• Journal of Medicine and Life Science
• /
• v.18 no.2
• /
• pp.25-30
• /
• 2021

Many people reported suspected food poisoning after consuming food at the same snack bar on June 18, 2020. Thus, an in-depth epidemiological investigation was conducted to identify the infectious agent and establish additional food poisoning prevention measures. The study included people who reported to the local public health center after June 18 with acute gastroenteritis symptoms within 4 days of consuming food from the snack bar. The onset of symptoms and food items consumed by individuals were then investigated via phone calls and on-site visits. Afterward, the infectious agent was identified from human samples (stool or rectal swab) of four restaurant employees and 89 people and from environmental samples (materials, cooking utensils, and water). The analysis revealed that the incubation period ranged from 2 hours to 92 hours, with a median and mode of 16 hours and 12 hours, respectively. Moreover, the epidemic curve had a unimodal shape because of common exposure, which reached its peak on June 18. After monitoring for 8 days, which is more than twice the maximum incubation period of 92 hours, the end of the epidemic was declared on June 28 as no additional cases were reported. Analysis of human and environmental samples revealed Salmonella bareilly of the pulsed-field gel electrophoresis pulsotype SAPX01.017 as the causative agent. Therefore, it was concluded that the food poisoning outbreak was caused by S. bareilly.

• Microbiology and Biotechnology Letters
• /
• v.47 no.2
• /
• pp.310-316
• /
• 2019

Distribution of Salmonella enterica serovars and their associated virulence determinants is wide-spread among food animals, which are continuously implicated in periodic salmonellosis outbreaks globally. The aim of this study was to determine and evaluate the diversity of five Salmonella serovar virulence genes (invA, pefA, cdtB, spvC and iroN) isolated from food animals and humans. Using standard microbiological techniques, Salmonella spp. were isolated from the feces of humans and three major food animals. Virulence determinants of the isolates were assayed using PCR. Clonal relatedness of the dominant serovar was determined via pulsed-field gel electrophoresis (PFGE) using the restriction enzyme, Xbal. Seventy one Salmonella spp. were isolated and serotyped into 44 serovars. Non-typhoidal Salmonella (NTS; 68) accounted for majority (95.8%) of the Salmonella serovars. Isolates from chicken (34) accounted for 47.9% of all isolates, out of which S. Budapest (14) was predominant (34.8%). However, the dominant S. Budapest serovars showed no genetic relatedness. The invA gene located on SPI-1 was detected in all isolates. Furthermore, 94% of the isolates from sheep harbored the spvC genes. The iroN gene was present in 50%, 100%, 88%, and 91% of isolates from human, chicken, sheep, and cattle, respectively. The pefA gene was detected in 18 isolates from chicken and a single isolate from sheep. Notably, having diverse Salmonella serovars containing plasmid encoded virulence genes circulating the food chain is of public health significance; hence, surveillance is required.

• Journal of Microbiology and Biotechnology
• /
• v.29 no.9
• /
• pp.1460-1469
• /
• 2019

The extensive distribution of multidrug-resistant (MDR) methicillin-resistant Staphylococcus aureus (MRSA) poses a threat to healthcare worldwide. This study aimed to investigate the MDR and molecular patterns of MRSA isolates in children admitted to the two biggest tertiary care pediatric hospitals in northern and southern Vietnam. A total of 168 MRSA strains were collected to determine antibiotic susceptibility by minimum inhibitory concentration tests. Antibiotic-resistant genes, pulsed-field gel electrophoresis, staphylococcal cassette chromosome mec (SCCmec) typing, and multilocus sequence typing were used for the molecular characterization of MRSA. Among the total strains, the MDR rate (51.8%) was significantly higher in the northern hospital than in the southern hospital (73% vs. 39%, p < 0.0001). The MDR-MRSA with the highest rates were "ciprofloxacin-erythromycin-gentamicintetracyclines" (35.6%), followed by "erythromycin-tetracycline-chloramphenicol" (24.1%), and "ciprofloxacin-erythromycin-gentamicin" (19.5%), showing an accumulative total of 79.3%. The most susceptible antibiotics were rifampicin (100%) and vancomycin (100%), followed by doxycycline (94.0%), meropenem (78.0%), and cefotaxime (75.0%). The SCCmecII strains showed greater resistance to gentamicin, ciprofloxacin, tetracycline, meropenem and cephalosporins compared with the other strains. The SCCmecII strains exhibited the highest rate in the tested genes (aacA/aphD: 55.2%, ermA/B/C: 89.7%, and tetK/M: 82.8%). ST5-SCCmecII was the predominant clone in the northern hospital, whereas SCCmecIVa was more pronounced in the southern hospital. In conclusion, our results raised concerns about the predominant MDR-MRSA strains in the pediatric hospitals in Vietnam. The north-south difference in the antibiotic resistance patterns and genetic structure of MRSA suggests different MRSA origins and various uses of antimicrobial agents between the two regions.

