Investigation of Positive Streptococcus pneumoniae Urinary Antigen Test Results in a Korean University Hospital / 대한임상미생물학회지

BACKGROUND: The Streptococcus pneumoniae urinary antigen test (SPUAT) (Binax Now, USA) was developed for detecting polysaccharide C in urine samples for rapid diagnosis of pneumococcal pneumonia, the most common cause of community-acquired pneumonia (CAP). To validate positive results of these tests, we retrospectively investigated all positive results obtained from the emergency room of a Korean university hospital among patients with suspected CAP. METHODS: One hundred twenty-three positive SPUAT results were abstracted and analyzed from the authors' laboratory information system among the SPUAT results performed from 1,143 pneumonic patients admitted from the emergency room of a university hospital between 2007 and 2008. Medical records, including conventional microbiologic analysis results, were reviewed in detail for all positive test results. RESULTS: Among 123 patients with the positive SPUAT results, 24 patients were excluded due to hospitalization history during the preceding month. Nine of 99 patients (9.1%) with suspected CAP had confirmed pneumococcal pneumonia upon conventional sputum or blood culture. Thirty-five positive results (35.4%) showed other microorganisms upon conventional methods, which might be due to possible cross-reactivity. Among those, 23 positive results were considered bacterial pneumonic agents, and 12 positive results were regarded as urinary tract infection strains or contaminating agents. Fifty-five positive SPUAT results (55.6%) showed negative conventional microbiologic growth, and some positive SPUAT results might be caused by true pneumococcal infection although without cultural evidence. CONCLUSION: Our retrospective study demonstrated that a positive SPUAT result typically does not agree well with conventional culture methods, suggesting that the value of a positive SPUAT result in etiology determination may be limited under practical conditions in a university hospital.

Antimicrobial Susceptibilities of Ureaplasma urealyticum and Mycoplasma hominis in Pregnant Women / 대한임상미생물학회지

BACKGROUND: Ureaplasma urealyticum and Mycoplasma hominis are associated with an increased risk of pregnancy complications, such as preterm birth and premature membrane rupture. The purpose of this study was to determine the isolation rates and antimicrobial susceptibilities of genital mycoplasma in a sample of pregnant women from Jinju, Korea. METHODS: Vaginal swabs were obtained from 258 pregnant women between 2004 and 2008 and tested for the presence of U. urealyticum and M. hominis at Gyeongsang National University Hospital. The identification and antimicrobial susceptibilities of U. urealyticum and M. hominis were determined with a commercially available kit, the Mycoplasma IST2 Kit (bioMe- rieux, Marcy-l'Etoile, France), and evaluated according to standards set by the Clinical and Laboratory Standards Institute (CLSI). RESULTS: U. urealyticum only was detected in 105 specimens (38.6%), while M. hominis only was detected only in 2 specimens (1.8%). Seven specimens (6.7%) were positive both for U. urealyticum and M. hominis. Susceptibilities of U. urealyticum to azithromycin, erythromycin, clarithromycin, and doxycycline were 75.2%, 82.9%, 88.6%, and 88.6%, respectively, while almost all of the isolates were susceptible to josamycin (99.0%) and pristinamycin (100%). The susceptibility of U. urealyticum to ofloxacin and ciprofloxacin was 56.2% and 15.2%, respectively. CONCLUSION: The rate of isolation of genital mycoplasma in pregnant women was 44.2% in Jinju; most of the mycoplasma were U. urealyticum. U. urealyticum and M. hominis were highly resistant to quinolones, but susceptible to josamycin. Therefore, empirical treatment without prior identification and determination of the antimicrobial susceptibility of genital mycoplasma will fail in many cases.

Association of T Antigens with emm Genotypes of Group A Streptococci / 대한임상미생물학회지

BACKGROUND: T typing has been used as a screening test for epidemiologic studies of group A streptococci (GAS) infections or carriers, and M typing has been performed for virulence studies. However, M typing is difficult to perform in routine laboratories. Recently, genotyping of the emm gene, which encodes the M protein, has become available. We investigated which T antigen is closely associated with a certain emmgenotype. METHODS: GAS were collected from the children in Jinju who were asymptomatic carriers (N=349) or had acute pharyngitis (N=122) during the 3 year-period from 2002 through 2004. T typing was performed by a slide aggulutination, and emmgenotyping by PCR and DNA sequencing. RESULTS: More than 90% of T1, T3, T6, T12, T25, and T5/27/44 antigens were associated with emm1, emm3, emm6, emm12 and 22, emm75, and emm44/61 genotypes, respectively; however, other T antigens, such as T2, T4, T7, T11, and B3264, were not associated with any particular emm genotypes. CONCLUSION: Several T antigens are so closely associated with particular emm genotypes that one could predict emmgenotypes based on the result of T typing.

