Rapid Detection of Mycoplasma pneumoniae and Antimicrobial Susceptibilities of the M. pneumoniae Isolates

The throat swabs obtained from 1,098 adults and 432 children patients with respiratory diseases were examined for Mycoplasma pneumoniae infection detected by culture and polymerase chain reaction (PCR). Antimicrobial susceptibilities of the resulting 60 M. pneumoniae isolates were evaluated by testing minimum inhibitory concentrations (MICs) of erythromycin, minocycline, tetracycline, josamycin, sparfloxacin, ofloxacin, and ciprofloxacin by a broth micro-dilution method. In a preliminary screening, the detection rate of M. pneumoniae by PCR was 29.2% (277/948) for the adults and 28.3% (90/318) for the children. In the second survey, the isolation rate of M. pneumoniae by culture was 29.3% (44/150) for the adults, and 14.0% (16/114) for the children. The PCR detection rate was 36.7% (55/150) for the adults and 23.7% (27/114) for the children. The MIC90s of the M. pneumoniae isolates were 0.015 mg/ml for erythromycin, lower than 0.03 mg/ml for josamycin, 0.06 mg/ml for sparfloxacin and minocycline, 0.12 mg/ml for tetracycline, 0.5 mg/ml for ofloxacin and CFC-222, and 1.0 mg/ml for ciprofloxacin. The isolates were susceptible to erythromycin, josamycin, sparfloxacin, minocycline, tetracycline, and ofloxacin, but the 63.3% of them was resistant to ciprofloxacin. These results indicate that the PCR method has a significant potential as a rapid and sensitive method for early detection of M. pneumoniae infection in clinical specimens as compared with the culture method, but the PCR method could not provide any information concerning the biological chracteristics of M. pneumoniae strains. Erythromycin, josamycin, sparfloxacin, minocycline, and tetracycline could be recommended as the antimicrobial agents of choice in Korea.

A case of autoimmune neutropenia / 대한내과학회지

Autoimmune neutropenia is characterized by severe neutropenia with cell-bound neutrophil antibodies or circulating antibodies for neutrophils. Diagnosis of disease is made of the basis of the presence of antibodies for neutrophil. Corticosteroid or rhG-CSF have been reported to be effective in some patients. Recently we experienced one case of autoimmune neutropenia patient who was admitted to our hospital in 1997 because of stomach cancer and degenerative joint disease. She had severe neutropenia without underlying autoimmune disease. And cell-bound neutrophil antibodies were detected by indirect immunofluorescence test. Treatments with rhG-CSF and steroid result in transient improvement of neutropenia and subtotal gastrectomy was done successfully. We herein report one case of autoimmune neutro- penia patient, to our best knowledge, the first report in Korea, with a brief review of literature.

Synovial Fluid Adenosine Deaminse Activity in the Patients of Rheumatoid Arthritis, Osteoarthritis, Ankylosing Spondylitis, and Gouty Arthritis / 대한류마티스학회지

OBJECTIVE: To investigate whether synovial fluid adenosine deaminase activity is useful in the differential diagnosis of joint swelling and in estimating the disease activity. METHOD: Adenosine deaminase activity was determined in the synovial fluid taken from patients with rheumatoid arthritis (n=21), osteoarthritis (n=ll), ankylosing spondylitis (n=3), and gouty arthritis (n=2). This enzyme activity was compared with the laboratory indices (ESR, CRP) in the blood and the other parameters in the synovial fluid. RESULT: More increased adenosine deaminase activity was found in the synovial fluid taken from patients with rheumatoid arthritis, ankylosing spondylitis, and gouty arthritis, as compared with that of osteoarthritis patients. Synovial fluid ADA activity was significantly corelated with the WBC count in the synovial fluid, but there was no statistical corelation between other synovial parameters and adenosine deaminase activity. CONCLUSION: Adenosine deaminase activity is useful in the differential diagnosis of joint swelling between inflammatory joint disease and osteoarthritis, but not useful in estimating the disease activity.

The Effect of Halofantrine in the Treatment of 14 Cases of Chloroquine Resistant Imported Malaria / 대한내과학회지

OBJECTIVES: The prevalence of malaria is increasing in recent years and also multidrug resistant malaria is increasing around the world and there is an increasing concern about imported malaria in nonendemic areas. Now many drugs are tried to find out effect on multidrug resistant malaria. We performed this study to investigate the thrapeutic effect of halofantrine in the treatment of chloroquine resistant imported malaria. METHODS: From Feb. 1992 to May 1995, we experienced 35 patients infected with malaria and treated 14 patients among 35 patients with halofantrine. RESULTS: 1) All 14 patients were sailor with a mean age of 39.4 years and infected with malaria. 2) The majority of patients were infected with malaria at Africa. 3) 10 patients were infected with Plasmodium falciparum and the remainder were undetermined. 4) In the 11 cases of chloroquine resistant malaria treated with quinine plus tetracycline combination therapy or Fansidar, 4 cases could not be tolerable due to side effects and resistance to the therapy, we substituted halofantrine for above regimens. 5) In the 10 cases, treated after May 1994, halofantrine was the first choice of treatment because they were the cases of malaria infected in the mid-Africa where the prevalence of chloroquine resistant malaria is high. 6) With halofantrine, all 14 cases were treated with minimal side effects suc4 as nausea, vomiting, anorexia, abdominal pain and fatigue. CONCLUSION: We think halofantrine is a simple and effective regimen against chloroquine resistant malaria and consider this agent as an alternative therapeutic regimen on chloroquine resistant malaria.