Annals of Clinical Microbiology

[카테고리:] Volume 12

  • Myositis due to Cryptococcus neoformans in a Diabetic Patient

    Case report

    Volume 12

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    Sang Taek Heo1,3, In-Gyu Bae1,3, Jin Yong Park1, Sun-Joo Kim2,3

    Departments of 1Internal Medicine and 2Laboratory Medicine, 3Gyeongsang Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea

    Corresponding to In-Gyu Bae, E-mail: ttezebae@empal.com

    Ann Clin Microbiol 2009;12(1):1-5.
    Copyright © Korean Society of Clinical Microbiology.

    Abstract

    We report a rare case of cryptococcalmyositis with dissemination to lung in a 66-year-old diabetic woman who had no apparent risk factors for cryptococcal disease. She visited the hospital with a continuous pain in the right thigh and fever despite of treatment with antibiotics. She developed a localized lung infiltration. Crytococcus neoformans was isolated from the abscess of the right thigh and confirmed by molecular identification with DNA sequence analysis. Biopsy of the involved lung showed numerous budding yeasts consistent with Cryptocococcus species. The patient was successfully treated with surgical drainage and systemic antifungal agents. (Korean J Clin Microbiol 2009;12:141-143) 

    Keywords

    Cryptococcus neoformans, Myositis, Diabetes mellitus, Sequence analysis

  • Misidentification of Candida parapsilosis as Large Platelets in an Automated Blood Analyzer

    Case report

    Volume 12

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    Do Hoon Kim, Jung Sook Ha, Nam Hee Ryoo, Dong Suk Jeon, Jae Ryong Kim, Young Rok Do, Ki Young Kwon

    Departments of Laboratory Medicine and Internal Medicine, Keimyung University School of Medicine, Daegu, Korea

    Corresponding to Nam Hee Ryoo, E-mail: nhryoo@dsmc.or.kr

    Ann Clin Microbiol 2009;12(3):138-140.
    Copyright © Korean Society of Clinical Microbiology.

    Abstract

    We experienced a case in which yeasts in blood sample from a patient with cervical cancer with hepatic metastasis and multiple intraperitoneal cysts interfered with platelet morphology flag in automated blood analyzer. The peripheral blood smear was performed to confirm the flag and revealed intracellular and extracellular yeasts, which were subsequently identified as Candida parapsilosis by blood culture. (Korean J Clin Microbiol 2009;12:138-140)

    Keywords

    Candida parapsilosis, Peripheral blood smear, Automated blood analyzer, Large platelet

  • A Case of Bacteremia Caused by Rothia dentocariosa

    Case report

    Volume 12

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    Soon Deok Park1, Young Uh1, Hyeun Gyeo Lee1, Ih Ho Jang1, Kap Jun Yoon1, Mee Kyung Namgoong2

    Departments of 1Laboratory Medicine and 2Pediatrics, Yonsei University Wonju College of Medicine, Wonju, Korea

    Corresponding to Young Uh, E-mail: u931018@yonsei.ac.kr

    Ann Clin Microbiol 2009;12(3):133-137.
    Copyright © Korean Society of Clinical Microbiology.

    Abstract

    Rothia dentocariosa, a pleomorphic gram-positive branching bacillus, is a common inhabitant of the nose and throat. It is a well-known causative agent of dental plaques and periodontal diseases. Although generally regarded as having a low virulence to humans, R. dentocariosa has been recognized as causative agents of infective endocarditis and bacteremia with increasing frequency. Consequently, it can be a very serious pathogen when isolated from usually sterile sites such as blood or cerebrospinal fluid. We report a case of Rothia dentocariosa bacteremia without endocarditis in a 17-month-old male patient with fever, vomiting and diarrhea. (Korean J Clin Microbiol 2009;12:133-137)

    Keywords

    Bacteremia, Rothia dentocariosa, Blood culture

  • A Case of Brain Abscess due to Parvimonas micra

    Case report

    Volume 12

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    Ohgun Kwon1, Young Uh1, Ih Ho Jang1, Hyeun Gyeo Lee1, Kap Jun Yoon1, Hyo Youl Kim2, Yong Pyo Han3

    Departments of 1Laboratory Medicine, 2Infectious Diseases and 3Neurosurgery, Yonsei University Wonju College of Medicine, Wonju, Korea

    Corresponding to Young Uh, E-mail: u931018@yonsei.ac.kr

    Ann Clin Microbiol 2009;12(3):129-132.
    Copyright © Korean Society of Clinical Microbiology.