A Decrease in Erythromycin Resistance Rate of Streptococcus pyogenes in 2004 in Jinju / 대한임상미생물학회지

BACKGROUND: The erythromycin (EM) resistance rates and emm genotypes of Streptococcus pyogenes could vary by geographical location and study period. The purpose of this study, involving a large number of children, was to determine EM resistance rate and its resistance mechanism of S. pyogenes, and to compare these results with those of previous studies performed at the same area. METHODS: Throat cultures were taken from 2,351 healthy children of four elementary schools from October through December, 2004 in Jinju. A total of 328 strains of S. pyogenes were isolated. Antimicrobial susceptibility test was performed by the agar dilution method against six antimicrobial agents. The phenotypes of EM resistance were evaluated by the double-disk diffusion test and the frequency of ermB and mefA genes was determined by polymerase chain reaction. RESULTS: Resistance rates of S. pyogenes to EM, clindamycin and tetracycline were 9.8%, 8.8% and 18.3%, respectively. Almost all isolates were susceptible to ofloxacin, levofloxacin and chloramphenicol. Constitutive resistance (CR) was observed in 87.5%, M phenotype in 9.4%, and inducible resistance only in 3.1%. The ermB and mefA genes were present in 90.6% and 9.4% of the isolates, respectively. CONCLUSION: The resistance rate to EM of S. pyogenes was 9.8% in 2004, which was a large drop from the 51% shown in 2002. CR with the ermB gene was predominant, suggesting that most of the EM resistant isolates have a high level of resistance.

Acquired Pure Red Cell Aplasia due to Anti-Erythropoietin Antibodies in a Patient Undergoing Hemodialysis

A 63-year-old man was placed on hemodialysis for the end-stage of renal disease secondary to renal artery stenosis. He was also regularly given epoetin, subcutaneously, for anemia associated with his renal disease. Rapidly progressing erythropoietin (EPO) resistant anemia and reticulocytopenia developed after 1 year of hemodialysis. The patient required frequent red blood cell transfusions. The bone marrow examination demonstrated selective erythroid hypoplasia. A detailed search for the cause of the erythroblastopenia revealed nothing, with the exception of anti-EPO antibodies (Ab). Pure red cell aplasia (PRCA) was suspected due to the anti-EPO Ab. With the immunosuppressive agent and change to the epoetin-therapy, the patient recovered his hemoglobin and reticulocyte counts. Particular attention should be paid for the possibility of PRCA due to anti-EPO Ab in patients undergoing rHuEPO therapy, with an unexplained recombinant human erythropoietin (rHuEPO) resistant anemia, especially via the subcutaneous route.

Antibiotic Susceptibility of Streptococcus pyogenes and Association of Ery-thromycin Resistance Phenotype with Resistance to Tetracycline / 대한진단검사의학회지

BACKGROUND: Streptococcus pyogenes is the most common bacterial cause of acute pharyngitis in children. The resistance rate and phenotype distribution of S. pyogenes could be different by geo-graphical locations and study periods. The purpose of this study was to determine the minimal inhibitory concentration (MIC), resistance rate to antimicrobial agents, and association of erythromycin (EM) resistance phenotype with resistance to tetracycline (TC) among S. pyogenes isolated in Jinju, Korea. METHODS: A total of 223 isolates of S. pyogenes were obtained from pediatric pharyngitis patients and asymptomatic carriers during the period from November 2001 to May 2002. Antibiotic susceptibility test was performed by the agar dilution and the disk diffusion methods against eight antimicro-bial agents. The phenotypes of EM resistance were determined by the double-disk diffusion test. RESULTS: Resistance rates of S. pyogenes to EM, clindamycin (CC), and TC were 48.9%, 22.0% and 29.6%, respectively. MIC(50) and MIC(90) were 0.25 mg/L and > or =256 mg/L of EM, or =256 mg/L of CC, and < or =0.5 mg/L and 64 mg/L of TC respectively. Almost all isolates were suscep-tible to penicillin, ampicillin, ofloxacin, levofloxacin and chloramphenicol. The M phenotype (55.0%) was slightly more common than the constitutive resistance (45.0%); the inducible resistance pheno-type was not detected. All strains of constitutive resistance phenotype were highly resistant to TC (MIC higher than 32 mg/L), while only 3.3% of M phenotype strains was resistant to TC. CONCLUSIONS: Almost all S. pyogenes isolated in the Jinju area were susceptible to penicillin, ampi-cillin, ofloxacin, levofloxacin and chloramphenicol, but resistance rates of S. pyogenes to EM, CC and TC were relatively high. This study showed that the EM phenotypes are associated with resistance to TC.

