Campylobacter Enteritis: Clinical Features and Laboratory Findings in Children Treated at a Single Hospital

PURPOSE: Campylobacter species are common causes of bacterial enteritis. There is limited knowledge on its prevalence and clinical features because of its fastidious culture conditions. The purpose of this study was to identify the clinical features of Campylobacter enteritis in children. METHODS: We obtained stool specimens from patients diagnosed with acute gastroenteritis in the Department of Pediatrics, Nowon Eulji Medical Center (NEMC) and identified the pathogens by performing cultures or polymerase chain reactions (PCR). We retrospectively reviewed the medical records of patients with Campylobacter enteritis at NEMC between January 2012 and December 2017. RESULTS: Overall, 123 patients were diagnosed with Campylobacter enteritis (60 by culture and PCR in EnterNet and 110 by multiplex PCR). The median (interquartile range [IQR]) age of patients was 12 years (IQR, 8 to 16 years). The disease occurred all year round, but 69.9% from June to September. Symptoms included diarrhea (97.6%), fever (96.7%), abdominal pain (94.3%), vomiting (37.4%), and headache (34.1%). Compared with other treatments, treatment with azithromycin was associated with a shorter hospitalization period (P<0.05). CONCLUSIONS: Campylobacter enteritis is common during summer and mostly infects adolescent patients. It causes severe abdominal pain and fever preceding the onset of diarrhea. Prompt diagnosis and appropriate use of antibiotics reduces the duration of the disease.

Characteristics and Clinical Correlations of Staphylococcus aureus Discovered in Stools from Children Hospitalized at a Secondary Hospital

PURPOSE: Research on the clinical role of Staphylococcus aureus as a pathogen in acute gastroenteritis (AGE) in children has been scarce. This study aimed to clarify the prevalence and clinical correlation of S. aureus detection in children with AGE. METHODS: Fecal samples were collected from children with symptoms of AGE who visited a secondary hospital between January 2012 and December 2015. The samples were sent to the Seoul Metropolitan Government Research Institute of Public Health and Environment to test for pathogenic organisms. Clinical patterns were analyzed through medical record review. RESULTS: Among the 663 participants, the bacteria detection rate was 26.2% (n=174), the virus detection rate was 29.7% (n=197), and the non-detection rate was 43.1% (n=286). S. aureus was tested positive from 102 cases and was confirmed as a single pathogen in 53 cases. It was the third most common pathogen. The prevalence by age was highest (45.3%) in 0–2 year-olds. Most cases occurred in summer. Symptoms included diarrhea (71.7%), vomiting (67.9%), fever (49.1%), and abdominal pain (37.7%). Only vomiting showed a significant difference between the S. aureus group and the non-detection group (67.9% vs. 43.0%; P=0.001). Among enterotoxins, the higher incidence of vomiting was associated with classical staphylococcal enterotoxins (SEA, SEB, SEC, SED, and SEE) and SEH (P=0.027). CONCLUSIONS: S. aureus was the bacteria commonly isolated from children with AGE. Our study identified cases of staphylococcal AGE in children based on fecal samples and confirmed the characteristic symptoms, affected age groups, seasonal distribution, and correlation with enterotoxins.

Validity and Reliability of the Self-Reflection and Insight Scale for Korean Nursing Students / 기본간호학회지

PURPOSE: The purpose of this study was to translate the Self-Reflection and Insight Scale (SRIS) into Korean and test its validity and reliability. METHODS: Participants were 340 nursing students who were recruited from 5 nursing colleges in Korea. Data were collected from November 21 to December 20, 2016 and analyzed using the IBM Statistics SPSS 22.0 and AMOS 23.0 programs. Exploratory factor analysis, Confirmatory factor analysis, and concurrent validity analysis were performed. RESULTS: For the Korean-SRIS (K-SRIS) 4 items were deleted from the original SRIS. The final scale consisted of 16 items which were sorted into- the 2 factors: self-reflection (11 items), insight (5 items). The cumulative percent of variance was 50.91%. The statistically significant correlation between K-SRIS scores and the Reflection in Learning Scale (RLS) support the concurrent validity of the K-SRIS. The reliability of the scale, Cronbach's α was .83. CONCLUSION: The finding indicate that the K-SRIS has validity and reliability. Therefore it can be used for measuring and developing reflection ability in nursing students.

