Publications by authors named "Seong Yeol Ryu"

57 Publications

Comparison of the clinical characteristics of community-acquired acute pyelonephritis between male and female patients.

J Infect Chemother 2021 Feb 25. Epub 2021 Feb 25.

Department of Internal Medicine, College of Medicine, Hanyang University, Seoul, South Korea. Electronic address:

Background: Community-acquired acute pyelonephritis (CA-APN) is relatively rare in men. This study aimed to compare the clinical characteristics of CA-APN between male and female patients.

Methods: We prospectively collected the clinical and microbiological data of hospitalized CA-APN patients aged ≥19 years in South Korea from March 2010 to February 2011 in 11 hospitals and from September 2017 to August 2018 in 8 hospitals. Only the first episodes of APN of each patient during the study period were included.

Results: From 2010 to 2011, 573 patients from 11 hospitals were recruited, and from 2017 to 2018, 340 patients were recruited from 8 hospitals. Among them, 5.9% (54/913) were male. Male patients were older (66.0 ± 15.2 vs. 55.3 ± 19.0 years, P < 0.001), had a higher Charlson comorbidity index (1.3 ± 1.5 vs. 0.7 ± 1.2, P = 0.027), and had a higher proportion of structural problems in the urinary tract (40.7% vs. 6.1%, P < 0.001) than female patients. Moreover, the total duration of antibiotic treatment was longer (21.8 ± 17.8 d vs. 17.3 ± 9.4 d, P = 0.001) and the proportion of carbapenem usage was higher (24.1% vs. 9.5%, P = 0.001) in men than in women. Male patients were hospitalized for longer durations than female patients (median, 10 d vs. 7 d, P < 0.001).

Conclusions: Male CA-APN patients were older and had more comorbidities than female CA-APN patients. In addition, male patients received antibiotic treatment for a longer duration than female patients.
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http://dx.doi.org/10.1016/j.jiac.2021.02.014DOI Listing
February 2021

Effects of steroid therapy in patients with severe fever with Thrombocytopenia syndrome: A multicenter clinical cohort study.

PLoS Negl Trop Dis 2021 Feb 19;15(2):e0009128. Epub 2021 Feb 19.

Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea.

Background: Severe fever with thrombocytopenia syndrome (SFTS) is an acute, febrile, and potentially fatal tick-borne disease caused by the SFTS Phlebovirus. Here, we evaluated the effects of steroid therapy in Korean patients with SFTS.

Methods: A retrospective study was performed in a multicenter SFTS clinical cohort from 13 Korean university hospitals between 2013 and 2017. We performed survival analysis using propensity score matching of 142 patients with SFTS diagnosed by genetic or antibody tests.

Results: Overall fatality rate was 23.2%, with 39.7% among 58 patients who underwent steroid therapy. Complications were observed in 37/58 (63.8%) and 25/83 (30.1%) patients in the steroid and non-steroid groups, respectively (P < .001). Survival analysis after propensity score matching showed a significant difference in mean 30-day survival time between the non-steroid and steroid groups in patients with a mild condition [Acute Physiology and Chronic Health Evaluation II (APACHE II) score <14; 29.2 (95% CI 27.70-30.73] vs. 24.9 (95% CI 21.21-28.53], P = .022]. Survival times for the early steroid (≤5 days from the start of therapy after symptom onset), late steroid (>5 days), and non-steroid groups, were 18.4, 22.4, and 27.3 days, respectively (P = .005).

Conclusions: After steroid therapy, an increase in complications was observed among patients with SFTS. Steroid therapy should be used with caution, considering the possible negative effects of steroid therapy within 5 days of symptom onset or in patients with mild disease (APACHE II score <14).
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http://dx.doi.org/10.1371/journal.pntd.0009128DOI Listing
February 2021

Fluoroquinolone Can Be an Effective Treatment Option for Acute Pyelonephritis When the Minimum Inhibitory Concentration of Levofloxacin for the Causative Is ≤16 mg/L.

Antibiotics (Basel) 2021 Jan 2;10(1). Epub 2021 Jan 2.

Department of Internal Medicine, College of Medicine, Hanyang University, Seoul 04763, Korea.

The purpose of this study was to determine whether the fluoroquinolone (FQ) minimum inhibitory concentration (MIC) for the causative agent influences the clinical response of FQ treatment at 72 h in patients with community-acquired acute pyelonephritis (CA-APN). We prospectively collected the clinical data of women with CA-APN from 11 university hospitals from March 2010 to February 2012 as well as isolates from the urine or blood. In total, 78 patients included in this study received FQ during the initial 72 h, and the causative was detected. The clinical response at 72 h was significantly higher in patients with a levofloxacin MIC ≤ 16 mg/L than in those with an MIC > 16 mg/L (70.4% vs. 28.6%, = 0.038). No difference was observed in clinical response at 72 h based on ciprofloxacin MIC. To summarize, FQ can be an effective treatment option for CA-APN when levofloxacin MIC against is ≤16 mg/L.
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http://dx.doi.org/10.3390/antibiotics10010037DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7823373PMC
January 2021

Infectious Spondylitis and Septicemia due to : a Literature Review of Non-Endocarditis Cases.

Infect Chemother 2020 09 1. Epub 2020 Sep 1.

Department of Infectious Diseases, Keimyung University Dongsan Hospital, Daegu, Korea.

Lactococci are Gram-positive cocci that occur in short chains or pairs and are traditionally considered to be of low virulence in human. Most species are not associated with human disease. There are few reports regarding isolation in humans and the clinical significance of this rarely-encountered genus is unknown. Here, we report a case of infectious spondylitis due to confirmed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOFMS). A 77-year-old man was admitted to our hospital with back pain that had lasted 5 days. He had diabetes mellitus, hypertension, and histories of pulmonary tuberculosis and endovascular aneurysm repair due to an abdominal aortic aneurysm. Magnetic resonance imaging of his spine revealed paravertebral enhancement on T8-9 and a compression fracture on the lower endplate of T8. On blood cultures, was identified by MALDI-TOF MS. To our knowledge, this is the first report of spondylitis caused by in Korea. In this context, we reviewed non-endocarditis cases due to reported in the English-language literature to summarize its clinical features and outcomes.
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http://dx.doi.org/10.3947/ic.2019.0015DOI Listing
September 2020

Changes in Clinical Characteristics of Community-Acquired Acute Pyelonephritis and Antimicrobial Resistance of Uropathogenic in South Korea in the Past Decade.

