• Title/Summary/Keyword: Clinical specimens

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Characterizations of the Antimicrobial Resistant Determinants in Proteus spp. Isolated from Humans and Chickens in the Chungcheong Province (충청지역의 사람과 닭으로부터 분리된 Proteus속에 속하는 균주에 존재하는 항균제 내성유전자의 유전형 분석)

  • Sung, Ji Youn
    • Korean Journal of Clinical Laboratory Science
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    • v.48 no.4
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    • pp.327-334
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    • 2016
  • Recently, antimicrobial resistance of pathogenic bacteria has been increasing due to excessive use of antimicrobial agents in both humans and livestock. PCR amplification and nucleotide sequence analyses were conducted to investigate16S ribosomal RNA methyltransferase (RMTase) genes and integrons in P. mirabilis strains isolated from clinical specimens and chickens in an area of the Chungcheong providence. In addition, clonality analysis of P. mirabilis strains was performed using a repetitive extragenic palindromic sequence-based PCR (REP-PCR) method. Of the total 38 P. mirabilis isolates, 7 (18.4%) strains were isolated from clinical specimens contained in the RMTase genes and showed resistance to amikacin, tobramycin, and gentamicin. A total of 23 (60.5%) isolates carried class 1 integrons, but no isolates in our study harbored class 2 and class 3 integrons. Class 1 integrons detected in our study harbored genes encoding resistance to aminoglycosides (aadA2, aadA5, aadA7, and aacCA5), ${\beta}$-lactams ($bla_{PSE}$), erythromycin (ereA), lincosamides (linF), and trimethoprim (dfrA12, dfrA17, and dfrA32). We confirmed that the RMTase genes had spread among only the P. mirabilis isolates from clinical specimens, but class 1 integrons had widely disseminated among P. mirabilis isolates from clinical specimens and chickens. In addition, identical REP-PCR banding patterns were evidenced in only P. mirabilis isolates from chickens. Our results suggest the horizontal spreading of P. mirabilis isolates in the chicken farm. To prevent further spreading of antimicrobial resistant genes among P. mirabilis isolates, monitoring and clinical policing will be required.

Analysis of the Results of Blood Cultures, 1984~1987 at Yeungnam University Hospital (형랙배양검사 성적의 분석 -1984년에서 1987년까지 -)

  • Kim, Chung-Sook;Lee, Chae-Hoon;Choi, Myung-Sook;Cheon, Chang-Ho;Kim, Kyung-Dong
    • Journal of Yeungnam Medical Science
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    • v.5 no.1
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    • pp.49-60
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    • 1988
  • Reviewing the results of the blood cultures performed at Yeungnam University Hospital during 4-year-period through January. 1, 1984 to December 31, 1987, the following results were obtained. 1) Out of 808:3 blood specimens cultured microorganisms grew in 582 specimens with positivity rate of 7.20%. Polymicrobial bacteremia was found in 16 patients. 2) Among 582 positive specimens, Gram-positive cocci grew in 189 specimens, and Gram-negative bacilli, in 393 specimens. Clinically significant microorganisms consisted of 82 Staphylococcus aureus, and 20 Strptococcus species in Gram-positive cocci group, 80 Salmonella typhi, 72 Escherichia coli, 72 Salmonella paratyphi A in Enterobacteriaceae, and 46 Pseudomonas cepacia, and 16 Pseudomonas aeruginosa in glucose non-fermentating microorganisms. 3) Increasing incidence of Serratia, Acinetobacter and Pseudomonas species as major nosocomial infection source is noteworthy. They showed increased tendency from 6.3% of 1984 to 17.7% of 1987 of total positive blood cultures. 4) High isolation rate of Pseudomonas species and Aeromonas hydrophilia was noted in summer, while Salmonella typhi showed high prevalence from May to September and in January. 5) In susceptibility tests of isolated organisms, staphylococcus aureus was sensitive to basic antimicrobial agents except for ampicillin. The glucose non-fermentating microorganisms showed high resistance to basic antimicrobial agents in 32.2%. In conclusion, considering the relatively higher incidence of growth of Staphylococcus epidermidis than ideal level indicates that sampling technique should be improved. Secondly, all the hospital staffs in cooperation with Hospital Infection Committee are desirable to pay efforts to decrease the nosocomial infection.

