• Clinical and Experimental Pediatrics
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• v.53 no.5
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• pp.648-652
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• 2010

Purpose: A brain abscess is a serious disease of the central nerve system. We conducted this study to summarize the clinical manifestations and outcomes of brain abscesses. Methods: A retrospective chart review of pediatric patients diagnosed with brain abscesses from November 1994 to June 2009 was performed at Samsung Medical Center, Seoul, Korea. Results: Twenty-five patients were included in this study. On average, 1.67 cases per year were identified and the median age was 4.3 years. The common presenting clinical manifestations were fever (18/25, 72%), seizure (12/25, 48%), altered mental status (11/25, 44%), and signs of increased intracranial pressure (9/25, 36%). A total of 14 (56%) patients had underlying illnesses, with congenital heart disease (8/25, 32%) as the most common cause. Predisposing factors were identified in 15 patients (60%). The common predisposing factors were otogenic infection (3/25, 12%) and penetrating head trauma (3/25, 12%). Causative organisms were identified in 64% of patients (16/25). The causative agents were $S$ $intermedius$ (n=3), $S$ $aureus$ (n=3), $S$ $pneumoniae$ (n=1), Group B streptococcus (n=2), $E.$ $coli$ (n=1), $P.$ $aeruginosa$ (n=1), and suspected fungal infection (n=5). Seven patients received medical treatment only while the other 18 patients also required surgical intervention. The overall fatality rate was 16% and 20% of patients had neurologic sequelae. There was no statistical association between outcomes and the factors studied. Conclusion: Although uncommon, a brain abscess is a serious disease. A high level of suspicion is very important for early diagnosis and to prevent serious consequences.

• Journal of Environmental Health Sciences
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• v.11 no.2
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• pp.41-54
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• 1985

This study was conducted for the improvement of milk quality and milk hygiene in public health point of view. Investigation of mastiris infection rate, isolation and identification of causative microorganisms in CMT positive milk, investigation of milk contamination level by measuring the bacteria and soma tic cell counts and investigation of dairy management in farms were performed on 1.605 quarters milk of 434 cows of 20 dairy farms in Gyunggi-area from September 1983 to March 1984. The results were summarized as follows 1. Sixteen (3.7%) of 434 cows were found to be infected with clinical mastiris. 234 (53.9%) of 434 cows and 608(37.9%) of 1, 605 quarters were found to be infected with subclinical mastiris. 2. The causative microorganisms isolated were Staphylococcus aureus (38.3%), Staphylococcus epidermidis(21.0%), Micrococci(13.6%), Streptococcus spp. (12.3%), E. coli (7.4%), Fungus & Yeast (1.6%) and others (5.8%). 3. Total numbers of bacteria were $9.2{\times}10^6$ to $1.21{\times}10^7/ml$(av. $1.805{\times} 10^7/ml$), numbers of coliform bacteria were $4.1{\times} 10^5$ to $9.4{\times} 10^5$/ml(av. $7.05{\times} 10^5$/ml) and somatic cell counts were $4.8{\times} 10^5$ to $1.52{\times} 10^6$ cells/ml (av. $9.5{\times} 10^5$cells/ml) in bulk milk. 4. As comparing with CMT score of +, ++ and +++, somatic cell counts were $3.4{\times} 10^5$ to $1.64{\times} 10^6$ cells/ml (av. $6.41{\times} 10^5$cells/ml), $5.4{\times} 10^5$ to $2.75{\times} 10^6$ cells/ml(av. $1.762{\times} 10^6$cells/ml) and $1.97{\times} 10^6$ to $9.75{\times} 10^6$ cells/ml(av. $7.781{\times} 10^6$cells/ml), respectively. 5. In investigation on dairy management, performance of dry cow therapy, teat dipping after milking, disinfection of milking machine at every milking, replacement of milk liner within 6months and opportunity of acquirement for the mastiris control techniques by dairy education were 65%, 40%, 45%, 55% and 50% in 20 dairy farms, respectively.

