• Korean Journal of Clinical Laboratory Science
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• v.54 no.2
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• pp.110-118
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• 2022

Candidemia is a major cause of nosocomial infections resulting in increased morbidity and mortality. It remains a serious risk in inpatients and increases medical treatment costs. From 2009 to 2018, Candida strains (3,533) isolated from blood culture tests at the S Hospital were analyzed according to the period, year, sex, age, ward, etc. During the entire period, 54,739 of 717,996 blood culture tests showed a positive rate (7.6%) and the Candida isolation rate was 3,533 (6.4%) out of 1,036 patients. Among the Candida isolates, C. albicans was most common (33.8%), followed by C. tropicalis (28.6%), C. glabrata (19.8%), C. parapsilosis (7.8%), and C. krusei (4.0%). In early (2009~2013)/late (2014~2018) isolation, C. tropicalis decreased by 3.8% and C. glabrata increased by 3.4%. After 50 years of age, the higher the separation frequency. C. parapsilosis (31.3%) in 1~10s, C. tropicalis (30.3%) and C. glabrata (27.6%) in 41~50s, and C. tropicalis (28.6%) in 80s are relatively frequent. has been separated C. krusei was isolated in a relatively high proportion from females (60.9%). Therefore, a systematic and continuous nosocomial infection control system should be established for appropriate treatment as per antifungal treatment guidelines. The system should continuously monitor the distribution of Candida species and provide rapid identification results.

• Korean Journal of Clinical Laboratory Science
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• v.48 no.2
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• pp.94-101
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• 2016

Acinetobacter species isolates are important opportunistic pathogens and commonly implicated in nosocomial infections. The therapeutic options for treatment of the bacterial infections are limited because the bacteria isolates are usually multidrug resistant (MDR). In the current study, we investigated various carbapenemase genes in 68 Acinetobacter species isolates. Antimicrobial susceptibilities were tested using the disk diffusion method. Screening of carbapenemase genes was performed via multiplex PCR. In addition, PCR and DNA sequencing were used to identify the carbapenemase genes. Repetitive extragenic palindromic-PCR (REP-PCR) was also performed to assess the clonality of isolates. In our study, A. baumannii isolates were highly resistant to all agents tested while all non-A. baumannii isolates were susceptible to all agents tested, with the exception of aztreonam and cefotaxime. All 51 A. baumannii isolates contained the $bla_{OXA-51}$ gene and 37 (72.5%) isolates also harbored the $bla_{OXA-23}$ gene. In addition, 39 MDR A. baumannii isolates were identified in our study and 37 isolates contained the $bla_{OXA-23}$ gene. The 37 MDR strains harboring $bla_{OXA-23}$ showed type I (n=22) or type II (n=15) banding patterns on their REP-PCR profiles. Our results suggest clonal relation and horizontal spreading of MDR A. baumannii isolates containing the $bla_{OXA-23}$ gene at the hospital located in Daejeon. Continuous investigation of antimicrobial resistant determinants and monitoring emergence and dissemination of MDR isolates is required to prevent and control infection and colonization of MDR A. baumannii isolates.

• Korean Journal of Clinical Laboratory Science
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• v.53 no.1
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• pp.49-59
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• 2021

This study investigated the use of real-time PCR melting curves for the diagnosis of blaKPC and blaNDM genes among the most frequently detected carbapenemase-producing Enterobacteriaceae in Korea. As a means of addressing the shortcomings of phenotype tests and conventional PCR. The modified Hodge test confirmed positivity in 25 of 35 strains, and carbapenemase inhibition testing confirmed positivity in 14 strains by meropenem+PBA or meropenem+EDTA. PCR analysis showed amplification products in 25 strains of Klebsiella pneumoniae carbapenemases (KPC), 10 of K. pneumoniae, 5 of E. coli, 5 of A. baumannii, 4 of P. aeruginosa, and 1 of P. putida. New Delhi metallo β-lactamase (NDM) identified amplification products in 8 strains, that is, 2 K. pneumoniae, 3 E. coli, 1 P. aeruginosa, 1 E. cloacae, and 1 P. retgeri strains. Real-time PCR melting curve analysis confirmed amplification in 25 strains of KPC and 8 strains of NDM, and these results were 100% consistent with PCR results. In conclusion, our findings suggest early diagnosis of carbapenem resistant Enterobacteriaceae by real-time PCR offers a potential means of antibacterial management that can prevent and control nosocomial infection spread.

