Solitary Brain Metastasis Detected 1 Year After Robot-Assisted Laparoscopic Radical Nephrectomy: A Case Report

Brain metastases are not rare in patients with renal cell carcinoma. However, there have been few reports of isolated brain metastases. In patients with localized renal masses, urologists tend to evaluate only the chest and abdomen region. We report the case of a 65-year-old patient who presented with sudden left-sided weakness. He underwent brain surgery after a mass was found on brain imaging. Histopathology analysis revealed a single brain metastasis that occurred 15 months after robot-assisted laparoscopic radical nephrectomy for renal cell carcinoma. Although the patient had been evaluated for localized kidney cancer in preoperative staging, he had not complained of any neurological symptoms before or after radical nephrectomy. Therefore, we had not perceived a need for brain evaluation at that time. This report is intended to draw attention to the need for further evaluation in patients with large renal masses, as well as patients with moderate to high recurrence risk scores.

Preputial Stones as a Rare Complication of Buried Penis: A Case Report

Preputial calculi are a very rare manifestation of urolithiasis that occur most often in uncircumcised elderly males with poor hygiene and low socioeconomic status. Here, we present a case of preputial calculi in a 13-year-old boy with a buried penis. No penile shaft was observed and hard materials palpated around the penile foreskin. Imaging examinations showed several stones around the penis and surgical correction was indicated. The stones were removed and a circumferential incision along the coronal edge allowed for degloving with rotated skin flaps. Surgical removal of the stones and reconstruction was performed to promote hygiene and prevent future infection.

Preputial Stones as a Rare Complication of Buried Penis: A Case Report

Preputial calculi are a very rare manifestation of urolithiasis that occur most often in uncircumcised elderly males with poor hygiene and low socioeconomic status. Here, we present a case of preputial calculi in a 13-year-old boy with a buried penis. No penile shaft was observed and hard materials palpated around the penile foreskin. Imaging examinations showed several stones around the penis and surgical correction was indicated. The stones were removed and a circumferential incision along the coronal edge allowed for degloving with rotated skin flaps. Surgical removal of the stones and reconstruction was performed to promote hygiene and prevent future infection.

Comparative Evaluation of the STANDARD F Influenza A/B FIA Test with the Sofia Influenza A+B FIA and SD BIOLINE Influenza Ag A/B/A(H1N1) tests for Influenza A Virus Detection / 대한임상미생물학회지

Background@#This study aimed to evaluate the diagnostic performance of the STANDARD F Influenza A/B FIA test (SD Biosensor Inc., Korea) for the rapid detection of influenza A virus in comparison with the Sofia Influenza A+B FIA (Quidel Corp., USA) and SD BIOLINE Influenza Ag A/B/A(H1N1) (Standard Diagnostic, Inc., Korea) tests. @*Methods@#A total of 227 non-duplicated nasopharyngeal aspirates submitted for real-time RT-PCR analysis were included in the study. We used the three commercial tests in remnant samples from routine assays, according to the manufacturer’s instructions. We analyzed the diagnostic performance, including sensitivity and specificity, of the three tests. @*Results@#Real-time RT-PCR analysis showed that 67 (29.5%) samples were positive and 160 (70.5%) were negative for influenza A virus, and that all the specimens were negative for influenza B. The overall sensitivity and specificity for influenza A virus detection were 50.7% and 100% for the STANDARD F, 50.7% and 100% for the Sofia, and 29.9% and 100% for the SD BIOLINE tests, respectively. The STANDARD F and SD BIOLINE tests showed negative results for influenza B virus in all specimens, whereas the Sofia test showed two false-positive results. @*Conclusion@#The STANDARD F Influenza A/B test showed a good diagnostic performance and may be useful for the rapid diagnosis of influenza A.