• Biomedical Science Letters
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• v.9 no.3
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• pp.139-144
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• 2003

Since water borne infection causes acute diseases and results in spread of diseases by secondary infection, the prevention is very important. Therefore, it is necessary to have a method that is rapid and effective to monitor pathogenic bacteria in drinking water. In this study, we employed a systematic method, Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) analysis, to develop an effective monitoring system for possible bacterial contaminants in drinking water. For this purpose, PCR primers were derived from 992 bp region of the 16s rRNA gene that is highly conserved through the different species of prokaryotes. To test whether the PCR primers designed are indeed useful for detecting all the possible microbial contaminants in the water, the primers were used to amplify 16s rRNA regions of different microbial water-borne pathogens such as E. coli, Salmonella, Yersinia, Listeria, and Staphylococcus. As expected, all of tested microorganisms amplified expected size of PCR products indicating designed PCR primers for 16s rRNA indeed can be useful to amplify all different microbial water-borne pathogens in the water. Furthermore, to test whether these 16s rRNA based PCR primers can detect bacterial populations present in the water, water samples taken from diverse sources, such as river, tap, and sewage, were used for amplification. PCR products were for then subjected for cloning into a T-vector to generate a library containing 16s rRNA sequences from various bacteria. With cloned PCR products, RFLP analysis was done using PCR products digested with restriction enzyme such as Hae III to obtain species-specific RFLP profiles. After PCR-RFLP, the bacterial clones which showed the same RFLP profiles were regarded as the same ones, and the clones which showed distinctive RFLP profiles were subsequently subjected for sequence analysis for species identification. By this PCR-RFLP analysis, we were able to reveal diverse populations of bacteria living in water. In brief, in unsterilized natural river water, over 60 different species of bacteria were found. On the other hand, no PCR products were detected in drinking tap-water. The results from this study clearly indicate that the PCR-RFLP-sequence analysis can be a useful method for monitoring diverse, perhaps pathogenic bacteria contaminated in water in a rapid fashion.

• Journal of Environmental Health Sciences
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• v.45 no.5
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• pp.434-442
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• 2019

Objectives: This study was performed in order to report the epidemiological features of a food poisoning outbreak caused by multiple pathogens in a high school in Chungcheongnam-do Province, Korea in April 2019 and to suggest measures to prevent a similar incidence. Methods: A total of 39 patients with diarrhea were examined. Environmental samples were obtained from 6 food handlers, 4 food utensils, 72 preserved foods served during the food poisoning outbreak, 9 door handles, 10 drinking water samples from water dispensers, and 6 ground water samples from water taps. These analyzed to detect viruses and bacteria. Results: Among the 39 patients, 21 cases (53.8%) of enteroaggregative E. coli (EAEC), 7 cases of Staphylococcus aureus (17.9%), and 17 cases of norovirus (43.6%) were positive, and in 16 of the cases a co-infection with at least one other pathogen were observed. EAEC was assumed to be transmitted from contaminated drinking water because it was also detected in the water sample from a water dispenser in the dormitory. Staphylococcus aureus was isolated only in the fecal samples of patients, meaning it was not possible to trace its origin. The genotype of norovirus detected in the drinking water and ground water was consistent with that isolated from patients, and it was determined that the norovirus infection originated from the school's water environment. Conclusions: These findings indicate that a lack of environmental hygiene management related to school meals caused the food poisoning incident. In particular, a lack of management of drinking water, water supply, and personal hygiene should be pointed out. This should be urgently addressed and continuous monitoring should be carried out in the future. In addition, students and staff should be educated and trained to improve their personal hygiene.

• Journal of Yeungnam Medical Science
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• v.16 no.1
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• pp.60-68
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• 1999

A nationwide survey was conducted to investigate the annual occurrence rate of neonatal sepsis, maternal risk factors in neonatal sepsis, localized infection in neonates, causative organisms in nosocomial infection and the most common causative organism for neonatal sepsis in Korea. Clinical and bacteriological data wele collected from 37 neonatal units to perform retrospective review of the medical records of the newborn infants who were confirmed as having neonatal sepsis and whose blood culture was collected to isolate organisms for one year study period from January to December in 1997. 78,463 neonates were born at 37 hospital in 1997, and 20,869 neonates were admitted to the neonatal units, During this period, 772 episodes of neonatal sepsis were recorded in 517 neonates. The occurrence rate of neonatal sepsis was 0.73%(0~2.95%). Male to female ratio was 1.15:1, and 303 cases(42.1%) were born prematurely. The main pathogens of early onset of sepsis were S. aureus(20%), S. epidermidis(14.4%) and coagulase negative staphylococcus(14. 4%). Gram negative bacilli including Enterobacter spp (7.2%), E. coli(5.1%), Klepstella(4.5%), Pseudomonas(3.7%) and Enterobacter faectum(3.6%) accounted for 24.1% of sepsis. Group B beta-hemolytic streptococcus were isolated only in two cases. Common obstetric factors were PROM(21.1%), difficulty delivery(18.7%), fetal tachycardia(5.3%), chorioamnionitis(4.9%), and maternal fever(4.7%). The main pathogens of late-onset sepsis were S. aureus(22.3%), S. epidermidis(20.4%) and CONS(9.9%). There were 6 cases(1.0%) of Candida sepsis, Frequent focal infections accompanying sepsis were pneumonia(26.1%), urinary tract infection(10.5%), meningitis(8.2%), and arthritis(3.6%), S. epidermidis(22.0%) and s. aureus(21.7%) were also the most common pathogens in 373 nosocomial infection.