• Pediatric Infection and Vaccine
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• v.8 no.2
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• pp.199-205
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• 2001

Purpose : Since the first report of vancomycin-resistant enterococci(VRE) in 1986, the resistance to vancomycin in enterococci has been increasingly rapidly. In this study, we investigated the clinical manifestations of pediatric patients with VRE and the pattern of the antibiotic use with increasing the rate of VRE in pediatrics Methods : We studied retrospectively 36 pediatric patients who were isolated VRE from January 1998 to December 2000. We classified patients into ICU and non ICU groups and reviewed species of VRE, specimens in which VRE were first detected and procedures performed before VRE detected. Results : We have found that the number of pediatric patients isolated VRE is increasingly annually in this study. In addition, the number of VRE-isolation in the ICU group and in patients who were operated or who underwent active procedures is much higher than that of in the non ICU group and in patients who were taken medication only. Enterococcus faecium is the main species of VRE. VRE showed high resistance to almost all antibiotics except tetracycline, and resistance was closely related to the duration of hospitalization and history of the antibiotic use. The proportion of the cephalosporin use was higher than any other antibiotic before VRE detection. In contrast, that of teicoplanin was higher than any other antibiotic after VRE detection(P<0.05). The cases of superinfection is higher in the ICU group than in non ICU group. Conclusion : In the hospital level, prevention of nosocomial infection through proper administrative policies, through surveillance of high risk VRE regions and prudent antibiotic use can prevent VRE outbreaks and corresponding side effects.

• Pediatric Infection and Vaccine
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• v.17 no.1
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• pp.1-8
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• 2010

Purpose : Recently, vancomycin-resistant enterococci (VRE) have become one of the major nosocomial pathogens in Korea. However, there have been few studies on the epidemiology of VRE colonization among neonates. In this study, we investigated the prevalence of VRE colonization, risk factors for VRE, and how to control the spread of VRE infection in the Neonatal Intensive Care Unit (NICU) of Pusan National University Hospital (PNUH). Methods : We retrospectively reviewed medical records of 192 neonates who were admitted to the NICU of PNUH from March 2006 to March 2007. Surveillance cultures from rectal swabs for detecting VRE were obtained weekly during the study period. We analyzed the prevalence of VRE and various risk factors. Results : The rate of VRE colonization among NICU patients was 25% (48/192). Thirty five of these VRE colonized patients were transferred to the NICU from other local hospitals. Compared with the non-VRE group, the risk factors associated with VRE colonization were lower birth weight, congenital heart disease, applied mechanical ventilation, use of a central venous catheter, chest tubing, a history of surgery, and use of antibiotics. Conclusion : VRE colonization among patients admitted to the NICU is rapidly increasing. Monitoring and managing premature neonates from the beginning of the birth process, avoiding many invasive procedures, avoiding antibiotics such as vancomycin and third generation cephalosporin are important for preventing the emergence and spread of VRE colonization in the NICU.

• Clinical and Experimental Pediatrics
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• v.48 no.9
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• pp.946-952
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• 2005

Purpose : Vancomycin-resistant enterococci(VRE) are now nosocomial pathogens in Korea. But little is known about the prevalence of stool colonization with VRE in neonates in Korea. So we studied the prevalence and risk factors of VRE colonization in the Neonatal Intensive Care Unit(NICU). Methods : From January 2000 to December 2004, the medical records of 294 neonates(127 cases of VRE group and 167 cases of non-VRE group, according to the results of stool culture) were reviewed retrospectively. We studied the annual prevalence of VRE and risk factors of VRE colonization in neonates. Results : From 2000 to 2003, the prevalence rate of VRE in NICU increased. After preventing VRE transmission, the prevalence rate of VRE has decreased. Conclusion : VRE colonization increased recently. Risk factors of VRE colonization were prematurity, lower birth weight, longer hospitalization and use of vancomycin or 3rd generation cephalosporin, compared with the non-VRE group. To prevent VRE transmission among newborns, aggressive infection control strategies by NICU staffs must be implemented immediately for all babies.