Kang, Hyun Mi;Park, Ki Cheol;Lee, Kyung-Yil;Park, Joonhong;Park, Sun Hee;Lee, Dong-Gun;Kim, Jong-Hyun
Pediatric Infection and Vaccine
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v.26
no.3
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pp.148-160
/
2019
Purpose: This study aimed to investigate the molecular epidemiology of a methicillin-resistant Staphylococcus aureus (MRSA) outbreak at a newborn nursery and neonatal intensive care unit (NICU). Methods: During the outbreak, from August to September 2017, MRSA isolates collected from neonates and medical staff underwent genotyping and screened for virulence factors. Antibiotic susceptibilities were tested. Results: During the study period, 41 neonates were admitted at the nursery (n=27) and NICU (n=14). Of these, 7 had MRSA infections (skin infection [n=6] and sepsis [n=1]) and 4 were colonized with MRSA. Associated medical staff (n=32) were screened; three were nasal MRSA carriers. Staphylococcal chromosomal cassette mec (SCCmec) type II, sequence type (ST) 89, spa type t375 was found to be the skin infection outbreak causing strain, with multi-drug resistance including low-level mupirocin resistance. SCCmec type IVa, ST 72, and a novel spa type designated t17879, was the cause of MRSA sepsis. Many different types of MRSA were colonized on the neonates; however, SCCmec type IVa, ST 72, spa type t664 was colonized in both neonates and a NICU nurse. All MRSA isolates from colonized infants were positive for the Panton-Valentine leukocidin (PVL) toxin gene. Conclusions: The strain causing an outbreak of skin infections had multi-drug resistance. Also, MRSA colonized in the neonates were found to carry the PVL toxin gene. Because different strains are present during an outbreak, molecular epidemiologic studies are important to identify the outbreak strain and colonized strains which aid in effective control and prevention of future MRSA outbreaks.
Clonal complex (CC) 398 community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) has emerged worldwide in a variety of livestock animals and humans. We report complete genome sequences of Panton-Valentine leucocidin (PVL) and immune evasion cluster (IEC) gene-positive CC398 MRSA strains isolated from patients in Korea.
Chang, Yun Sil;Sung, Dong Kyung;Kang, Saem;Park, Soo Kyung;Jung, Yu Jin;Seo, Hyun Joo;Choi, Seo Heui;Park, Won Soon
Clinical and Experimental Pediatrics
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v.51
no.8
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pp.874-878
/
2008
Purpose : This study was undertaken to develop an animal model of periventricular leukomalacia (PVL) induced by in utero clamping of pregnant rat aorta in fetal rats. Methods : A timed pregnanct Sprague-Dawley rat on embryonic day 21 just prior to delivery was sedated and anesthetized, and a Harvard ventilator for small animals was applied. Following laparotomy, the maternal aorta was clamped reversibly for 40 minutes using a surgical clip. The fetal rats were then delivered by Cesarean section, resuscitated if necessary, and reared by a surrogate mother rat until postnatal day 21 to obtain the brain specimen. After systemic perfusion and fixation, $10{\mu}m$ thick serial brain sections were obtained and stained for pathologic examination and assessment of ventriculomegaly. Ventriculomegaly was assessed by the measured ventricle to total brain volume ratio. Results : Eight out of eleven fetal rats (73%) survived in the ischemia group after induction of in utero ischemia by clamping maternal rat aorta, and all ten survived in the control group. Body and brain weights measured at postnatal day 21 were significantly lower in the ischemia group compared to the control group. In pathologic findings, significant ventriculomagaly ($3.67{\pm}1.21%$ vs. $0.23{\pm}0.06%$) was observed in the ischemia group compared to the control group; although cystic lesion was not observed, mild (n=6) and moderate (n=2) rerefaction of the brain tissue was observed. Conclusion : A fetal rat model of PVL induced by in utero clamping of pregnant rat aorta was developed.
The molecular epidemiological characteristics of methicillin-resistant Staphylococcus aureus (MRSA) isolates have demonstrated their genetic diversity and evolution. A total of 137 strains of MRSA clinical isolates was collected from Korean healthcare facility in 2007. The MRSA clinical isolates were analyzed by molecular typings (SCCmec element and agr locus typing), virule nce factor gene detections {(Panton-Valentine leukocidin (PVL), enterotoxin, exfoliative toxin and toxic shock syndrome toxin-1), and amplified fragment length polymorphism (AFLP)}. The MRSA clinical isolates were classified as SCCmec type II-agr type 1 (2 strains), type II-agr type 2 (79 strains), type III-agr type 1 (24 strains), type III-agr type 2 (2 strains), type IV-agr type 1 (27 strains), type IV-agr type 2 (2 strains), and non-typable (1 strain, agr type 3). Based on SCCmec types, SCCmec type II (95.1%) and III (88.5%) indicated higher multidrug resistance rate than SCCmec type IV (10.3%) (P<0.001). The most common enterotoxin genes were seg (83.8%), sei (83.1%), and sec (80.2%). The tst gene was present in 86 out of 137 (62.8%) MRSA isolates. All MRSA isolates were negative for PVL and exfoliative toxin genes. The combinations of toxin genes were observed in particular SCCmec types; 97.6% of SCCmec type II strains carried sec, seg, sei and tst genes, 73.0% of SCCmec type III strains carried sea gene, and 89.7% of SCCmec type IV strains carried sec, seg and sei genes. Each of the SCCmec types of MRSA isolates had distinct AFLP profile. In conclusion, SCCmec type II, agr type 1 and 2 have demonstrated to be the most common types in Korea, and the results indicated that the virulence factors are closely associated with their molecular types (SCCmec and agr types).