Analysis of Classical Risk Factors and Homocysteine Level in Acute Myocardiac Infarction / 임상검사와정도관리

BACKGROUND: Hyperhomocysteinemia can be treated and is more preventable compared to the classical risk factors such as age, sex, smoking, obesity, diabetes mellitus, hypertension and hyperlipidemia. METHODS: Serum homocysteine levels were analyzed with fluorescence polarized immunoassay (IMx, Abbott Diagnostics) for 63 patients with acute myocadiac infarction (AMI) and 43 controls who did not have coronary arterial disease from 1997 to 1998. Medical records were reviewed to compare the classical risk factors between the two groups. RESULTS: The mean homocysteine level of AMI was 9.3 +/-5.3 micronmol/L, which is slightly lower than 9.8+/-5.8 micronmol/L in the control group (P>0.05). Other risk factors were not significantly different between the two groups with the exception of serum cholesterol level. CONCLUSIONS: It is concluded that hypercholesterolemia is an important risk factor for AMI, while serum homocysteine level is not, as far as this study goes. Well planned follow up studies are needed to establish the degree to which homocysteine is a risk factor for AMI.

Evaluation of Chlamydia Antibody Using Micro-immunofluorescence in Acute Myocardiac Infarction / 대한진단검사의학회지

BACKGROUND: Chlamydia pneumoniae can cause chronic inflammation in the arterial wall. C. pneumoniae infection has been investigated as a new risk factor for acute myocardiac infarction (AMI), afatal outcome of coronary artery occlusion. METHODS: IgG and IgM for C. pneumoniae using micro-immunofluorescence were evaluated in 80 AMI patients and 46 controls without coronary arterial disease. RESULTS: Chronic infection, defined by equal or higher than 1: 32 titers of IgG of C. pneumoniae, was observed in 51.3% (41/80) in AMI and 17.4% (8/46) in controls (P<0.05). None of the subjects showed acute infection, defined by equal or higher than either 1: 16 of IgM or 1: 512 of IgG of C. pneumoniae. CONCLUSIONS: Chronic C. pneumoniae infection was significantly more common in AMI patients compared to the controls.

Prolonged Remission Following Autologous Peripheral Blood Stem Cell Transplantation in an Infant with Familial Hemophagocytic Lymphohistiocytosis / 대한혈액학회지

Familial hemophagocytic lymphohistiocytosis (FHL) is a fatal illness with a median life expectancy of 2 months if not treated. However, with the recent employment of allogeneic bone marrow transplantation in the treatment of FHL, even complete cure might be anticipated. We report here a case of prolonged remission following autologous peripheral blood stem cell transplantation (Auto-PBSCT) which was first attempted for FHL in Korea. A 4-month-old girl presented with high fever and a huge hepatosplenomegaly. Bone marrow examination revealed the proliferation of both non-malignant histiocytes engulfing red blood cells and lymphocytes. Her brother died at the age of 18 months showing quite similar manifestations. A diagnosis of FHL was made. Following 8 courses of chemotherapy with multiple drugs, Auto-PBSCT was performed. She has been well without any evidence of disease over 8 months of post- transplant period. This case illustrates that it might be worth trying Auto- PBSCT in the treatment of FHL.

Detection of Chlamydia pneumoniae in the Atherosclerotic Tissue by Immunohistochemistry / 대한임상병리학회지

