• Pediatric Infection and Vaccine
• /
• v.19 no.3
• /
• pp.141-148
• /
• 2012

Purpose : Ventriculoperitoneal (VP) shunt insertion is an important treatment modality in children with hydrocephalus. VP shunt infection is a major complication and an important factor that determines the surgery outcome. This 15-year study was performed to evaluate the epidemiology of VP shunt infections in pediatric patients treated at our center. Methods : A retrospective review of medical records was performed in patients 18 years old or younger who underwent VP shunt insertion surgery from April 1995 to June 2010. Results : Three hundred twenty-seven VP shunt surgeries were performed in a total of 190 pediatric patients (83 females, 107 males). The median age of the patients was 2.4 years (range, 0.02-17.9 years). Having a malignant brain tumor was the most frequent cause for VP shunt insertion. The shunt infection rate was 6.7% (22/327) per 100 operations and 9.5% (18/190) per 100 patients, and the incidence rate was 0.45 infection cases per 100 shunt operations-year. The most common pathogen was coagulase-negative staphylococcus (n=7) followed by methicillin resistant Staphylococcus aureus (n=1). Ten cases were treated with vancomycin and beta-lactam antibiotic (cephalosporin or carbapenem) combination therapy and 7 cases were treated with vancomycin monotherapy. The median duration of antibiotic treatment was 26 days (range, 7 to 58 days). Surgical intervention was performed in 18 cases (18/22, 81.8%). Conclusion : Epidemiologic information regarding VP shunt infections in pediatric patients is valuable that will help guide proper antibiotic management. Additional studies on the risk factors for developing VP shunt infections are also warranted.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.30 no.6
• /
• pp.497-503
• /
• 2004

One of the most difficult problems to damage in dentistry is an odontogenic infection. These infections may range from low-grade, well-localized infections that require only minimal treatment to a severe, life-threatenig fascial space infection. Although the overwhelming majority of odontogenic infections are easily managed by minor surgical procedures and supportive medical therapy that includes antibiotic administration, the practitioner must constantly bear in mind that these infections may become severe in a very short time. We made an investigation was targeting on 78 male and 47 female patients (125 patients in total) who had been hospitalized because of the fascial space abscess on the oral and maxillofacial area and gained a complete recovery in Daegu Catholic University Hospital, Oral & Maxillofacial Surgery from January 1999 to December 2003. By tracing their charts, we could grasp the characteristics such as age, gender, the time of breakout and specific areas of the attacks, making a conclusive study of the statistical analysis and finally, we could reach conclusions. Now, we report the conclusion from the investigation with the literature. The proportion of males and females was approximately 3 to 2, and in age group, patients under 10 years old marked the highest, 22.4%. The patients between the age of 10 and 40 were only 14.4%, yet those who were between 40 and 80 marked 53.6% in contrast. In the monthly distribution, the order was Dec.(13.6%)-Sep.(12%)-Jan.(10.4%) and in seasonal distribution, it was winter(30.4%)-fall(28%)- summer(24.4%)- spring(19.2%). Considering the medical history, D.M. was the highest which was 30.3%, hypertension marked 24.4%, and the patients with both D.M. and hypertension were 9.0%. The major cause of infection of oral and maxillofacial areas was odontogenic infection, which marked about 96%, and especially the cases related to dental caries occurred most frequently, which was 51.2%. In the number of relaxed fascial space, single fascial space was 81.6%, and in the degree of relaxation of fascial space, the buccal space abscess marked 40.8%, following submandibular space abscess, which was 30.4%.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.21 no.2
• /
• pp.85-93
• /
• 2020

Despite the development of modern medical sciences, the outbreak and spread of infections continue to threaten populations, and the spread of infections among populations is caused by social contacts. There have only been a few studies on social contacts in the Republic of Korea (hereafter Korea). This study identified the types of social contacts in other countries through a systemic literature review and this helped provide basic data for Korea. Twelve studies were finally selected and then published from 2000 to December 2017. The most common study method was a retrospective contact diary (7cases, 58.3%), and random sampling (9cases, 75%). The number of contacts was 4.9-17.7/day, there were more frequent contacts during the weekdays than on weekends, and the most contacted people were those people that met daily. Physical contact was frequent at home. The highest frequency of contacts was between people 5-19 years old. In case of an epidemic, the spread of infection by this age group could be a concern. Assortative mixing was high in the 5-20 years old group, suggesting that this age group may be more likely to spread infection by contact within the same age group. Therefore, a national-wide survey on social contacts will be needed to predict the spread of infections, and to develop infection prevention based on a domestic basis in Korea.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.3
• /
• pp.1177-1180
• /
• 2014