Antibiotic Treatment of Vertebral Osteomyelitis caused by Methicillin-Susceptible Staphylococcus aureus: A Focus on the Use of Oral β-lactams

BACKGROUND@#Vertebral osteomyelitis (VO) is a rare but serious condition, and a potentially significant cause of morbidity. Methicillin-susceptible Staphylococcus aureus (MSSA) is the most common microorganism in native VO. Long-term administration of parenteral and oral antibiotics with good bioavailability and bone penetration is required for therapy. Use of oral β-lactams against staphylococcal bone and joint infections in adults is not generally recommended, but some experts recommend oral switching with β-lactams. This study aimed to describe the current status of antibiotic therapy and treatment outcomes of oral switching with β-lactams in patients with MSSA VO, and to assess risk factors for treatment failure.@*MATERIALS AND METHODS@#This retrospective study included adult patients with MSSA VO treated at nine university hospitals in Korea between 2005 and 2014. Treatment failure was defined as infection-related death, microbiological relapse, neurologic deficits, or unplanned surgical procedures. Clinical characteristics and antibiotic therapy in the treatment success and treatment failure groups were compared. Risk factors for treatment failure were identified using the Cox proportional hazards model.@*RESULTS@#A total of 100 patients with MSSA VO were included. All patients were treated, initially or during antibiotic therapy, with one or more parenteral antibiotics. Sixty-nine patients received one or more oral antibiotics. Antibiotic regimens were diverse and durations of parenteral and oral therapy differed, depending on the patient and the hospital. Forty-two patients were treated with parenteral and/or oral β-lactams for a total duration of more than 2 weeks. Compared with patients receiving parenteral β-lactams only, no significant difference in success rates was observed in patients who received oral β-lactams for a relatively long period. Sixteen patients had treatment failure. Old age (adjusted hazard ratio [HR] 5.600, 95% confidence interval [CI] 1.402 – 22.372, P = 0.015) and failure to improve C-reactive protein levels at follow-up (adjusted HR 3.388, 95% CI 1.168 – 9.829, P = 0.025) were independent risk factors for treatment failure.@*CONCLUSION@#In the study hospitals, diverse combinations of antibiotics and differing durations of parenteral and oral therapy were used. Based on the findings of this study, we think that switching to oral β-lactams may be safe in certain adult patients with MSSA VO. Since limited data are available on the efficacy of oral antibiotics for treatment of staphylococcal VO in adults, further evaluation of the role of oral switch therapy with β-lactams is needed.

Clinical Characteristics and Antimicrobial Susceptibility Trends in Citrobacter Bacteremia: An 11-Year Single-Center Experience

BACKGROUND@#Recently, Citrobacter freundii bacteremia outbreak in a neonatal intensive care unit has attracted public attention in Korea. However, Citrobacter bacteremia is uncommon and usually occurs in patients with underlying diseases such as malignancy and hepatobiliary diseases. Increase in resistance and emerging of multidrug resistance among Citrobacter species have gradually been reported. The aim of this study was to investigate the clinical characteristics and outcome of C. freundii and non-freundii bacteremia and antimicrobial susceptibility trends.@*MATERIALS AND METHODS@#We reviewed the medical records of patients with Citrobacter bacteremia at St. Mary's Hospital, from 2007 to 2017.@*RESULTS@#A total of 43 patients with a median age of 72 (24-93) years was identified and 90.7% of them had comorbidities. Twenty-nine (67.4%) patients had C. freundii bacteremia while 14 had non-freundii bacteremia (six of C. braakii, five of C. koseri, two of C. amalonaticus and one of C. youngae). A total of 26 (51.2%) patients had community-acquired infection and intra-abdominal infection including hepatobiliary tract was the most common portal of entry (24/43, 55.8%). Moreover, hepatobiliary tract was the leading primary site of nosocomial infection (9/17, 52.9%). Polymicrobial bacteremia was observed in 21 (48.8%) patients. The percentages of Citrobacter species susceptible to ampicillin, amikacin, aztreonam, cefazolin, cefoxitin, cefotaxime, cefepime, piperacillin-tazobactam, ciprofloxacin, and imipenem were 9.5%, 97.6%, 73.8%, 9.5%, 14.3%, 71.4%, 92.9%, 83.3%, 83.3% and 100%, respectively. The resistance rate did not increase during the study period. Of 39 patients treated with antibiotics, 36 (92.3%) received appropriate empirical antibiotics. Overall mortality was 18.6%. High Charlson comorbidity index and Pitt bacteremia score were significant risk factors for death in univariate analysis and showed trends in the multivariate analysis. No significant difference in clinical features and antimicrobial susceptibility rate was observed between C. freundii and non-freundii bacteremia.@*CONCLUSION@#Citrobacter bacteremia was predominant in the elderly with comorbidities, while no pediatric case was observed. Hepatobiliary tract is the leading primary focus of bacteremia both in community-acquired and nosocomial infection. The rate of susceptibility to antibiotics has not changed in the last 11 years.