Etiology and Clinical Features of Acute Bacterial Gastroenteritis in Children Mananged at a Secondary Hospital

PURPOSE: Acute bacterial gastroenteritis (ABG) can cause more severe symptoms than acute viral gastroenteritis in children. This study was aimed at determining the etiologic trends and to examine the clinical characteristics of ABG in children. METHODS: We sent stool samples from the children with acute gastroenteritis who were treated at a secondary hospital located in Seoul, Korea between January 2011 and December 2014 to Seoul Metropolitan Government Research Institute of Public Health and Environment to find the causative organisms. Clinical characteristics of patient were analyzed through a medical records review. RESULTS: Out of 664 stool samples, 183 (27.6%) yielded bacterial pathogens. Staphylococcus aureus was the most common bacterial pathogen, found in 72 cases (39.3%), even though it was only tested for since 2012. The monthly isolation rate was the highest (24.6%) in August. The isolation rate of Campylobacter spp. by patient's age group was high (16.7%) in the 12- to 18-year-age group (P =0.04). In patients with bloody stool, Campylobacter spp. was the most commonly isolated (31.0%, P =0.04). When comparing C-reactive protein, the Salmonella spp.- or Campylobacter spp.-isolated group showed higher values than the S. aureus - or pathogenic Escherichia coli -isolated group (5.7±0.6 mg/dL vs. 2.1±0.3 mg/dL, P <0.01). CONCLUSIONS: S. aureus, Salmonella spp., pathogenic E. coli , and Campylobacter spp. were important pathogens of ABG among children. Considering the differences in pathogens found according to age, a clinical symptom and inflammation index might be helpful in assuming the causative organism.

Action Research in Hospital Settings: A Literature Review of International Nursing Journals / 간호행정학회지

PURPOSE: Purpose of this study was to identify major trends of action research from 2006 to 2013 and suggest directions for activating and advancing domestic action research in nursing. METHODS: A review was made of 118 action research studies in hospital settings reported in international journals. Search from PubMed, Ovid, and CINHAL was done using analysis criteria developed by the researchers. General and methodological characteristics and focus on changing outcomes of action research were analyzed. RESULTS: The major group of researchers belonged to colleges/universities (40.7%). Methods included use of qualitative methods (61.0%), research questions (24.6%), and use of theoretical models (35.6%). Prevalent data collection methods were interviews (20.2%), and 48.3% showed more than a 1-cycle process including spiral circulation structure. Focus of changing outcomes of the 56 papers including more than 1-cycle were practice (66.1%), environment (8.9%), client-nurse (7.1%). CONCLUSION: Trends in action research in nursing were identified providing necessary reasons to increase action research in nursing as follows: needs of various researchers including stakeholders as well as healthcare providers, various research designs including unconstrained reflection and writing, specific presentation of adapted theoretical models and action strategies, and quality assurance for validity and reliability of research processes and outcomes.

Comparison of Blended Practicum Combined E-learning between Cooperative and Individual Learning on Learning Outcomes / 한국간호교육학회지

PURPOSE: This study was conducted to compare blended practicum with clinical and lab combined e-learning between cooperative and individual group on learning outcomes. METHOD: A total of 63 junior Nursing students were recruited from C University in G city from May, 2012 to June, 2012. Ten hours lab practicum for two weeks was provided for both two groups during the period of adult nursing practicum. Prior to blended practicum, e-learning was conducted. For cooperative group, two hours off line team learning with a tutor for eight weeks was provided, in other hands, for individual group, any off line team learning was not provided and self study on line was not evaluated by the tutor. RESULTS: The result of ANCOVA showed that critical thinking and self directed learning were significantly improved in the individual group compared to the cooperative group (F=-18.15, p<.001; F=28.12, p<.001). In other hands, clinical competence was significantly higher in the cooperative group than in the individual group (F=16.61, p<.001). CONCLUSION: Through development of self-leaning facilitating online contents, the blended practicum combined e-learning could be effective in critical thinking, self-directed learning and clinical competence. Further studies about e-learning strategies of off-line learning are still needed.