    Abstract

    Parvimonas micra is a non-spore-forming anaerobic gram-positive coccus, widely distributed as normal flora in the skin, vagina and mucosa, and able to cause opportunistic infections, particularly endocarditis and brain abscess following dental manipulations. A 49-year-old woman was hospitalized due to fever and headache. She had been diagnosed with periodontitis at the beginning of fever. A brain abscess was noted in the right temporal lobe on the brain CT, and she was treated with ceftriaxone, isepamicin and metronidazole. In the next day, abscess was aspirated and drained by a surgical procedure. An organism was isolated from an anaerobic culture of the abscess aspirate, and was identified as P. micra by a commercial kit and 16S rRNA sequencing. (Korean J Clin Microbiol 2009;12:129-132)

    Keywords

    Parvimonas micra, Peptostreptococcus, Brain abscess

  • Evaluation of VITEK-2 Antifungal Susceptibility Test (AST-YS01) for Candida Species Isolates in Korea

    Original article

    Volume 12

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    Da-Woon Kim, Jong Hee Shin, Seung Jung Kee, Soo-Hyun Kim, Myung Geun Shin, Soon Pal Suh, Dong Wook Ryang

    Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Korea

    Corresponding to Jong Hee Shin, E-mail: shinjh@chonnam.ac.kr

    Ann Clin Microbiol 2009;12(3):122-128.
    Copyright © Korean Society of Clinical Microbiology.

    Abstract

    Background: VITEK-2 yeast susceptibility test (AST- YS01; bioMerieux, Hazelwood, MO, USA) has recently been introduced as a fully automated commercial antifungal susceptibility test system that determines MIC (minimum inhibitory concentrations) endpoints spectrophotometrically, thereby eliminating subjective errors. We compared the VITEK-2 system with the CLSI (the Clinical and Laboratory Standards Institute) M27 method for susceptibility testing of Candida isolates from Korea.

    Methods: A total of 175 Candida bloodstream isolates were collected from two hospitals during a 18-month period. We compared the MIC results for amphotericin B, fluconazole and voriconazole obtained with the VITEK-2 system to those obtained by the CLSI M27 broth microdilution method after 24-hr and 48-hr incubation.

    Results: VITEK-2 system MIC endpoints for 175 isolates were determined after 11.75 to 35.50 hr of incubation (mean, 16.3±4.8 hr). The essential agreement (within 2 dilutions) between amphotericin B, fluconazole and voriconazole MICs obtained by the VITEK-2 system and CLSI method was 98.3%, 90.9% and 96.0%, respectively, at 24-hr incubation and 100%, 92.6% and 94.9%, at 48-hr incubation. The categorical discrepancy for fluconazole was 6.3% (major error, 2.9% and minor error, 3.4%) at 24-hr and 6.3% (major error, 2.3% and minor error, 4.0%) at 48-hr. The categorical discrepancy for voriconazole was 1.7% (major error, 1.1% and minor error, 0.6%) at both 24-hr and 48-hr. There were no very major errors for fluconazole and voriconazole.

    Conclusion: The VITEK-2 antifungal susceptibility test system appears to be rapid and highly correlative with the CLSI method, sugesting that this system can be effective for antifungal susceptibility testing for Candida species in the clinical laboratory. (Korean J Clin Microbiol 2009;12:122-128)

    Keywords

    Candida, VITEK-2, Antifungal susceptibility, CLSI

  • Evaluation of OraQuick Advance Rapid HIV-1/2 Antibody Test as a Screening Test for HIV Infection

    Original article

    Volume 12

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    Tae Youn Choi1, Young Ik Seo1, Tae Hyong Kim2, Jeong Won Shin1, Rojin Park1

    Departments of 1Laboratory Medicine and 2Internal Medicine, Soonchunhyang University Hospital, Seoul, Korea

    Corresponding to Tae Youn Choi, E-mail: choity@hosp.sch.ac.kr

    Ann Clin Microbiol 2009;12(3):116-121.
    Copyright © Korean Society of Clinical Microbiology.