Clinical and Laboratory Predictors associated with Complicated Scrub Typhus

BACKGROUND@#Scrub typhus, a mite-borne disease caused by bites of Orientia tsutsugamushi-infected chiggers, is endemic in Asia-Pacific countries. In Korea, it is a seasonal disease prevalent in autumn and one of the important causes of acute undifferentiated febrile illness. The purpose of this study was to identify the risk factors for the prediction of the severe clinical course of scrub typhus and to investigate the differences in the clinical and laboratory findings of hospitalized elderly and non-elderly patients with scrub typhus.@*MATERIALS AND METHODS@#This study retrospectively reviewed the medical records of patients diagnosed with scrub typhus.@*RESULTS@#A total of 710 patients were enrolled and 43.9% of them were elderly patients. The number of patients with complicated scrub typhus was 168 (23.7%) and the most common complication of severe scrub typhus was hepatic dysfunction (10.7%) followed by pneumonia (7.2%), acute kidney injury (4.9%) and shock (2.4%). Blood urea nitrogen ≥20 mg/dL, adenosine deaminase (ADA) ≥100 IU/L, pulmonary edema or pleural effusion, lactate dehydrogenase ≥500 U/L, alkaline phosphatase ≥400 IU/L, ferritin ≥500 ng/mL and absence of skin rash were independently associated with severe scrub typhus. There was no significant difference in the incidence of complicated scrub typhus between elderly and non-elderly patients. Absence of skin rash, pulmonary edema, pleural effusion, serum creatinine ≥1.5 mg/dL, total bilirubin ≥1.5 mg/dL, ADA ≥100 IU/L and ferritin ≥500 ng/mL were significantly associated with a longer hospitalization (≥10 days).@*CONCLUSION@#The several independent predictors of complicated scrub typhus were identified in this study. Absence of skin rash, the increased levels of serum ADA and ferritin were identified as the predictors of complicated scrub typhus, which were also associated with a prolonged hospitalization.

Erratum: Carbapenem-Resistant Enterobacteriaceae: Prevalence and Risk Factors in a Single Community-Based Hospital in Korea

The authors found errors in their published article.

Development and Evaluation of Multiplex PCR for the Detection of Carbapenemase-Producing Enterobacteriaceae / 대한임상미생물학회지

BACKGROUND: The isolation of carbapenemase-producing Enterobacteriaceae (CPE) has become increasingly common. Continuous surveillance for these organisms is essential because their infections are closely related to outbreaks of illness and are associated with high mortality rates. The aim of this study was to develop and evaluate multiplex PCR as a means of detecting several important CPE genes simultaneously. METHODS: We aimed to develop a multiplex PCR that could detect seven CPE genes simultaneously. The multiplex PCR was composed of seven primer sets for the detection of KPC, IMP, VIM, NDM-1, GES, OXA-23, and OXA-48. We designed different PCR product sizes of at least 100 bp. We evaluated the performance of this new test using 69 CPE-positive clinical isolates. Also, we confirmed the specificity to rule out false-positive reactions by using 71 carbapenem-susceptible clinical strains. RESULTS: A total of 69 CPE clinical isolates showed positive results and were correctly identified as KPC (N=14), IMP (N=13), OXA-23 (N=12), OXA-48 (N=11), VIM (N=9), GES (N=5), and NDM (N=5) by the multiplex PCR. All 71 carbapenem-susceptible clinical isolates, including Enterococcus faecalis , Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii, and Pseudomonas aeruginosa, showed negative results. CONCLUSION: This multiplex PCR can detect seven CPE genes at a time and will be useful in clinical laboratories.

