• Pediatric Infection and Vaccine
• /
• v.24 no.2
• /
• pp.87-94
• /
• 2017

Purpose: The inappropriate prescription of antibiotics in children with upper respiratory tract infection (URTI) is common. This study evaluated the factors that influence antibiotics use in hospitalized children with viral URTI confirmed by reverse transcriptase-polymerase chain reaction (RTPCR) assay. Methods: The medical records of admitted patients who performed RT-PCR assay for respiratory virus pathogens from January 2013 to November 2014 were examined. The demographic and clinical features were compared between patients who were administered antibiotics at admission and those who were not. We also investigated differences between children who continued antibiotics and those who stopped antibiotics after a viral pathogen was identified. Results: In the total 393 inpatients, the median age was 23 months (interquartile range, 13 to 41.3 months). Antimicrobial agents were prescribed in 79 patients (20.1%) at admission. Patients with acute otitis media (AOM) had higher rates of antibiotics prescription than those without AOM (48.1% vs. 2.2%, P<0.001), with an adjusted odds ratio of 91.1 (95% confidence interval, 30.5 to 271.7). Level of high-sensitivity C-reactive protein and the proportion of acute rhinosinusitis were also significantly associated with antibiotics use (P<0.001). Among the 44 patients with viruses identified using the RT-PCR method during hospitalization, antibiotic use was continued in 28 patients (63.6%). AOM was statistically associated with continued antibiotic use in the patients (P=0.002). Conclusions: Although the respiratory virus responsible for URTI etiology is identified, clinicians might not discontinue antibiotics if AOM is accompanying. Therefore, careful diagnosis and management of AOM could be a strategy to reduce unjustified antibiotic prescriptions for children with URTI.

• Tuberculosis and Respiratory Diseases
• /
• v.78 no.4
• /
• pp.366-370
• /
• 2015

Although influenza A (H1N1) virus leads to self-limiting illness, co-infection with bacteria may result in cases of severe respiratory failure due to inflammation and necrosis of intra-airway, as pseudomembranous tracheobronchitis. Pseudomembranous tracheobronchitis is usually developed in immunocompromised patients, but it can also occur in immunocompetent patients on a very rare basis. We report a case of pseudomembranous tracheobronchitis complicated by co-infection of inflenaza A and Staphylococcus aureus, causing acute respiratory failure in immunocompetent patients.

• Pediatric Infection and Vaccine
• /
• v.14 no.2
• /
• pp.179-187
• /
• 2007

Purpose : Acute viral respiratory tract infection is the most common illness among children. Involved organisms are respiratory syncytial virus (RSV), influenza virus, adenovirus, parainfluenza virus, etc. The objective of the present study is to determine epidemiology of each viral infection in Busan, South Korea between January 2004 and December 2006. Methods : We retrospectively analyzed the results of clinical samples of throat and nasal swab collected from Busan city, South Korea between January 2004 and December 2006. We collected these samples from the children with acute respiratory illness. Viruses were detected by virus culture Results : The identified pathogens were influenza A in 131 cases (46.6 percent), RSV in 40 cases (14.2 percent), influenza B in 37 cases (13.2 percent), adenovirus in 23 cases (8.2 percent), enterovirus in 37 cases (13.2%) [coxsackie virus in 20 cases (7.1 percent), atypical enterovirus in 9 cases (3.2 percent), poliovirus in 4 cases (1.4 percent), echovirus in 4 cases (1.4 percent)], rhinovirus in 9 cases (3.2 percent), parainfluenza virus in 2 cases (0.7 percent), coronavirus and bocavirus in each 1 case (0.4 percent). Influenza A were detected every year, mostly in December through April and RSV in October through February. Adenovirus were detected through out the year. Bocavirus occurred in December, 2006. Conclusion : We analyzed epidemiologic characteristics of viruses to cause the respiratory disease that prevailed at Busan area for recent three years, and from now on, a further continuous study will be necessary.