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Recovery Rate of Nontuberculous Mycobacteria and the Clinical Course of Nontuberculous Mycobacterial Pulmonary Disease at a Secondary Hospital (일개 2차 의료기관에서의 비결핵성 마이코박테리아 분리비율 및 폐질환의 임상 경과)

  • Lee, Jae Kwang;Kwon, Hwuck Young;Kwon, Jong Kyu;Lee, Hwa Jeong;Lee, Dong Wook;Lee, Yu Jin;Yoon, Kyung Hwa;Song, Do Young;Lee, Byung Ki;Kim, Yeon Jae
    • Tuberculosis and Respiratory Diseases
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    • v.67 no.3
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    • pp.199-204
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    • 2009
  • Background: To examine the recovery rate of nontuberculous mycobacteria (NTM) from respiratory specimens and the clinical course of NTM pulmonary disease at a 700-bed secondary hospital. Methods: This study analyzed the results of 843 acid-fast bacilli (AFB) culture-positive respiratory specimens from 650 subjects collected between May 2003 and April 2008. In addition, the clinical course of NTM pulmonary disease, diagnosed using criteria established by the American Thoracic Society, was examined. Results: There were 67 (7.9%) NTM isolates recovered from 52 (8.0%) subjects. Among the 535 AFB smear-positive specimens, 34 (6.3%) NTM isolates were recovered. There were 33 (10.7%) NTM isolates were recovered from 308 AFB smear-negative specimens. Of 52 subjects with isolated NTM, M. intracellulare was the most common species at 73.1% (n=33), followed by M. kansassi (n=7), M. abscessus (n=2), M. fortuitum (n=2), and M. avium (n=1). Sixteen (30.8%) patients had NTM pulmonary disease and the most common causative organism was M. intracellulare (n=14, 87.5%). Of these, 6 cases attained negative conversion in culture, 4 cases failed to attain negative conversion because of poor cooperation or expiration from complicated underlying lung disease, and 5 cases were transferred to a higher-grade hospital. Conclusion: The recovery rate of NTM from respiratory specimens was relatively low and the most common species was M. intracellulare. Patients with NTM pulmonary disease showed variable clinical outcomes.

Clinical Usefulness of Helicobactor pylori Ag Stool Test (Immunochromatographic Assay) for Diagnosis of H. pylori Infection (Helicobacter pylori 감염진단에 있어 H. pylori Ag Stool 검사 (면역크로마토그라피법)의 임상적 유용성)

  • Seo, Seol
    • Korean Journal of Clinical Laboratory Science
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    • v.42 no.1
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    • pp.38-45
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    • 2010
  • The aim of this study was to assess the Clinical Usefulness of Helicobacter pylori Stool Antigen (HpSA) immunochromatographic assay for the diagnosis of H. pylori infection. In this study, we had compared HpSA-immunochromatographic assay with CLO test and UBT test. From a total of 140 patients (M:F=88:52) with upper endoscopy, biopsy specimens were obtained for CLO test. Stool specimens was collected from all patients and tested using a HpSA-immunochromatic assay. H. pylori infection status was defined as infected if the results of both CLO test and UBT test were positive. CLO test and UBT test findings showed that 92 patients were H. pylori positive and 48 patients were H. pylori negative. According to this definition, the sensitivity, specificity, and positive or negative predictive value (PPV, NPV) of HpSA-immunochromatographic assay were 97.8%, 100%, 100%, and 96%, respectively. Cross reactivity test of HpSA-immunochromatographic assay were performed with 10 enteric bacteria strains in fecal habitat, and there were no false positive reaction. We evaluated the usefulness of HpSA assay for eradication therapy with 10 of 92 H. pylori positive patients, positive results of them at pre-eradication therapy were converted to negative at post-eradication. The HpSA-immunochromatographic assay is a highly sensitive and specific non-invasive diagnostic method for detection of H. pylori infection, a useful diagnostic method for H. pylori in post eradication stage.