Serotype Distribution and Antimicrobial Resistance of Invasive and Noninvasive Streptococcus pneumoniae Isolates in Korea between 2014 and 2016

BACKGROUND: Several factors contribute to differences in Streptococcus pneumoniae serotype distribution. We investigated the serotype distribution and antimicrobial resistance of S. pneumoniae isolated between 2014 and 2016 in Korea. METHODS: We collected a total of 1,855 S. pneumoniae isolates from 44 hospitals between May 2014 and May 2016, and analyzed the serotypes by sequential multiplex PCR. We investigated the distribution of each serotype by patient age, source of the clinical specimen, and antimicrobial resistance pattern. RESULTS: The most common serotypes were 11A (10.1%), followed by 19A (8.8%), 3 (8.5%), 34 (8.1%), 23A (7.3%), and 35B (6.2%). The major invasive serotypes were 3 (12.6%), 19A (7.8%), 34 (7.8%), 10A (6.8%), and 11A (6.8%). Serotypes 10A, 15B, 19A, and 12F were more common in patients ≤5 years old, while serotype 3 was more common in patients ≥65 years old compared with the other age groups. The coverage rates of pneumococcal conjugate vaccine (PCV)7, PCV10, PCV13, and pneumococcal polysaccharide vaccine 23 were 11.8%, 12.12%, 33.3%, and 53.6%, respectively. Of the 1,855 isolates, 857 (46.2%) were multi-drug resistant (MDR), with serotypes 11A and 19A predominant among the MDR strains. The resistance rates against penicillin, cefotaxime, and levofloxacin were 22.8%, 12.5%, and 9.4%, respectively. CONCLUSIONS: There were significant changes in the major S. pneumoniae serotypes in the community. Non-PCV13 serotypes increased in patients ≤5 years old following the introduction of national immunization programs with the 10- and 13-polyvalent vaccines.

Serotyping and Antimicrobial Susceptibility of Salmonella Isolated in Korea in 2015 / 대한임상미생물학회지

BACKGROUND: Salmonella is an important pathogen that causes gastroenteritis and sepsis in humans. Recently, changes in serotype prevalence and an increase in antimicrobial resistance have been reported. This study investigated the distribution of Salmonella serotypes and determined the antimicrobial susceptibility of various strains. METHODS: We collected 113 Salmonella isolates other than Salmonella serotype Typhi from 18 university hospitals in 2015. The serotypes were identified by Salmonella antisera O and H according to the Kauffman White scheme. Antimicrobial susceptibility tests for 12 antibiotics were performed using the disk diffusion method or E-test. RESULTS: We identified 22 serotypes. Serotype group B (44.2%) was the most common, followed by groups C (34.5%) and D (21.2%). Salmonella I 4,[5],12:i:- (23.0%), S. Enteritidis (16.8%), and S. Typhimurium (12.4%) were the most common species. Resistance rates for ampicillin, chloramphenicol, ceftriaxone, and trimethoprim/sulfamethoxazole were 46.9%, 18.5%, 8.8%, and 5.3%, respectively. The intermediate resistance rate to ciprofloxacin was 29.2%. Six isolates were extended-spectrum β-lactamase (ESBL) producers, including 5 bla(CTX-M-15) and 1 bla(CTX-M-55). CONCLUSION: There have been changes in the serotype prevalence and antimicrobial resistance of Salmonella in Korea, with a high prevalence of CTX-M 15-positive strains. Continuous monitoring of Salmonella serotypes and antimicrobial resistance is warranted.

Point-of-Care Diagnostics for Infectious Diseases: Present and Future / 대한내과학회지

No abstract available.

