• Journal of Environmental Health Sciences
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• v.48 no.3
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• pp.176-182
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• 2022

Background: The risk of imported infectious diseases has been increasing with the annual rise in the number of international travelers. Objectives: This study aims to analyze the distribution and characteristics of intestinal bacteria isolated in 2019 from residents of Chungcheongnam-do Province with experience of travelling overseas. Methods: Twenty-three former overseas travelers with diarrhea were analyzed to detect viruses and bacteria according to the Manual for Detection of Foodborne Pathogens at Outbreaks. Additionally, antibiotic susceptibility tests and 16s rRNA sequencing were performed. Results: Twenty-five strains of ten pathogens were isolated from 18 samples. Pathogenic E. coli was the most common at 57.7%, followed by Clostridium perfringens (15.4%), Campylobacter spp. (7.7%), and Salmonella spp. (7.7%). The serotype of Salmonella was confirmed as Salmonella Braenderup, II 9,46:g,[m],[s],t:[e,n,x]. Conclusions: It was confirmed that the major enteric bacterial pathogens isolated from overseas travelers in Chungcheongnam-do Province were pathogenic E. coli, as found in other studies. The study on Plesiomonas shigelloides is meaningful in that it is reported as a rare case of infection in Korea. Antibiotic resistance and 16s rRNA analysis were performed, which is expected to provide important basic data for the prevention of traveler's diarrhea.

• Childhood Kidney Diseases
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• v.4 no.2
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• pp.136-143
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• 2000

Purpose : The hemolytic uremic syndrome (HUS) is characterized by microangiopathic hemolytic anemia thrombocytopenia, and acute renal failure. It is ole of tile most common cause of acute renal failure in children but few reports are available in Korea. Thus we investigated the 23 patients diagnosed as HUS during last 14 years. Method : We retrospectively investigated the etiologic factor, clinical manifestations laboratory findings, treatment modalities, and final outcomes of the patients. Then patients were divided into two groups according to outcome, md comparison was performed. Group A(8) comprised patients who progressed to end-stage renal disease or expired. Group B(15) comprised patients who completely recovered after dialysis treatment. Result The number of patients aged less than 4 years were 17; between 5 and 10 were 4 and more than 10 were 2. The gende ratio was M:F=2 : 1. The etiologic factors were as follows: acute gastroenteritis in 14 patients including 4 bloody diarrhea, upper respiratory tract infection in 7 patients, and 1 patient with herbal mediation. The overall mortality rate was 22$\%$: 2 patients died of US complications, 2 patients died of sepsis, and 1 patient died of pulmonary hemorrhage. Group A (Hb 4.8${\pm}$1.2 g/dL) showed lower value in hemoglobin than group B (Hb 6.3${\pm}$1.7 g/dL) during hospital stay (P< 0.05), And the time interval between tile disease onset and dialysis treatment was significantly longer in group A ($11.9{\pm}9.1\;days\;vs\;2.8{\pm}2.1\;days$) (P< 0.05). Conclusion : Overall mortality rate was 22$\%$. Low hemoglobin value and the prolonged time interval between the disease onset and dialysis treatment were related with poor prognosis. So early diagnosis and appropriate intensive care including dialysis treatment is essential to achieve better outcome in children.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.13 no.1
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• pp.30-35
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• 2010

