Clinical Characteristics of Pediatric Patients with Candidemia / 대한임상미생물학회지

BACKGROUND: The incidence of candidemia in paediatric patients has increased over the last decade. We analysed the clinical characteristics of pediatric patients with candidemia over a 3-year period in Chonnam National University Hospital. METHODS: The medical records of 28 patients with candidemia diagnosed between 1996 and 1998 were retrospectively reviewed. Clinical characteristics including underlying illness, risk factors, therapy and outcome were assessed in relation to causing Candida species. RESULTS: The causing agents were mainly non-C. albicans species (24/28 cases, 81.5%). Underlying illnesses of patients were malignancy (n=12), surgical diseases (n=4), prematurity (n=2), and other medical illnesses of (n=10). Studies on clinical status at positive culture revealed antibiotic exposure (28/28, 100%), placement of central venous catheter (CVC, 16/28, 57.1%), use of total parenteral nutrition (15/28, 53.6%), and chemotherapy (14/28, 50%). Twenty patients were treated with amphotericin B and/or fluconazole and 15 patients'CVCs were removed. Overall mortality due to candidemia was 25%(7/28). CONCLUSIONS: These data show that most of pediatric candidemia cases are caused by non-C. albicans species and associated with a relatively lower mortality rate

Evaluation of Genedia HCV Rapid for Rapid Detection of Antibody to Hepatitis C Virus / 대한임상병리학회지

BACKGROUND: Hepatitis C virus (HCV) is a major agent of transfusion-associated non-A, non-B hepatitis. The best method for prevention of HCV infection through transfusion is blood donor screening using reliable diagnostic tools. Enzyme immunoassays (EIA) for detection of HCV antibody were developed, but it required equipment and time consuming. In emergency situation such as massive bleeding, HCV screening of blood donor needs more simple, rapid and reliable method. Recently, for rapid detection of HCV antibody, Genedia HCV Rapid assay was developed. To evaluate the usefulness of this assay, comparative studies with third generation anti- HCV EIA and two HCV confirmatory tests (Genedia HCV Confirm 4.0 and Chiron RIBA HCV 3.0 SIA) were performed. METHODS: A total of 156 sera (106 positive and 50 negative), screened by second generation IMx anti-HCV assay (Abbott 2.0; Abbott Laboratories, U.S.A.), were examined with Genedia HCV Rapid (Green Cross, Korea) and Genedia HCV ELISA 3.0 (Green Cross, Korea). The discrepant sera between Genedia HCV Rapid and Genedia HCV ELISA 3.0 were confirmed by both Genedia HCV Confirm 4.0 and Chiron RIBA HCV 3.0 SIA. RESULTS: The concordance rates of Abbott 2.0 vs Genedia HCV Rapid, Abbott 2.0 vs Genedia HCV ELISA 3.0, and Genedia HCV Rapid vs Genedia HCV ELISA 3.0 were 88.4%, 89.7%, and 96.1%, respectively. The sensitivity, specificity, positive predictive value and negative predictive value of Genedia HCV Rapid for Genedia HCV Confirm 4.0 were 97.7%, 100%, 98.9%, and 97.0%, respectively, and for Chiron RIBA HCV 3.0 SIA 97.8%, 98.5%, 98.9%, and 97.0%, respectively. Of discrepant 6 sera between Genedia HCV Rapid and Genedia HCV ELISA 3.0, 2 were positive by Genedia HCV Confirm 4.0, and 3 positive by Chiron RIBA HCV 3.0 SIA. However, 14 negative sera by both Genedia HCV rapid and Genedia HCV ELISA 3.0, which were all positive by Abbott 2.0, were all negative by two confirmatory tests. CONCLUSIONS: These data show that Genedia HCV Rapid could be used in emergency blood donor screening for HCV antibody detection.

Use of blood components, irradiated and filtered blood products in Chonnam University Hospital / 대한수혈학회지

BACGROUND: Recently, transfusion by component blood products instead of whole blood has gradually increased. And also filtered and/or irradiated blood products for the prevention of GVHD and other transfusion reaction has been used. To probe trends of recent transfusion, we analysed the use of blood components from 1989 through 1996 in Chonnam University Hospital. METHODS: We reviewed blood bank records from 1989 through 1996 in Chonnam University Hospital. RESULTS: 1. Total numbers of transfused blood units from 1989 to 1996 were 369,326 and the rate of component transfusion increased from 24.5% (1989) to 99.6% (1996) in Chonnam University Hospital. 2. Total numbers of transfused whole bloods were 5,569 units (24.5%) in 1989, then declined to 327 units (0.5%) in 1996. 3. Transfusion of PRC increased from 9,325 units (41.1%) in 1989 to 24,368 units (35.8%) in 1996, and also FFP from 7,371 units (32.4%) in 1989 to 15,546 units (22.9%) in 1996. 4. Use of platelet concentrates increased 16.4-fold from 2,223 units (2.5%) in 1989 to 36,531 units (46.8%) in 1996. 5. In 1996, percentage of filtered and irradiated blood products was 32.3% from cellular blood products. 6. With the use of the advanced blood seperator, hemapheresis showed slight increase annually. CONCLUSION: This paper will provide the basis of blood supply in Chonnam University Hospital and blood center.

Hematological Recovery of Post-Donated Donors after Plateletpheresis / 대한임상병리학회지

BACKGROUND: To prevent the platelet refractoriness, repeated plateletpheresis is often required in HLA matched single-donors. Korean Transfusion Standard permits the repeated plateletpheresis of a single donor at 72-hour intervals. To evaluate this standard, hematological responses of donors were assessed after plateletpheresis by Haemonetics V50 (Haemonetics Co., USA). METHODS: The pre- and post-donated hematological indices of 22 healthy donors(17 males and 5 females) were evaluated. Single donated donors were 12 males and 4 females. Multiple donated donors were 5 males and one female. Post-donated platelet counts were measured immediately, 6 hours, 12 hours, 1 day, 3 days, 5 days, 7 days and 9 days after plateletpheresis. Platelet aggregation test, serum protein, PT, and aPTT were also examined before and after platelet collection. RESULTS: Only 9 (56.2%) of 16 single-donated donors and 4 (66.7%) of 6 multiple donated donors showed normal restoration up to 97% of platelet counts of pre-donation levels at the day 3. In 9 (75%) of 12 single donated males restoration of platelet count was observed within 3 days, but 3 (75%) of 4 single donated females showed restoration of platelet count within 5 days. Changes of other indices were not significantly different between the pre- and post-donations of platelet. CONCLUSIONS: Although no clinical complication was noted after plateletpheresis, these data suggested that Korean Transfusion Standard on plateletpheresis should be reconsidered.