. The frequency of H. influenzae meningitis decreased after the introduction of H. influenzae type b vaccination. A strategy for the prevention of GBS meningitis in neonates should be established. The influence of the pneumococcal conjugate vaccine on S. pneumoniae meningitis should be studied.

• The Journal of the Korean Society for Microbiology
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• v.20 no.1
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• pp.35-44
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• 1985

Isolation and identification of anaerobic bacteria from blood cultures are still technically demanding procedures. Recently, with the use of gas liquid chromatography, the accuracy of identification is much improved. However, there has never been a satisfactory data analysis on anaerobic bacteremia in Korea. The authors evaluated both the clinical and the bacteriological data of 129 anaerobic bacteremias found at the Yonsei Medical Center during the period of 1973 to 1984. The most frequently isolated anaerobic bacteria were Bacteroides (52.7%), among which the major species was B. fragilis (38.7%). Incidence of anaerobic bacteremia by sex was 57% in male and 43% in female. Mortality was higg in groups below 1-year old and above 50-year old. The cause of death seemed closely correlated with the patient's age, general condition and the severity of the underlying disease. Various neoplasms were the most common (20%) underlying diseases predisposing the anaerobic bacteremia. Biliary tract was considered the most frequent route of infection in anaerobic bacteremia. The frequent clinical signs in anaerobic bacteremia were fever (65%), followed by liver function abnormality (29%), jaundice (20%) and hypotention(18%). When analysis of positive rate of blood culture was made on the patients from whom 4 cultures were done within 24 hours, it was found that 33% of the samples were positive. Isolation rate of anaerobic bacteria in thioglycollate medium was 83.8%, while it was 44% in Tryptic soy broth. Among the anaerobic bacteremia, 25.4% were polymicrobial infections with aerobic bacteria (92.5%), such as E. coli(33.3%). From these studies, it is concluded that B. fragilis is the most important causative organism in anaerobic bacteremia, with high fatality, particularly in those who have underlying diseases. The ports of entry are mainly biliary, gastrointestinal and female genital tract. Fever is the most frequent clinical sign. Single blood culture is not sufficient to detect all anaerobic bacteremia, therefore more cultures with optimal time interval are needed. The incidence of polymicrobial infection in anaerobic bacteremia is higher than that in overall bacteremia.

• Journal of Environmental Science International
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• v.12 no.7
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• pp.725-733
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• 2003

This survey was carried out to assess important species of phytoplankton in the ocean and bay in Korea from 32 references. The number of important species assessed from 50 genera 116 species. Of them, Bacillariophycea(diatoms) 34 genera 89 speceis(76.6%), Dinophyceae(dinoflagellates) 11 genera 22 species(18.9%), Chrysophyceae 2 genera 2 species(1.7%), Cyanophycea(blue-green algae), Raphidophyceae, Euglenophyceae(euglenoids) 1 genera 1 species(0.9%) respectively. By ecological characters, the number of dominant species were 79 species including Actinoptychus seranius, 50 species including Coscinodiscus centralis were recorded as frequently apperaing species and 36 species including Cochlodinium polykrikoides were recorded as red-tide causative organism. Also, 11 species including Prorocentrum micans were surveyed as the indicator including all ecological characters.

• Tuberculosis and Respiratory Diseases
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• v.39 no.5
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• pp.438-442
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• 1992

Actinomycosis is a chronic suppurative infection characterized by extensive necrosis, fibrosis and sinus formation without regard to normal tissue planes. The causative organism in human infection is Actinomyces israelii. Thoracic actinomycosis is diagnosed in the presence of poor oral hygiene, pulmonary infiltrate, empyema, sinus tract and osteomyelitis of ribs. However, in the absence of chest wall involvement, the diagnosis of pulmonary actinomycosis is difficult and its initial clinical manifestations may lead physicians to suspect tuberculosis or neoplasm. It could not be distinguished from tuberculosis or neoplasm radiologically. We report a case of pulmonary actinomycosis in a 64 year old woman with a review of the literature.