Background: Anogenital warts (AGWs) are common results of sexually transmitted infection (STI). Human papillomavirus (HPV) types 6 and 11, which are non-oncogenic types, account for 90% of the clinical manifestations. Although the quadrivalent HPV vaccine has been launched, AGW remains prevalent in some countries and shows association with abnormal cervical cytology. Objectives: To study the prevalence of abnormal cervical cytology (low grade squamous intraepithelial lesions or worse; LSIL+) in immunocompetent Thai women newly presenting with external AGWs. Materials and Methods: Medical charts of all women attending Siriraj STI clinic during 2007-2011 were reviewed. Only women presenting with external AGWs who were not immunocompromised (pregnant, human immunodeficiency virus positive or being on immunosuppressant drugs) and had not been diagnosed with cervical cancer were included into the study. Multivariate analysis was used to determine the association between the characteristics of the patients and those of AGWs and LSIL+. Results: A total of 191 women were eligible, with a mean age of $27.0{\pm}8.9$ years; and a mean body mass index of $20.6{\pm}8.9kg/m^2$. Half of them finished university. The most common type of AGWs was exophytic (80.1%). The posterior fourchette appeared to be the most common affected site of the warts (31.9%), followed by labia minora (26.6%) and mons pubis (19.9%). The median number of lesions was 3 (range 1-20). Around 40% of them had recurrent warts within 6 months after completing the treatment. The prevalence of LSIL+ at the first visit was 16.3% (LSIL 12.6%, ASC-H 1.1%, HSIL 2.6%). After adjusting for age, parity and miscarriage, number of warts ${\geq}5$ was the only factor associated with LSIL+(aOR 2.65, 95%CI 1.11-6.29, p 0.027). Conclusions: LSIL+ is prevalent among immunocompetent Thai women presenting with external AGWs, especially those with multiple lesions.

• Tuberculosis and Respiratory Diseases
• /
• v.70 no.6
• /
• pp.490-497
• /
• 2011

Background: It is difficult but important to differentiate between bacterial and viral infections, especially for respiratory infections. Hence, there is an ongoing need for sensitive and specific markers of bacterial infections. We investigated novel biomarkers for discriminating community acquired bacterial pneumonia from 2009 H1N1 influenza A infections. Methods: This was a prospective, observational study of patients with community acquired bacterial pneumonia, 2009 H1N1 Influenza A infection, and healthy controls. Serum samples were obtained on the initial visit to the hospital and stored at $-80^{\circ}C$. We evaluated CRP (C-reactive protein), PCT (procalcitonin), LBP (lipopolysaccharide-binding protein) and copeptin. These analytes were all evaluated retrospectively except CRP. Receiver operating characteristic curve (ROC) analyses were performed on the resulting data. Results: Enrolled patients included 27 with community acquired bacterial pneumonia, 20 with 2009 H1N1 Influenza A infection, and 26 who were healthy controls. In an ROC analysis for discriminating community acquired bacterial pneumonia from 2009 H1N1 influenza A infection, areas under the curve (AUCs) were 0.799 for CRP (95% Confidence interval [CI], 0.664~0.934), 0.753 for PCT (95% CI, 0.613~0.892) and 0.684 for LBP (95% CI, 0.531~0.837). Copeptin was not different among the three groups. Conclusion: These findings suggest that serum CRP, PCT and LBP can assist physicians in discriminating community acquired bacterial pneumonia from 2009 H1N1 influenza A infection.

• Parasites, Hosts and Diseases
• /
• v.45 no.3
• /
• pp.213-218
• /
• 2007

The prevalence of liver and intestinal fluke infections was surveyed on residents of Savannakhet Province, Laos. Fecal specimens were collected from a total of 981 residents in 4 Mekong riverside villages and examined by the Kato-Katz thick smear technique. The results revealed that the overall helminth egg positive rate was 84.2%, and the positive rate for small trematode eggs, including Opisthorchis viverrini, heterophyids, or lecithodendriids, was 67.1 %. To obtain adult flukes, 38 small trematode egg positive cases were treated with a 20-30 mg/kg single dose of praziquantel and purged. Diarrheic stools were then collected from 29 people and searched for helminth parasites using stereomicroscopes. Mixed infections with O. viverrini and 6 kinds of intestinal flukes were found, namely, Haplorchis taichui, Haplorchis pumilio, Haplorchis yokogawai, Prosthodendrium molenkampi, Phaneropsolus bonnei, and echinostomes. The total number of flukes collected was 7,693 specimens (av. no. per treated person; 265.3). The most common species was O. viverrini, followed by H. taichui, P. molenkampi, echinostomes, H. pumilio, P. bonnei, and H. yokogawai. The results indicate that foodborne liver and intestinal fluke infections are prevalent among residents of Savannakhet Province, Laos.

