Sunjoo Kim
Ann Clin Microbiol 2013 December, 16(4): 153-161. Published on 20 December 2013.
Sepsis is a common and critical illness diagnosed via blood culture. Although a continuous blood culture monitoring system was introduced several decades ago, optimal utilization and improvement of blood culture methods has not been discussed recently. The author describes several blood culture-related topics including optimal blood collection procedures, quality control indicators, prior antibiotic treatment, delayed entry, time to detection, follow-up blood culture, catheter-related bloodstream infection, and new techniques to rapidly identify microorganisms. Although rapid, automatic blood culture systems are likely to be developed in the near future, quality improvement should be accomplished by well-educated medical personnel.
[in Korean]
Patrick R. Murray
Ann Clin Microbiol 2013 December, 16(4): 162-167. Published on 20 December 2013.
In 1884 Robert Koch and Friedrich Loeffler published Koch’s Postulates defining our historical understanding of the relationship between an organism and infection: one organism: one disease. In the last decade with research on the microbial community living on and in humans, a new concept of microbial diseases has emerged; that is, alterations of the microbial community can lead to disease including an extension beyond traditional “infectious” diseases to include metabolic disorders such as type 2 diabetes and obesity. As we continue to gain knowledge about the functions of the normal microbiome and the effects of alterations of the microbial population on disease pathogenesis, a new era of diagnostics and therapeutics will evolve.
Dong-Hyun Lee, Eun-Ha Koh, Sae-Rom Choi, Sunjoo Kim, Dong Hoon Kim, Nam Yong Lee
Ann Clin Microbiol 2013 December, 16(4): 168-173. Published on 20 December 2013.
Background: This study compared the growth of Staphylococcus aureus, Escherichia coli, Pseudomonas aeruginosa, Streptococcus pneumoniae, and Haemophilus influenzae in blood culture bottles containing anticoagulants, sodium polyanethol sulfonate (SPS) and sodium citrate.
Methods: One hundred and fifty colony forming units of five different bacterial species were inoculated into standard aerobic (SA) and standard anaerobic (SN) bottles and were combined with 5 mL of human blood in solution with SPS or sodium citrate. Time to detection (TTD) was then monitored using the BacT/ Alert 3D system (bioMerieux Inc.).
Results: Compared to the bacteria-only controls, cultures containing S. aureus, E. coli, P. aeruginosa, and S. pneumoniae plus SPS blood or citrated blood trended toward reduced TTD in both SA and SN bottles; however, there was no significant difference in TTD between SPS and sodium citrate anticoagulant. Although H. influenzae showed a remarkable difference in TTD between SPS (SA 14.8 h, SN 15.0 h) and sodium citrate (SA 23.5 h, SN 18.3 h), this difference was not statistically significant (P=0.10).
Conclusion: Addition of blood enhanced growth of bacteria. All experimental bacteria except H. influenzae showed similar TTD in SPS blood and citrated blood. These results support the usefulness of sodium citrate anticoagulant for artificial inoculation in blood culture bottles.
Nan-Ok Kim, Injun Cha, Jae-Seok Kim, Gyung Tae Chung, Yeon-Ho Kang, Sahyun Hong
Ann Clin Microbiol 2013 December, 16(4): 174-181. Published on 20 December 2013.
Background: Through change in the climate and living environment, bacterial pathogens that cause diarrhea also change. This study sought to determine the characteristics of pathogens according to species, isolated region, and patient age/sex using National Surveillance Data for diarrhea, and to provide basic data for the prevention of diarrheal disease.
Methods: From January to December 2012, stool specimens were collected from 21,180 diarrheal patients in Korea to identify the pathogenic bacteria involved. Pathogenic bacteria were analyzed according to isolated region and patient age/sex. Identification and analysis of the pathogens were conducted based on the Guidelines of the National Institute of Health Diagnostic Laboratory: Disease-specific protocol (2005).
Results: Among the 21,180 stool specimens, pathogenic bacteria known to cause diarrhea were isolated from 2,444 stool specimens (11.5%). The isolation rate was highest in the summer (from June to September) for most pathogenic bacteria, except Escherichia coli, Staphylococcus aureus, and Clostridium perfringens. The isolation rate of pathogenic bacteria based on patient age was highest in children under the age of 10.