Antibiotics (Basel) 2020 Sep 18;9(9). Epub 2020 Sep 18.

Department of Internal Medicine, College of Medicine, Hanyang University, Seoul 04763, Korea.

This study examined changes in the clinical characteristics of community-acquired acute pyelonephritis (CA-APN) in South Korea between the period 2010-2011 and 2017-2018. We recruited all CA-APN patients aged ≥19 years who visited eight hospitals in South Korea from September 2017 to August 2018, prospectively. Data collected were compared with those from the previous study in 2010-2012, with the same design and participation from 11 hospitals. A total of 617 patients were enrolled and compared to 818 patients' data collected in 2010-2011. was the most common causative pathogen of CA-APN in both periods (87.3% vs. 86.5%, = 0.680). isolates showed significantly higher antimicrobial resistance against fluoroquinolone (32.0% vs. 21.6%, < 0.001), cefotaxime (33.6% vs. 8.3%, < 0.001), and trimethoprim/sulfamethoxazole (37.5% vs. 29.2%, = 0.013) in 2017-2018 than in 2010-2011. Total duration of antibiotic treatment increased from 16.55 ± 9.68 days in 2010-2011 to 19.12 ± 9.90 days in 2017-2018 ( < 0.001); the duration of carbapenem usage increased from 0.59 ± 2.87 days in 2010-2011 to 1.79 ± 4.89 days in 2010-2011 ( < 0.001). The median hospitalization was higher for patients in 2017-2018 than in 2010-2011 (9 vs. 7 days, < 0.001). In conclusion, antimicrobial resistance of to almost all antibiotic classes, especially third generation cephalosporin, increased significantly in CA-APN in South Korea. Consequently, total duration of antibiotic treatment, including carbapenem usage, increased.
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http://dx.doi.org/10.3390/antibiotics9090617DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7559700PMC
September 2020

Molecular Epidemiology of Ciprofloxacin-Resistant Isolated from Community-Acquired Urinary Tract Infections in Korea.

Infect Chemother 2020 Jun 13;52(2):194-203. Epub 2020 May 13.

Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.

Background: is the predominant causative pathogen for community-acquired urinary tract infections (UTIs), and the increase in fluoroquinolone-resistant is of great concern in Korea. The objectives of this study were to investigate the genotypic characteristics and molecular epidemiology of ciprofloxacin-resistant (CIP-R) isolated from community-acquired UTIs in Korea.

Materials And Methods: samples isolated from the blood or urine were collected from patients with community-acquired acute pyelonephritis aged 15 years and more who were admitted to 12 Korean hospitals from 1st April 2010 to 29th February 2012. Phylogenetic typing, multilocus sequence typing, and molecular characterization of β-lactamase and plasmid-mediated quinolone resistance determinants were performed for CIP-R isolates.

Results: A total of 569 isolates were collected, and 122 (21.4%) isolates were CIP-R isolates. The most prevalent sequence type (ST) was ST131 (28.7%, 35/122), followed by ST393 (14.7%, 18/122), ST1193 (13.1%, 16/122), ST38 (9.0%, 11/122), and ST405 (8.2%, 10/122). The antimicrobial resistance rates of ST131 to cefepime (22.9%, 8/35), ST38 to gentamicin (100%, 11/11), and ST405 to cefotaxime (66.7%, 6/9) were significantly higher than the resistance rates of all other STs combined. Notably, 40% (4/10) of ST405 clones produced extended-spectrum β-lactamases and were co-resistant to trimethoprim/sulfamethoxazole. (20%, 7/35) and CTX-M-14 (40%, 4/10) were more frequently observed in ST131 and ST405 compared with other clones, respectively.

Conclusions: Among the CIP-R uropathogenic isolates in this study, ST131, ST38, and ST405 were specifically associated with antimicrobial resistance.
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http://dx.doi.org/10.3947/ic.2020.52.2.194DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7335657PMC
June 2020

The clinical and economic burden of community-onset complicated skin and skin structure infections in Korea.

Korean J Intern Med 2020 11 20;35(6):1497-1506. Epub 2020 Feb 20.

Pfizer Pharmaceuticals Korea Ltd., Seoul, Korea.

Background/aims: To investigate epidemiologic characteristics, clinical and economic burdens, and factors associated with mortality in complicated skin and skin structure infection (cSSSI) patients in Korea.

Methods: A retrospective, observational, nationwide study was conducted between April to July 2012 at 14 tertiary-hospitals in Korea. Eligible patients were hospitalized adults with community acquired cSSSI, who underwent surgical intervention and completed treatment between November 2009 and October 2011. Data on demography, clinical characteristics, outcomes and medical resource utilization were collected through medical record review. Direct medical costs were calculated by multiplying quantities of resources utilized by each unit price in Korea.

Results: Of 473 patients enrolled, 449 patients (except 24 patients with no record on surgical intervention) were eligible for analysis. Microbiological testing was performed on 66.1% of patients and 8.2% had multiple pathogens. Among culture confirmed pathogens (n = 297 patients, 340 episodes), 76.2% were gram-positive (Staphylococcus aureus; 41.2%) and 23.8% were gram-negative. The median duration of hospital stay was 16 days. Among treated patients, 3.3% experienced recurrence and 4.2% died in-hospital. The mean direct medical costs amounted to $4,195/ person, with the greatest expenses for hospitalization and antibiotics. The in-hospital mortality and total medical costs were higher in combined antibiotics therapy than monotherapy (p < 0.05). Charlson's comorbidity index ≥ 3, standardized early warning scoring ≥ 4, sub-fascia infections and combined initial therapy, were all found to be associated with higher mortality.

Conclusion: Korean patients with community-onset cSSSI suffer from considerable clinical and economic burden. Efforts should be made to reduce this burden through appropriate initial treatment.
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http://dx.doi.org/10.3904/kjim.2018.374DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7652669PMC
November 2020

Antibiotic Treatment of Vertebral Osteomyelitis caused by Methicillin-Susceptible : A Focus on the Use of Oral β-lactams.

Infect Chemother 2019 Sep;51(3):284-294

Division of Infectious Diseases, Inje University Sanggye Paik Hospital, Seoul, Korea.

