Annals of Clinical Microbiology, The official Journal of the Korean Society of Clinical Microbiology


Weeks in Review


Weeks to Publication
Indexed in KCI, KoreaMed, Synapse, DOAJ
Open Access, Peer Reviewed
pISSN 2288-0585 eISSN 2288-6850

June, 2012. Vol. 15 No. 2.

Review article

Sentinel Surveillance and Molecular Epidemiology of Multidrug Resistance Bacteria

Yeong Seon Lee, Hwa-Su Kim, Jungsik Yoo, Jae-Il Yoo, Young-Hee Jung

Ann Clin Microbiol 2012 June, 15(2): 43-48. Published on 20 June 2012.

The global emergence and spread of multidrug resistant bacterial infections in communities and hospitals has become an important issue in public health. The resistance rate of gram-positive cocci to vancomycin and the resistance rate of several gram-negative bacilli against cefotaxime and carbapenem have been continuously increasing. Surveillance of antimicrobial resistance is essential for providing information on the magnitude of and trend in multidrug resistance. Therefore, beginning 2011, more robust and effective management is to be legally required for six multidrug-resistant bacteria that have been linked to healthcare-related infections: vancomycin-resistant Staphylococcus aureus (VRSA), vancomycin- resistant enterococci (VRE), methicillin- resistant S. aureus (MRSA), multidrug-resistant Pseudomonas aeruginosa (MRPA), multidrug-resistant Acinetobacter baumannii (MRAB), and carbapenem-resistant Enterobactericeae (CRE). We have also performed laboratory-based sentinel surveillance for VRSA/VISA since 2002 and carbapenemase-producing Enterobacteriaceae since November, 2010. This article reviews the national surveillance programs, and molecular epidemiology of multidrug-resistant bacteria.

[in Korean]

Original article

Vaginal Candida and Microorganisms Related to Sexual Transmitted Diseases in Women with Symptoms of Vaginitis

Kye Hyun Kim, Mi-Kyung Lee

Ann Clin Microbiol 2012 June, 15(2): 49-53. Published on 20 June 2012.

Background: The female genital tract is equipped to deal with a variety of foreign substances including a wide array of microorganisms. It is important to consider Candida-bacterial interactions in balance between healthy colonization versus vaginitis. The objectives of this study were to evaluate the association between microorganism distribution and vaginitis, and to investigate the possibility of an interaction between vaginal Candida and other microorganisms in female genital tract.

Methods: A total of 516 vaginal secretions were collected between October 2008 and June 2010 from patients with suspected vaginitis. Identification of Candida species and detection of 6 fastidious microorganisms (Trichomonas vaginalis, Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma hominis, Mycoplasma genitalium, and Ureaplasma urealyticum) were performed using a VITEK 2 system (bioMérieux, Inc., Hazelwood, MO, USA) and multiplex PCR (Seegene, Biotechnology, Inc., Seoul, Korea), respectively.

Results: MgenitaliumUurealyticum, and Ctrachomatis were more often detected in association with vaginal candidiasis. A statistically significant association between Candida and Mgenitalium was observed (P<0.05). Ngonorrhoeae was detected less often in women with vaginal candidiasis.

Conclusion: The results of this study suggest the possibility that vaginal Candida may associate with some microorganisms in patients with vaginitis. Further studies will be required to define the Candida-bacterial interactions and its mechanisms. 

[in Korean]

Original article

Epidemiologic Features of Parainfluenza Virus Type 1, 2 and 3 Infection in Seoul and a Neighboring Area, 2008-2011

Hyejin Lee, Chang Kyu Lee, Myung-Hyun Nam, Kyoung Ho Roh, Soo-Young Yoon, Chae Seung Lim, Yunjung Cho, Young Kee Kim, Kap No Lee, Young Yoo

Ann Clin Microbiol 2012 June, 15(2): 54-59. Published on 20 June 2012.

Background: Parainfluenza virus (PIV) is a significant cause of acute respiratory infections. Epidemiological information on PIV infection could be very helpful for patient management. The aim of this study was to investigate the epidemiology of PIV infection in Seoul and a neighboring area with regard to PIV type.

Methods: The diagnosis of PIV infection was made by virus isolation. The R-mix Too cell system (Diagnostic Hybrids, Inc., Athens, OH, USA) and D3 Ultra DFA Respiratory Virus Screening & ID kits (Diagnostic Hybrids, Inc.) were used for virus culture and identification. The medical records of patients with positive virus cultures were reviewed retrospectively.

Results: Seven hundred and ten PIV viruses (5.6%) were isolated from 12,723 specimens. The number of subjects with PIV type III, I and II was 357, 304 and 49, respectively. PIV infection showed a peak incidence in the first year of life regardless of subtypes. The most common diagnosis among all PIV subtypes was pneumonia. Lower respiratory tract infections constituted the majority (76.3%) of PIV infections. The most common diagnosis of PIV type I and II was croup and that of PIV type III was pneumonia. A difference in seasonal variation between subtypes was observed. PIV I (62.2%) was mainly isolated from July to September while PIV type III (86.8%) was isolated from April to July.

Conclusion: Lower respiratory infection was most commonly found in hospitalized patients with PIV infection. Clinical features of PIV infection were similar those seen in Western PIV reports, with the exception of the seasonal outbreak pattern.