• Pediatric Infection and Vaccine
• /
• v.22 no.1
• /
• pp.7-15
• /
• 2015

Purpose: The purpose of this study is to investigate secondary infections within the households of newly diagnosed tuberculosis patients. Methods: We collected data on household infections of tuberculosis patients by retrospective review of medical records and telephone surveys. Results: Out of 321 newly diagnosed tuberculosis cases, a total of 253 patients who received telephone surveys were enrolled in this study. Less than 50% of the patients had household contacts screened for tuberculosis infection, and most of the patients were not aware of the necessity of testing. Out of 562 household contacts, there were 8 cases of secondary tuberculosis (1.4%, 8/562) in 7 households. There were 15 cases of latent infection (2.7%, 15/562) in 13 households. Out of 110 child and adolescent household contacts, there were no cases of secondary tuberculosis, and there were 8 cases of latent infection (7.3%) in 7 households, which was 20.5% among child and adolescent contacts screened for tuberculosis infection. In 3 of the cases (13.0%) that had secondary tuberculosis or latent infection in their households, the source of infection was extrapulmonary tuberculosis. There was no correlation between the frequency of household infections and the presence of pulmonary cavities, sputum AFB smear results, and microbiologically confirmed results. Conclusions: For effective investigation of tuberculosis contacts, it is necessary to raise general awareness on the necessity of investigating household contacts, and there should also be a continued assessment on tuberculosis contact investigation since government-supported programs.

• Pediatric Infection and Vaccine
• /
• v.5 no.2
• /
• pp.215-220
• /
• 1998

Purpose : Asymptomatic infections with positive throat culture for group A beta-hemolytic streptococci(GABHS) and high antistreptolysin O(ASO) concentration may lead to sequelae such as rheumatic fever or acute poststreptococcal glomerulonephritis. Children with asymptomatic infections were treated with oral penicillin V to evaluate the effectiveness of penicillin treatment on the asymptomatic infections. Methods : Throat culture and ASO concentration analysis were performed against healthy elementary school children. Thirty-six children with positive throat culture for GABHS and ASO concentrations of 400 IU/mL or more were divided into two groups. Twenty-two children were treated with oral penicillin V for 10 days, and the others were not treated. Eradication rate of GABHS and the change of ASO concentration between the two groups were compared after one month later. Results : Eradication rates of GABHS between treated and untreated children were 91%(20/22) and 50%(7/14) respectively(P<0.05). Children showing elevation of ASO levels more than 100IU/mL were 22%(4/18) in the treated group and 30%(3/10) in the untreated group, while children showing a decrease of more than 200IU/mL in the ASO level were 44%(8/18) and 40%(4/10) respectively. Conclusion : We confirmed the validity of penicillin treatment, because when we treated the asymptomatic children with penicillin V, the GABHS was eradicated effectively. But there was no significant difference of decrease in the ASO levels between the two groups due to long half-life of ASO or poor compliance. Treatment failure was 22% in terms of elevated ASO levels after penicillin treatment.

• Pediatric Infection and Vaccine
• /
• v.26 no.3
• /
• pp.140-147
• /
• 2019

Purpose: Staphylococcus aureus is a major cause of skin and soft tissue infections (SSTIs). This study aimed to determine the temporal trends in antibiotic susceptibility of S. aureus in SSTI patients aged <19 years. Methods: This retrospective observational study was conducted in pediatric patients with SSTI caused by community-associated S. aureus. Microbiologic and demographic data were collected, and the trends of antibiotic susceptibility results were evaluated. Results: From January 2010 to December 2018, a total of 807 S. aureus isolates were included. An overall increase in susceptibility of isolates to oxacillin was noted (P<0.001), with 75.0% of isolates being oxacillin-susceptible in 2018. S. aureus remained highly susceptible to trimethoprim/sulfamethoxazole and tetracycline, with 97.6% and 95.2% isolate susceptibility in 2018, respectively. Isolates from younger children aged 1 to 5 years had a significantly lower rate of susceptibility to oxacillin than older children aged 6 to 18 years (53.4% vs. 75.0%, P<0.001). Conclusions: The proportion of methicillin-resistant S. aureus isolates appears to decrease in pediatric patients with community-associated SSTI caused by S. aureus. Clinicians should be aware of regional susceptibility patterns when choosing empirical regimens.

• Pediatric Infection and Vaccine
• /
• v.26 no.3
• /
• pp.199-205
• /
• 2019

Enteroviral infections are common in neonates. One important infection pathway is vertical transmission from an infected mother to her neonate. Here, we report the early detection and successful treatment of a vertically transmitted fulminant enteroviral infection associated with myocarditis and hepatitis. The patient had a sudden onset of high fever on the fourth day of life and developed severe, rapidly progressing symptoms of disseminated intravascular coagulopathy (DIC), hepatitis, and myocarditis accompanied by tachyarrhythmia. As it was the peak season for enteroviral infections and both the mother and the patient's 36-month-old sibling had a high fever around the time of delivery, we suspected an enteroviral infection. Thus, we initiated prompt evaluation of enteroviral infection, as well as close observation and intensive care of the neonate. We strongly recommend evaluation for the possibility of vertical enterovirus infection in neonates when the mother is suspected of having a viral infection (e.g., high fever and negative results from bacterial infectious studies) around the time of delivery and when the neonate shows some early symptoms of infectious diseases such as thrombocytopenia, DIC, hepatitis, and myocarditis. Early detection of enteroviral infections and prompt implementation of proper treatment are key to reduce the risk of complications and mortality associated with enteroviral infections in neonates.