BACKGROUND: Chlamydia pneumoniae is an important pathogen to cause approximately 5-10% of community-acquired respiratory infections and has been recently reported as a tentative causative agent of atherosclerosis in western countries. Considering that the most common cause of death is cerebral artery disease and coronary heart disease in Korea, we attempted to elucidate C. pneumoniae in atheromatous plaques. METHODS: Twenty-eight cases of atherectomy from 1996 to 1998, which included 20 patients with cerebral artery stenosis, two patients with carotid artery stenosis and six patients with coronary artery stenosis were prepared for immunohistochemistry to demonstrate C. pneumoniae. The Coronary arteries from 35 cadavers obtained were also stained with chlamydia genus-specific and C. pneumoniae-specific monoclonal antibodies. RESULTS: Eighteen of 20(90%) of cerebral artery stenosis, one of two of carotid artery stenosis and all six cases of coronary artery stenosis were positive for C. pneumoniae. Thirteen over 35(37.1%) cadavers presented arterial stenosis, while eight cases(61.5%) were positive for C. pneumoniae. CONCLUSIONS: This is the first report demonstrating C. pneumoniae in atheroma in Korea. In regard of the high positive rate of C. pneumoniae(89.3%) in cases of atherosclerosis, C. pneumoniae might be closely associated with atherosclerosis in Korea.

Analysis of Chromosomal DNA of Shingella Isolates Using Pulsed-Field Gel Electrophorrsis / 대한임상미생물학회지

BACKGROUND: It is difficult to control an outbreak of Shigella infection, because of the ease of transmission and the resistance to multiple antibiotics. Recently, there were outbreaks of Shigella infection in Chinju area. The objective of this study was to investigate the molecular epidemiology of the outbreaks using pulsed-field gel electrophoresis(PFGE). METHOD: Thirteen S. flexneri strains, 25 S. sonnei strains from Chinju and 15 S. sonnei strains from Pusan were studied. All strains were isolated from stool cultures of diarrheal patients. Identification and antimicrobial susceptibility test those were tested by Vitek GNI and GNS-LH. Chromosomal DNA restricted with Xbal was resolved by PFGE. RESULT: All the S. flexneri strains and 23(92%)S. sonnei strains from Chinju were resistant to one or more antimicrobial agents. All the clinical isolates of S. flexneri showed the same PFGE pattern which was different from type strains(KTCC 2517). PFGE patterns of 25 (100%) S. sonnei strains from Chinju and 12 (80%) S. sonnei strains from Pusan were identical to those of type strain (KTCC 2009). Three S. sonnei strains from Pusan showed distinct PFGE patterns, respectively. CONCLUSION: PFGF demonstrated identical restriction pattern among most of Shigella isolates from Chinju and Pusan, indicating that an outbreak with genetically related strains had occurred. PFGE was useful in molecular epidemiology of Shigella outbreaks

Detection of Chlamydia pneumoniae in Atherosclerotic Tissue on Electron Microscopy / 감염

BACKGROUND: Chlamydia pneumoniae is an obligate intracellular organism, which can cause respiratory tract infections, exacerbation of asthma, and possibly atherosclerosis. Detection of C. pneumoniae in the atherosclerotic tissue was made using electron microscopy to elucidate the correlation between C. pneumoniae and atherosclerosis. METHODS: Ten cases of paraffin-embedded atherectomy tissue, which were positive in the immunohistochemistry (IHC) were prepared to demonstrate C. pneumoniae on the electron microscope. Two cases of atherosclerotic tissue, which were negative in IHC were processed identically at the same time as negative controls. The tissues were embedded in resin, ultrathin-sectioned, and stained with uranyl acetate and lead citrate, and then observed on electron microscopy. RESULTS: Nine of 10 (90%) atherosclerotic tissue samples were positive for C. pneumoniae on electron microscopy. Negative controls did not show elementary bodies. Elementary bodies of C. pneumoniae were rarely observed in a scattered pattern in the positive specimens. CONCLUSION: Elementary bodies of C. pneumoniae could be demonstrated on electron microscopy in 9 out of 10 atherosclerotic tissue samples with positive IHC for C. pneumoniae. This finding suggests that C. pneumoniae may play an important role in atherogenesis.

Throat Culture and Anti-OF Antibodies in the Elementary School Children / 대한임상병리학회지

