• 대한수의학회지
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• 제62권1호
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• pp.4.1-4.5
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• 2022

This paper describes a fatal case of pneumonia in a 14-day-old dog caused by extraintestinal pathogenic Escherichia coli (ExPEC). The necropsy showed that almost all of left lobes of the lungs had dark-red consolidation. A histopathology examination revealed moderate acute fibrino-hemorrhagic necrotizing pneumonia with intralesional bacterial colonies. Non-suppurative epicarditis, congestion in the liver, and necrosis in the white pulp of the spleen also were found. E. coli with cytotoxic necrotizing factor 1 and α-hemolysin was isolated from the lung. This case was confirmed to have fatal pneumonia caused by ExPEC that led to a systemic infection.

• Parasites, Hosts and Diseases
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• 제56권1호
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• pp.71-74
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• 2018

Soluble antigens from an axenic culture of Entamoeba histolytica were used to develop a commercial ELISA kit to quantify anti-E. histolytica antibodies in sera of patients with extraintestinal amebiasis in non-endemic settings. The diagnostic specificity and sensitivity of the test were assessed retrospectively using 131 human serum samples with amoebic serologic status available. They were selected according to their results in immunofluorescence (IFAT) and were separated in 2 sample categories: 64 sera with positive results by IFAT and 67 with negative results by IFAT. The sensitivity and specificity of the ELISA kit were assessed at 95.0% and 94.0% compared to the IFAT. The test can be useful to exclude a potential diagnosis of amebiasis and could be used as a screening method since ELISA is an automated technique.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제19권4호
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• pp.236-242
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• 2016

Purpose: The aim of this study was to investigate the clinical features and extraintestinal manifestations (EIMs) of Crohn disease (CD) in Korean pediatric patients. Methods: The medical records of 73 children diagnosed with CD were retrospectively reviewed. Data regarding baseline demographic and clinical characteristics, including CD phenotype at diagnosis based on the Montreal classification, and clinical features and course of EIMs were investigated. Results: Fifty-two (71.2%) of the patients were males. The mean age of the patients was 12.5 years. The mean follow-up period was 3.4 years. The disease location was ileal in 3 (4.1%) of the patients, colonic in 13 (17.8%), ileocolonic in 56 (76.7%). The clinical behavior was inflammatory in 62 (84.9%) of the patients, stricturing in 8 (11.0%), and penetrating in 3 (4.1%). Perianal abscesses or fistulas were found in 37 (50.7%) of the patients. EIMs observed during the study period were anal skin tag in 25 patients (34.2%), hypertransaminasemia in 20 (27.4%), peripheral arthritis in 2 (2.7%), erythema nodosum in 2 (2.7%), vulvitis in 1 (1.4%), uveitis in 1 (1.4%), and pulmonary thromboembolism in 1 (1.4%). Conclusion: Perianal diseases and manifestations were present in more than half of Korean pediatric CD patients at diagnosis. Inspection of the anus should be mandatory in Korean children with suspicious CD, as perianal fistulas, abscesses, and anal skin tags may be the first clue to the diagnosis of CD.

• Annals of Clinical Neurophysiology
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• 제12권2호
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• pp.76-78
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• 2010

• Clinical and Experimental Pediatrics
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• 제46권6호
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• pp.602-605
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• 2003

저자들은 salmonella group D로 인한 장염 및 패혈증이 동반된 음낭내 농양을 진단하여 항생제와 절개 및 배농으로 치료한 1례를 경험하였기에 보고하는 바이다.

• Journal of Microbiology and Biotechnology
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• 제30권7호
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• pp.974-981
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• 2020

Sequence type 410 (ST410) of Escherichia coli is an extraintestinal pathogen associated with multi drug resistance. In this study, we aimed to investigate the horizontal propagation pathway of a high-risk clone of E. coli ST410 that produces Klebsiella pneumoniae carbapenemase (KPC). blaKPC-encoding E. coli and K. pneumoniae isolates were evaluated, and complete sequencing and comparative analysis of blaKPC-encoding plasmids from E. coli and K. pneumoniae, antimicrobial susceptibility tests, polymerase chain reaction, multilocus sequence typing, and conjugal transfer of plasmids were performed. Whole-genome sequencing was performed for plasmids mediating KPC-2 production in E. coli and K. pneumoniae clinical isolates. Strains E. coli CPEc171209 and K. pneumoniae CPKp171210 were identified as ST410 and ST307, respectively. CPEc171209 harbored five plasmids belonging to serotype O8:H21, which is in the antimicrobial-resistant clade C4/H24. The CPKp171210 isolate harbored three plasmids. Both strains harbored various additional antimicrobial resistance genes. The IncX3 plasmid pECBHS_9_5 harbored blaKPC-2 within a truncated Tn4401a transposon, which also contains blaSHV-182 with duplicated conjugative elements. This plasmid displayed 100% identity with the IncX3 plasmid pKPBHS_10_3 from the K. pneumoniae CPKp171210 ST307 strain. The genes responsible for the conjugal transfer of the IncX3 plasmid included tra/trb clusters and pil genes coding the type IV pilus. ST410 can be transmitted between patients, posing an elevated risk in clinical settings. The emergence of a KPC-producing E. coli strain (ST410) is concerning because the blaKPC-2-bearing plasmids may carry treatment resistance across species barriers. Transgenic translocation occurs among carbapenem-resistant bacteria, which may spread rapidly via horizontal migration.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제25권3호
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• pp.180-193
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• 2022

