• 보건행정학회지
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• 제25권4호
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• pp.323-332
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• 2015

Background: Antibiotic resistance has been becoming serious challenge to human beings. Overuse of antibiotics, especially, for infants is concerned, but studies are very few for the prescribing pattern of antibiotic use for infants. This study analyzes prescribing patterns of antibiotics in outpatients of preschool children with acute respiratory tract infections in South Korea. Methods: Data are used from 2011 Health Insurance Review & Assessment Services-pediatric patients sample. Inclusion criteria is outpatient children (0 to 5 years) with top five frequent diseases. Prescription rates are analyzed by types of disease, provider, specialty, region, and ages. Binary or multinomial logit models are used to analyze determinants of providers' prescription pattern. Results: The main findings are as follows. First, distributions of prescription rates are shown as L-shape or M-shape depending on the types of disease. Second, the prescription variation is so large among providers, where providers are polarized as a group with low prescription rates and the other group with high prescription rates, though the shapes are shown diversified across types of disease. Third, prescription rates appear to be lower in pediatrics and higher in ENT (ear-nose-throat). Fourth, broad spectrum antibiotics are widely used among children. Finally, the logit analysis shows similar results with descriptive statistics, but partly different results across types of disease. Conclusion: Antibiotics for respiratory tract infections of infants are used excessively with a large variation among providers, and especially broad spectrum antibiotics are used. The prescription guideline for antibiotics should be provided for each specific disease to reduce antibiotic resistance in the future.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제16권2호
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• pp.89-94
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• 2013

Purpose: The aim of this study was to evaluate the prevalence of increased aminotransferase levels and to identify associated factors in children admitted to hospital with urinary tract infections (UTIs). Methods: The study included children with a diagnosis of UTI who were admitted to the Konyang University Hospital from January 2007 to May 2011. The total number of patients was 249 and the mean age was $15.88{\pm}28.21$ months. UTI was defined as a positive urine culture (> $10^5$/colony forming unit [CFU]) with pyrexia. Patients were treated by intravenous antibiotics, such as ampicillin/sulbactam, aminoglycoside, cephalosporins or vancomycin. Patients with neonatal jaundice or other liver disease were excluded. We investigated the relationship of aminotransferase levels with the type of antibiotic, degree of vesicoureteral reflux (VUR), and causative organisms. Results: Children with increased aminotransferase levels were younger than those with normal levels (p=0.001), but white blood cell count, platelet count, causative organisms, type of antibiotics and presence of VUR were not associated with aminotransferase levels. Aminotransferase levels became normal within 1 month after discharge without special measures, except in 1 case. Conclusion: We found that many children with UTI have abnormal aminotransferase levels. In most cases, this change is mild and self-limiting. We conclude that increased aminotransferase level increase during UTI do not require unnecessary tests and excessive treatment.

• Pediatric Infection and Vaccine
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• 제23권1호
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• pp.62-66
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• 2016

최근 전세계적으로 지역사회 기원 메티실린내성 황색포도알균(CA-MRSA)에 의한 피부연부조직 감염증이 증가하고 있다. 16개월의 한국 여아가 생후 6개월부터 시작된 반복되는 피부연부조직 감염증을 주소로 내원하였다. 환아의 가족들도 환아와 비슷한 시기에 피부연부조직 감염증의 병력이 있었다. 환아의 혈중 면역글로불린 및 NBT 검사는 정상이었고, 피부 병변 외에는 가족 모두 건강하였다. 환아의 감염증 부위의 고름 배양 및 비강 내 보균 검사시 모두 PVL genes을 생성하는 CA-MRSA ST714 SCCmec type IV가 확인되었고, 이는 ST30의 single locus variant로서 국내에서는 보고된 적이 없는 MRSA의 유전형이다. 환아와 함께, 환아의 균주와 동일 항생제 감수성 양상을 보이는 MRSA 보균자인 환아부에게 재발 방지를 위해서 비강내 mupirocin 5일 요법을 시행하였고 이후 10개월간 추가적인 재발은 없었다.

