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

December, 2015. Vol. 18 No. 4.

Review article

Active Surveillance of Multidrug-Resistant Organisms with Rapid Detection Methods for Infection Control

Young Ah Kim, Kyungwon Lee

Ann Clin Microbiol 2015 December, 18(4): 103-110. Published on 20 December 2015.

Antibiotic-resistant bacteria have become an increasingly serious problem in Korea, and multidrug-resistant organisms (MDROs) such as methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococcus (VRE), and multidrug-resistant Pseudomonas aeruginosa and Acinetobacter baumannii have increased over the recent years. More seriously, the recent emergence of carbapenem resistance among Enterobacteriaceae is thought to be an urgent worldwide threat. Active surveillance have been identified as an important tool as an intensified infection control intervention for the control of MRSA and VRE and may be also an effective strategy for multidrug-resistant Gram-negative bacilli. Rapid detection using molecular methods could aid in the timely detection of MDRO carriers, and adequate application of infection control strategy could reduce the transmission of MDROs within hospital settings.

[in Korean]

Original article

Comparison of Antibiotic Resistance Rate of Medically Important Microorganisms between Japan and Korea

Keigo Shibayama, Hyukmin Lee, Sunjoo Kim

Ann Clin Microbiol 2015 December, 18(4): 111-118. Published on 20 December 2015.

Background: A surveillance system for antibiotic resistance is well organized in both Japan and Korea; however, a comparative analysis by microorganism has not previously been conducted.

Methods: We compared the latest antibiotic resistance rates of medically important pathogens, such as Staphylococcus aureus, enterococci, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii, between Japan and Korea. Data were collected by JANIS (Japan Nosocomial Infections Surveillance) and KARMS (Korean Antimicrobial Resistance Monitoring System) from 2007-2012.

Results: In 2012, the proportions of oxacillin-resistant S. aureus, vancomycin-resistant Enterococcus faecium (VRE), cefotaxime-resistant E. coli, ceftazidime-resistant K. pneumoniae, imipenem-resistant P. aeruginosa, and imipenem-resistant A. baumannii were 53%, 0.4%, 16.6%, 2.9%, 18.5%, and 2% in Japan and 67%, 32%, 29%, 40%, 28%, and 70% in Korea, respectively.

Conclusion: There were large differences in the frequencies of VRE, ceftazidime-resistant K. pneumoniae, and imipenem-resistant A. baumannii between Japan and Korea. A collaborative study to probe the differences in the antibiotic resistance rates between the two countries should be performed. 

Original article

Comparison of Nasopharyngeal Aspirates and Nasopharyngeal Flocked Swabs for Respiratory Virus Detection

Heungsup Sung, Jung Oak Kang, Nam Yong Lee, Chang Kyu Lee, Han-Sung Kim, Kyu Man Lee, Eui Chong Kim

Ann Clin Microbiol 2015 December, 18(4): 119-125. Published on 20 December 2015.

Background: Nasopharyngeal aspirate (NPA) is known as the best specimen for accurate diagnosis of viral respiratory infections in pediatric patients, but the procedure is very annoying. Recently introduced flocked swabs have been reported to be easy to obtain a good quality specimen and comfortable to patients. The purpose of this study was to compare the sensitivities between NPA and nasopharyngeal flocked swabs (NPFS) for detection of respiratory viruses in children.

Methods: For this study, 111 hospitalized children with acute respiratory tract infections were recruited. NPA and NPFS were performed in parallel from each patient. NPFS were always collected after NPA. Specimens were tested for six common respiratory viruses in triplicate using indirect immunofluorescence (IIF), viral cultures, and multiplex reverse transcription PCR (RT- PCR).

Results: The proportion of specimens inadequate for IIF was higher in NPA (23.4%) than NPFS (5.4%). According to the consensus positive, the positive rates of NPFS were higher than those of NPA when using IIF (45.7% and 30.6%, P=0.048) and culture (38.7% and 27.9%, P=0.004). However, the false-positive rates of NPFS were higher than those of NPA when using IIF (12.4% and 1.2%, P=0.004). The positive rates of NPFS and those of NPA were not different in multiplex RT-PCR (67.6% and 55.9%, P=0.055).