Journal of the Korea Academia-Industrial cooperation Society
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v.16
no.5
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pp.3315-3322
/
2015
Staphylococcus aureus is the major causative organism of nasocomial infection being the important pathogen in the clinic. Appearance of staphylococcus aureus resistant to methicillin (MRSA) is becoming a big problem in clinics and dynamics all over the world acquiring antibiotic resistance with virulence factors as its feature differentiated from other pathogenic bacteria fast. This research intended to compare and analyze the correlation of antibiotics resistance between strains with toxin genes and distribution of toxin genes of MRSA 101 strains acquired from clinical specimen in one general hospital (enterotoxin(se), toxic shock syndrome toxin-1(tst), exfoliative toxin(et), Panton Valentine leukocidin(pvl)). seg gene, isolated the most among toxin genes, was detected in 59 strains (58.4%) and more than two toxin genes were detected in 70 strains (69.3%). As a combination possessing toxin genes, it was detected in 19 strains (18.8%) as seb, sec, seg, sei, tst and the second frequent combination was sec, seg, sei shown in 11 strains (10.9%). 19 strains (18.8%) with combinations of toxin genes same with seb, sec, seg, sei, tst had 100% resistance Ampicillin, Benzylpenicillin, Ciprofloxacin, Clindamycin, Gentamicin, Erythromycin, Telithromycin, Tetracycline antibiotics. Strains with many toxin genes showed high correlation of antibiotic resistance. Afterwards, effective therapy and thorough infection management should be preceded not to spread the resistance of MRSA strain.
Kim, Ki-Jeong;Seo, Jin-Hee;Sung, Yun-Hee;Kim, Bo-Kyun;Kim, Dae-Young;Lee, Sang-Hak;Kim, Chang-Ju;Kim, Young-Pyo
Korean Journal of Exercise Nutrition
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v.13
no.3
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pp.203-209
/
2009
Periventricular leukomalacia (PVL) is a common white matter lesion affecting the neonatal brains. PVL is closely associated with cerebral palsy (CP). It has been suggested that maternal or placental infection can induce damage to the neonatal brains. In the present study, we investigated the effects of treadmill running and swimming of rat pups on the GFAP and MBP expressions in the brains of rat pups with maternal lipopolysaccharide (LPS)-induced CP. The rats were divided into the six groups for experiment 1: the control group, the control with mild exercise group, the control with moderate exercise group, the LPS-treated group, the LPS-treated with mild exercise group, and the LPS-treated with moderate exercise group (n=6 in each group). The rats in the running groups were forced to run on a motorized treadmill for 30 min 5 times a week for 4 weeks. For experiment 2, the rats were divided into four groups: the control group, the LPS-treated group, the LPS-treated with swimming group, and the LPS-treated with treadmill running group (n = 5 in each group). The rats in the swimming group were made to swim for 30 min once a day for 5 times per week during 2 weeks. The rats in the treadmill running group were made to run for 30 min once a day for 5 times per week during 2 weeks. The present results showed that intracervical maternal LPS injection during pregnancy significantly increased GFAP expression in the striatum and significantly decreased MBP expression in the corpus callosum of rat pups. The present results also showed that treadmill running and swimming significantly suppressed GFAP expression and significantly enhanced MBP expression in the brains of rat pups with maternal LPS-induced CP. This effect of treadmill running was shown as equally both in the mild-intensity exercise and in the moderate-intensity exercise. The present study revealed that exercise, both the treadmill running and swimming, is effective for the treatment of astrogliosis and hypomyelination associated with CP. Here in this study, we showed that treadmill running and swimming are effective for alleviating the detrimental effects of CP.
