• Tuberculosis and Respiratory Diseases
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• 제68권4호
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• pp.205-211
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• 2010

Background: Procalcitonin is a well known marker in infection that plays a role in distinguishing between bacterial and viral infections in screening. The aim of the present study was to evaluate the role of procalcitonin in differentiating between 2009 H1N1 influenza pneumonia and community acquired pneumonia of bacterial origin, or mixed bacterial origin and 2009 H1N1 influenza infection. Methods: A retrospective observational study was performed over the 6-month winter period during the 2009 H1N1 influenza pandemic. Ninety-six patient-subjects were enrolled, all of whom had been diagnosed with community acquired pneumonia in emergency department during the study period. On admission, laboratory studies were performed, which included 2009 H1N1 influenza real-time polymerase chain reaction of nasal secretions and procalcitonin on serum; the laboratory values were compared between the study groups. Receiver operating characteristic curve analyses were performed on the resulting data. Results: Compared to those with bacterial or mixed infections (n=62) and bacterial pneumonia with confirmed organisms (n=30), patients with 2009 H1N1 pneumonia (n=34) were significantly more likely to have low procalcitonin levels (p=0.008, 0.001). Using cutoff of value >0.3 ng/mL, the sensitivity and specificity of procalcitonin for detection of patients with confirmed bacterial pneumonia were 76.2% and 60.6%, respectively. A significant difference in procalcitonin was found between 2009 H1N1 pneumonia and pneumonia caused by mixed influenza viral and bacterial infections (0.15 [0.05~0.84] vs. 10.3 [0.05~22.87] ng/mL, p=0.045). Conclusion: Serum procalcitonin measurement may assist in the discrimination between pneumonia of bacterial and of 2009 H1N1 influenza origin. High values of procalcitonin suggest that bacterial infection or mixed infection of bacteria and 2009 H1N1 influenza is more likely.

• Journal of Microbiology and Biotechnology
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• 제24권8호
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• pp.1059-1064
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• 2014

Staphylococcus aureus is a major human pathogen, implicated in both community and hospital acquired infections. The therapy for methicillin-resistant Staphylococcus aureus (MRSA) infections is becoming more difficult because of multidrug resistance and strong biofilm-forming properties. Schiff bases have attracted attention as promising antibacterial agents. In this study, we investigated the in vitro activity of taurine-5-bromosalicylaldehyde Schiff base (TBSSB) against MRSA. The minimum inhibitory concentrations (MIC) and minimum bactericidal concentration (MBC) were determined using a microtiter broth dilution method. TBSSB effectively inhibited planktonic MRSA, with an MIC of $32{\mu}g/ml$. The time-kill curve confirmed that TBSSB exhibited bactericidal activity against MRSA. TBSSB was also found to significantly inhibit MRSA biofilm formation at 24 h, especially at $1{\times}MIC$ and sub-MIC levels. Furthermore, scanning electron microscopy and transmission electron microscopy showed remarkable morphological and ultrastructural changes on the MRSA cell surface, due to exposure to TBSSB. This study indicated that TBSSB may be an effective bactericidal agent against MRSA.

• 보건의료생명과학 논문지
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• 제9권2호
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• pp.303-308
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• 2021

최근 MRSA와 같은 항생제 내성 균주에 감염되는 사례가 점점 증가하는 추세이며, 특히 원내에서 감염되는 경우도 상당수 찾아볼 수 있다. 본 연구에서는 강원에 소재한 대학에 재학생들을 대상으로 병원 실습 경험 여부를 조사하고, 각각 비강 검체를 채취하여 황색포도알균인 Staphylococcus aureus 균주 및 MRSA (methicillin resistant Staphylococcus aureus)의 존재 여부를 동정하여 임상 실습 경험이 있는 학생과 MRSA 검출에 대한 관계를 확인하고자 하였다. 실험에 참여한 인원은 64명 학생으로 남학생 22명, 여학생 42명이다. 멸균된 면봉으로 비강 검체를 채취하여 수송 배지인 Thioglycollate broth로 수송한 뒤, 선택배지인 MSA(mannitol salt agar)에 접종했다. 균을 배양하여 다양한 생화학적 test 및 상용화 키트인 API Kit를 사용하여 분리 및 동정을 하였고, 최종으로 분자생물학적 방법을 사용하여 MRSA 검출 양상을 확인하였다. 64명 학생 중 Staphylococcus aureus 균주가 46명에서 검출되었으며, 46명의 검체 중에 22명에서 MRSA가 검출되었다, 22명의 학생 중에 남학생은 5명, 여학생은 17명이었으며, 15명의 학생은 최근 1년 이내에 입원, 수술력 또는 임상현장실습 등의 의료기관 관련 MRSA(HR-MRSA)로 확인되었고, 나머지 7명(%)은 CA-MRSA로 확인되었다. MRSA가 검출된 학생들의 감염경로를 확인한 결과, 평상시 의료기관 방문 여부와 임상 실습경험 등으로 비추어 볼 때 원내에서 감염되었다고 추정할 수 있으며, 임상실습에 참가하는 학생들을 대상으로 원내 감염 예방을 위한 추가적인 교육과 학생들의 적극적인 참여가 필요하다고 여겨진다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제13권2호
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• pp.146-153
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• 2010