Comparative Genotype Analysis of Hepatitis A Virus: Two One-Year Studies in South Korea in 2002 and 2011

Hepatitis A virus (HAV) positive stool samples were collected from acute hepatitis A patients during the two study periods of 2002 and 2011 in Seoul, South Korea, and their genetic variability was determined. From a total of 79 specimens, the nucleotide sequences of the VP1 and 2A junction were successfully amplified in 27 (34.2%) samples and subjected to sequence analysis. Genetically, there was a dramatic change in HAV subgenotypes from IA to IIIA during the past ten years. Sequence analysis identified that most strains belonged to genotype I, which is the main genotype globally. The subgenotype IA (93.3%, n=13/14) was the major subgenotype in 2002, whereas the subgenotype IIIA (69.2%, n=9/13) was predominant in 2011. Interestingly, a IIIA strain was identified from a patient who had a history of travel to India in 2002. The finding presented provides new insight into the genetic shift of circulating HAVs in South Korea.

A Journey to Action Research in a Clinical Nursing Context / 간호행정학회지

PURPOSE: The purpose of this study was to examine the effectiveness of Action Research (AR) approach in nursing. METHODS: Participants were 64 perioperative nurses recruited from C hospital in Gwangju, Korea. The nurses were engaged in the project through 2 cycles of planning, acting, observing, and reflecting. A mixed-methods design was used to examine changes in participants and their knowledge management practice. Quantitative data were analyzed using SPSS 20.0 program and qualitative reflection data underwent content analysis. RESULTS: During the project, participants developed standardized pre-operative checklists and opened an Internet Cafe to better manage their perioperative nursing information. At the end of the project, there was a significant increase in nurses' knowledge management (p=.015) and the rate of surgical material prescription errors decreased from 8.0% to 2.9%. Core AR project team members' teamwork skills and organizational commitment increased significantly (p=.040, p=.301, respectively). The main themes that emerged from the qualitative data were learning how to solve problems in practice, facilitating team activities through motivation, barriers of large participation, and rewarded efforts and inflated expectations. CONCLUSION: The AR project contributed to empowering participants to solve local problems. AR is a useful methodology to promote changes in practices and research participants.

Molecular Epidemiology of Human Astrovirus Infection in Hospitalized Children with Acute Gastroenteritis / 대한소아소화기영양학회지

PURPOSE: Human astrovirus (HAstV) is known to be an important etiologic agent of acute gastroenteritis in infants worldwide. However, the prevalence of HAstV infection varies according to geographic region and patient age. The purpose of our study was to investigate the incidence of HAstV infection among hospitalized children at a tertiary hospital in Seoul. METHODS: Fecal samples were collected from hospitalized children up to five years of age with acute gastroenteritis. A total of 812 fecal samples were collected from hospitalized children with acute gastroenteritis between February 2004 and January 2005. Fecal specimens were screened for rotavirus, enteric adenovirus and norovirus by enzyme immunoassay (EIA) or reverse transcriptase polymerase chain reaction (RT-PCR). HAstV positive samples were characterized by RT-PCR. RESULTS: Rotavirus was detected in 16.9% (138/812), norovirus in 11.6% (94/812), and adenovirus in 4.0% (33/812) of the study population. HAstV was detected in 4.0% (33/812) samples by RT- PCR. The age distribution of HAstV positive patients was as follows: <12 month old, 82.0% (27/ 33); 1~2 years old, 6.0% (2/33); 2~5 years old, 12.0% (4/33). The seasonal distribution of HAstV positive samples was as follows; April (3), May (5), June (4), August (12), September (4), October (2), November (2), and December (1). The peak rate of HAstV infection was observed during the summer season, 2004. A mixed infection of viral agents was confirmed in 2.7% (22 /812) of the study population, most commonly with rotavirus and norovirus, and with rotavirus and HAstV. Genotype 1 was the predominant type (91%, 20/22) and genotype 8 was detected in two cases. CONCLUSION: The prevalence of HAstV infection was 4.0% in hospitalized children with acute gastroenteritis, and was especially high in infants. HAstV can be considered as an important etiologic agent of gastroenteritis in children.