• Journal of Microbiology and Biotechnology
• /
• v.30 no.3
• /
• pp.313-324
• /
• 2020

Coronavirus disease 2019 (COVID-19), which causes serious respiratory illness such as pneumonia and lung failure, was first reported in Wuhan, the capital of Hubei, China. The etiological agent of COVID-19 has been confirmed as a novel coronavirus, now known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is most likely originated from zoonotic coronaviruses, like SARS-CoV, which emerged in 2002. Within a few months of the first report, SARS-CoV-2 had spread across China and worldwide, reaching a pandemic level. As COVID-19 has triggered enormous human casualties and serious economic loss posing global threat, an understanding of the ongoing situation and the development of strategies to contain the virus's spread are urgently needed. Currently, various diagnostic kits to test for COVID-19 are available and several repurposing therapeutics for COVID-19 have shown to be clinically effective. In addition, global institutions and companies have begun to develop vaccines for the prevention of COVID-19. Here, we review the current status of epidemiology, diagnosis, treatment, and vaccine development for COVID-19.

• Tuberculosis and Respiratory Diseases
• /
• v.80 no.4
• /
• pp.325-335
• /
• 2017

Chronic obstructive pulmonary disease (COPD) is associated with abnormal inflammatory response and airflow limitation. Acute exacerbation involves increased inflammatory burden leading to worsening respiratory symptoms, including dyspnea and sputum production. Some COPD patients have frequent exacerbations (two or more exacerbations per year). A substantial proportion of COPD patients may remain stable without exacerbation. Bacterial and viral infections are the most common causative factors that breach airway stability and lead to exacerbation. The increasing prevalence of exacerbation is associated with deteriorating lung function, hospitalization, and risk of death. In this review, we summarize the mechanisms of airway inflammation in COPD and discuss how bacterial or viral infection, temperature, air pollution, eosinophilic inflammation, and concomitant chronic diseases increase airway inflammation and the risk of exacerbation.

• Tuberculosis and Respiratory Diseases
• /
• v.85 no.4
• /
• pp.283-288
• /
• 2022

Asthma is a chronic inflammatory disease of the airways characterized by varying and recurrent symptoms, reversible airway obstruction, and bronchospasm. In this paper, clinical important studies on asthma published between March 2021 and February 2022 were reviewed. A study on the relationship between asthma and chronic rhinosinusitis, bronchiectasis, and hormone replacement therapy was published. A journal on the usefulness of fractional exhaled nitric oxide for the prediction of severe acute exacerbation was also introduced. Studies on the effect of inhaler, one of the most important treatments for asthma, were published. Studies on the control of severe asthma continued. Phase 2 and 3 studies of new biologics were also published. As the coronavirus disease 2019 (COVID-19) pandemic has been prolonged, many studies have explored the prevalence and mortality of COVID-19 infection in asthma patients.

• Tuberculosis and Respiratory Diseases
• /
• v.69 no.2
• /
• pp.75-80
• /
• 2010

The year of 2009~2010 brought a number of concepts and new ideas were evaluated with promising results. However, some studies that challenged many beliefs. In acute respiratory distress syndrome (ARDS), recent clinical studies took into consideration of pathophysiologic changes of respiratory system compliance. Meta-analysis of positive end-expiratory pressure trials showed survival benefit of high positive end-expiratory pressure in ARDS. Until now, prone positioning did not show survival benefit in patients with ARDS. Extracorporeal membrane oxygenation (ECMO) based management improved survival in patients with severe ARDS. ECMO can be a management option in severe ARDS. Sedation is a standard practice in critically ill patients needing mechanical ventilation. However, Danish group reported less sedation of critically ill patients receiving mechanical ventilation was associated with an increase in days without ventilation. Although this single center study has some limitations, the overall results are promising. Use of maximal sterile barrier precautions (mask, sterile gown, sterile gloves, and large sterile drapes) with chlorhexidine-impregnated dressing reduced central venous catheter related infection. Selective oropharyngeal decontamination (application of topical antibiotics in the oropharynx) reduced the mortality rate of an intensive care unit (ICU) population. Normoglycemia in Intensive Care Evaluation and Survival Using Glucose Algorithm Regulation (NICE-SUGAR) trial reported intensive glucose control increased mortality among adults in the ICU. Some of the results of above papers are promising. However, some ideas may need for more frequent individual assessment and increase the workload of ICU staffs. Before implementation of new practice in ICU, we should take into consideration of individual hospital situation including human and material resources.