• Infection and chemotherapy
• /
• v.50 no.4
• /
• pp.357-361
• /
• 2018

While carbapenems are the drug of choice to treat extended-spectrum-${\beta}$-lactamase (ESBL)-producing strains, some alternative carbapenem-sparing regimens are suggested for antibiotic stewardship. We experienced a case of ciprofloxacin treatment failure for acute pyelonephritis caused by an apparently susceptible Escherichia coli. A 71-year-old woman presented the emergency department with fever for 7 days and bilateral flank pain for 2 days. The laboratory results and abdominopelvic computed tomography finding were compatible with acute pyelonephritis. During 3-day ciprofloxacin therapy, the patient remained febrile with persistent bacteremia. After the change in antibiotics to ertapenem, the patient's clinical course started to improve. ESBL-producing E. coli isolates were identified in all three consecutive blood samples. Pulsed-field gel electrophoresis (PFGE) patterns, serotypes, and sequence types showed the three isolates were derived from the identical strain. The isolates produced CTX-M-14 type ESBL belonging to the ST69 clonal group. Despite in vitro susceptibility, the failure was attributed to a gyrA point mutation encoding Ser83Leu within quinolone resistance-determining regions. This case suggests that ciprofloxacin should be used cautiously in the treatment of serious infections caused by ciprofloxacin-susceptible, ESBL-producing E. coli, even in acute pyelonephritis because in-vitro susceptibility tests could fail to detect certain genetic mutations.

• Journal of Microbiology and Biotechnology
• /
• v.32 no.10
• /
• pp.1307-1314
• /
• 2022

In this study, we sought to investigate the various characteristics of Salmonella spp. isolated from raw chicken meats available in Korean markets. The data collected, such as food source of isolation, sampling information, serotype, virulence, and genetic profile including sequence type, were registered in the database for further comparative analysis of the strains isolated from the traceback investigation samples. To characterize serotype, virulence and gene sequences, we examined 113 domestically distributed chicken meat samples for contamination with Salmonella spp. Phylogenetic analysis was conducted on 24 strains (21.2%) of Salmonella isolated from 113 commercially available chicken meats and by-products, using pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). Serotyping of the isolated Salmonella spp. revealed S. Enteritidis in 11 strains (45.8%), S. Virchow in 6 strains (25%), S. Montevideo in 2 strains (8.3%), S. Bsilla in 2 strains (8.3%), S. Bareilly in 1 strain (4.2%), S. Dessau in 1 strain (4.2%), and S. Albany in 1 strain (4.2%). The genetic correlation indicated that 24 isolated strains were classified into 18 clusters with a genetic similarity of 64.4-100% between them. Eleven isolated S. Enteritidis strains were classified into 9 genotypes with a sequence identity of 74.4%, whereas the most distantly related S. Virchow was divided into five genotypes with 85.9% identity. Here, the MLST analysis indicated that the major Sequence Type (ST) of the Salmonella spp. isolated from domestic chicken sold in Chungcheong Province belongs to the ST 11 and 16, which differs from the genotype of Salmonella isolated from imported chicken. The differential sequence characteristics can be a genetic marker for identifying causative bacteria for epidemiological investigations of food poisoning.

• Journal of agricultural medicine and community health
• /
• v.34 no.1
• /
• pp.24-33
• /
• 2009

Objectives: In September 2008, an outbreak of diarrhea occurred among students attending Y school in Yeongcheon-si. Shigella sonnei was cultured from some of the rectal swabs. An epidemiological investigation was carried out to determine the source of the infection and the mode of transmission of the shigellosis outbreak. Methods: The index case lived in the D rehabilitation facility in Gyeongsan-si and an additional epidemiological investigation was carried out there. The cases could not be questioned due to their mental handicaps. The teachers were interviewed instead. A patient case was defined as a resident with diarrhea more than one time a day from September 18 to September 26, 2008 or a resident with confirmed Shigella sonnei at the Y school or the D rehabilitation facility. Results: The attack rate was 1.2% (8 persons) among 659 persons in the Y school and D rehabilitation facility. Five persons were microbiologically confirmed to have the infection and three persons were diagnosed on the basis of symptoms. Shigella sonnei was cultured from five of the 659 rectal swabs. However, 80 environmental specimens including drinking water, preserved foods, and cooking utensils were negative. All eight patients were Y school students and had been living in group boarding and lodging. Six of them lived in the D rehabilitation facility and two lived in the dormitory at the Y school. Five cases showed pulsed-field gel electrophoresis patterns that were identical for Shigella sonnei. Conclusions: The results of this study showed that the infection source of the shigellosis outbreak, in the two places, were identical. It is likely that the infections initially spread from a teacher or volunteer and then among the students.