Detection of Antibiotic Resistant Genes in Salmonella enterica Serovar Typhimurium Isolated from Foodborne Patients in Seoul Using Multiplex-PCR

The frequency of antibiotic resistance among Salmonella enterica serovar Typhimurium has increased due to the transfer of multiple resistance factors. We detected the 13 antibiotic resistance genes by multiplex-PCR and compared with the results of phage typing and antibiotic disk diffusion for 49 S. typhimurium isolated from food-poisoning outbreaks in Seoul from 1999 to 2002. Resistance genes for tetracycline, streptomycin, ampicillin, sulfonamide, amino-glycoside-modifying enzyme, chloramphenicol, kanamycin, and trimethoprim were detected in 67.3%, 57.1%, 26.5%, 8.1%, 8.1%, 5%, 2.0%, and 0% of isolates, respectively. Overall 28 isolates (57.1%) possessed two or more antibiotic resistance genes. Class 1 integron carrying multidrug resistace genes, ant(3")-IaB, blaPSE, qacE delta1/sul, and tet G were amplified especially in only DT104 isolates. Among the related resistance genes for same antibiotics, strA and strB for streptomycin resistance were simultaneously detected but tetA and tetB for tetracycline were sporadically detected. DT 104 isolates contained only aadA2 and tetG.

Distribution of Pathogenic Genes and Molecular Typing of Yersinia pseudotuberculosis Isolated from Spring Water in Seoul

In order to investigate pathogenic genes and genetic relationships of Y. pseudotuberculosis strains, We isolated 9 strains of Y. pseudotuberculosis from 380 spring water sites in Seoul from 2000 to 2003. All isolates were distributed to the northeast area in Seoul. The isloates were analyzed for chromosomal virulence gene (inv) and plasmid-borne genes (yadA and lcrF) using PCR to assume pathogenicity. As a result, all isolates were positive for the inv gene, but only five isolates (55.6%) were positive for the yadA and lcrF genes. RAPD and PCR-ribotyping were tested and all isolates were grouped with 90% similarity. RAPD revealed 4 clusters and PCR-ribotyping revealed 2 clusters. The result of this experiments confirmed the view that RAPD had better powerful discrimination than PCR-ribotyping and RAPD typing was effective to distinguish between various strains of Y. pseudotuberculosis from spring water.

Profile of Virulence Genes and Rep-PCR Genomic Fingerprinting on Escherichia coli Strains Isolated from Patients with Urinary Tract Infection

The profile of virulence genes and repetitive element sequence-based PCR (rep-PCR) genomic fingerprinting were determined on Escherichia coli strains isolated from patients with urinary tract infection to investigate genetic relatedness and its identification. Thirty nine strains of E. coli were examined genotypically by using the multiplex polymerase chain reaction for the presence of five urovirulence genes; pyelonephritis-associated pili (pap), S. fimbriae (sfa), afimbrial adhesin (afa), cytotoxic necrotizing factor (cnf ), and a-hemolysin (hly). As a result, genotype pap+sfa-afa-cnf -hly- was the most dominant (14 strains: 36%). But no urovirulence-genes were detected in 12 strains (31%). On the basis of rep-PCR, the dendrograms generated from REP-PCR and ERIC-PCR revealed that uropathogenic E. coli strains were clustered into non-uropathogenic E. coli ATCC 43894 O157:H7 with the degree of similarity 37% and 44%, respectively. On the contrary, BOX-PCR results showed that uropathogenic E. coli strains differed from non-uropathogenic E. coli ATCC 43894 O157:H7 with the degree of similarity 37%. According to these findings, REP-PCR and ERIC-PCR were unable to discriminate reliably uropathogenic E. coli from non-uropathogenic E. coli. However, BOX-PCR provided an effective mean of differentiating E. coli strains between uropathogenic and non-uropathogenic.

Detection of Virulence Genes in Uropathogenic Escherichia coli by Multiplex Polymerase Chain Reaction(PCR) : Comparison with Clinical Characteristics / 대한신장학회잡지