BACKGROUND: Anti-OF (opacity factor) antibody (Ab) is useful to study past infection or outbreak of group A streptococci (GAS) and to identify OF antigen (Ag). Throat cultures were taken from 172 elementary school children and venous blood were collected at the same time to screen the frequency of anti-OF Ab. METHODS: The presence of OF Ag was recognized by turbidity of horse serum. OF Ag was identified with inhibition of opacity reaction by known anti-OF Ab. The sera of children were screened for the presence of anti-OF Ab with the representative OF Ag. RESULTS: The positive rate of anti-OF Ab was very high regardless of OF production or throat culture results. Thirty two of 38 (84%) OF Ag producing GAS carriers, 25 of 35 (71%) OF Ag non-producing GAS carriers and 72 of 99 (73%) throat culture negative children harbored anti-OF Ab. While among OF Ag, non-typable and OF 22 were high in prevalence (36.8% and 29.0% respectively), anti-OF 4, anti-OF 28 and anti-OF 12 of OF Ab were identified highly (39.5%, 29.7% and 15.7% respectively). Forty-five (26.2%) among 172 children had two anti-OF Abs and 11 (6.4%) had more than three anti-OF Abs. CONCLUSIONS: Seventy five percent of school children was proven to be previously infected with GAS through this anti-OF Ab study. The anti-OF Ab carrying rates were high, regardless of positivity of throat culture and OF Ag production. We could demonstrate that the prevalent strains of GAS changed in according to time span by proving the difference of frequency of OF Ag and anti-OF Ab and one-fourth of children had been infected with more than 2 different serotypes.

Comparison of Serotypes of Group A Streptococci between Seoul and Chinju / 대한임상병리학회지

BACKGROUND: To interpret the serotyping data from group A streptococcal infections and their complications, serotyping data from healthy children are essential. In this study, we determined the serotypes of the strains isolated from the elementary school children located in Seoul and Chinju. METHOD: Eighty-two strains of group A streptococci isolated from Seoul and 76 strains from Chinju were serotyped with T typing, serum opacity reaction (SOR), opacity factor (OF) and M typing. T typing was undertaken by slide agglutination after trypsinization of bacteria, SOR and OF typing by microwell technique and M typing by Ouchterlony double immunodiffusion after Lancefield's extraction method. RESULTS: In Seoul T 12 (52.4%), T 3 (9.8%), T 5 (8.5%) and T 27 (8.5%) were frequently encountered. In Chinju T 12 (44.7%), T 28 (13.2%) and T 6 (7.9%) were commonly identified. While M 12 (48.8%) and M 5 (14.6%) were most common in Seoul, M 12 (26.3%), M 22 (14.5%) and M 28 (10.5%) were widely distributed in Chinju. SOR positivity was 15.9% in Seoul and 54.0% in Chinju respectively. CONCLUSIONS: The distributions of serotypes of group A streptococci between the two areas were more or less different. Serotyping of strains from healthy children may be considered as the basic data to understand the epidemiology of bona fide group A streptococcal infections and disease association of virulent strains.

Distribution and Upper Limit of Normal Antistreptolysin O Concentrations According to Age / 감염

BACKGROUND: Antistreptolysin O (ASO) is very useful as an indicator of recent streptococcal infection and its sequelae, such as rheumatic fever and acute glomerulonephritis. Because the upper limit of normal (ULN) value of ASO varies according to age, the ULN value of ASO in an area should be evaluated to accurately interpret single ASO levels of patients. METHODS: The ULN value and distribution of ASO concentrations were investigated in three age groups of preschool children (N=162), elementary school children (N=436), and adults (N=231) in Chinju. ASO concentra-tions were measured quantitatively by autoanalyzer or nephelometer from sera of healthy population in Chinju who had no symptoms or signs of streptococcal infec-tions. RESULTS: The mean(+/-SD) ASO concentrations were 71(+/-107) IU/mL, 285(+/-246) IU/mL, and 80(+/-64) IU/mL and the UNL value of ASO concentrations were 131 IU/mL, 433 IU/mL, and 136 IU/mL in each group of preschool children, elementary school children, and adults, respectively. CONCLUSION: The distribution and ULN value of ASO concentrations varied according to age group. The ULN value of ASO concentrations should be set differ-ently according to the patient' s age. Group A strepto-coccal infections might be quite common in elementary school children, while very rare in preschool children or adults.

Quantitative Analysis of Antideoxyribonuclease B Concentrations in the Carriers of Beta-hemolytic Streptococci