• Animal Bioscience
• /
• v.36 no.1
• /
• pp.43-52
• /
• 2023

Objective: This study aimed to examine the influence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on pregnancy in cytokeratin-18 (K18)-hACE2 transgenic mice. Methods: To determine the expression of hACE2 mRNA in the female reproductive tract of K18-hACE2 mice, real-time polymerase chain reaction (RT-PCR) was performed using the ovary, oviduct, uterus, umbilical cord, and placenta. SARS-CoV-2 was inoculated intranasally (30 μL/mouse, 1×10⁴ TCID₅₀/mL) to plug-checked K18-hACE2 homozygous female mice at the pre-and post-implantation stages at 2.5 days post-coitum (dpc) and 15.5 dpc, respectively. The number of implantation sites was checked at 7.5 dpc, and the number of normally born pups was investigated at 20.5 dpc. Pregnancy outcomes, including implantation and childbirth, were confirmed by comparison with the non-infected group. Tissues of infected mice were collected at 7.5 dpc and 19.5 dpc to confirm the SARS-CoV-2 infection. The infection was identified by performing RT-PCR on the infected tissues and comparing them to the non-infected tissues. Results: hACE2 mRNA expression was confirmed in the female reproductive tract of the K18-hACE2 mice. Compared to the non-infected group, no significant difference in the number of implantation sites or normally born pups was found in the infected group. SARS-CoV-2 infection was detected in the lungs but not in the female reproductive system of infected K18-hACE2 mice. Conclusion: In K18-hACE2 mice, intranasal infection with SARS-CoV-2 did not induce implantation failure, preterm labor, or miscarriage. Although the viral infection was not detected in the uterus, placenta, or fetus, the infection of the lungs could induce problems in the reproductive system. However, lung infections were not related to pregnancy outcomes.

• Journal of Microbiology and Biotechnology
• /
• v.30 no.8
• /
• pp.1109-1115
• /
• 2020

The outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is spreading globally, and the WHO has declared this outbreak a pandemic. Vaccines are an effective way to prevent the rapid spread of COVID-19. Furthermore, the immune response against SARS-CoV-2 infection needs to be understood for the development of an efficient and safe vaccine. Here, we review the current understanding of vaccine targets and the status of vaccine development for COVID-19. We also describe host immune responses to highly pathogenic human coronaviruses in terms of innate and adaptive immunities.

• Tuberculosis and Respiratory Diseases
• /
• v.70 no.1
• /
• pp.51-57
• /
• 2011

Background: Early recognition and treatment of sepsis would improve patients' outcome. But it is difficult to distinguish between sepsis and non-infectious conditions in the acute phase of clinical deterioration. We studied serum level of procalcitonin (PCT) as a method to diagnose and to evaluate sepsis. Methods: Between 1 March 2009 and 30 September 2009, 178 patients had their serum PCT tested during their clinical deterioration in the medical intensive care unit. These laboratories were evaluated, on a retrospective basis. We classified their clinical status as non-infection, local infection, sepsis, severe sepsis, and septic shock. Then, we compared their clinical status with level of PCT. Results: The number of clinical status is as follows: 18 non-infection, 33 local infection, 39 sepsis, 26 severe sepsis, and 62 septic shock patients. PCT level of non-septic group (non-infection and local infection) and septic group (sepsis, severe sepsis, septic shock) was $0.36{\pm}0.57$ ng/mL and $18.09{\pm}36.53$ ng/mL (p<0.001), respectively. Area under the curve for diagnosis of sepsis using cut-off value of PCT >0.5 ng/mL was 0.841 (p<0.001). Level of PCT as clinical status was statistically different between severe sepsis and septic shock ($^*severe$ sepsis; $4.53{\pm}6.15$ ng/mL, $^*septic$ shock $34.26{\pm}47.10$ ng/mL, $^*p$ <0.001). Conclusion: Level of PCT at clinical deterioration showed diagnostic power for septic condition. The level of PCT was statistically different between severe sepsis and septic shock.