Implementation of Hospital Policy for Healthcare Workers and Patients Exposed to Varicella-Zoster Virus

Varicella-zoster virus (VZV) causes a highly contagious and generally benign, self-limited disease. However, in high-risk populations including immunocompromised patients, pregnant women, and neonates, VZV infection can be associated with significant morbidity and mortality. Healthcare-associated transmission of VZV occurs among healthcare workers (HCWs) and patients by airborne transmission or by direct contact with the index case. To minimize the risk of transmission in healthcare settings, all VZV-susceptible HCWs should be encouraged strongly to be immunized with the varicella vaccine. For post-exposure management, active immunization (varicella vaccine), passive immunization (varicella-zoster immune globulin) and/or antiviral agents, and isolation could be used in specific situations. To prevent the transmission of VZV infection in the hospital settings, the development and implementation of hospital policies for appropriate infection control is also warranted. This article reviews the general information and healthcare-associated transmission of VZV and summarizes the recommendations for the pre- and post-exposure management of HCWs and patients, in hospital settings.

Lower Respiratory Tract Diseases Caused by Common Respiratory Viruses among Stem Cell Transplantation Recipients: A Single Center Experience in Korea

PURPOSE: To describe the incidence, clinical courses, and risk factors for mortality of lower respiratory tract diseases (LRDs) caused by common respiratory viruses (CRVs) in stem cell transplantation (SCT) recipients. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 1038 patients who received SCT between January 2007 and August 2011 at a single center in Korea. RESULTS: Seventy-one CRV-LRDs were identified in 67 (6.5%) patients. The human parainfluenza virus (HPIV) was the most common causative pathogen of CRV-LRDs at 100 days [cumulative incidence estimate, 23.5%; 95% confidence interval (CI), 3.3–43.7] and 1 year (cumulative incidence estimate, 69.2%; 95% CI, 45.9–92.5) following SCT. The 30-day overall mortality rates due to influenza-LRDs, respiratory syncytial virus-LRDs, HPIV-LRDs, and human rhinovirus-LRDs were 35.7, 25.8, 31.6, and 42.8%, respectively. Co-pathogens in respiratory specimens were detected in 23 (33.8%) patients. The overall mortality at day 30 after CRV-LRD diagnosis was 32.8% (22/67). High-dose steroid usage (p=0.025), a severe state of immunodeficiency (p=0.033), and lymphopenia (p=0.006) were significantly associated with death within 30 days following CRV-LRD diagnosis in a univariate analysis. Multivariate logistic regression analysis revealed that high-dose steroid usage [odds ratio (OR), 4.05; 95% CI, 1.12–14.61; p=0.033] and lymphopenia (OR, 6.57; 95% CI, 1.80–24.03; p=0.004) were independent risk factors for mortality within 30 days of CRV-LRDs. CONCLUSION: CRV-LRDs among SCT recipients showed substantially high morbidity and mortality rates. Therefore, the implement of an active diagnostic approaches for CRV infections is required for SCT recipients with respiratory symptoms, especially those receiving high-dose steroids or with lymphopenia.

Distribution and Antimicrobial Resistance of Streptococcus pneumoniae at Four University Hospitals in Busan and Gyeongnam / 대한임상미생물학회지

BACKGROUND: Streptococcus pneumoniae is the most common human pathogen causing community-acquired pneumonia. There is little information on the recent antimicrobial susceptibility patterns of S. pneumoniae in Busan and Gyeongnam of Korea. The aim of this study was to investigate the distribution and antimicrobial resistance of S. pneumoniae at 4 university hospitals in Busan and Gyeongnam. METHODS: We collected and analyzed the antimicrobial susceptibility results of 850 S. pneumoniae strains isolated from regional 4 university hospitals during the last 2 years from July 2013 through June 2015. RESULTS: Among 850 S. pneumoniae strains, 635 strains were isolated from respiratory specimens, followed by blood (N=121), CSF (N=13), and others (N=81). Antimicrobial susceptibility rates to penicillin, cefotaxime and ceftriaxone were 79.4%, 76.6% and 83.6%, respectively. The resistant rates to erythromycin and clindamycin were 80.9% and 68.2%, respectively. The resistant rates to levofloxacin were 9.2%. There were some differences in resistant rates by age groups, years, and specimen types. CONCLUSION: We found the changes of antimicrobial resistance of S. pneumoniae during the last 2 years. It is necessary to monitor the antimicrobial susceptibility of S. pneumoniae regularly for empirical therapy and for early detection of the changes of resistance.