    Abstract

    Background: For the diagnosis of HIV infection, enzyme immunoassay (EIA) or chemiluminescence immunoassay (CLIA) is commonly used as a screening test. Although these methods have a high sensitivity and low cost, their high false positive rate can cause confusion in the patients and clinicians until a more specific test is done. OraQuick Advance Rapid HIV-1/2 Antibody Test (OraQuick) (OraSure Technologies, USA) is a rapid test that can detect HIV-1/2 antibodies in 20 minutes. It uses oral fluid, whole blood or serum sample. In this study, we evaluated the usefulness of the OraQuick as a screening and point-of-care test for HIV infection.

    Methods: From Jan 2007 to Dec 2008, 45,276 samples referred to our laboratory were tested by CLIA method using the ADVIA Centaur (Bayer Healthcare LTD., USA) for HIV-1/2 antibody detection. Among them, 74 positive and 50 negative samples were tested by the Western immunoblot assay (WIB) and OraQuick test as a case-control study. Also, oral fluids from 30 HIV patients and 48 healthy persons were tested by OraQuick test.

    Results: The sensitivity and specificity of OraQuick test (using serum samples) were 100% and 98.8% (95% confidence interval 96.9∼100%), respectively. OraQuick tests (using oral fluid samples) were all positive for HIV patients but all negative for healthy persons.

    Conclusion: This study suggests that OraQuick can be used successfully as a rapid test for the early detection of HIV-1/2 antibody in patients visiting emergency departments and for the prevention of HIV infection in the health care providers. (Korean J Clin Microbiol 2009;12:116-121)

    Keywords

    HIV-1/2 antibody, OraQuick test, Rapid test, Infection control

  • Detection of Respiratory Viruses in Children by Multiplex Reverse Transcriptase PCR, Direct Immunofluorescence Assay, and Shell Vial Culture

    Original article

    Volume 12

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    Kui Hyun Yoon1, Ji Hyun Cho2

    1Department of Laboratory Medicine, Wonkwang University Sanbon Hospital, Gunpo, 2Department of Laboratory Medicine, College of Medicine, Wonkwang University, Iksan, Korea

    Corresponding to Ji Hyun Cho, E-mail: cjh@wonkwang.ac.kr

    Ann Clin Microbiol 2009;12(3):110-115.
    Copyright © Korean Society of Clinical Microbiology.

    Abstract

    Background: Direct immunofluorescence assay (DFA) and shell vial culture (SVC) have been used to diagnose respiratory viral infections. Recently a multiplex reverse transcriptase PCR (mRT-PCR) for 12 respiratory viruses has been introduced. We evaluated the diagnostic usefulness of these methods.

    Methods: Among 275 nasopharyngeal aspirates (NPAs) received from pediatric patients during the 3-month period from May through July, 2007, 122 samples were selected so as to include diverse viruses and varying numbers of DFA-positive cells for mRT-PCR. Also, the results of the 85 NPAs that had been analyzed by both DFA and SVC were reviewed retrospectively.

    Results: Detection rates for the seven major respiratory viruses, respiratory syncytial virus (RSV), influenza virus A and B, parainfluenza virus 1, 2, and 3, and adenovirus by DFA vs mRT-PCR were 32.0% and 55.7%, and by DFA vs SVC were 32.9% and 40.0%. A number of adenovirus detected by DFA vs mRT-PCR were 12 and 22, and by DFA vs SVC were 6 and 18. A number of RSV detected were 3 and 6, and 13 and 8, respectively.

    Conclusion: mRT-PCR detected the respiratory viruses at the highest rate, followed by SVC and DFA in a decreasing order. However, DFA and multiplex PCR were more sensitive than SVC for RSV, while SVC was more sensitive than the other methods for adenovirus. (Korean J Clin Microbiol 2009;12:110-115)

    Keywords

    Direct immunofluorescence assay, Shell vial culture, Multiplex PCR, Respiratroy virus

  • Metallo-β-lactamase Producing Gram-negative Bacilli

    Review article

    Volume 12

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    Dongeun Yong

    Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, Korea

    Corresponding to Dongeun Yong, E-mail: deyong@yuhs.ac

    Ann Clin Microbiol 2009;12(3):103-109.
    Copyright © Korean Society of Clinical Microbiology.