Background: Vertebral osteomyelitis (VO) is a rare but serious condition, and a potentially significant cause of morbidity. Methicillin-susceptible (MSSA) is the most common microorganism in native VO. Long-term administration of parenteral and oral antibiotics with good bioavailability and bone penetration is required for therapy. Use of oral β-lactams against staphylococcal bone and joint infections in adults is not generally recommended, but some experts recommend oral switching with β-lactams. This study aimed to describe the current status of antibiotic therapy and treatment outcomes of oral switching with β-lactams in patients with MSSA VO, and to assess risk factors for treatment failure.

Materials And Methods: This retrospective study included adult patients with MSSA VO treated at nine university hospitals in Korea between 2005 and 2014. Treatment failure was defined as infection-related death, microbiological relapse, neurologic deficits, or unplanned surgical procedures. Clinical characteristics and antibiotic therapy in the treatment success and treatment failure groups were compared. Risk factors for treatment failure were identified using the Cox proportional hazards model.

Results: A total of 100 patients with MSSA VO were included. All patients were treated, initially or during antibiotic therapy, with one or more parenteral antibiotics. Sixty-nine patients received one or more oral antibiotics. Antibiotic regimens were diverse and durations of parenteral and oral therapy differed, depending on the patient and the hospital. Forty-two patients were treated with parenteral and/or oral β-lactams for a total duration of more than 2 weeks. Compared with patients receiving parenteral β-lactams only, no significant difference in success rates was observed in patients who received oral β-lactams for a relatively long period. Sixteen patients had treatment failure. Old age (adjusted hazard ratio [HR] 5.600, 95% confidence interval [CI] 1.402 - 22.372, = 0.015) and failure to improve C-reactive protein levels at follow-up (adjusted HR 3.388, 95% CI 1.168 - 9.829, = 0.025) were independent risk factors for treatment failure.

Conclusion: In the study hospitals, diverse combinations of antibiotics and differing durations of parenteral and oral therapy were used. Based on the findings of this study, we think that switching to oral β-lactams may be safe in certain adult patients with MSSA VO. Since limited data are available on the efficacy of oral antibiotics for treatment of staphylococcal VO in adults, further evaluation of the role of oral switch therapy with β-lactams is needed.
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http://dx.doi.org/10.3947/ic.2019.51.3.284DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6779581PMC
September 2019

Poor prognosis of Candida tropicalis among non-albicans candidemia: a retrospective multicenter cohort study, Korea.

Diagn Microbiol Infect Dis 2019 Oct 31;95(2):195-200. Epub 2019 May 31.

Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. Electronic address:

To evaluate clinical features and prognostic factors of non-albicans candidemia, we conducted a retrospective multicenter cohort study at 7 university hospitals in Korea from January 2010 to February 2016. A total of 721 patients with non-albicans candidemia were included in the analysis. C. tropicalis was most commonly identified (36.5%), followed by C. glabrata (27.2%), C. parapsilosis (25.7%), and C. krusei (2.4%). Clinical presentation of C. tropicalis candidemia was most severe with highest median C-reactive protein level (10.1 mg/dL) and Acute Physiology and Chronic Health Evaluation II score (14, both P ≪ 0.05). C. tropicalis showed the highest 14- and 30-day mortality (28.9% and 44.1%). In multivariate analysis, C. tropicalis infection was significantly related with 14- (P = 0.005) and 30-day mortality (P = 0.033). In conclusion, C. tropicalis infection presented most severely and showed worst clinical outcome among non-albicans candidemia.
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http://dx.doi.org/10.1016/j.diagmicrobio.2019.05.017DOI Listing
October 2019

Comparison of and Acute Pyelonephritis in Korean Patients.

Infect Chemother 2019 Jun;51(2):130-141

Department of Infectious Diseases, Keimyung University Dongsan Medical Center, Daegu, Korea.

Background: and are two of the most common causes of urinary tract infection. The purpose of this study was to compare clinical characteristics and antimicrobial susceptibility of acute pyelonephritis (APN) between and K. pneumoniae.

Materials And Methods: We retrospectively reviewed medical records of patients with APN due to and K. pneumoniae between February 2014 and October 2017.

Results: A total 329 patients were enrolled; 258 cases of and 71 cases of . Among them, 219 cases were categorized into community-onset APN; 194 cases of and 25 cases of , and 110 patients were categorized into healthcare-associated APN; 64 cases of and 46 cases of . Catheter-associated APN was more frequently observed in in both community-onset and healthcare-associated APN. Neurogenic bladder, obstructive uropathy, urinary tract stone, bacteremia, and severe APN were more related to in healthcare-associated APN. In multivariate analysis, urinary catheter was more associated with (odds ratio [OR] 9.643, 95% confidence intervals [CI] 4.919-18.904, = 0.001) and neurogenic bladder was more associated with (OR 3.765, 95% CI 1.112-12.772, = 0.033). Extended-spectrum β-lactamase (ESBL) production was observed in 29.0% of in community-onset APN. Among ESBL, antimicrobial susceptibility of piperacillin/tazobactam was significantly higher in and ciprofloxacin was significantly higher in .

Conclusion: were more associated with urinary catheter while tended to be more associated with urogenital problems. ESBL positivity showed no significance in healthcare-associated APN. In community-onset APN, ESBL producing was more observed than .
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http://dx.doi.org/10.3947/ic.2019.51.2.130DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6609746PMC
June 2019

Antibiotic Resistance and Clinical Presentation of Health Care-Associated Hypervirulent Infection in Korea.

Microb Drug Resist 2019 Oct 8;25(8):1204-1209. Epub 2019 May 8.

Department of Infectious Diseases, Dongsan Medical Center, School of Medicine, Keimyung University, Daegu, Republic of Korea.