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Usefulness of PCR to Mycobacterium Tuberculous and Nontuberculous Mycobacteria from Paraffin-embedded Tissues

  • Choi, Yeon-Il;Kim, Hye-Young
    • Korean Journal of Clinical Laboratory Science
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    • v.46 no.2
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    • pp.47-53
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    • 2014
  • The purpose of this study was to evaluate the clinical utility of TB/NTM PCR by comparing the results of TB PCR to detect Mycobacterium tuberculous (MTB) and nontuberculous mycobacteria (NTM) from paraffin-embedded tissue specimens. A total of 60 cases were tested using TB PCR and TB/NTM PCR. The MTB and NTM rate of TB/NTM PCR was 84.2% (16/19), 10.5% (2/19) in TB positive of TB PCR. The NTM rate of TB/NTM PCR was 29.3% (12/41) in TB negative of TB PCR. Fourteen different species of NTM were identified, the common isolate was M. gordonae (21.4%), M. avium (14.3%), M. ulcerans (7.1%), M. interjectum (7.1%), M. gilvum (7.1%), M. fortuitum (7.1%), M. mucogenicum (7.1%). The rare species identified were M. farcinogenes (7.1%), M. tokaiense (7.1%). Therefore, TB/NTM PCR is useful to differentiate MTB and NTM from paraffin-embedded tissue specimens and it is more effective in detecting NTM with TB PCR.

Whole Genome Analysis of Human Papillomavirus Type 16 Multiple Infection in Cervical Cancer Patients

  • Chansaenroj, Jira;Theamboonlers, Apiradee;Junyangdikul, Pairoj;Swangvaree, Sukumarn;Karalak, Anant;Poovorawan, Yong
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.2
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    • pp.599-606
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    • 2012
  • The characterization of the whole genome of human papillomavirus type 16 (HPV16) from cervical cancer specimens with multiple infections in comparison with single infection samples as the oncogenic potential of the virus may differ. Cervical carcinoma specimens positive for HPV16 by PCR and INNO-LiPA were randomly selected for whole genome characterization. Two HPV16 single infection and six HPV16 multiple infection specimens were subjected to whole genome analysis by using conserved primers and subsequent sequencing. All HPV16 whole genomes from single infection samples clustered in the European (E) lineage while all multiple infection specimens belonged to the non-European lineage. The variations in nucleotide sequences in E6, E7, E2, L1 and Long control region (LCR) were evaluated. In the E6 region, amino acid changes at L83V were related to increased cancer progression. An amino acid variation N29S within the E7 oncoprotein significantly associated with severity of lesion was also discovered. In all three domains of the E2 gene non synonymous mutations were found. The L1 region showed various mutations which may be related to conformation changes of viral epitopes. Some transcription factor binding sites in the LCR region correlated to virulence were shown on GRE/1, TEF-1, YY14 and Oct-1. HPV16 European variant prone to single infection may harbor a major variation at L83V which significantly increases the risk for developing cervical carcinoma. HPV16 non-European variants prone to multiple infections may require many polymorphisms to enhance the risk of cervical cancer development.

Relation of Sampling Time to the Detection of Enteroviral RNA in Cerebrospinal Fluid from the Patients with Aseptic Meningitis (무균성 수막염 환자의 뇌척수액 채취 시기와 장바이러스 RNA 검출과의 관계)

  • Lee, Kyu Man;Park, Soon Young;Kang, Hee Jung;Lee, Eun Hee
    • Pediatric Infection and Vaccine
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    • v.3 no.2
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    • pp.163-167
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    • 1996
  • Aseptic meningitis, the most common infection of the central nervous system, is an acute illness mostly caused by enteroviruses. Cerebrospinal fluid(CSF) has been used for the detection of enteroviral RNA but the detection has been mostly performed in a single CSF specimen obtained during the illness. A major objective was to evaluate the relation of sampling time to the recovery of enteroviral RNA in CSF. Thirty seven CSF specimens were obtained from 24 patients between May and August 1993, when an outbreak of asceptic meningitis by echovirus type 9 occurred. Enteroviral RNA in CSF was detected by polymerase chain reaction(PCR). Data about onset of symptom development were obtained by review of medical records. Enteroviral RNA was detected by PCR in 29 of 37 CSF specimens. PCR yielded positive results in 4 of 5 CSF specimens obtained on day 1 to 3, 10 of 11 on day 4 to 6, 8 of 10 on day 7 to 9, 6 of 8 on day 10 to 12, 1 of 3 on day 13 to 15 postonset. Of 11 patients from each of whom more than one CSF were obtained on different day postonset, PCR yielded positive resutls in 2 of 3 cases in whom enteroviral RNA detection was negative in the first CSF. These results indicate that two or more CSF specimens obtained within 12 days postonset are required for improving the accuracy of the diagnosis of enteroviral meningitis.