• 한국임상수의학회지
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• 제23권3호
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• pp.300-307
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• 2006

In the present study, methods of the reverse transcription-polymerase chain reaction(RT-PCR) were evaluated for the rapid detection and differentiation of transmissible gastroenteritis virus(TGEV), porcine epidemic diarrhea virus(PEDV) and rotavirus in piglets suffering from diarrhea. For the purposes, the PCR conditions were first confirmed for the amplification of VP7 gene of rotavirus and N gene of TGEV and PEDV using each specific primers and their annealing temperature. Multiplex RT-PCR methods were further determined to distinguish these viral infections and the results are as follows. For the specific amplification of these viral genes, the reliable PCR condition was determined as 30 cycles of reaction consisting each 1 min of denature at $94^{\circ}C$, annealing at $42^{\circ}C$ and polymerization at $72^{\circ}C$ with 1.0 mM $MgCl_2$. It was able to differentiate these viral infections in the intestines and feces of piglets suffering from diarrhea by duplex PCR for TGEV and PEDV and single PCR for rotavirus with a primer-annealing temperature of $42^{\circ}C$. When the multiplex RT-PCR were undertaken for the field samples, 17 cases of PEDV and 5 cases of rotavirus infections were differential diagnosed in a total of 92 samples of intestines and feces of the piglets with diarrhea.

• Clinical and Experimental Pediatrics
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• 제59권3호
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• pp.120-125
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• 2016

Purpose: Viral gastroenteritis among children is mainly caused by rotavirus, norovirus, astrovirus, or adenovirus strains. However, changing socioeconomic conditions and a rotavirus vaccination program may be affecting the prevalence of these viral infections. Therefore, we aimed to elucidate the season-specific trends in viral infections for facilitating prophylaxis and surveillance in our region. Methods: We evaluated 345 pediatric patients (203 males, 142 females; age, 1 month to 16 years) who visited the CHA Bundang Medical Center because of gastroenteric symptoms between June 2014 and May 2015. The specimens were simultaneously tested for norovirus, rotavirus, astrovirus, and adenovirus via multiplex reverse transcription polymerase chain reaction. Clinical characteristics of patients were analyzed retrospectively. Results: The most common virus was norovirus, followed by rotavirus, adenovirus, and astrovirus. Of all viral infections, 45.2% occurred mainly between 6 and 24 months of age; in particular, norovirus infection mostly occurred in all age groups except those below 6 months of age, when rotavirus was most prevalent. In addition, seasonal variation was observed, such as norovirus infection from December to February, rotavirus infection from February to April, and adenovirus infection from July to October. Conclusion: Our results showed that the most common cause of acute pediatric viral gastroenteritis had changed from rotavirus to norovirus in our patients, because of effective rotaviral vaccination. We recommend the management of food and personal hygiene in accordance with age or seasons as well as active vaccination for preventing viral gastroenteritis.

• Parasites, Hosts and Diseases
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• 제22권1호
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• pp.43-50
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• 1984

이형흡충류의 하나인 Stellantchasmus falcatu에 의한 인체기생 2례가 praziquantel투약후 성충을 수집함으로써 화인되었다. 환자는 서울에 거주하는 24세 (제 1례) 및 55세 (제 2례) 남여로 제 1페는 설사, 복통 등 소화기증상과 불정맥(arrhythmia) 등 심식증상을 호소하면서 대편내에 광절렬류조충란이 양성이었고 제 2례는 소화불량과 조충류 편절 배출을 호소하였다. 조충감염 치료를 위해 praziquantel 15∼20mg/kg를 투여하고 MgSO4 30g으로 충체배출을 유도한 바 배출된 조충을 각각 확인하였다. 그러나 나머지 설사편을 입체해부현미경으로 세밀히 조사한 결과 제 1례에서는 188마리의 S. falcatus와 다른 3종의 이형흡충류가, 제 2례에서는 5마리의 S. falcatus가 수집되었다. 환자들은 숭어(Mugil cephalus) 등 반염수9을 회로 먹었다고 하며 이들이 감염원일 것으로 추측되었다.

• Parasites, Hosts and Diseases
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• 제56권2호
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• pp.147-152
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• 2018

This prospective study was aimed to detect acute and chronic ocular toxoplasmosis by comparison of anti-Toxoplasma gondii IgM and IgG antibody levels and IgG avidity test. One hundred and seventeen patients with ocular toxoplasmosis (OT) who referred to the Farabi Eye Hospital, Tehran, Iran were included in this study. Of the patients, 77 cases were positive for anti-T. gondii IgG, and 8 cases were positive for anti-T. gondii IgM. IgG avidity test revealed 11, 4, and 102 cases were low, intermediate, and high, respectively, and 6.8% and 9.4% of cases were positive for IgM and IgG avidity tests, respectively (P=0.632). Agreement (Kappa value) between paired tests IgG-IgM, IgG-IgG avidity, and IgM-IgG avidity was 0.080, 0.099, and 0.721, respectively (P<0.05). This study showed that conventional serologic tests (IgM and IgG levels) and IgG avidity correlate well each other and can be used to differentiate recent infections from old OT. It seems that reactivated old infections rather than recently acquired infections are majority of Iranian OT patients.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제19권4호
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• pp.243-250
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• 2016