Hypervirulent typically presents as a community-acquired infection causing a liver abscess. It is often associated with A and A genes and confers a mucoid phenotype. Our aim was to evaluate the clinical presentation and antibiotic resistance of hypervirulent (hvKP) of health care-associated origin. The study was performed on 414 isolates recovered from patients that visited our hospital from December 2013 through November 2015. Hypervirulence was determined by the presence of a hypermucoviscous phenotype, in 155 isolates (37.4%). We compared health care-associated hvKP infections with community-acquired infections. The hypermucoviscous phenotype was 60 isolates (24.2%) in health care-associated infection and 90 isolates (53.8%) in community-acquired infection. Respiratory infection was the most common source of health care-associated . Antibiotic resistance was higher in health care-associated hvKP infections, which were more frequently associated with non-K1/K2 serotypes and less frequently associated with gene. In our study, 38% of hvKP was health care associated. Pneumonia is the most common infection, besides intraabdominal infection, in community-originating strains. These results suggest that health care-associated hvKP may have different microbiological characteristics from classical community-associated infections. Further investigation is needed for other virulent factors associated with health care-associated hvKP.
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http://dx.doi.org/10.1089/mdr.2018.0423DOI Listing
October 2019

Preliminary Report of Seroprevalence of Anti-Measles Immunoglobulin G among Healthcare Workers of 6 Teaching Hospitals of Daegu, Korea in 2019.

Infect Chemother 2019 Mar;51(1):54-57

Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea.

The measles outbreak in Daegu of January 2019 made 6 teaching hospitals' organization test the measles immunity of their healthcare workers (HCWs). We found that 6,935 (75.9%) of 9,132 HCWs tested seropositive for anti-measles immunoglobulin G (IgG), and seropositivity rate was very different between 6 hospitals (range, 59.9-93.1%). The seroprevelence was lowest in the age of twenties, but the rate was different between 6 hospitals (range 47.0-85.5%). Therefore, to prevent measles from spreading to HCWs, each hospital should make their own data periodically about anti-measles IgG seropositivity of their HCWs.
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http://dx.doi.org/10.3947/ic.2019.51.1.54DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6446006PMC
March 2019

Severe fever with thrombocytopenia syndrome: comparison with scrub typhus and clinical diagnostic prediction.

BMC Infect Dis 2019 Feb 19;19(1):174. Epub 2019 Feb 19.

Department of Internal Medicine, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, the Republic of Korea.

Background: Severe fever with thrombocytopenia syndrome (SFTS) is emerging in Asian 3 countries, China, Japan and Korea, which are scrub typhus endemic areas, and its incidence is increasing. As the two infections overlap epidemiologically and clinically and the accessibility or sensitivity of diagnostic tests is limited, early clinical prediction may be useful for diagnostic and therapeutic purposes.

Methods: Patients aged ≥16 years who were clinically suspected and laboratory-confirmed to be infected with Orientia tsutsugamushi or the SFTS virus in South Korea were enrolled. Clinical and laboratory parameters were compared. Scrub typhus was further subclassified according to the status of eschar and skin rash. An SFTS prediction scoring tool was generated based on a logistic regression analysis of SFTS compared with scrub typhus.

Results: The analysis was performed on 255 patients with scrub typhus and 107 patients with SFTS. At initial presentation, subjective symptoms except for gastrointestinal symptoms, were more prominent in scrub typhus patients. In addition to the characteristic eschar and skin rash, headache was significantly more prominent in scrub typhus, while laboratory abnormalities were more prominent in SFTS. Leukopenia (white blood cell count < 4000/mm; odds ratio [OR] 30.13), thrombocytopenia (platelet count < 80,000 /mm; OR 19.73) and low C-reactive protein (< 1 mg/dL; OR 67.46) were consistent risk factors for SFTS (all P < 0.001). A prediction score was generated using these 3 variables, and a score ≥ 2 had a sensitivity of 93.1% (95% confidence interval [CI], 87.9-96.4%) and a specificity of 96.1% (95% CI, 93.8-97.6%) for SFTS.

Conclusion: This prediction scoring tool may be useful for differentiating SFTS from eschar- or skin rash-negative scrub typhus. It is a simple and readily applicable tool with potential for use in primary care settings.
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http://dx.doi.org/10.1186/s12879-019-3773-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6381645PMC
February 2019

Changing epidemiology of non-albicans candidemia in Korea.

J Infect Chemother 2019 May 26;25(5):388-391. Epub 2018 Oct 26.

Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. Electronic address:

An epidemiologic surveillance of non-albicans candidemia for a 6-year period was conducted in Korea. Compared to the published epidemiologic data for the previous 6 years, an increase of C. glabrata (from 21.3% to 28.5%) and a decrease of C. parapsilosis (from 36.5% to 24.7%) were noticed. During the study period, C. tropicalis (36.4%) was most frequently isolated non-albicans Candida, followed by C. glabrata (28.5%), C. parapsilosis (24.7%), and C. krusei (2.6%). Replacement of primary amphotericin B treatment with echinocandins (P < 0.001) eliminated amphotericin B resistance (from 7.8% in 2011 to 0% in 2014).
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http://dx.doi.org/10.1016/j.jiac.2018.09.016DOI Listing
May 2019

Safety and Effectiveness of Peramivir in Korean Adult Influenza Patients: Prospective Observational Study Based on Post-Marketing Surveillance Data.

J Korean Med Sci 2018 Aug 26;33(32):e212. Epub 2018 Jun 26.

Division of Infectious Diseases, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.

Background: The safety and clinical effectiveness data of peramivir in the real clinical field are limited. A prospective observational study was conducted based on the post-marketing surveillance data to evaluate the post-marketing safety and effectiveness of peramivir in Korean adults with seasonal influenza.

Methods: Among adults aged 20 years or older who were diagnosed with influenza A or B, patients who started peramivir within 48 hours from the initial symptoms of influenza were enrolled. All adverse events (AEs) that occurred within 7 days after administration of peramivir were checked. For the evaluation of effectiveness, changes in the severity of influenza symptoms and daily living performance were examined before and 7 days after the administration of peramivir. The date on which influenza related symptoms disappeared was checked.

Results: A total of 3,024 patients were enrolled for safety evaluation and 2,939 patients were for effectiveness evaluation. In the safety evaluation, 42 AEs were observed in 35 (1.16%) patients. The most common AE was fever. AEs were mostly rated as mild in severity. Serious AEs were observed in 10 patients and two of them died. However, both deaths were considered to be less relevant to peramivir. In the effectiveness evaluation, the severity of influenza symptoms decreased by 10.68 ± 4.01 points and daily living performance was improved 5.59 ± 2.16 points. Influenza related symptoms disappeared on average 3.02 ± 2.39 days after peramivir administration.

