• Pediatric Infection and Vaccine
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• v.26 no.1
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• pp.51-59
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• 2019

Purpose: The aim of this study was to evaluate the relationships between cytokine and chemokine levels and the clinical severity of Mycoplasma pneumoniae pneumonia. Methods: A retrospective analysis of clinical and laboratory parameters were performed. Serum levels of interleukin (IL)-6, IL-8, IL-10, IL-18, interferon-${\gamma}$-inducible protein-10 (IP-10), macrophage inflammatory $protein-1{\beta}$, and tumor necrosis $factor-{\alpha}$ were measured. The severity of patients' clinical course and radiologic findings were also assessed. Results: Seventy-two patients (35 males and 37 females) with a median age of 3.9 years (range, 1-16 years) were enrolled. Patients with lobar pneumonia (n=29) had significantly higher C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and IL-18 values than those with broncho-interstitial pneumonia (n=43). However, the cytokine and chemokine values did not differ between the group that was treated with corticosteroids (n=31) and the one that was not (n=41). The CRP, ESR, lactate dehydrogenase (LDH), IL-18, and IP-10 values showed positive correlations with fever duration prior to admission. The CRP and ESR values were positively correlated with IL-18, and LDH, with IP-10 levels. Conclusions: CRP, ESR, LDH, IL-18, and IP-10 values were associated with the severity of the disease, manifesting lobar pneumonia or prolonged fever duration prior to admission.

• Pediatric Infection and Vaccine
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• v.26 no.2
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• pp.112-117
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• 2019

Eikenella corrodens rarely causes invasive head and neck infections in immunocompetent children. We report a case of epidural abscess caused by E. corrodens in a previously healthy 13-year-old boy who presented with fever, headache, and vomiting. On physical examination upon admission, there was no neck stiffness, but discharge from the right ear was observed. Brain magnetic resonance imaging (MRI) revealed approximately 4.5-cm-sized epidural empyema on the right temporal lobe as well as bilateral ethmoid and sphenoid sinusitis, right mastoiditis, and right otitis media. During treatment with vancomycin and cefotaxime, purulent ear discharge aggravated, and on follow-up brain MRI, the empyema size increased to $5.6{\times}3.4cm$ with interval development of an abscess at the right sphenoid sinus. Burr hole trephination was performed, and foul-smelling pus was aspirated from the epidural abscess near the right temporal lobe. Pus culture yielded E. corrodens. Endoscopic sphenoidotomy was also performed with massive pus drainage, and the same organism was grown. The patient was treated with intravenous cefotaxime for 3 weeks and recovered well with no other complications. Therefore, E. corrodens can cause serious complications in children with untreated sinusitis.

• Korean Journal of Poultry Science
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• v.46 no.2
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• pp.127-136
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• 2019

Three strains of infectious bronchitis viruses (IBVs), designated VNUA3, VNUA8 and VNUA11, were isolated from diseased/infected chickens in Hanoi, Thainguyen, and Haiphong provinces of Vietnam. These birds had received a live IBV vaccination but still suffered from infectious bronchitis. VNUA3, VNUA8 and VNUA11 harbor cleavage sites (RRTGR, HRRRR, and HRRKR, respectively) within the S protein. A BLASTN search revealed that the S gene of VNUA3, VNUA8, and VNUA11 showed the highest nucleotide identity with those of IBV strains CK/Italy/I2022/13, CK/CH/LHLJ/08-6, and GX-NN120084, respectively. Phylogenetic analyses based on the S gene nucleotide sequences revealed that VNUA3, VNUA8 and VNUA11 clustered with Q1-like, QX-like and TC07-2-like genotypes, respectively, and were closely related to reference IBV strains from China. However, the Vietnam IBVs showed high divergence from vaccine strains 4/91 and Ma5, which are used in the Vietnamese farms from which the isolates were obtained. Taken together, these results indicate that at least three genotypes of IBV are circulating among chickens in North Vietnam. This is the first report of the molecular epidemiology of IBV in Vietnam.