Carbapenem-resistant Enterobacteriaceae: Prevalence and Risk Factors in a Single Community-Based Hospital in Korea

BACKGROUND: Carbapenemase-producing Enterobacteriaceae (CPE) are Gram-negative bacteria with increasing prevalence of infection worldwide. In Korea, 25 cases of CPE isolates were reported by the Korea Centers for Disease Control and Prevention in 2011. Most CPE cases were detected mainly at tertiary referral hospitals. We analyzed the prevalence and risk factors for carbapenem-resistant Enterobacteriaceae (CRE) in a mid-sized community-based hospital in Korea. MATERIALS AND METHODS: We retrospectively analyzed all consecutive episodes of Enterobacteriaceae in a mid-sized community-based hospital from January 2013 to February 2014. CRE was defined as organisms of Enterobacteriaceae showing decreased susceptibility to carbapenems. Risk factors for CRE were evaluated by a case–double control design. Carbapenemase was confirmed for CRE using a combined disc test. RESULTS: During 229,710 patient-days, 2,510 Enterobacteriaceae isolates were obtained. A total of 41 (1.6%) CRE isolates were enrolled in the study period. Thirteen species (31.7%) were Enterobacter aerogenes, 8 (19.5%) Klebsiella pneumoniae, 5 (12.2%) Enterobacter cloacae, and 15 other species of Enterobacteriaceae, respectively. Among the 41 isolates, only one (2.4%) E. aerogenes isolate belonged to CPE. For evaluation of risk factors, a total of 111 patients were enrolled and this included 37 patients in the CRE group, 37 in control group I (identical species), and 37 in control group II (different species). Based on multivariate analysis, regularly visiting the outpatient clinic was a risk factor for CRE acquisition in the control group I (P = 0.003), while vascular catheter and Charlson comorbidity index score ≥ 3 were risk factors in control group II (P = 0.010 and 0.011, each). Patients with CRE were more likely to experience a reduced level of consciousness, use a vasopressor, be under intensive care, and suffer from acute kidney injury. However, CRE was not an independent predictor of mortality compared with both control groups. CONCLUSION: In conclusion, the prevalence of CRE was higher than expected in a mid-sized community-based hospital in Korea. CRE should be considered when patients have a vascular catheter, high comorbidity score, and regular visits to the outpatient clinic. This study suggests the need for appropriate prevention efforts and constant attention to CRE infection control in a mid-sized community-based hospital.

Comparison of the Clinical Performance of Binax NOW RSV Versus Multiplex RT-PCR for Detection of Respiratory Syncytial Virus

BACKGROUND: Respiratory syncytial virus (RSV) is one of the most important causes of lower respiratory tract infection. The rapid antigen test is a simple, cheap, and quick method for RSV detection, however, it has an acknowledged low sensitivity. The aim of this study is to evaluate the diagnostic performance of the rapid antigen test by comparing it with a multiplex reverse transcription-PCR (RT-PCR). METHODS: A total of 557 nasopharyngeal aspirates or swabs that were submitted for both a rapid antigen test, Binax NOW RSV (Binax; Alere Scarborough, Inc., USA) and multiplex RT-PCR, Seeplex RV7 (Seegene Inc., Korea) were included in this study. We performed both tests according to the manufacturer's recommendations and analyzed the diagnostic performances of a rapid antigen tests based on the results of multiplex RT-PCR. RESULTS: Among the 557 specimens, the positive rates determined from the rapid antigen test and multiplex RT-PCR were 12.2% (N=68) and 25.1% (N=140), respectively. The relative sensitivity and specificity of the rapid antigen test were 46.4% and 99.3% based on the multiplex RT-PCR, respectively. Positive and negative predictive values were 95.6% and 84.7%, respectively. The diagnostic sensitivity was lower (28.6%) in children >36 months compared with children < or =36 months of age. Test sensitivity declined when RSV infection was accompanied by infection with other respiratory viruses. CONCLUSIONS: Binax NOW RSV exhibited good diagnostic performance, easy handling, and rapidity. However, it does have the possibility of false-negative results, and additional tests are needed when there is clinical suspicion of RSV infection.