• Journal of Food Hygiene and Safety
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• v.15 no.2
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• pp.61-67
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• 2000

Bacteriological quality evaluations were carried out for rice rolled in laver(Kimbab), Hamburger, Walnut cake and chinese noodle (Jajangmyun), which were on sale in April and May 1995, in May and July 1997 and in January 1999, at 20 different resting places on Kyung-Bu, Ho-Nam, Joong-Bu and Young-Dong Highway in Korea. Food poisoning bacteria were not detected. However numerous coliform bacteria were dectected saying that the sanitary condition of foods on sale at resting places of the highways was not hygienic. There exited 8.8$\times$10$^{4}$~6.6$\times$10$^{5}$ cells/g of coliform bacteria in all the Kimbab sold in 1995. As for Hamburger, 1.8$\times$10$^{2}$~4.7$\times$10$^{4}$ cells/g of coliform bacteria proliferated in all the samples. In 1997,E. coli was found in 16 cases and 21 cases respectively out of 22 Kimbab samples, Hamburger dealing at 7 resting places out of 14 were contaminated with 1.7$\times$10$^{2}$~1.9$\times$10$^{7}$ cells/g of coliform bacteria and Hamburgers dealing at 2 resting places were infected by 5. coli. In contrast to the Kimbab and Hamburger, all the 6 Walnut cake samples were free from the microbial pollution exhibitory that their hygienic condition was satisfactory. 3 samples out of 6 Jajangmyun were contaminated by 7.1$\times$10$^{2}$~2.0$\times$10$^{3}$ cells/g of coliform bacteria, but E. coli was not detected. Compared Kimbab sold in 1995 and 1997 with 1999, Kimbab sold in it can be said that hygienic control fur Kimbab should be performed more strictly during hot season than during cold season. Walnut cake was the safest against microbial contamination, followed by Jajangmyun, Hamburger and Kimbab in decreasing order, indicating that foods with mixed ingredients such as Kimbab and Hamburger were more susceptible to microbial infection, so that a more systematic safety control is needed for such foods during cooking, processing and distribution.

• 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.

• Childhood Kidney Diseases
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• v.3 no.1
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• pp.72-79
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• 1999

Renal scarring associated with vesico-ureteral reflux(VUR) is one of the major causes of end stage renal failure and renal hypertension in children. Urinary ${\beta}_2$-microglobulin(MG) has been suggested as a potential marker for presence of renal tubular damage. This study was designed to evaluate the significance of random urine ${\beta}_2$-MG as a predictor of presence of vesico-ureteral reflux in children with urinary tract infection(UTI). 57 children with urinary tract infection were studied. Patients were devided into two groups; 35($78.9\%$) children have UTI without VUR and 12($21.1\%$) children have UTI and VUR. Beta2-MG and creatinine in random urine sample was measured to decide the excretion ratio(${\beta}_2$-MG/creatinine). Among the 57 children with UTI, 44 children were confirmed by urine culture study and 13 children suspected by compatible clinical feature. Random urine ${\beta}_2$-MG of VUR group ($2.2{\pm}5.91$ mg/L) were significantly higher than that of simple UTI group($0.19{\pm}0.16mg/L$)(P=0.03). The ${\beta}_2$-MG/creatinine ratio of VUR group($32.41{\pm}25.7$) were significantly higher than that of simple UTI group($3.93{\pm}3.44$)(P=0.007). In conclusion, random urine ${\beta}_2$-MG and excretion ratio deserved early predictor of presence of VUR in children with UTI. And this method was more simple and inexpensive than the method of measuring ${\beta}_2$-MG with 24 hour urine collection, so might be a useful screening test for VUR in children with UTI.