Purpose: Infectious ileocecitis is an infection confined to the ileocecal area and one of the most common causes of pediatric abdominal pain. This study was performed to demonstrate the clinical features of infectious ileocecitis in children. Methods: The medical records and radiologic findings of 37 patients with ileocecitis diagnosed by ultrasonography and/or computed tomography, who were admitted to Pusan National University Hospital from January 2004 and July 2008, were reviewed retrospectively. Viral gastroenteritis and secondary ileocecitis were excluded. Results: The mean age of the patients was 4.8${\pm}$3.4 years. One-half of the patients were preschool children. The chief complaint was abdominal pain (75.7%), diarrhea (10.8%), and vomiting (8.1%). Accompanying symptoms were fever (56.8%), vomiting (21.6%), and diarrhea (16.2%). The mean duration of abdominal pain, fever, diarrhea, and vomiting was 3.8${\pm}$2.1, 3.0${\pm}$1.9, 3.4${\pm}$1.9, and 2.4${\pm}$2.3 days, respectively. The frequency of diarrhea and vomiting was 5.8${\pm}$2.2 and 4.0${\pm}$2.8 per day, respectively. Diagnosis was made by abdominal ultrasonography in 22 patients (59.5%), abdominal CT in 2 patients (5.4%), and both modalities in 13 patients (35.1%). Besides the radiologic finding of thickening of the bowel wall, mesenteric lymphadenitis (59.5%), ascites (5.4%), and both mesenteric lymphadenitis and ascites (16.2%) were revealed. The mean duration of illness was 7.5${\pm}$5.0 days. There were no specific laboratory findings, and culture studies with stool or blood were negative. All of the patients recovered completely without specific treatment. Conclusion: Infectious ileocecitis has acute appendicitis-mimicking symptoms, but is self-limited within a few days, thus unnecessary treatment and work-up is avoided. However, distinguishing infectious ileocecitis from appendicitis, inflammatory bowel disease, and mesenteric lymphadenitis is important.

• Journal of Environmental Health Sciences
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• v.46 no.5
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• pp.525-531
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• 2020

Objectives: This study was performed to identify the epidemiological features of a food poisoning outbreak in a company cafeteria located in Chungcheongnam-do Province, Korea in June of 2020 and to suggest preventive measures for a similar incidence. Methods: A total of 84 patients with acute gastroenteritis were examined. Environmental samples were obtained from 16 food handlers, six food utensils, 135 preserved foods served over three days and nine menus, and six drinking water samples. These are analyzed to detect viruses and bacteria. Results: Ninety-four out of the 402 people who were served meals (23.4%) predominantly showed symptoms of diarrhea, and the number was over 3 times. Among the 84 patients under investigation, 17 cases (20.2%) were positive for Enteropathogenic E. coli (EPEC) and 18 cases were positive for Clostridium (C.) perfringens (21.4%). Based on the investigation, it was concluded that the main pathogens were EPEC and C. perfringens. For EPEC, it was detected in three of the food service employees and in the preserved food and curry rice. The results of pulsed field gel electrophoresis indicate that all EPEC cases are closely related except for one food service employee. Assuming that isolated EPEC originated from the preserved food, the incubation period is about 25 hours. The origin of the C. perfringens was not determined as it was not detected in the food service employees or environmental samples. Conclusions: This case suggests that food provided in group food service centers must be thoroughly managed. In addition, identifying the pathogens in preserved food is very important for tracing the causes of food poisoning, so food must be preserved in an appropriate condition. To prevent similar food poisoning cases, analyzing cases based on epidemiological investigation and sharing the results is needed.

• The Journal of Korean Society of Virology
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• v.29 no.4
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• pp.247-259
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• 1999

Small round structured viruses (SRSV) are the major ethological agents which can cause outbreaks of non-bacterial gastroenteritis or food poisoning both in children and adults. The classification of family Caliciviridae to which SRSV belong, is based on the genome encoding three open reading frames. The rotavirus is another major pathogen which causes diarrhea in young children. We examined stool specimens obtained from diarrheal patients in Wonju from which bacterial pathogens were not found. To detect causative viruses from stool specimens of patients, reverse transcription (RT)-polymerase chain reaction (PCR) or nested PCR using rotavirus or SRSV specific primers was performed. In this study, RT-nested PCR procedure which can amplify a 330 bp fragment derived from RNA dependent RNA polymerase (RDRP) region within ORF1 was applied for the detection of SRSV. For the detection of rotaviruses, a 877 bp fragment from the VP4 region of rotavirus genome was amplified. As a result, rotavirus was not detected while SRSV sequences were detected from one out of five specimens. The nucleotide and amino acid sequences of the Wonju isolate were compared with other 6 Korean isolates which have been isolated and sequenced in our laboratory. Sequence analysis revealed that the Wonju isolate was rather distinct from other Korean isolates: the Wonju isolate was closer to genogroup I of SRSV while other 6 Korean isolates belonged to genogroup II.