BACKGROUND: We identified virulence genes in uropathogenic E. coli isolates and studied the association between virulence gene and clinical characteristics in order to predict the severity and recurrency. METHODS: 39 Escherichia coli strains from patients with urinary tract infection were clinically and genotypically characterized. The strains were examined genotypically by using the multiplex polymerase chain reaction for presence of 5 urovirulence genes : pyelonephritis-associated pili(pap), S. fimbriae(sfa), afimbrial adhesin(afa), cytotoxic necrotizing factor (cnf), and alpha-hemolysin(hly). The patient's clinical characteristics were determined retrospectively. RESULTS: 17 pap(+), 4 sfa(+), 7 afa(+), 6 cnf(+), and 8 hly(+) strains were identified. And there were 10 genotypes. Among them, genotype pap(+)sfa(-)afa(-)cnf(-) hly(-) was most dominant(36%). But no urovirulence gene was detected in 12 strains(31%). When the data was analyzed, it was apparent that an association among various urovirulence genes exists. sfa gene was frequently associated with cnf gene(p < 0.001). And afa gene was associated cnf and hly gene(p= 0.026, <0.001). An association between cnf gene and hly gene was observed(p=0.002). Positive rates of virulence genes were not different between male and female. In infancy, pap(-)sfa(-)afa(+)cnf(+)hly(+) genotype was dominant. In 2-15 years old age group, pap(-) sfa(-)afa(-)cnf(-)hly(-) genotype was dominant. And in 16- 40 years old age group, pap(+)sfa(-)afa(-)cnf(-)hly(-) was dominant. So, some virulence genotype might be associated with specific age group. Presence of virulence gene or specific genotype was not different among diseases(acute pyelonephritis, cystitis, asymptomatic bacteriuria). So, virulence genes were not associated with severity of urinary tract infection. Virulence genes were not associated with susceptibility of recurrent infection. In neurogenic bladder patients, there were significantly more sfa(+) strains (p=0.019). And all isolates of neurogenic bladder patients were genotype pap(+)sfa(+)afa(-)cnf(+)hly(-)(p < 0.001). CONCLUSION: In this study, We found which genotype is most dominant in uropathogenic Escherichia coli, and that virulence genes do not suggest severity or recurrency of urinary tract infection. In neurogenic bladder patients, some virulence genes were more prevalent.

Evaluation of rep-PCR Genomic Fingerprinting for the Molecular Systematics Study of Yersinia Species

No abstract available.

Identification and Molecular Taxonomy of Bacillus anthracis Based on Amplified Frgment Length Polymorphism

No abstract available.

Sequence Analysis of the VP4 Gene of Rotavirus Isolated from an Infant in Korea

No abstract available.

Typing and Sequence Analysis of the VP7 Gene of Rotavirus Isolated from Infants in Korea

No Abstract Available.

Identification and Molecular Evolution of Baillus anthracis Based on PEP - PCR Genomic Fingerprinting and Amplified Fragment Length Polymorphism

No Abstract Available.

Identification and Molecular Evolution of Baillus anthracis Based on PEP - PCR Genomic Fingerprinting and Amplified Fragment Length Polymorphism

No Abstract Available.

Analysis of cellular fatty acid methyl esters (FAMEs) for the identification of Bacillus anthracis

Bacillus anthracis, the etiological agent of anthrax has been classified into the Bacillus subgroup I with B. cereus, B. mycoides and B. thuringiensis based on morphological and DNA similarity. DNA studies have further indicated that these species have very AT-rich genomes and high homology, indeed it has been proposed that these four sub-species be recognized as members of the one species. Several methods have been developed to obtain good differentiation between these species. However, none of these methods provides the means for an absolutely correct differntiation. The analysis of fatty acid methyl esters (FAMEs) was employed as a quick, simple and reliable method for the identification of 21 B. anthracis strains and closley related strains. The most significant differences were found between B. anthracis and B. anthracis closely related strains in FAMEs profiles. All tested strains of B. anthracis had a branched fatty acid C17:1 Anteiso A, whereas the fraction of unsaturated fatty acid Iso C17:1 w10c was found in B. anthracis closely related strains. By UPGMA clustering analysis of FAMEs profiles, all of the tested strains were classified into two clusters defined at Euclidian distance value of 24.5. The tested strains of B. anthracis were clustered together including Bacillus sp. Kyungjoo 3. However, the isolates of B. anthracis closely related spp. Rho, S10A, 11R1, CAU9910, CAU9911, CAU9912 and CAU9913 were clustered with the other group. On the basis of these results, isolates of B. anthracis Bongchon, Kyungjoo 1, 2 and Bacillus sp. Kyungjoo 3 were reclassified as a B. anthracis. It is concluded that FAMEs analysis provides a sensitive and reliable method for the identification of B. anthracis from closely related taxa.