Pediatric inflammatory bowel disease (PIBD) is a multisystem disorder characterized by intestinal and extraintestinal manifestations and complications. Cerebrovascular events (CVE) are rare extraintestinal complications in patients with PIBD. Statistics show that 3.3% patients with PIBD and 1.3-6.4% adult patients with inflammatory bowel disease (IBD) experience CVE during the course of the disease. Therefore, this study aimed to review the records of children with IBD who developed CVE during the course of the disease. We retrospectively reviewed 62 cases of PIBD complicated by CVE. The mean patient age at the time of thrombotic events was 12.48±4.13 years. The incidence of ulcerative colitis was significantly higher than that of Crohn's disease (43 [70.5%] vs. 13 [21.3%] patients). Most patients (87.93%) were in the active phase of IBD at the time of CVE. The mean time interval between the onset of IBD and CVE was 20.84 weeks. Overall, 11 (26.83%) patients showed neurological symptoms of CVE at disease onset. The most frequent symptom on admission was persistent and severe headaches (67.85%). The most common site of cerebral venous thrombosis was the transverse sinuses (n=23, 53.48%). The right middle cerebral artery (n=3, 33.34%) was the predominant site of cerebral arterial infarction. Overall, 41 (69.49%) patients who were mostly administered unfractionated heparin or low-molecular-weight heparin (56.09%) recovered completely. Patients with IBD are at a risk of thromboembolism. CVE may be the most common type of thromboembolism. Based on these findings, the most common risk factor for CVE is IBD flares. In patients with CVE, anticoagulant therapy with heparin, followed by warfarin, is necessary.

• 대한임상검사과학회지
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• 제48권2호
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• pp.82-87
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• 2016

Enterotoxigenic Bacteroides fragilis (ETBF)는 병독소 인자로 알려진 장독소를 생성하는 균종이다. B. fragilis enterotoxin (BFT)은 bft-1, bft-2 및 bft-3 세 개의 유전자 아형들이 밝혀졌다. 본 연구에서는 임상 검체에서 분리된 B. fragilis에서 bft 유전자의 유무와 BFT 음성 및 양성 균주의 항균제 내성을 조사하였다. 국내의 한 대학병원에서 8년간(2006~2013년) 장외 검체에서 분리된 B. fragilis는 총 537주이었다. 다중중합연쇄반응으로 시험하여 bft 유전자 아형을 확인하였다. BFT 음성 74주와 양성 33주를 포함한 B. fragilis 107주의 항균제 감수성은 CLSI 한천희석법으로 시험하였다. 임상 검체에서 분리된 B. fragilis의 bft 유전자 검출율은 30% 이었고, 이 중 혈액과 혈액 외 장외 검체 분리주에서는 각각 33%, 29% 이었다. ETBF 중에서 가장 흔한 아형은 bft-1 이었고, 그 다음은 bft-2, bft-3 순이었다(bft-1: 77%, bft-2: 14%, bft-3: 9%). BFT-음성과 양성 균주의 내성률은 일부 항균제에 대해서 차이가 있었다(BFT-음성 균주: piperacillin-tazobactam 3%, cefoxitin 5%, imipenem 1%, clindamycin 38%; BFT-양성 균주: piperacillin-tazobactam 3%, cefoxitin 6%, imipenem 3%, clindamycin 42%). BFT-음성 및 BFT-양성 균주 모두는 chloramphenicol과 metronidazole에 대한 내성은 없었다. 결론적으로, 혈액 분리주에서의 ETBF 검출율은 혈액 외 장외 검체 분리주에서와 비슷하였고, 가장 흔한 유전자 아형은 bft-1 이었다. 항균제 내성은 BFT 양성 균주가 음성 균주보다 대체로 높았으나 통계학적으로 유의한 차이는 없었다.

• 대한임상검사과학회지
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• 제37권2호
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• pp.84-87
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• 2005

Hafnia alvei is a gram-negative facultatively anaerobic bacillus that is rarely isolated from human specimens and is rarely considered to be pathogenic. It has been associated with gastroenteritis, pneumonia, meningitis, bacteremia, and nosocomial wound infections. But, only one case of extraintestinal H. alvei infection was documented in Korea to our knowledge. A 74-years old women with bronchial tuberculosis and cerebral infarct was admitted to out hospital via the internal medicine department due to the use of anti-tuberculotic agents. The two consecutive blood cultures yielded H. alvei. The organism was susceptible to all antimicrobial agents tested, except ampicillin and amoxacillin-clavulanic acid. The patients was treated with ceftriaxone and recovered effectively.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제18권3호
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• pp.149-159
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• 2015

Crohn's disease is a chronic idiopathic inflammatory disease of the intestines characterized by frequent relapse and remission. It often develops in children and adolescents, who are vulnerable to repeated exposure to ionizing radiations. Magnetic resonance enterography (MRE) is an increasingly important radiation-free imaging modality that is used to evaluate pediatric patients with Crohn's disease. MRE can evaluate extraluminal and extraintestinal abnormalities as well as the status of the bowel wall. In addition, MRE has an advantage in the evaluation of the small bowel involvement. MRE can be used for the initial diagnosis of Crohn's disease, and can aid in the assessment of disease activity and complications such as penetrating and fibrostenotic diseases. The aims of this article are to review the MRE technique for obtaining diagnostic and high-quality images and to discuss interpretations of imaging findings in patients with Crohn's disease.