목 적: 최근 소아에서의 지역사회 획득 Clostridium difficile 관련질환(CDAD)은 증가하는 것으로 보고된다. 그러나 아직 소아에서 발생한 CDAD에 대한 정보는 부족한 실정이다. 저자들은 소아 CDAD환자에서 지역사회감염(CA-CDAD)과 병원감염(HA-CDAD)의 역학과 임상양상의 차이를 비교하여 알아보고자 하였다. 방 법: 2008년 4월부터 2010년 3월까지 가천의대 길병원 소아청소년과에 내원한 환자들의 의무기록을 후향적으로 분석하여 소화기계 증상을 가지고 있으면서 C. difficile 독소 A, B 또는 C. difficile 배양검사에서 양성으로 확인된 경우 CDAD로 진단하였다. 결 과: 총 61명(남 32, 여 29)의 환자가 연구에 포함되었고, 평균연령은 3.79${\pm}$4.54세였으며, 1세 미만이 22명(36.1%)으로 가장 많았다. 전체 중 23명(37.7%)의 환자만이 증상 발현 3개월 이내에 항생제를 투여 받은 적이있었다. 총 61명의 환자 중 CA-CDAD군이 41명, HA-CDAD군이 20명이었고, 나이, 성별, 증상, 검사실소견, 회복기간, 합병증 발생 및 재발률은 두 군 간에 유의한 차이가 없었으나 항생제 노출 여부는 HACDAD의 발생과 관련이 있었다. 결 론: 소화기계 증상을 가지고 외래에 내원한 영아와 어린 소아에서 항생제 노출력이 없는 CA-CDAD의 발생이 증가하고 있다. 신속하게 검사를 시행하는 것이 정확한 진단과 치료를 위해 요구된다.

• Childhood Kidney Diseases
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• 제23권2호
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• pp.121-123
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• 2019

Urinary tract infection is common in the pediatric population. The most common causative agents are bacteria, among which Escherichia coli is the most frequent uropathogen. Although fungal urinary tract infection is rare in the healthy pediatric population, it is relatively common among hospitalized patients. Fungus may be isolated from the urine of immunocompromised patients or that of patients with indwelling catheters. The most common cause of funguria is Candida albicans. Although more than 50% of Candida isolates belong to non-albicans Candida, the prevalence of non-albicans candiduria is increasing. Herein, we report a case of community-acquired candiduria in a 4-month-old immunocompetent male infant who had bilateral vesicoureteral reflux and was administered antibiotic prophylaxis. He was diagnosed with urinary tract infection caused by Candida lusitaniae and was managed with fluconazole.

• Tuberculosis and Respiratory Diseases
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• 제74권5호
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• pp.207-214
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• 2013

Background: Community-acquired pneumonia (CAP) is one of the leading causes of death among the elderly. Several studies have reported the clinical usefulness of serum procalcitonin, a biomarker of bacterial infection. However, the association between the levels of procalcitonin and the severity in the elderly with CAP has not yet been reported. The aim of this study was to evaluate usefulness of procalcitonin as a predictor of severity and mortality in the elderly with CAP. Methods: This study covers 155 CAP cases admitted to Pusan National University Hospital between January 2010 and December 2010. Patients were divided into two groups (${\geq}65$ years, n=99; <65 years, n=56) and were measured for procalcitonin, C-reactive protein (CRP), white blood cell, confusion, uremia, respiratory rate, blood pressure, 65 years or older (CURB-65) and pneumonia severity of index (PSI). Results: The levels of procalcitonin were significantly correlated with the CURB-65, PSI in totals. Especially stronger correlation was observed between the levels of procalcitonin and CURB-65 in the elderly (procalcitonin and CURB-65, ${\rho}$=0.408 with p<0.001; procalcitonin and PSI, ${\rho}$=0.293 with p=0.003; procalcitonin and mortality, ${\rho}$=0.229 with p=0.023). The correlation between the levels of CRP or WBC and CAP severity was low. The existing cut-off value of procalcitonin was correlated with mortality rate, however, it was not correlated with mortality within the elderly. Conclusion: The levels of procalcitonin are more useful than the levels of CRP or WBC to predict the severity of CAP. However, there was no association between the levels of procalcitonin and mortality in the elderly.