Purpose: We sought to examine the relationship between the clinical manifestations of nonspecific reactive hepatitis and respiratory virus infection in pediatric patients. Methods: Patients admitted to the pediatric unit of Konyang University Hospital for lower respiratory tract disease between January 1, 2014 and December 31, 2014 and who underwent reverse transcriptase polymerase chain reaction tests were examined. The patients were divided into those with increased levels of alanine aminotransferase (ALT) or aspartate aminotransferase (AST) and those with normal ALT or AST levels. Further, patients with increased ALT and AST levels were individually compared with patients in the normal group, and the blood test results were compared according to the type of respiratory virus. Results: Patients with increased ALT or AST levels had one more day of hospital stay, on average, compared with patients in the normal group ($5.3{\pm}3.1$ days vs. $4.4{\pm}3.0$ days, p=0.019). Patients in the increased ALT level group were younger and had a longer mean hospital stay, compared with patients in the normal group (p=0.022 and 0.003, respectively). The incidences of increased ALT or AST were the highest in adenovirus infections (6/24, 25.0%), followed by enterovirus (2/11, 18.2%) and respiratory syncytial virus A (21/131, 16.0%) infections. Conclusion: Nonspecific reactive hepatitis is more common among patients with adenovirus, enterovirus and respiratory syncytial virus infection, as well as among those infected at a younger age. Compared with AST levels, ALT levels are better indicators of the severity of nonspecific reactive hepatitis.

• Childhood Kidney Diseases
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• 제21권2호
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• pp.101-106
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• 2017

Purpose: The aim of this study was to analyze the incidence and microbiological characteristics of urinary tract infection in infants aged younger three months and to compare with other infection with positive urine culture. Methods: We retrospectively reviewed the medical records of 425 infants with a tympanic temperature >$37.6^{\circ}C$, aged younger than three months, who were admitted to Cheil General Hospital in Seoul, Korea, from January 2013 to December 2016. Demographic and clinical features, laboratory findings, respiratory virus PCR and the pathogens of a urine culture were analyzed. Results: A total of 88 infants (63 males, 25 females) had urinary pathogens detected in the urine culture test. The incidence of UTI in febrile infants aged younger 3 months was 11%. The most common pathogen which causes UTI was E. coli as same as in previous studies. They were divided into a UTI group (n=48) and a non-UTI group (n=40). In comparison of both group, leukocytosis, C-reactive protein level, Absolute neutrophil count level, peak temperature is statistically significant. In both group, there were co-infections with viral pathogens in some cases, and the odd ratio of non-UTI group with viral infection was 3.28. Conclusion: The study determined the incidence and pathogen of UTI in febrile infants, aged younger three months. E. coli was responsible for the majority UTI. There were some viral co-infections in febrile infants with bacteriuria and incidence was higher in non-UTI group. WBC count, ANC count and CRP level were the differentiating factors of UTI from non-UTI group.

• Journal of Microbiology and Biotechnology
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• 제15권4호
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• pp.728-733
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• 2005

To elucidate the question of whether biofilm formed by the intercellular adhesion (ica) gene cluster has influences on antibiotic resistance in Staphylococcus epidermidis, we compared 124 skin strains with strains isolated from 50 blood cultures that cause septicemic diseases. The results revealed that the blood culture isolates were more resistant to the antibiotics tested than the saprophytic isolates. Moreover, antibiotic multiresistance was more prevalent in the clinical isolates. In the blood culture isolates, $46\%$ of the strains were resistant to three or more antibiotics, whereas only $12\%$ of the saprophytic isolates were resistant to three or more antibiotics. Interestingly, these characteristics were highly correlated with the biofilm formed by the ica gene cluster. In biofilm-producing strains, $84\%$ of the blood culture isolates and $44\%$ of the saprophytic isolates were antibiotic multiresistant, whereas only $22\%=;and\;9\%$, respectively, were antibiotic multiresistant in biofilm-nonproducing strains. Additionally, in the biofilm-producing ica-positive strains, $89\%$ of the blood culture isolates and $57\%$ of the saprophytic isolates were antibiotic multiresistant. However, the rate of the antibiotic multiresistance in the ica-negative strains was very low, thus indicating that the biofim formed by the lea gene cluster in S. epidermidis is an important pathogenic factor in association with the antibiotic multiresistance.