Conclusion: Peramivir showed a tolerable safety profile and acceptable effectiveness in Korean adult patients with seasonal influenza.
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http://dx.doi.org/10.3346/jkms.2018.33.e212DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6070467PMC
August 2018

Impact of high MIC of fluconazole on outcomes of Candida glabrata bloodstream infection: a retrospective multicenter cohort study.

Diagn Microbiol Infect Dis 2018 Oct 19;92(2):127-132. Epub 2018 Jun 19.

Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

To evaluate the impacts of fluconazole minimum inhibitory concentration (MIC) according to primary antifungal agents on Candida glabrata bloodstream infection (BSI), a multicenter retrospective cohort study was conducted in Korea, concerning the time period from January 2010 to February 2016. A total of 197 adult patients with C. glabrata BSI were included in the study, and neutropenia (P = 0.026), APACHE II score (P = 0.004), and fluconazole resistance (HR 3.960, 95% CI 1.395-11.246, P = 0.010) were associated with 30-day mortality in multivariate analysis. In subgroup analysis, fluconazole MIC = 32 μg/mL in the azole-treated group (HR 6.691, 95% CI 1.569-28.542, P = 0.010) and fluconazole MIC ≥ 64 μg/mL in the non-azole-treated group (HR 3.337, 95% CI 1.183-9.411, P = 0.023) showed the highest hazard ratio (HR) for 30-day mortality. Increased fluconazole MIC was associated with poor outcome both in azole- and non-azole-treated patients with C. glabrata BSI.
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http://dx.doi.org/10.1016/j.diagmicrobio.2018.05.001DOI Listing
October 2018

Changing trends in clinical characteristics and antibiotic susceptibility of bacteremia.

Korean J Intern Med 2018 05 10;33(3):595-603. Epub 2017 Nov 10.

Department of Infectious Diseases, Keimyung University Dongsan Medical Center, Daegu, Korea.

Background/aims: is second most common organism of gram-negative bacteremia in Korea and one of the most common cause of urinary tract infection, and intra-abdominal infection.

Methods: We compared clinical and microbiological characteristics about bacteremia in a tertiary hospital between 10 years. Group A is who had bacteremia at least one time from January 2004 to December 2005. Group B is from January 2012 to December 2013. We also analyzed antibiotic resistance, clinical manifestation of the bacteremia divided into community-acquired infections, healthcare associated infections, and nosocomial infections.

Results: The resistance for ampicillin, aztreonam, cefazolin, and cefotaxime significantly increased compared to 10 years ago. Extended spectrum β-lactamase positivity surged from 4.3% to 19.6%. Ten years ago, 1st, 2nd cephalosporin, and aminoglycoside were used more as empirical antibiotics. But these days, empirical antibiotics were broad spectrum such as 3rd and 4th cephalosporin. In treatment outcome, acute kidney injury decreased from 47.5% to 28.7%, and mortality decreased from 48.9% to 33.2%. In community-acquired infections, there was similar in antimicrobial resistance and mortality. In healthcare-associated and nosocomial infections, there was significantly increasing in antibiotic resistance, decreasing in mortality, and acute kidney injury.

Conclusions: In community-acquired infections, broader antibiotics were more used than 10 years ago despite of similar antimicrobial resistance. When bacteremia is suspected, we recommend to use the narrow spectrum antibiotics as initial therapy if there are no healthcare-associated risk factors, because the antibiotic resistance is similar to 10 years ago in community-acquired infections.
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http://dx.doi.org/10.3904/kjim.2015.257DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5943641PMC
May 2018

Current status of indwelling urinary catheter utilization and catheter-associated urinary tract infection throughout hospital wards in Korea: A multicenter prospective observational study.

PLoS One 2017 9;12(10):e0185369. Epub 2017 Oct 9.

Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.

To evaluate the frequency and appropriateness of indwelling urinary catheters (IUC) use and the incidence of catheter-associated urinary tract infections (CA-UTI), and explore the risk factors for CA-UTI in hospitals as a whole, we conducted a study. This study was divided into two parts; a point-prevalence study on Dec 12th 2012 and a prospective cohort study from Dec 13th 2012 to Jan 9th 2013 were performed in six hospitals in Korea. All hospitalized patients with newly-placed IUCs were enrolled and monitored weekly for 28 days after IUC placement. In the point-prevalence study, the IUCs were present in median 14.9/100 hospitalized patients (1Q 14, 3Q 16) across the six hospitals. In the prospective cohort study, the median IUC-days per patient was 5 (1Q 3, 3Q 10) and the median CA-UTI prevalence per 1,000 catheter days was 1.9 (1Q 0.7, 3Q 3.8) with significant inter-hospital variation. The proportion of patients with inappropriate IUC maintenance increased with number of IUC-days (8.5% on day 7, 9.4% on day 14, 16.3% on day 21, and 23.1% on day 28). Urinary output monitoring (23/36, 63.9%) was the most common indication for inappropriate use after 1 week of ICU placement. In multivariate analysis, IUC-days was significantly associated with the development of CA-UTI (odds ratio 1.122, 95% confidence interval 1.074-1.173, P< 0.001). IUC-days and CA-UTI rates vary between hospitals. IUC-days is a risk factor for CA-UTI, and is correlated with inappropriate use.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0185369PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5633151PMC
October 2017

Effect of Early Plasma Exchange on Survival in Patients with Severe Fever with Thrombocytopenia Syndrome: A Multicenter Study.

Yonsei Med J 2017 Jul;58(4):867-871

Department of Internal Medicine, Jeju National University School of Medicine, Jeju, Korea.

Despite a high mortality rate, no specific treatment for severe fever with thrombocytopenia syndrome (SFTS) has been established. This study compared the clinical outcomes of SFTS patients treated with plasma exchange (PE group) with those who were not treated (non-PE group) at nine Korean hospitals between May 2013 and August 2015. A total of 53 SFTS patients were included: 24 (45.3%) PE cases and 29 (54.7%) non-PE cases. The overall in-hospital mortality rate was 32.1% (17/53). The in-hospital mortality rate of the PE group did not differ from that of the non-PE group (29.3% vs. 34.5%, p=0.680). Of the 24 PE cases, 16 (66.7%) were treated with PE within 7 days of symptom onset (early PE group). The early PE group survived longer than the non-PE group (mean 28.4 days vs. 22.6 days, p=0.044). Multivariate analysis showed an inverse association between early PE implementation and 30-day mortality (adjusted hazard ratio 0.052, 95% confidence interval 0.004-0.678, p=0.024). The results of this study suggest that early PE implementation may have a beneficial effect on the clinical outcome of SFTS patients.
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http://dx.doi.org/10.3349/ymj.2017.58.4.867DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5447121PMC
July 2017

Usefulness of Blood Cultures and Radiologic Imaging Studies in the Management of Patients with Community-Acquired Acute Pyelonephritis.