A Nationwide Multicenter Survey for Mycobacterial Testing in Korea / 대한임상미생물학회지

BACKGROUND: There have been steady changes and improvements in diagnostic tests for Mycobacterium tuberculosis, so it is necessary to carry out periodic surveys to understand the current situation. The aims of this study were to investigate the changes in principal practices and quality control for M. tuberculosis using a nationwide survey in the Republic of Korea. METHODS: We constructed a questionnaire composed of four subseries with 42 items. We e-mailed this survey to members of the Korean Society of Clinical Microbiology from April to September 2014 and analyzed the replies. RESULTS: Employees at a total of 65 hospital laboratories and 5 commercial laboratories participated in the survey. AFB staining was reportedly performed in all 70 institutions, and fluorescent staining was used as the primary detection method in 59 (84.3%) laboratories. Solid and liquid culture methods for Mycobacterium were performed at 62 (88.6%) and 59 (84.3%) laboratories, respectively. There were 57 laboratories (90.5%) that identified strains growing on primary culture media using a rapid antigen kit or molecular method. The mean values of positive and contamination rates for solid culture media were 8.2% (range 3.7-19.9%) and 4.0% (0.4-8.4%), respectively. In liquid culture, the mean values of positive and contamination rates were 11.5% (4.8-22.3%) and 6.8% (0.3-18.7%), respectively. CONCLUSION: There have been significant changes and improvements in overall mycobacterial testing, especially in the numbers of laboratories using fluorescent staining, liquid culture, and identification of M. tuberculosis cultured media compared with previous surveys in Korea.

Clinical Usefulness of Routine Use of Anaerobic Blood Culture Bottle / 대한임상미생물학회지

BACKGROUND: Blood culture for diagnosis of bacteremia and fungemia comprises aerobic and anaerobic cultures. The clinical utility of routine anaerobic blood culture has been questioned for a long time and was evaluated in this study. METHODS: A total of 9,028 positive blood cultures were collected from adults at four university-affiliated hospitals. We recorded the species distribution according to growth in aerobic or anaerobic culture. RESULTS: Among the 9,028 positive results, 3,239 cases (35.9%) occurred in aerobic culture, 1,543 cases (17.1%) in anaerobic culture and 4,246 cases (47.0%) in both cultures. The species grown only in the anaerobic cultures consisted of 81.4% facultative anaerobes, 2.0% strict anaerobes, 8.5% strict aerobes, and 8.1% yeasts. CONCLUSION: Routine use of paired aerobic/anaerobic blood culture is essential because a considerable number of facultative anaerobes and yeasts grow only in anaerobic blood culture. Strict aerobes and fungi were more commonly isolated in the anaerobic bottles than were strict anaerobes.

Postsurgical Wound Infection Caused by Mycobacterium conceptionense Identified by Sequencing of 16S rRNA, hsp65, and rpoB Genes in an Immunocompetent Patient / 대한임상미생물학회지

Rapidly growing mycobacteria are ubiquitous in the environment and are increasingly being recognized as opportunistic pathogens. Recently, a new species, Mycobacteium conceptionense, has been validated from the Mycobacterium fortuitum third biovariant complex by molecular analysis. However, there are few reports, and postsurgical wound infection by this species is rare. We report a case of postsurgical wound infection caused by M. conceptionense in an immunocompetent patient that was identified by a sequencing analysis of 16S rRNA, hps65, and rpoB genes.