Conclusion: The higher sensitivity of IIF for NPFS specimens and of culture for respiratory viruses and the similar sensitivities in multiplex PCR could make them an alternative to NPA samples, especially in physician clinics or emergency rooms.

[in Korean]

Original article

Eleven-Year Experience of Clostridial Bacteremia at a Tertiary Care Hospital in South Korea

Yeongbin Kim, Jae Won Yun, Sejong Chun, Hee Jae Huh, Nam Yong Lee

Ann Clin Microbiol 2015 December, 18(4): 126-132. Published on 20 December 2015.

Background: Clostridial bacteremia (CB) is the second most frequent anaerobic bacteremia, and CB patients show high mortality without prompt antimicrobial therapy. We retrospectively reviewed 11 years of CB cases in a tertiary care hospital to describe the clinical and microbiological characteristics of CB and to define the risk factors of fatal CB.

Methods: All patients with CB from January 2002 to December 2012 were included in the study. Age, sex, underlying diseases, antibiotic use, and clinical outcome were reviewed. Antibiotic therapy was classified as either ‘appropriate’ or ‘inappropriate’ based on the activity against Clostridium species.

Results: A total of 118 Clostridium isolates (0.79% of all blood culture isolates) were recovered from the blood cultures of 114 patients. The underlying conditions of patients with CB were neoplasm in 87 cases (76.3%), gastrointestinal symptoms in 84 cases (73.7%), diabetes in 17 cases (14.9%), and hemodialysis in six cases (5.3%). Of the 118 Clostridium isolatesC. perfringens was the most frequent species (42 isolates, 35.6%). Thirty-two patients (28.1%) showed polymicrobial bacteremia, which was most commonly combined with Escherichia coli. Two patients harbored more than two Clostridium species. ‘Appropriate’ antibiotics were given to 97 (85.1%) patients. The mortality rate of CB at days 2, 8, and 30 was 7.9% (9/114), 14.0% (16/114), and 26.3% (30/114), respectively.

Conclusion: Neoplasm, especially in the gastrointestinal tract or of hematologic origin, and hemodialysis were considered to be risk factors of blood stream clostridial infection. Early appropriate antibiotic coverage of CB was not definitely associated with lower mortality in our study.

Case report

Possibility of Frequent Detection of Invasive Cyberlindera fabianii Infection Using Molecular Method

Young Jin Kim, John Jeongseok Yang, Hee Joo Lee

Ann Clin Microbiol 2015 December, 18(4): 133-134. Published on 20 December 2015.

A case of fungemia caused by Cyberlindera fabianii was reported in the September issue of Annals of Clinical Microbiology. The C. fabianii that causes rare invasive infection can easily be misidentified as Candida utilis by Vitek-2 YST ID (bioMérieux, USA) and as Candida pelliculosa by API kit (bioMérieux, USA) with high probability. Recently, we also experienced a case of fungemia caused by C. fabianii that was misidentified as C. pelliculosa using API 20C Aux (bioMérieux, USA). As molecular identification is becoming more widespread, cases of C. fabianii infection are expected to be more frequently identified.

Case report

First Report of Yokenella regensburgei Isolated from the Wound Exudate after Disarticulation Due to Diabetic Foot Infection in Korea

Sae-Mi Lee, Young-Jin Kang, Hee Jae Huh, Chang-Seok Ki, Nam Yong Lee

Ann Clin Microbiol 2015 December, 18(4): 135-139. Published on 20 December 2015.

Yokenella regensburgei, a member of the family Enterobacteriaceae, is rarely isolated in humans. Here, we report a 71-year-old man with diabetic foot infection from which Y. regensburgei was isolated. Following debridement and disarticulation of the foot, an exudate specimen was obtained, from which Gram- negative bacilli were recovered. The organism was identified as Y. regensburgei using the Vitek 2 system (bioMérieux, USA) and 16S rRNA and gyrB gene sequencing. To our knowledge, this is the first case of Y. regensburgei isolation in Korea.