Infect Chemother 2017 Mar 24;49(1):22-30. Epub 2017 Feb 24.

Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, Hanyang University, Seoul, Korea.

Background: The objective of this study was to examine the usefulness of blood cultures and radiologic imaging studies for developing therapeutic strategies in community-acquired acute pyelonephritis (CA-APN) patients.

Materials And Methods: We prospectively collected the clinical data of CA-APN patients who visited 11 hospitals from March 2010 to February 2011.

Results: Positive urine and blood cultures were obtained in 69.3% (568/820) and 42.7% (277/648), respectively, of a total of 827 CA-APN patients. Blood culture identified the urinary pathogen in 60 of 645 (9.3%) patients for whom both urine and blood cultures were performed; the organisms isolated from urine were inconsistent with those from blood in 11 and only blood cultures were positive in 49 patients. Final clinical failure was more common in the bacteremic patients than the non-bacteremic ones (8.0% vs. 2.7%, P = 0.003), as was hospital mortality (3.6% vs. 0.3%, P = 0.003). Likewise, durations of hospitalization and fever were significantly longer. Bacteremia was independent risk factor for mortality (OR 9.290, 1.145-75.392, P = 0.037). With regard to radiologic studies, the detection rate of APN was 84.4% (445/527) by abdominal computed tomography and 40% (72/180) by abdominal ultrasonography. Eighty-one of 683 patients (11.9%) were found to have renal abscess, perinephric abscess, urolithiasis, hydronephorosis/hydroureter or emphysematous cystitis, which could potentially impact on clinical management. Patients with Pitt score ≥ 1, flank pain or azotemia were significantly more likely to have such structural abnormalities.

Conclusion: Blood cultures are clinically useful for diagnosis of CA-APN, and bacteremia is predictive factor for hospital mortality. Early radiologic imaging studies should be considered for CA-APN patients with Pitt scores ≥1, flank pain or azotemia.
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http://dx.doi.org/10.3947/ic.2017.49.1.22DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5382046PMC
March 2017

Severe Fever with Thrombocytopenia Syndrome in South Korea, 2013-2015.

PLoS Negl Trop Dis 2016 12 29;10(12):e0005264. Epub 2016 Dec 29.

Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.

Background: Severe fever with thrombocytopenia syndrome (SFTS) is an emerging infectious disease that was recently identified in China, South Korea and Japan. The objective of the study was to evaluate the epidemiologic and clinical characteristics of SFTS in South Korea.

Methods/principal Findings: SFTS is a reportable disease in South Korea. We included all SFTS cases reported to the Korea Centers for Disease Control and Prevention (KCDC) from January 2013 to December 2015. Clinical information was gathered by reviewing medical records, and epidemiologic characteristics were analyzed using both KCDC surveillance data and patient medical records. Risk factors for mortality in patients with SFTS were assessed. A total of 172 SFTS cases were reported during the study period. SFTS occurred throughout the country, except in urban areas. Hilly areas in the eastern and southeastern regions and Jeju island (incidence, 1.26 cases /105 person-years) were the main endemic areas. The yearly incidence increased from 36 cases in 2013 to 81 cases in 2015. Most cases occurred from May to October. The overall case fatality ratio was 32.6%. The clinical progression was similar to the 3 phases reported in China: fever, multi-organ dysfunction, and convalescence. Confusion, elevated C-reactive protein, and prolonged activated partial thromboplastin times were associated with mortality in patients with SFTS. Two outbreaks of nosocomial SFTS transmission were observed.

Conclusions: SFTS is an endemic disease in South Korea, with a nationwide distribution and a high case-fatality ratio. Confusion, elevated levels of C-reactive protein, and prolonged activated partial thromboplastin times were associated with mortality in patients with SFTS.
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http://dx.doi.org/10.1371/journal.pntd.0005264DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5226827PMC
December 2016

Tree-structured survival analysis of patients with Pseudomonas aeruginosa bacteremia: A multicenter observational cohort study.

Diagn Microbiol Infect Dis 2017 Feb 7;87(2):180-187. Epub 2016 Oct 7.

Department of Biostatistics, Korea University College of Medicine, Republic of Korea. Electronic address:

This study aimed to construct a prediction algorithm, which is readily applicable in the clinical setting, to determine the mortality rate for patients with P. aeruginosa bacteremia. A multicenter observational cohort study was performed retrospectively in seven university-affiliated hospitals in Korea from March 2012 to February 2015. In total, 264 adult patients with monomicrobial P. aeruginosa bacteremia were included in the analyses. Among the predictors independently associated with 30-day mortality in the Cox regression model, Pitt bacteremia score >2 and high-risk source of bacteremia were identified as critical nodes in the tree-structured survival analysis. Particularly, the empirical combination therapy was not associated with any survival benefit in the Cox regression model compared to the empirical monotherapy. This study suggests that determining the infection source and evaluating the clinical severity are critical to predict the clinical outcome in patients with P. aeruginosa bacteremia.
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http://dx.doi.org/10.1016/j.diagmicrobio.2016.10.008DOI Listing
February 2017

Association of biofilm production with colonization among clinical isolates of .

Korean J Intern Med 2017 Mar 22;32(2):345-351. Epub 2016 Sep 22.

Department of Infectious Diseases, Keimyung University Dongsan Medical Center, Daegu, Korea.

Background/aims: The pathogen is increasingly causing healthcare-associated infections worldwide, particularly in intensive care units. Biofilm formation, a factor contributing to the virulence of , is associated with long-term persistence in hospital environments. The present study investigates the clinical impact of biofilm production on colonization and acquisition after patient admission.

Methods: Forty-nine isolates were obtained between August and November 2013 from Keimyung University Dongsan Medical Center, Daegu, Korea. All isolates were obtained from sputum samples of new patients infected or colonized by . The microtiter plate assay was used to determine biofilm formation.