• Journal of Environmental Health Sciences
• /
• v.46 no.5
• /
• pp.525-531
• /
• 2020

Objectives: This study was performed to identify the epidemiological features of a food poisoning outbreak in a company cafeteria located in Chungcheongnam-do Province, Korea in June of 2020 and to suggest preventive measures for a similar incidence. Methods: A total of 84 patients with acute gastroenteritis were examined. Environmental samples were obtained from 16 food handlers, six food utensils, 135 preserved foods served over three days and nine menus, and six drinking water samples. These are analyzed to detect viruses and bacteria. Results: Ninety-four out of the 402 people who were served meals (23.4%) predominantly showed symptoms of diarrhea, and the number was over 3 times. Among the 84 patients under investigation, 17 cases (20.2%) were positive for Enteropathogenic E. coli (EPEC) and 18 cases were positive for Clostridium (C.) perfringens (21.4%). Based on the investigation, it was concluded that the main pathogens were EPEC and C. perfringens. For EPEC, it was detected in three of the food service employees and in the preserved food and curry rice. The results of pulsed field gel electrophoresis indicate that all EPEC cases are closely related except for one food service employee. Assuming that isolated EPEC originated from the preserved food, the incubation period is about 25 hours. The origin of the C. perfringens was not determined as it was not detected in the food service employees or environmental samples. Conclusions: This case suggests that food provided in group food service centers must be thoroughly managed. In addition, identifying the pathogens in preserved food is very important for tracing the causes of food poisoning, so food must be preserved in an appropriate condition. To prevent similar food poisoning cases, analyzing cases based on epidemiological investigation and sharing the results is needed.

• Korean Journal of Clinical Laboratory Science
• /
• v.50 no.3
• /
• pp.359-369
• /
• 2018

An essential measure to prevent healthcare-associated infections (HAI) is to develop a consistent system of surveillance, thereby promoting a reliable situation diagnosis to perform efficient control for the problem. Patient-to-patient transmission of pathogens within the hospital plays a substantial role in the epidemiology of HAIs. Contamination of healthcare environments commonly occurs, including facilities surfaces (e.g., bed rails, bedside tables), drinking water, cooling tower water, endoscopic instruments, food, airborne, endotoxin test, sterile test and medical equipment, with pathogenic organisms. In addition, epidemiological analysis is performed by multi locus sequence tying, pulsed-field gel electrophoresis for active surveillance. Therefore, an environmental surveillance culture test for prevention improves patient safety and blocks infection agents. Effective infection control and increased safety are possible by controlling the national infection control system. In conclusion, this study contributes to an effective infection control system through the standardization of active surveillance culture laboratory and secure expertise as infection control specialist. The primary objective of the standardization is to improve the safety of the nation's healthcare system by reducing the rates of HAIs.

• Journal of Microbiology and Biotechnology
• /
• v.20 no.2
• /
• pp.425-432
• /
• 2010

Staphylococcus intermedius is a common cause of otitis externa, pyoderma, and wound infections in companion animals. Although S. intermedius infections are rare in humans, it is zoonotic, with several case reports describing fatal human infections. Presently, we sought to isolate S. intermedius strains from various sources at animal hospitals nationwide in Korea, examine their antibiotic susceptibilities, and determine the possibility of horizontal transmission between animals and humans. Pulsed-field gel electrophoresis (pFGE) was used to compare the mecA gene in S. intermedius strains from humans, animals, and the environment in animal hospitals. A total of 119 S. intermedius strains were isolated from 529 samples. Using the disk diffusion method, over 90% of the isolates were found to be susceptible to cephalothin, amoxicillin-clavulanic acid, vancomycin, imipenem, nitroflurantoin, and amikacin, whereas 97.5% and 98.3% of the isolates were resistant to penicillin and ampicillin, respectively. Among the 39 S. intermedius strains harboring mecA, similar PFGE patterns were observed between seven isolates from an animal, two isolates from veterinary staff, and the environment in one animal hospital, and single isolates from an animal and a veterinarian at another hospital. This result suggests the possibility of horizontal transmission of S. intermedius containing mecA between humans, animals, and the environment in animal hospitals and also emphasizes on the importance of S. intermedius with mecA as a possible emerging threat to public health.

• Korean Journal of Microbiology
• /
• v.48 no.2
• /
• pp.116-124
• /
• 2012

Identification was performed in March 2008 for the 76 Enterococcus strains isolated from the Han-river, which is used as water supply for Seoul citizens. The antibiotic susceptibility, antibiotic resistant structural analysis, trans-conjugation, pulsed-field gel electrophoresis (PFGE) and multi-locus sequence typing (MLST) were also carried out for the isolated strains. Among the isolated strains, 25 strains were E. casseliflavus, 4 strains were E. faecalis and 1 strain was E. hirae. Investigation of antibiotic susceptibility indicated that 15 strains demonstrated tolerance against vancomycin, and that 11 strains of E. faecium and 4 strains of E. casseliflavus were VRE. The vanA gene detection of the VRE strains revealed that 6 E. faecium strains were vancomycin-resistant Enterococcus faecium (VREF) possessing vanA. Analyses of transposon Tn1546 structure containing vanA demonstrated that Km36 and Km37 belonged to Tn1 type, Km20 and Km38 was Tn2 type, and Km39 and Km40 was Tn3 type. PFGE disclosed that among the 6 VREF strains, Km36 and Km37 exhibited equivalent subtype, while the rest 4 strains showed subtypes different to each other. MLST for the 6 VREF strains disclosed that 3 strains were ST78, while the rest 3 strains were ST18, ST192 and ST230, respectively. All these clonal complexes were derived from CC17 which has been isolated from clinical sources. 4 strains belonged to CC78, while the rest 2 strains were CC18 and CC192, respectively.