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Clinical and Pathological Findings of Renal Biopsy in Children: Outcomes from a Single Center Over 27 Years

  • Lee, Shin Ae;Kim, Min Sun;Kim, Soon Chul;Lee, Dae-Yeol
    • Childhood Kidney Diseases
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    • v.21 no.1
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    • pp.8-14
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    • 2017
  • Purpose: To classify the results of renal biopsy in pediatric patients and to compare pathological findings with clinical features. Methods: This study included data of 318 children who underwent renal biopsy at our hospital between December 1987 and November 2014. Biopsy specimens were examined histopathologically using light, immunofluorescence, and electron microscopy. Results: Asymptomatic urinary abnormalities was the most common clinical diagnosis (35.9%), followed by nephrotic syndrome (29.3%), and acute glomerulonephritis (18.0%). Glomerular disease was identified in 98.1% of the renal biopsy specimens. The most common primary cause of glomerulonephritis was IgA nephropathy, with gross hematuria in 61.9% of the patients, hypertension in 14.2%, proteinuria >1.0 gm/24-hr in 33.3%, and impaired renal function in 3.6% patients. Conclusion: The most common clinical diagnosis was asymptomatic urinary abnormalities, with primary glomerular disease being the most common renal biopsy finding, and IgA nephropathy the most common histopathological lesion. This study provides a 27-year overview of pediatric renal disease at our center and underlines the importance of renal biopsy for accurate diagnosis and proper management.

Comparison of Detection Sensitivity for Human Papillomavirus between Self-collected Vaginal Swabs and Physician-collected Cervical Swabs by Electrochemical DNA Chip

  • Nilyanimit, Pornjarim;Wanlapakorn, Nasamon;Niruthisard, Somchai;Takahashi, Masayoshi;Vongpunsawad, Sompong;Poovorawan, Yong
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.24
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    • pp.10809-10812
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    • 2015
  • Background: Human papillomavirus (HPV) DNA testing is an effective method to screen for precancerous changes in the cervix. Samples from self-collection rather than Pap smear can potentially be used to test for HPV as they are more acceptable and preferred for use in certain settings. The objective of this study was to compare HPV DNA testing from self-collected vaginal swabs and physician-collected cervical swabs. Materials and Methods: A total of 101 self-collected vaginal and physician-collected cervical swabs of known cytology from Thai women were tested by electrochemical DNA chip assay. The specimens were divided into 4 groups: 29 with normal cytology, 14 with atypical squamous cells of undetermined significance (ASCUS), 48 with low-grade squamous intraepithelial lesion (LSIL), and 10 with high-grade squamous intraepithelial lesion (HSIL). Results: Positive detection rates of HPV from self-collected swabs were similar to those from physician-collected swabs. Among specimens with abnormal cytology, HPV was found in 50% of self-collected swabs and 47.2% of physician-collected swabs. In specimens with normal cytology, 17.2% of self-collected swabs and 24.1% of physician-collected swabs were positive for HPV. Concordance was relatively high between results from self-collected and physician-collected samples. The most common HPV genotype detected was HPV 51. Conclusions: HPV DNA testing using self-collected swabs is a feasible alternative to encourage and increase screening for cervical cancer in a population who might otherwise avoid this important preventive examination due to embarrassment, discomfort, and anxiety.

Practical Understanding of Gross Examination Techniques (육안검사기술의 실무적 이해)

  • Woo-Hyun JI
    • Korean Journal of Clinical Laboratory Science
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    • v.56 no.1
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    • pp.89-98
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    • 2024
  • Gross examination techniques (GETs) of specimens collected from cancer surgery or endoscopy comprise the act of recording visual information about cancer for accurate histopathological diagnosis and collecting sections of the lesion to create microscopic specimens. GETs must include concise and accurate expressions, appropriate structuring, sufficient resections, error-free standardization of important information, and photo-diagramming of complex specimens. To increase the satisfaction of pathological interpretation, it is a task that must be performed accurately and carefully to gain confidence on a theoretical and practical basis with a sufficient understanding of gross examination. Based on the experience of clinical pathologists in the field of GETs, additional specimen types should be identified as viable candidates. Also, their needs and concerns regarding treatment should be carefully considered. In addition, departments at each institution should review the national focus on clinical partnerships, continuous professional training, diagnostic errors, and value-based healthcare provision.