Results: Twenty-four isolates (48%) demonstrated enhanced biofilm formation capacity than that of the standard strain (ATCC 19606). All isolates were resistant to carbapenem, 38 isolates (77%) were collected from patients in an intensive care unit, and 47 isolates (95%) were from patients who had been exposed to antibiotics in the previous month. The median duration of colonization was longer for biofilm-producing isolates than that of the biofilm non-biofilm producing isolates (18 days vs. 12 days, < 0.05). Simultaneous colonization with other bacteria was more common for biofilm-producing isolates than that for the non-biofilm producing isolates. The most prevalent co-colonizing bacteria was .

Conclusions: Biofilm-producing isolates seem to colonize the respiratory tract for longer durations than the non-biofilm producing isolates. During colonization, biofilm producers promote co-colonization by other bacteria, particularly . Additional research is required to determine possible links between biofilm formation and nosocomial infection.
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http://dx.doi.org/10.3904/kjim.2015.287DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5339464PMC
March 2017

Predictive risk factors for Listeria monocytogenes meningitis compared to pneumococcal meningitis: a multicenter case-control study.

Infection 2017 Feb 19;45(1):67-74. Epub 2016 Aug 19.

Division of Infectious Diseases, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea.

Purpose: Various immunocompromised conditions increase the risk of meningitis caused by Listeria monocytogenes. However, the relative importance of these risk factors has not been well established. We determined the risk factors that predict meningitis due to L. monocytogenes compared to that caused by Streptococcus pneumoniae.

Methods: A nationwide multicenter case-control study was conducted in Korea. Cases of meningitis caused by L. monocytogenes between 1998 and 2013 were included. Patients with pneumococcal meningitis were included as controls. Multivariate logistic regression analysis was used to predict the risk factors of Listeria meningitis.

Results: A total of 36 cases and 113 controls were enrolled. The most significant predictive risk factor of Listeria meningitis was a prior history of receiving immunosuppressive therapy (odds ratio 8.12, 95 % CI 2.47-26.69). Chronic liver disease was the second most important predictive risk factor (OR 5.03, 95 % CI 1.56-16.22). Delaying appropriate antibiotic therapy by more than 6 h (hazard ratio 2.78) and fatal underlying disease (hazard ratio 2.88) were associated with increased mortality.

Conclusions: Patients with a prior history of receiving immunosuppressive therapy within 1 month and chronic liver disease have 8.1-fold and 5-fold increased risk of meningitis by L. monocytogenes compared to S. pneumoniae, respectively.
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http://dx.doi.org/10.1007/s15010-016-0939-2DOI Listing
February 2017

Recurrent Kikuchi's Disease Treated by Hydroxychloroquine.

Infect Chemother 2016 Jun 30;48(2):127-31. Epub 2016 Jun 30.

Department of Infectious Disease, Keimyung University School of Medicine, Daegu, Korea.

Kikuchi-Fujimoto disease (KFD) is a benign, self-limiting disease, with a specific histopathology. It can be diagnosed clinically, and specific symptoms include fever and cervical lymphadenopathy. The histological finding of KFD in cervical lymph nodes includes necrotizing lymphadenitis. KFD needs conservative treatments. If KFD persists for a long period, steroids or nonsteroidal antiinflammatory drugs can be used to control symptoms. Previous studies have reported the treatment of KFD with hydroxychloroquine (HC) in patients unresponsive to steroids. Herein, we report a case of a 25-year-old female patient diagnosed with KFD unresponsive to steroids, and was successfully treated with HC.
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http://dx.doi.org/10.3947/ic.2016.48.2.127DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4945722PMC
June 2016

Effects of inappropriate empirical antibiotic therapy on mortality in patients with healthcare-associated methicillin-resistant Staphylococcus aureus bacteremia: a propensity-matched analysis.

BMC Infect Dis 2016 Jul 15;16:331. Epub 2016 Jul 15.

Department of Internal Medicine, Korea University College of Medicine, Seoul, Republic of Korea.

Background: The purported value of empirical therapy to cover methicillin-resistant Staphylococcus aureus (MRSA) has been debated for decades. The purpose of this study was to evaluate the effects of inappropriate empirical antibiotic therapy on clinical outcomes in patients with healthcare-associated MRSA bacteremia (HA-MRSAB).

Methods: A prospective, multicenter, observational study was conducted in 15 teaching hospitals in the Republic of Korea from February 2010 to July 2011. The study subjects included adult patients with HA-MRSAB. Covariate adjustment using the propensity score was performed to control for bias in treatment assignment. The predictors of in-hospital mortality were determined by multivariate logistic regression analyses.

Results: In total, 345 patients with HA-MRSAB were analyzed. The overall in-hospital mortality rate was 33.0 %. Appropriate empirical antibiotic therapy was given to 154 (44.6 %) patients. The vancomycin minimum inhibitory concentrations of the MRSA isolates ranged from 0.5 to 2 mg/L by E-test. There was no significant difference in mortality between propensity-matched patient pairs receiving inappropriate or appropriate empirical antibiotics (odds ratio [OR] = 1.20; 95 % confidence interval [CI] = 0.71-2.03). Among patients with severe sepsis or septic shock, there was no significant difference in mortality between the treatment groups. In multivariate analyses, severe sepsis or septic shock (OR = 5.45; 95 % CI = 2.14-13.87), Charlson's comorbidity index (per 1-point increment; OR = 1.52; 95 % CI = 1.27-1.83), and prior receipt of glycopeptides (OR = 3.24; 95 % CI = 1.08-9.67) were independent risk factors for mortality.

Conclusion: Inappropriate empirical antibiotic therapy was not associated with clinical outcome in patients with HA-MRSAB. Prudent use of empirical glycopeptide therapy should be justified even in hospitals with high MRSA prevalence.
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http://dx.doi.org/10.1186/s12879-016-1650-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4946186PMC
July 2016

The acceptable duration between occupational exposure to hepatitis B virus and hepatitis B immunoglobulin injection: Results from a Korean nationwide, multicenter study.

Am J Infect Control 2016 Feb 27;44(2):189-93. Epub 2015 Oct 27.