• Korean Journal of Veterinary Service
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• v.42 no.1
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• pp.39-42
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• 2019

Tetanus is an acute, often fatal, and infectious disease of all species of domestic animals caused by the neurotoxin of Clostridium tetani (C. tetani). This disease is usually known to develop after microbial contamination in the deep or penetrating wound sites. In February 2017, a farmer who was raising 76 cows injected foot and mouth disease vaccine to three or more cows with one syringe. Their clinical symptoms were observed 2 to 16 days after the vaccination. The initial symptoms were stiffness, rigidity of the neck and limbs, pricked ears, and prolapse of the third eyelid. Subsequently, there was recumbency with extension of the limbs, convulsions and opistotonus and the affected 20 cows were all died. Two dead cows were submitted to Animal and Plant Quarantine Agency for disease diagnosis. At necropsy, a focal edematous abscess of 15 to 20 cm in diameter was grossly observed in the subcutaneous and intramuscular tissue of scapular region and filled with a large amount of greenish pus. The feed was full in oral cavity and slightly observed in the trachea and lobes of lung. Histopathologically, focal granulomatous nodules with eosinophilic materials in the tissue were observed. In the lung, aspiration pneumonia and gram (+) bacteria were seen. The C. tetani was isolated in samples anaerobically cultured using reinforced clostridial medium and identified by PCR. To our knowledge, no previous outbreak of tetanus in cattle has affected such a high number of animals; neither has it been associated with misuse of the same syringe and needle to administer multiple individuals.

• Pediatric Infection and Vaccine
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• v.26 no.1
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• pp.22-31
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• 2019

Purpose: Campylobacter species are common causes of bacterial enteritis. There is limited knowledge on its prevalence and clinical features because of its fastidious culture conditions. The purpose of this study was to identify the clinical features of Campylobacter enteritis in children. Methods: We obtained stool specimens from patients diagnosed with acute gastroenteritis in the Department of Pediatrics, Nowon Eulji Medical Center (NEMC) and identified the pathogens by performing cultures or polymerase chain reactions (PCR). We retrospectively reviewed the medical records of patients with Campylobacter enteritis at NEMC between January 2012 and December 2017. Results: Overall, 123 patients were diagnosed with Campylobacter enteritis (60 by culture and PCR in EnterNet and 110 by multiplex PCR). The median (interquartile range [IQR]) age of patients was 12 years (IQR, 8 to 16 years). The disease occurred all year round, but 69.9% from June to September. Symptoms included diarrhea (97.6%), fever (96.7%), abdominal pain (94.3%), vomiting (37.4%), and headache (34.1%). Compared with other treatments, treatment with azithromycin was associated with a shorter hospitalization period (P<0.05). Conclusions: Campylobacter enteritis is common during summer and mostly infects adolescent patients. It causes severe abdominal pain and fever preceding the onset of diarrhea. Prompt diagnosis and appropriate use of antibiotics reduces the duration of the disease.

• Pediatric Infection and Vaccine
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• v.26 no.1
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• pp.42-50
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• 2019

Purpose: We investigated the clinical features and epidemiology of staphylococcal scalded skin syndrome (SSSS) from year 2006 to 2015 in Changwon city, Korea. Methods: We reviewed medical records of 69 patients diagnosed with SSSS from year 2006 to 2015. Antibiotic susceptibility testing was performed by agar dilution method. Methicillinresistant Staphylococcus aureus (MRSA) was phenotypically identified by oxacillin susceptibility testing and genotypically confirmed by the existence of the mecA gene. Results: The median age of patients was 2.0 years (range 0.2-6 years). Three (4.3%), 53 (76.8%), and 13 (18.9%) patients showed the generalized type, the intermediate type, and the abortive type, respectively. Patients occurred throughout the year, but most patients occurred between July and October. MRSA was isolated from 54 of the 60 patients regardless of the clinical types. All patients recovered without any complications. Conclusions: There was a constant occurrence of SSSS patients caused by MRSA in Changwon area during 2006 and 2015. It is needed to constantly monitor the occurrence of patients with SSSS.

• Pediatric Infection and Vaccine
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• v.28 no.2
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• pp.66-81
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• 2021

The coronavirus disease 2019 pandemic has been continuously spreading throughout the world. As of July 15, 2021, there have been more than 188 million confirmed cases and more than 4.06 million deaths. Although the incidence of severe infections is relatively low in children and adolescents compared to adults, a complication called multisystem inflammatory syndrome in children (MIS-C) may occur in some cases at approximately 2-6 weeks after severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. MIS-C can be seen in patients of various ages, from young infants to adolescents, and may present with diverse clinical manifestations. While fever present in a great majority of patients, symptoms suggesting the involvement of the digestive or nervous system and the skin and mucous membranes (Kawasaki disease-like symptoms) also appear in many cases. Cardiac involvement may also be observed, including left ventricular dysfunction, myocarditis, coronary artery dilatation, and coronary aneurysm. In some cases, hypotension or shock can occur, and mechanical ventilation or treatment in the intensive care unit may be necessary. Fortunately, recovery is generally reported after appropriate treatment. MIS-C is a rare but important complication of SARS-CoV-2 infection in children and adolescents. As such, it is important to recognize the clinical symptoms and provide appropriate treatment at an early stage. In this review, the epidemiology, clinical symptoms, suggested pathophysiology, diagnostic approach, and treatment of MIS-C will be discussed.