• Pediatric Infection and Vaccine
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• v.25 no.2
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• pp.82-90
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• 2018

Purpose: Survival after liver transplantation (LT) has improved over the years, but infection is still a major complication. We aimed to identify the characteristics of bacterial infections in pediatric LT recipients. Methods: This study is a retrospective review of 189 consecutive children undergoing LT between 2000 and 2015 at a single center. In this study, the incidence of infection was determined for the following periods: within 1 month, between 1-5 months, and between 6-12 months. Patients who underwent liver transplants more than once or multiple organ transplants were excluded. Results: All patients had received postoperative antibiotic for 3 days. Only the maintenance immunosuppression with oral tacrolimus and steroids were performed. As a result, 132 bacterial infections developed in 87 (46.0%) patients (0.70 events per person-year). Bacterial infections occurred most frequently within the first month (n=84, 63.6%) after LT. In the pathogens, Staphylococcus aureus (15.2%), Enterococcus species (15.2%), and Klebsiella species (13.6%) were most common. Regarding the organ infected, bloodstream was most common (n=39, 29.5%), followed by peritoneum (n=28, 21.2%), urinary tract (n=25, 18.9%), and lungs (n=20, 15.2%). We changed prophylactic antibiotics from ampicillin-sulbactam to piperacillin-tazobactam at 2011, October, there were no significant effects in the prevalence of antibiotics resistant bacterial infections. The 1-year mortality was 9.0% (n=17), in which 41.2% (n=7) was attributable to bacterial infection; septicemia (n=4), pneumonia (n=2), and peritonitis (n=1). Conclusions: The incidence and type of bacterial infectious complications after LT in pediatric patients were similar to those of previous studies. Bacterial complications affecting mortality occur within 6 months after transplantation, so proper prophylaxis and treatment in this period may improve the prognosis of LT.

• Tuberculosis and Respiratory Diseases
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• v.49 no.2
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• pp.217-224
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• 2000

Background : It is well known that when macrophages are stimulated with endotoxin, they produce a wide variety of cytokine mediators, including TNF-$\alpha$ and IL-1$\beta$. However, there is an alteration in the macrophages' responsiveness when they are challenged with repeated bouts of endotoxin, termed "endotoxin tolerance" which is regarded as a self-protective phenomenon from continuous stimulation. In this study, endotoxin tolerance in the peripheral blood monocytes of sepsis patients was evaluated. Methods : Fourteen patients with organism-documented sepsis were included. The severity of illness was evaluated by APACHE II score. Peripheral blood monocytes were isolated from the patients and diluted to $1{\times}10^5$ well. After stimulation with endotoxin (LPS of E. coli O114 : B4, 100 ng/ml), they were incubated at $37^{\circ}C$ in 5% $CO_2$ incubator for 24 hours. Supernatant was collected for the measurement of TNF-$\alpha$ and IL-1$\beta$ with ELISA method. Peripheral blood monocytes of seven healthy volunteers were used as control. Results : The APACHE II score (mean$\pm$SD) of the patients at the time of blood sampling was 12.2$\pm$5.7. The primary infection foci were urinary tract infection, pneumonia, subacute bacterial endocarditis, and catheter related infection, etc. The causative organisms were gram negative rods (10 cases), gram positive cocci (6 cases) with two cases of mixed infection. Serum TNF-$\alpha$ could be measured in 4 cases with 29.9$\pm$27.7 pg/ml. Serum IL-1$\beta$was measurable in only one patient. The TNF-$\alpha$ level of supernatant of cultured peripheral blood monocytes was 2,703$\pm$2,066 pg/ml in patients and 2,102$\pm$1914 pg/ml in controls. The IL-1$\beta$level of supernatant was 884$\pm$1,050 pg/ml in patients and 575$\pm$558 pg/ml in controls. There was no difference of TNF-$\alpha$ and IL-1$\beta$ level between patients and controls. Conclusion : We cannot prove the phenomenon of endotoxin tolerance in this study. Future study needs to be focused on the more severe sepsis patients who were taken for sampling earlier. Addition of serum to the culture medium could be an another valuable option for the success of this study.