Conclusion: Hygiene education should be addressed in diarrheal disease-susceptible groups, such as children under 10, people in their 50s, and those greater than 70 years old, and ongoing monitoring for pathogens is needed. In addition, an efficient information system and surveillance program should be continued for infection prevention.
[in Korean]
Hyo Jin Kim, Younghee Seo, Wan Hee Kim, Yangsoon Lee, Hyukmin Lee, Kyungwon Lee, Yunsop Chong
Ann Clin Microbiol 2013 December, 16(4): 182-187. Published on 20 December 2013.
Background: Antimicrobial resistance of Neisseria gonorrhoeae has become a serious problem worldwide, and ceftriaxone non-susceptible isolates have been recently reported from Japan and Europe. In this study, we evaluated the antimicrobial susceptibilities and molecular epidemiological characteristics of isolates from Korea in 2013.
Methods: Sixty strains of N. gonorrhoeae were collected from Korean patients and prostitutes. Antimicrobial susceptibility was tested by the agar dilution and disk diffusion methods. N. gonorrhoeae multi-antigen sequence typing (NG-MAST) was performed in order to determine the molecular epidemiologic relatedness.
Results: All of isolates were non-susceptible to penicillin G and tetracycline, and the rate of ciprofloxacin- resistant isolates was 95% in 2013. The MICs of ceftriaxone were within the susceptible range for all isolates, but one isolate non-susceptible to cefixime (MIC=0.5 μg/mL) was encountered. The isolates with decreased susceptibility (MIC≤0.12 μg/mL) to cefixime or ceftriaxone accounted for 10% and 14% of the isolates tested, respectively. In NG-MAST analysis, 40 different STs were encountered among the 59 isolates. Isolates that belonged to tbpB110 showed higher cefixime and ceftriaxone MICs (0.12-0.5 μg/ mL) as well as cefixime resistance.
Conclusion: Most of the N. gonorrhoeae isolates showed susceptibility to spectinomycin and cephalosporins. Due to the emergence of isolates that are non-susceptible to cefixime and the prevalence of isolates with the tbpB110 allele belonging to ST1407, which cause cefixime and ceftriaxone treatment failure in successful global clones of N. gonorrhoeae, a continuous nationwide antimicrobial surveillance program is required to monitor the emergence of cephalosporin resistance in N. gonorrhoeae.
[in Korean]
Heejin Ham, Jungim Jang, Sungsun Choi, Seah Oh, Sukju Jo, Sungmin Choi, Sonil Pak
Ann Clin Microbiol 2013 December, 16(4): 188-195. Published on 20 December 2013.
Background: Viruses that cause acute respiratory infection include adenovirus (ADV), respiratory syncytial virus A and B (RSV(A), RSV(B)), influenza virus A and B (FluA, FluB), parainfluenza virus 1, 2 and 3 (PIV1, PIV2, PIV3), human metapneumovirus (hMPV), human coronavirus (hCoV), human rhinovirus (hRV), and enterovirus, among others.
Methods: Viral incidence was evaluated in acute respiratory patients in Seoul, Korea from 2010 to 2012. A total of 2,544 oropharyngeal swab specimens were tested by real-time polymerase chain reaction (PCR) methods. RNA viruses (hRV, PIV, RSV, hCoV, and hMPV) and DNA viruses (ADV and bocavirus) were detected using the one-step reverse transcriptase PCR (RT-PCR) premix kit (SolGent, Korea) from January 2010 to June 2011, and using the real-time PCR kit (Kogenebiotech, Korea) from July 2011 to December 2012.
Results: Thirty-two percent (813/2,544) of specimens were positive; 31.9% (294/923) in 2010, 31.4% (232/ 738) in 2011, and 32.5% (287/883) in 2012. The most frequently isolated virus was hRV (40.7%, 331/813), followed by ADV (23.9%, 194/813), RSV (14.1%, 115/ 813), PIV (12.3%, 100/813), and hCoV (8.7%, 71/813). PIV1 was the most commonly isolated PIV, followed by PIV3 and PIV2, respectively. hCo OC43 was the most commonly isolated hCoV, followed by hCoV NL63 and hCoV 229E, respectively.
Conclusion: Information on respiratory viruses circulating in Seoul, Korea over the last three years will be helpful in the management of acute respiratory infections, and for larger-scale epidemiological studies.
[in Korean]
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