Kyungpook National University Hospital School of Medicine, Daegu, Korea. Electronic address:

Background: Postexposure prophylaxis for occupational exposure to hepatitis B virus (HBV) plays an important role in the prevention of HBV infections in health care workers (HCWs). We examined data concerning the acceptable duration between occupational exposure and administration of a hepatitis B immunoglobulin (HBIG) injection in an occupational clinical setting.

Methods: A retrospective analysis was conducted with data from 143 cases of HCWs exposed to HBV in 15 secondary and tertiary teaching hospitals between January 2005 and June 2013. Data were taken from the infection control records of each hospital.

Results: Active vaccination after HBV exposure was started in 119 cases (83.2%) and postvaccination testing for hepatitis B antibody showed positive seroconversion in 93% of cases. In 98 cases (68.5%), HBIG was administered within 24 hours after HBV exposure; however, 45 HCWs (31.5%) received an HBIG injection more than 24 hours postexposure and 2 among the 45 received an injection after 7 days. Although 31.5% received an HBIG injection more than 24 hours postexposure, no cases of seroconversion to hepatitis b antibody positivity occurred.

Conclusions: For susceptible HCWs, HBIG administered between 24 hours and 7 days postexposure may be as effective as administration within 24 hours in preventing occupational HBV infection.
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http://dx.doi.org/10.1016/j.ajic.2015.08.024DOI Listing
February 2016

The cefazolin inoculum effect in methicillin-susceptible Staphylococcus aureus blood isolates: their association with dysfunctional accessory gene regulator (agr).

Diagn Microbiol Infect Dis 2015 Nov 18;83(3):286-91. Epub 2015 Jul 18.

Division of Infectious Diseases, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

We evaluated the clinical significance of the cefazolin inoculum effect (CIE) in methicillin-susceptible Staphylococcus aureus (MSSA) isolates. In total, 146 isolates were recovered from patients with MSSA bacteremia at 9 hospitals in Korea. The CIE was observed in 16 MSSA isolates, and while type A was the only detected β-lactamase in MSSA isolates exhibiting the CIE, no strains expressing type B, C, or D β-lactamases exhibited this effect. The CIE was only observed in agr group III and I isolates and was significantly more common in isolates with agr dysfunction than in those with functional agr (P<0.001). Even among isolates producing type A β-lactamase, the CIE was also prevalent in isolates with dysfunctional agr than in isolates with functional agr (P=0.025). This study demonstrates an association between the CIE of MSSA isolates and agr dysfunction, in addition to those between the CIE and type A β-lactamase.
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http://dx.doi.org/10.1016/j.diagmicrobio.2015.07.011DOI Listing
November 2015

Phylogenetic Analysis of Severe Fever with Thrombocytopenia Syndrome Virus in South Korea and Migratory Bird Routes Between China, South Korea, and Japan.

Am J Trop Med Hyg 2015 Sep 1;93(3):468-74. Epub 2015 Jun 1.

Ewha Medical Research Institute, Ewha Womans University, Seoul, South Korea; Department of Infectious Disease, Jeju National University School of Medicine, Jeju, South Korea; Department of Microbiology and Immunology, Department of Biomedical Science, Seoul National University College of Medicine, Seoul, South Korea; Virology and Pathogenesis Group, WHO Collaborating Centre for Virus Reference and Research, Public Health England, Porton Down, Salisbury Wiltshire, United Kingdom; Department of Microbiology and Immunology, Department of Biomedical Science, Seoul National University College of Medicine, Seoul, South Korea; Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, South Korea; Department of Internal Medicine, Keimyung University Dongsan Medical Center, Daegu, South Korea; Division of Infectious Diseases, Daegu Fatima Hospital, Daegu, South Korea; Medical Entomology and Zoonoses Ecology, Microbial Risk Assessment, Emergency Response Department, Public Health England, Porton Down, Salisbury Wiltshire, United Kingdom

Severe fever with thrombocytopenia syndrome (SFTS) is a tick-borne viral disease. The SFTS virus (SFTSV) has been detected in the Haemaphysalis longicornis, which acts as a transmission host between animals and humans. SFTSV was first confirmed in China in 2009 and has also been circulating in Japan and South Korea. However, it is not known if a genetic connection exists between the viruses in these regions and, if so, how SFTSV is transmitted across China, South Korea, and Japan. We therefore hypothesize that the SFTSV in South Korea share common phylogenetic origins with samples from China and Japan. Further, we postulate that migratory birds, well-known carriers of the tick H. longicornis, are a potential source of SFTSV transmission across countries. Our phylogenetic analysis results show that the SFTSV isolates in South Korea were similar to isolates from Japan and China. We connect this with previous work showing that SFTSV-infected H. longicornis were found in China, South Korea, and Japan. In addition, H. longicornis were found on migratory birds. The migratory bird routes and the distribution of H. longicornis are concurrent with the occurrence of SFTSV. Therefore, we suggest that migratory birds play an important role in dispersing H. longicornis-borne SFTSV.
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http://dx.doi.org/10.4269/ajtmh.15-0047DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4559681PMC
September 2015

Biofilm Formation and Colistin Susceptibility of Acinetobacter baumannii Isolated from Korean Nosocomial Samples.

Microb Drug Resist 2015 Aug 25;21(4):452-7. Epub 2015 Feb 25.

2 Department of Microbiology, Keimyung University School of Medicine , Daegu, Republic of Korea.

Biofilm formation, a virulence factor of Acinetobacter baumannii, is associated with long-term survival in hospital environments and provides resistance to antibiotics. Standard tests for antibiotic susceptibility involve analyzing bacteria in the planktonic state. However, the biofilm formation ability can influence antibiotic susceptibility. Therefore, here, the biofilm formation ability of A. baumannii clinical isolates from Korea was investigated and the susceptibility of biofilm and planktonic bacteria to colistin was compared. Of the 100 clinical isolates examined, 77% exhibited enhanced biofilm formation capacity relative to a standard A. baumannii strain (ATCC 19606). Differences between the minimal inhibitory concentrations and minimal biofilm-inhibitory concentrations of colistin were significantly greater in the group of A. baumannii that exhibited enhanced biofilm formation than the group that exhibited less ability for biofilm formation. Thus, the ability to form a biofilm may affect antibiotic susceptibility and clinical failure, even when the dose administered is in the susceptible range.
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http://dx.doi.org/10.1089/mdr.2014.0236DOI Listing
August 2015