• Journal of Food Hygiene and Safety
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• v.39 no.2
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• pp.102-108
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• 2024

This study was performed to establish the epidemiological features of a food poisoning outbreak that occurred in the cafeteria of a company in Chungcheongnam-do Province, Korea, in October 2020, and to recommend measures to prevent similar outbreaks. Twenty-one patients with acute gastroenteritis, three food handlers, seven cooking utensils, and 12 preserved food samples were subjected to viral and bacterial analyses based on procedures described in the "Manual for Detection of Foodborne Pathogens at Outbreaks". Among 135 individuals who had been served the meals, 21 (15.6%) showed symptoms of nausea and vomiting within an hour of consuming the food. Bacillus cereus were isolated from 11 (52.4%) of the 21 patients, one food service employee, one item of cooking ware, and 12 preserved food samples. In addition, we confirmed the toxin genes CER, nheA, and entFM from the isolated B. cereus strains. Pulsed-field gel electrophoresis results indicated that all of the isolated B. cereus strains were closely related, with the exception of strains obtained from one patient and one sample of preserved food. These findings provide evidence to indicate that the isolated B. cereus originated from preserved foods and an unhygienic eating environment. This outbreak highlights that the provision of food in non-commercial food systems must be thoroughly managed. In addition, it emphasizes the necessity for the correct and timely identification of causal pathogens for tracing the cause of food poisoning outbreaks, and the need to preserve food under appropriate conditions. To prevent similar cases of food poisoning, it is necessary to investigate cases based on an epidemiological approach and share the findings.

• Clinical and Experimental Pediatrics
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• v.49 no.5
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• pp.513-518
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• 2006

Purpose : This study was undertaken to determine the differences in genotypes of rotavirus and their incidence between patients with acute rotaviral enteritis who suffered neurologic complications and those who did not suffer neurologic complications. Methods : Among the 82 patients with rotaviral enteritis whose genotype was analyzed, 71 patients were not associated with neurologic complications(neurology(-) group), and eleven patients were associated with neurologic complications(neurology(+) group). Four G genotypes and four P genotypes were determined by reverse trans cription and multiplex polymerase chain reaction. Results : In the neurology(-) group, the number of G4, G3, G2 and G1 was 24(35.3 percent), 23 (33.8 percent), 17(25.0 percent) and 4(5.6 percent), respectively and the number of P6, P4, P8 and P9 was 26(36.1 percent), 23(31.9 percent), 22(30.6 percent) and 1(1.4 percent), respectively. G2P4, and G4P6 were the most frequently found com bination genotypes, respectively. In the neurology(+) group, the number of G2, G3 and G4 was 9(75.0 percent), 2(16.7 percent) and 1(8.3 percent), respectively and the number of P4, P6, P8 and P9 was 8(66.7 percent), 2(16.7 percent), 1(8.3 percent) and 1(8.3 percent), respectively. G2P4 was the most frequently found combination genotype. The incidence of each of the G2, P4 and G2P4 was significantly higher in the neurology(+) group when compared to that of each of the G2, P4, and G2P4 in the neurology(-) group. Conclusion : In the patients with acute rotavirus gastroenteritis associated with neurologic complications, the G1 genotype was not found and genotypes of the G2, P4, and G2P4 were more frequently found.