[in Korean]

Original article

Evaluation of Matrix-Assisted Laser Desorption Ionization-Time of Flight Mass Spectrometry for Identification of Aerobic Bacteria in a Clinical Microbiology Laboratory

Myungsook Kim, Mi Jung Kwon, Hae-Sun Chung, Yangsoon Lee, Dongeun Yong, Seok Hoon Jeong, Kyungwon Lee, Yunsop Chong

Ann Clin Microbiol 2012 June, 15(2): 60-66. Published on 20 June 2012.

Background: Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) has been used for the identification of bacteria worldwide. To our knowledge, the evaluation of MALDI-TOF MS for the identification of bacteria in Korea has not been studied. In this paper we compared the identification results of aerobic bacteria using MALDI-TOF MS to those results using conventional biochemical methods.

Methods: We evaluated the performance of a MALDI- TOF MS system (Bruker Daltonics, Leipzig, Germany) on consecutive aerobic isolates collected from January to February of 2011 which were identified using conventional methods (biochemical testing and commercial identification kits). Either directly smearing onto the target plate or protein extraction methods were additionally used if no reliable or discordant results were obtained.

Results: Among 523 isolates tested, 506 (97%) isolates had valid scores (≥2.0), 11 (2%) isolates gave intermediate scores (1.7≤ score <2.0), and 6 (1%) isolates yielded no reliable identification (score <1.7). Of the 506 valid results (score ≥2.0) by MALDI-TOF MS, the identification matched at the species level in 486 (96%) isloates, matched at the genus level in 17 (3%) isloates, and was discordant at the genus and species levels in 3 (1%) isloates.

Conclusion: The overall matching rate at the species level of MALDI-TOF MS was very high. When MALDI-TOF MS did not yield reliable results by direct smear, additional direct smears or protein extraction methods could be used to obtain better results. Our results showed that MALDI-TOF MS is a very useful method for the identification of aerobic bacteria isolated in clinical microbiology laboratories.

[in Korean]

Case report

Number of Blood Cultures per 1,000 Patient Days at University-Affiliated Hospitals in Korea

Eui Chong Kim, Jeong Hwan Shin, Sunjoo Kim, Nam Yong Lee, Ji-Hyun Cho, Sun Hoe Koo, Nam Hee Ryoo, Sae Ick Joo

Ann Clin Microbiol 2012 June, 15(2): 67-69. Published on 20 June 2012.

The authors calculated the number of blood cultures per 1,000 admitted patient days at seven university-affiliated hospitals in 2010, which ranged from 65 to 129 (mean 110). The number of blood cultures per 1,000 patient days could possibly be a good parameter for assessing the appropriateness of blood culture.

Case report

Primary Cutaneous Cryptococcosis in a Patient with Iatrogenic Cushing’s Syndrome: A Case Report and Review of the Literature

Young Jin Ko, Mi Hyun Hong, Chul-Min Park, Hee-Won Moon, Mina Hur, Yeo-Min Yun

Ann Clin Microbiol 2012 June, 15(2): 70-73. Published on 20 June 2012.

Cryptococcus neoformans (Cneoformans) is a ubiquitous yeast-like fungus that has been a common opportunistic human pathogen, especially in immunocompromised patients. Although skin lesions due to Cneoformans are found in 10-15% of patients with systemic cryptococcosis, primary cutaneous cryptococcosis without systemic infection is rare and now considered a distinct clinical entity. We report a case of primary cutaneous cryptococcosis in a patient with iatrogenic Cushing’s syndrome. A 73-year-old woman presented with pain and discharge from lesions on her left forearm. The patient had been treated with oral corticosteroids for 20 years, and as a result had developed iatrogenic Cushing’s syndrome. A skin fragment of the ulcer was cultured, and the encapsulated fungus were isolated and identified as Cneoformans using a Vitek2 system (Vitek2 ID-YST, bioMérieux, France) and API 20C (bioMérieux). Concurrent blood and urine cultures were negative for growth. At first, she was treated with antibiotics due to suspicion of cellulitis. After surgical resection and treatment with systemic and oral fluconazole, her wound was improved with scar. Primary cutaneous cryptococcosis should be considered when skin lesions are not responsive to antibiotics and accurate identification is important for proper treatment.

[in Korean]

Case report

A Case of Anaerobiospirillum succiniciproducens Isolated from Blood Culture

Woo Ri Jang, Chung Hyun Nahm, Yeon Sook Moon, Young Soo Je, Dongeun Yong, Jin Ju Kim

Ann Clin Microbiol 2012 June, 15(2): 74-77. Published on 20 June 2012.

Anaerobiospirillum succiniciproducens is a spiral-shaped, gram-negative anaerobic bacterium. Asucciniciproducens is a rare cause of bacteremia in human, especially immunocompromised patients. This organism may be mistakenly identified when using an automated bacterial identification system, and may be mistaken for Campylobacter spp. when using Gram staining. We report a case of bacteremia caused by Asucciniciproducens, which was negative for catalase, oxidase, and urease and confirmed by 16S rRNA sequencing (analysis revealed a 99% similarity), in a 69-year-old patient who was undergoing chemotherapy for treatment of a malignancy. To the best of our knowledge, this is the first report of bacteremia caused by Asucciniciproducens in Korea.

[in Korean]