• Pediatric Infection and Vaccine
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• 제16권2호
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• pp.123-130
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• 2009

목 적: 원내 감염 로타바이러스 위장관염의 역학적 및 임상적 특성을 지역사회 획득 감염과 비교하고자 하였다. 방 법: 2001년 1월부터 2005년 12월까지 5년간 로타바이러스 위장관염으로 입원한 환아 들 중, 원내 감염군(100명)과 지역사회 획득 감염군(528명)의 역학적 특성을 비교하였다. 또한 지역사회 획득 감염군 중 연령을 일치시킨 100명을 대상으로 임상적 특성을 비교하였다. 결 과: 양군 간에서 남녀비는 1:4 및 1:5를 보였으며, 원내 감염군의 평균 연령이 지역사회 획득 감염군에 비해 더 낮았다 (21.9${\pm}$15.5개월 vs.16.6${\pm}$10.3개월, P <0.001). 연령별, 연도별 분포와 계절별 발생은 양군에서 비슷한 양상을 보였다. 5년간 연도별 발생 수에 대한 원내 감염 비율은 9.8-22.4 %를 보였으며, 원내 감염 발생 수는 2003년에, 지역사회획득 감염 발생 수는 2002년에 가장 많았다. 임상 양상 비교에서 원내 감염군에서 발열 기간이 길었으나(P<0.001), 설사 중등도에 서는 양군에서 차이가 없었다(P =0.07). 검사실 소견에서 원내 감염군의 백혈구 수가 더 높았으나(P =0.04), BUN의 평균값(P =0.02) 및 20 mg/dL 이상인 환아의 수(16% vs. 4%, P=0.01)는 지역사회 획득 감염군에서 더 많았다. 결 론: 원내 감염 로타바이러스 위장관염은 사회획득 감염 위장염과 비교하여 연령별, 연도별, 계절적 발생 양상 및 임상양상에서 유사하였다.

• 대한의생명과학회지
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• 제11권4호
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• pp.525-531
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• 2005

Staphylococcus aureus is a major cause of nosocomial infections and is one of the most commonly isolated bacterial species in the hospital and continues to be an important pathogen in both community and hospital-acquired infection. Methicillin resistant S. aureus (MRSA), which is associated with hospitals is now being isolated in the community. The purpose of this study is to investigate the carrier rate of S. aureus in the community, antibiotic resistance patterns of the organism, detection of MRSA and mecA gene in MRSA. Ninety strains $(46.4\%)$ of S. aureus were isolated from the nasal specimens of 194 elementary school students. Eighty-nine strains $(98.9\%)$ of 90 S. aureus were resistant to penicilin, 36 strains $(40.0\%)$ to erythromycin, 14 strains $(15.6\%)$ to fusidic acid, 11 strains $(12.2\%)$ to gentamycin, 9 strains $(10.0\%)$ to tobramycin, 5 strains $(5.6\%)$ to oxacillin, 4 strains $(4.4\%)$ to clindamycin, 2 strains $(2.2\%)$ to tetracycline, 1 strains $(1.1\%)$ to fosfomycin. None of $90(0\%)$ S. aureus isolates was resistant to ciprpfloxacin, trimethoprim/sulfamethoxazole, levofloxacin, linezolid, moxifloxacin, nitrofurantoin, norfloxacin, rifampicin, quinupristin/dalfopristin, teicoplanin, and vancomycin. Five strains $(5.6\%)$ of 90 S. aureus isolates were MRSA. The mecA gene was detected from five MRSA strains by PCR.

• Clinical and Experimental Pediatrics
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• 제55권2호
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• pp.42-47
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• 2012

$Mycoplasma$ $pneumoniae$ (MP), the smallest self-replicating biological system, is a common cause of upper and lower respiratory tract infections, leading to a wide range of pulmonary and extra-pulmonary manifestations. MP pneumonia has been reported in 10 to 40% of cases of community-acquired pneumonia and shows an even higher proportion during epidemics. MP infection is endemic in larger communities of the world with cyclic epidemics every 3 to 7 years. In Korea, 3 to 4-year cycles have been observed from the mid-1980s to present. Although a variety of serologic assays and polymerase chain reaction (PCR) techniques are available for the diagnosis of MP infections, early diagnosis of MP pneumonia is limited by the lack of immunoglobulin (Ig) M antibodies and variable PCR results in the early stages of the infection. Thus, short-term paired IgM serologic tests may be mandatory for an early and definitive diagnosis. MP infection is usually a mild and self-limiting disease without specific treatment, and if needed, macrolides are generally used as a first-choice drug for children. Recently, macrolide-resistant MP strains have been reported worldwide. However, there are few reports of apparent treatment failure, such as progression of pneumonia to acute respiratory distress syndrome despite macrolide treatment. The immunopathogenesis of MP pneumonia is believed to be a hyperimmune reaction of the host to the insults from MP infection, including cytokine overproduction and immune cell activation (T cells). In this context, immunomodulatory treatment (corticosteroids or/and intravenous Ig), in addition to antibiotic treatment, might be considered for patients with severe infection.

• Pediatric Infection and Vaccine
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• 제16권2호
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• pp.215-219
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• 2009

5-14세에 호발하는 마이코플라즈마 폐렴은 20-25%에서 폐외 증상을 일으키는 것으로 알려져 있으며 이 중 혈액계 질환에는 용혈성 빈혈, 혈소판 감소증, 혈구포식세포 증식증(hemophagocytosis) 등이 있다. 마이코플라즈마 폐렴에서의 냉항체에 의한 자가면역성 용혈로 용혈성 빈혈이 발생할 수 있으며, 이 때 항체의 역가와 용혈의 정도에 상관관계가 있을 수 있다. 저자들은 마이코플라즈마 폐렴에 의해 용혈성 빈혈이 발현된 유전성 구상 적혈구증 1례를 경험하였기에 보고하는 바이다.