    Abstract

    Among gram-negative bacteria, rate of antibiotic resistance has been increasing. As a result, carbapenem is now considered as a last resort of therapeutic regimens for gram-negative bacterial infections. The choice of antibiotics has been impeded by the spread of organisms producing metallo-β-lactamases (MBL), which can confer resistance to nearly all β-lactams. MBLs have extremely diverse structures and are carried by various organisms including human pathogens. This review will focus on the classification and current status of MBL reported in Korea. (Korean J Clin Microbiol 2009;12:103-109)

    Keywords

    Metallo-β-lactamase, Gram-negative bacilli

  • Central Venous Catheter-Related Microbacterium Bacteremia Identified by 16S ribosomal RNA Gene Sequencing

    Case report

    Volume 12

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    Chang-Jin Moon, Jong-Hee Shin, Eun-Sun Jeong, Seung-Jung Kee, Soo-Hyun Kim, Myung-Geun Shin, Soon-Pal Suh, Dong-Wook Ryang

    Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Korea

    Corresponding to Jong-Hee Shin, E-mail: shinjh@chonnam.ac.kr

    Ann Clin Microbiol 2009;12(2):97-101.
    Copyright © Korean Society of Clinical Microbiology.

    Abstract

    We describe here a case of central venous catheter (CVC)-related bacteremia caused by Microbacterium species in a 14-year-old patient, who had received chemotherapy for acute lymphoblastic leukemia. All nine blood cultures obtained from admission day 2 to day 62 yielded the same yellow-pigmented coryneform rod. Both Vitek 2 (bioMerieux, USA) and MicroScan (Dade Behring, USA) identified the isolate as Micrococcus species, and the API Coryne (bioMerieux, France) identified the isolate as Rhodococcus or Brevibacterium species. However, the 16S rRNA gene sequence showed a 99% identity with Microbacterium species. The bacteremia was recurrent or persistent over 60 days despite alternate systemic antibiotic therapy, but blood culture became negative after an addition of teicoplanin lock therapy for eradicating CVC-related bacteremia. This represents the first report of CVC-related Microbacterium bacteremia cured by antibiotic lock therapy in Korea. (Korean J Clin Microbiol 2009;12:97-101)

    Keywords

    16S rRNA sequencing, Catheter-related bacteremia, Microbacterium species

  • A Case of Streptococcus salivarius Meningitis in a Patient with Cerebrospinal Fluid Rhinorrhea after Skull Base Fracture

    Case report

    Volume 12

    PDF

    Kyeong Seob Shin1, Dong Ik Shin2, Woo Sub Shim3, Byeong Cheol Rim4, Il Hun Bae5, Seung Young Lee5, Dong Hee Ryu6, Eun Jung Kim7, Bo Ra Son1

    Departments of 1Laboratory Medicine, 2Neurology, 3Otorhinolaryngology-Head and Neck Surgery, 4Neurosurgery, 5Radiology and 6Surgery, Chungbuk National University College of Medicine, 7Department of Pathology, Chungbuk National University Hospital, Cheongju, Korea

    Corresponding to Kyeong Seob Shin, E-mail: ksshin@chungbuk.ac.kr

    Ann Clin Microbiol 2009;12(2):92-96.
    Copyright © Korean Society of Clinical Microbiology.

    Abstract

    Streptococcus salivarius meningitis is very uncommon, and most cases are iatrogenic, occurring after invasive procedures such as spinal anesthesia or lumbar puncture etc.. Post-traumatic occurrence of this infection is especially rare. A 20-year-old man with a previous history of skull base fracture was seen at the emergency department with signs of acute bacterial meningitis. The CSF had a few gram positive cocci with neutrophilic pleocytosis, which were identified as S. salivarius by the Vitek system (bioMerioux, Inc., Hazelwood, MO, USA), rapid ID 32 Strep (bioMerieux, Marcy-l’Etoile, France) and 16S rRNA sequencing. The microorganism showed intermediate resistance to penicillin (MIC=0.25μg/mL) but was susceptible to cefotaxime (MIC=0.25μg/mL) and vancomycin (MIC= 0.75μg/mL). The patient was treated with ceftriaxone and vancomycin. He also had his CSF leakage repaired by an endoscopic approach. To our knowledge, this is the first case of S. salivarius meningitis reported in Korea. (Korean J Clin Microbiol 2009;12:92-96)

    Keywords

    Streptococcus salivarius, Meningitis, Skull fracture, Basilar