As grouper aquaculture production intensifies worldwide, hybrids are increasingly produced to induce heterosis of traits such as rapid growth and strong environmental adaptability. In this study, we compared the morphological characteristics of a hybrid grouper to those of its parent species Epinephelus moara and E. lanceolatus. The coefficients of external and skeletal traits evaluated using soft X-rays did not differ significantly among groups; however, several patterns were detected among measured traits. The body depth (BD), length of caudal peduncle (LCP), and pre-anal fin length (PAL) of the hybrid were the same as those of E. moara, whereas the pre-pectoral fin length (PPL) and interorbital width (IOW) of the hybrid were the same as those of E. lanceolatus. Traits that did not differ significantly among the three groups included pre-dorsal fin length (PDL), pre-ventral fin length (PVL), length of anal fin (LAF), and length of dorsal fin (LDF), whereas the depth of caudal peduncle (DCP) and snout length (SNL) showed intermediate traits, and eye diameter (ED) was significantly smaller in the hybrid. Therefore, intermediate traits such as DCP and SNL and specific traits such as ED may be used as indices for hybrid classification.
Purpose: The object of this study was to evaluate the efficacy of early total parenteral nutrition with early amino acid in extremely low birth weight infant (ELBWI). Methods: We retrospectively analyzed the medical records of all ELBWIs who were born and admitted to Samsung Medical Center from January 2003 to December 2003 and January 2009 to December 2009 and alive at the time of discharge. Data for nutritional status and morbidities were compared between period 1 (2003, n=22), in which parenteral nutritional support was started gradually over several days and period 2 (2009, n=38), in which parenteral nutrition with amino acid was started as soon as possible after birth. Results: Compared to period 1, birth weight and Apgar score were lower in period 2. The intake amount of glucose, amino acid and total calorie was higher and the level of blood urea nitrogen was increased more from 7th day to 14th day after birth in period 2 when compared than period 1. The weight gain velocity was faster at 7th and 14th postnatal day in period 2. There were no differences in the incidence of necrotizing enterocolitis, moderate to severe bronchopulmonary dysplasia, and severe intraventricular hemorrhage (${\geq}$ Gr III) between two periods but, the incidence of periventricular leukomalacia(PVL) was significantly lower in period 2. Conclusion: Early initiation of total parenteral nutrition with early amino acid in ELBWIs was beneficial at weight gain with lowering catabolism and increasing anabolism. And it could be related with reducing the incidence of PVL.
Lee, Jun Seok;Koo, Kyo Yeon;Lee, Soon Min;Park, Min Soo;Park, Kook In;Namgung, Ran;Lee, Chul;Choi, Seung Hoon
Clinical and Experimental Pediatrics
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v.52
no.11
/
pp.1216-1220
/
2009
Purpose:To analyze and compare various cases in which peritoneal drainage was used as the primary treatment method in preterm infants with intestinal perforation. Methods:Among the preterm infants of less than 28 weeks of gestation who were admitted to the neonatal intensive care unit (NICU) at the Gangnam Severance Hospital from April 2006 to April 2009, 7 who had developed intestinal perforation were studied retrospectively. We investigated the clinical characteristics, secondary operation performances, morbidities, complications, and mortalities. Results:Among the 7 infants, 5 survived. Of the 5 cases, 3 received laparotomy, of which 2 were confirmed as having necrotizing enterocolitis. Of the 2 infants who died, 1 had received laparotomy before 48 h of peritoneal drainage, while the other had not received any subsequent treatment. Of the 7 children, 4 had patent ductus arteriosus (PDA), of which 3 had received indomethacin injection. Five infants had begun enteral feeding before they developed intestinal perforation. Of the 5 infants who survived, 4 were diagnosed with cholestasis. Of the 7 infants, 4 developed periventricular leukomalacia (PVL) and 3 developed rickets. Conclusion:Although the use of peritoneal drainage as the primary management of intestinal perforation in preterm infants is controversial, we suggest that it can be used for treating extreme premature neonates. Further randomized controlled study will be required to determine the feasibility of using this method.
Purpose : This study compares the first epileptic seizures between preterm and term-born children with periventricular leukomalacia and epilepsy. Methods : From 108 cases having lesions of high signal intensity around the ventricles in T2 weighted imaging of a brain magnetic resonance study, we selected 37 cases that showed epileptic seizures two times or more and divided them into the group of preterm-born(27 cases) and term-born children(10 cases). A retrospective study was made by comparing the two groups with regard to age, type of the first epileptic seizures, EEG findings and responsiveness to anticonvulsants. Results : The age of the first epileptic seizure was $22.2{\pm}18.3$ months in the preterm-born group and $26.9{\pm}21.1$ months in the term-born group(P=0.505). As for the first epileptic seizure, 11 out of the 27 cases in the preterm-born group had infantile spasms. Out of the 10 cases in the term-born group, 7 had complex partial seizures. In the preterm group, hypsarrhythmias were found in 11 cases, focal epileptiform discharges in 6 cases. In term-born group, focal epileptiform discharges were found in 5 cases but no epileptiform discharge was found in 3 cases. Intractable epilepsies were diagnosed in 6 cases and all of them belonged to the preterm-born group. Conclusion : More severe epilepsies such as infantile spasm and intractable epilepsies seem to be more common in preterm-born epileptic children with PVL as well as more severely abnormal EEG finding compared to term-born epileptic children.
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