Although throat culture is a gold standard to diagnose group A streptococcal (GAS) pharyngitis or its sequelae, antistreptolysin O (ASO) is useful to confirm the diagnosis. In case there is no elevation of ASO, it is necessary to add one or more serologic tests, such as antideoxyribonuclease (ADNase) B test. ADNase B levels were analyzed in the carriers of beta-hemolytic streptococci (BHS) in this study. ADNase B concentrations were determined quantitatively by nephelometry (Behring Nephelometer 100 Analyzer, Germany) on 157 sera of healthy elementary school children in Chungnam who were positive of BHS in the throat culture. ASO levels were measured previously by autoanalyzer (Hitachi 747, Japan). Mean ADNase B and ASO levels were compared according to serological group of BHS and number of colonies. The carriers of GAS had significantly higher ADNase B levels (mean 453 IU/ml) than those of non-A beta-hemolytic streptococci (NGAS, 278 IU/ml), while the difference of ASO levels between GAS (482 IU/ml) and NGAS (350 IU/ml) carriers was not so high. The carriers who had more than 10 CFU of BHS had significantly higher ADNase B or ASO levels than those who had less than 10 CFU. The correlation between ADNase B (Y) and ASO (X) was Y=0.4X+229 (r2=0.13). ADNase B test could discriminate GAS from NGAS more effectively than ASO test. The carriers who have more than 10 CFU might undergo asymptomatic infection, as their ADNase B or ASO levels were significantly high. Because distribution of ADNase B showed little correlation to that of ASO, ADNase B test could be used as a supplementary test to diagnose GAS infection.

Whole blood and Plasma Vitamin C Concentrations of Elementary School Children in Chinju

PURPOSE: Recommended dietary allowance of vitamin C was determined on the basis of preventing the scurvy without considerations of the important function of the vitamin C as a first line antioxidant. So we measured the whole blood and plasma vitamin C concentrations of the contemporay healthy elementary school children in Chinju for the establishment of the optimal daily vitamin C requirment in the elementary school children. METHODS: Whole blood and plasma vitamin C concentrations were measured by the 2,4-dinitrophenylhydrazine method in 338 children from the 1st to the 6th grade of one elementary school in Chinju. RESULTS: Whole blood and plasma vitamin C concentrations were 1.36+/-0.34mg/dL and 1.07+/-0.33mg/dL respectively. There existed an close relationship between whole blood and plasma vitamin C concentrations (r=0.77, p=0.0001). Whole blood vitamin C concentration decreased as the age became older (r=-0.22 p=0.0001), but plasma vitamin C concentration did not change. There were no sex differences in the whole blood and plasma vitamin C concentrations except in the 3rd grade (p<0.05). Twenty-three of 338 elementary school children (6.8%) had the plasma vitamin C concentration less than 0.6mg/dL. CONCLUSIONS: We produced the blood and plasma vitamin C concentrations of the contemporay elementary school children in Chinju. These values were not satisfactory in consideration of the importance of the childhood health.

A Case of Sepsis due to Vibrio damsela / 대한임상병리학회지

Vibrio damsela is a halophilic bacterium that has been reported to cause skin ulcers and death in damselfish (Chromis punctipinnis) as well as wound and soft-tissue infections in human. Most of the previously reported cases in humans haute involved wound infections associated with exposure to seawater or handling fish. We experienced a case of primary septicemia due to V. damsela after eating raw fists in a healthy 66-year-old woman who had neither wounds nor history of exposure to sea- water. She presented fever and diarrhea followed by rapidly pregressive bullae and painful edema on left band and forearm. The patient was Improved by intensive surgical debrldement of necrotic tissue and antibiotic therapy.

Bacteriological Survey of beta-Hemolytic Streptococci from the Throats of Elementary School Children in Chinju: Compared with the Results of Children in Kangwon, Chungnam and Seoul

PURPOSE: Throat culture for streptococcal pharyngitis is a gold standard to diagnose, but it may be misleading to interpret due to the carriers. The isolation rates of beta-hemolytic streptococci (BHS) and Streptococcus pyogenes in the school children in Chinju were investigated and compared with those of Kangwon, Chungnam and Seoul previously reported. METHODS: Throat cultures were taken from the healthy 476 elementary school children who had no symptoms or signs of upper respiratory tract infection in April 1995, and the beta-hemolytic streptococci were identified with bacitracin disk (0.04 U) and latex agglutination. RESULTS: One-hundred fifty-four (32.4%) yielded BHS and 88 (18.5%) had S. pyogenes. The serogrouping revealed 30 (6.7%) group G, 24 (5.0%) group C, 4 (0.8%) group B, and 8 (1.7%) non-group A,B,C,G respectively. CONCLUSIONS: The isolation rate of BHS in Chinju was significantly higher (p<0.001) than the results of Kangwon, Chungnam and Seoul. The identification of BHS was also different from the other areas. In addition to these bacteriologic investigation, the study should be followed whether these carriers were simple contact ones or suffered from asymptomatic infections, and the epidemiologic study using serotyping, such as M or T typing, is necessary.

Investigation of renal function test and urinalysis findings onhepatitis B surface antigen positive patients / 대한임상병리학회지

No abstract available.