• Pediatric Infection and Vaccine
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• v.9 no.2
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• pp.215-221
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• 2002

Purpose : This study was done to compare the vitamin A levels between hospitalized patients of measles symptoms and of the other infectious diseases common in childhood (bronchiolitis, penumonia, gastroenteritis and etc.). Methods : We have set up a population of 133 hospitalized patients of measles symptoms in the pediatric department of Kangnam Sacred Heart Hospital between Nov. 2000~Apr. 2001 and compared them to a group of 30 hospitalized patients of other infectious diseases between Dec. 2001~Feb. 2002. The whole patients were divided into three groups by diagnosing measles-specific IgM antibody positive as measles group(n=104), negative as measles-susepcted group(n=29) and other infectious disease group. And we compared the vitamin A levels, clinical symptoms, and general hematological and biochemical results. Results : Among the 104 measles patients, the concentrated age groups were 10 12 months(n=24, 23.1%), 13~15 months(n=16, 15.3%) and 16 months~4 years of age(n=24, 23.1%). The mean levels of vitamin A of measles and measles-susepcted groups were $69.6{\pm}28.6{\mu}g/dL$ and $75.2{\pm}34.4{\mu}g/dL$, respectively, and that of other infectious disease group was $28.1{\pm}17.5{\mu}g/dL$. Conclusion : The mean levels of vitamin A of both measles and measles-suspected groups were significantly higher than that of other infectious disease group(P<0.05) and showed no significant correlations with clinical symptoms and hospitalization duration.

• Pediatric Infection and Vaccine
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• v.21 no.2
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• pp.96-103
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• 2014

Purpose: The aim of this study is that the prevalence of rotavirus infection was evaluated by each group and clinical features of group A, B and C rotaviruses infections were described respectively to compare one with another. Methods: Between January 2010 and December 2010, we enrolled a group of children below 10 years of age admitted for management of acute diarrhea at the Catholic University of Korea Bucheon St. Mary's Hospital. A total of 310 stool samples documented to be free of common bacterial pathogens were collected from children with diarrhea. The presence of group A, B or C rotavirus is indicated by amplification of DNA segments of the expected lengths after the first and second PCRs Results: In a total of 310 stool specimens, 40 (12.9%) specimens were positive for rotaviruses. These included 23 (7.4%) positive for group A, 5 (1.6%) for group B and 12 (3.9%) for group C rotaviruses. Group B rotavirus infected patients had significantly less diarrheas per day (group A: P =0.01, group C: P =0.01) and shorter duration of vomiting days (group A: P =0.03, group C: P =0.03) than those with group A and C rotaviruses infection respectively. All the group B rotaviruses had been isolated in March and October. Group C rotavirus infections were prevalent during late summer and early winter and peaked in October. Conclusion: These findings indicate that group B and C rotaviruses are notable causes or the contributing causes of diarrhea among infants and children in Korea.

• Clinical and Experimental Pediatrics
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• v.48 no.12
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• pp.1354-1361
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• 2005

Purpose : Rotavirus is an enteric pathogen that affects millions of children globally each year. But no specific therapy is available for the management of rotavirus diarrhea. Due to the clear need to define improved modality for treatment of rotavirus diarrhea, we evaluated the efficacy of antirotavirus IgY in the treatment of infants and children with gastroenteritis. Methods : First, the amount of viral particle in the stools of thirteen patients(seven were given IgY, 6 placebo) infected by rotavirus were evaluated for 3 days with the quantitative RT-PCR method. Second, 36 children with known rotavirus infection identified by ELISA or semi-quantitative RT-PCR were evaluated. We gave 5 g anti-rotavirus egg yolk daily in two equally divided doses for 3 days to two groups(an 18 IgY group and an 18 placebo group), respectively after parenteral consent. Daily vomiting frequency, stool frequency, oral intake and urine output were monitored for 3 days, and electrolyte and blood chemistry were checked at the first and third days. Results : First, in the placebo group, the amount of virus particles increased daily, but in the IgY group it decreased daily. Second, when IgY and placebos were given to children infected with rotavirus, diarrhea on the third day decreased significantly in the IgY group, compared with the placebo group. Conclusion : Treatment with antirotavirus immunoglobulin from immunized chicken's egg resulted in a decrease in the amount of viral particles in stools and diarrhea frequency in children. These results suggest that anti-rotavirus IgY is effective in the treatment of rotavirus gastroenteritis.