• Journal of agricultural medicine and community health
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• v.46 no.2
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• pp.67-77
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• 2021

Objectives: This study aimed to identify the vaccination rate for pneumococcus among aged 65 or older, and at the same time to determine the reasons for vaccination or non-vaccination. Methods: The population of this study was aged 65 or older, with a total of 1,150 subjects to be analyzed and a computer assisted telephone interviewing was used. The survey included pneumococcal vaccination status, reasons of vaccination, sources of information on vaccination, reasons for not vaccination, and other related factors. Results: The vaccination rate for pneumococcus among aged 65 or older was 56.2 percent, lower than 69.0 percent in the U.S. (2017), and 69.2 percent in the U.K. (2019). Among the factors related to the pneumococcal vaccination, the groups with the high vaccination rate were women, low age groups, residents of urban areas, people without a job, people with high education, medical insurance subscribers, married people, and people who have family members. In addition, the groups with high vaccination rates were those with high awareness, those who received recommendations from doctors, those who had vaccination records, those who believed in vaccination effects, and those who saw public service advertisements. Conclusions: In the future, it is necessary to develop alternatives to accurately manage vaccination records for adults who are not eligible for state support, and regular adult vaccination rates should be calculated so that they can be used as evidence for the country's infection control policy.

• Pediatric Infection and Vaccine
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• v.27 no.3
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• pp.147-157
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• 2020

Purpose: We investigated the trend of antibiotic susceptibility of Haemophilus influenzae over 5 consecutive years. Methods: We analyzed the antibiotic susceptibility of H. influenzae isolated from children aged <18 years, who were admitted to the Asan Medical Center Children's Hospital from March 2014 to April 2019. Antibiotic susceptibility of H. influenzae was determined by the disk diffusion test according to the European Committee on Antimicrobial Susceptibility Testing guidelines. Results: Excluding duplicates, 69 isolates were obtained over the past 5 years. The median age of the patients was 5 years (range, 2.8-8.6 years). The antibiotic susceptibility patterns were as follows: ampicillin (AMP)-susceptible/amoxicillin-clavulanate (AMC)-susceptible (AS/ACS; n=15 [21.7%]), AMP-resistant/AMC-susceptible (AR/ACS; n=21 [30.4%]), and AMP-resistant/AMC-resistant (AR/ACR; n=33 [47.8%]). The prevalence of isolates with AR/ACR phenotype tended to increase from 42.1% in 2014-2015 to 54.5% in 2018-2019 (P=0.342). Compared to 2014-2015, the resistance rates to cefuroxime and ceftriaxone in 2018-2019 increased from 31.6% to 77.3% and from 0.0% to 59.1%, respectively (P=0.003 and P<0.001, respectively). Conclusions: Over the last 5 years, H. influenzae isolates with AR/ACR phenotype and ceftriaxone resistance were frequently observed at our institute. The incidence of resistance to cefuroxime and ceftriaxone has increased significantly.

• Pediatric Infection and Vaccine
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• v.27 no.3
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• pp.198-204
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• 2020

Cytomegalovirus (CMV) disease is rare in children who receive anticancer chemotherapy and have no history of stem cell transplantation (SCT). We report a case of CMV retinitis that developed during maintenance chemotherapy for acute leukemia. A 7-year-old boy developed decreased visual acuity and persistent pancytopenia during maintenance chemotherapy. Laboratory investigations initially showed significant CMV antigenemia (51 positive cells/200,000 leukocytes); however, antiviral therapy was not deemed necessary in this patient who had no history of SCT. CMV antigenemia worsened to 170 positive cells/200,000 leukocytes over 3 weeks. Ophthalmological examination revealed multiple bilateral retinal infiltrates and granular lesions. He was diagnosed with CMV retinitis and was treated with a 4-week course of intravenous ganciclovir and intravitreal injection of ganciclovir 6 times, followed by a 1-month course of orally administered valganciclovir. A CMV antigenemia assay showed negative results, and follow-up fundoscopy revealed lesser retinal infiltration after the sixth intravitreal ganciclovir injection. Future studies should focus on the development of standardized screening methods and preemptive therapeutic strategies for CMV disease in high-risk children.