Same-Day Identification and Antimicrobial Susceptibility Testing of Bacteria in Positive Blood Culture Broths Using Short-Term Incubation on Solid Medium with the MicroFlex LT, Vitek-MS, and Vitek2 Systems

BACKGROUND: Early and appropriate antibiotic treatment improves the clinical outcome of patients with septicemia; therefore, reducing the turn-around time for identification (ID) and antimicrobial susceptibility test (AST) results is essential. We established a method for rapid ID and AST using short-term incubation of positive blood culture broth samples on solid media, and evaluated its performance relative to that of the conventional method using two rapid ID systems and a rapid AST method. METHODS: A total of 254 mono-microbial samples were included. Positive blood culture samples were incubated on blood agar plates for six hours and identified by the MicroFlex LT (Bruker Daltonics) and Vitek-MS (bioMeriéux) systems, followed by AST using the Vitek2 System (bioMeriéux). RESULTS: The correct species-level ID rates were 82.3% (209/254) and 78.3% (199/254) for the MicroFlex LT and Vitek-MS platforms, respectively. For the 1,174 microorganism/antimicrobial agent combinations tested, the rapid AST method showed total concordance of 97.8% (1,148/1,174) with the conventional method, with a very major error rate of 0.5%, major error rate of 0.7%, and minor error rate of 1.0%. CONCLUSIONS: Routine implementation of this short-term incubation method could provide ID results on the day of blood culture-positivity detection and one day earlier than the conventional AST method. This simple method will be very useful for rapid ID and AST of bacteria from positive blood culture bottles in routine clinical practice.

MALDI-TOF-MS Fingerprinting Provides Evidence of Urosepsis caused by Aerococcus urinae

Urosepsis due to Aerococcus urinae is rare in clinical settings with only a few of reported cases worldwide by 16S rRNA sequencing. Here we report a case of sepsis caused by A. urinae in a 86 year-old male with complicated urinary tract infection which was confirmed through peptide mass fingerprinting of matrix-assisted laser desorption ionization time of flight mass spectrometry.

Performance of Matrix-Assisted Laser Desorption Ionization Time-of-Fight Mass Spectrometry for Rapid Discrimination of Methicillin-Resistant Staphylococcus aureus (MRSA): First Report of a Relation Between Protein Peaks and MRSA spa Type

No abstract available.

Analysis of the Vaginal Microbiome by Next-Generation Sequencing and Evaluation of its Performance as a Clinical Diagnostic Tool in Vaginitis

BACKGROUND: Next-generation sequencing (NGS) can detect many more microorganisms of a microbiome than traditional methods. This study aimed to analyze the vaginal microbiomes of Korean women by using NGS that included bacteria and other microorganisms. The NGS results were compared with the results of other assays, and NGS was evaluated for its feasibility for predicting vaginitis. METHODS: In total, 89 vaginal swab specimens were collected. Microscopic examinations of Gram staining and microbiological cultures were conducted on 67 specimens. NGS was performed with GS junior system on all of the vaginal specimens for the 16S rRNA, internal transcribed spacer (ITS), and Tvk genes to detect bacteria, fungi, and Trichomonas vaginalis. In addition, DNA probe assays of the Candida spp., Gardnerella vaginalis, and Trichomonas vaginalis were performed. Various predictors of diversity that were obtained from the NGS data were analyzed to predict vaginitis. RESULTS: ITS sequences were obtained in most of the specimens (56.2%). The compositions of the intermediate and vaginitis Nugent score groups were similar to each other but differed from the composition of the normal score group. The fraction of the Lactobacillus spp. showed the highest area under the curve value (0.8559) in ROC curve analysis. The NGS and DNA probe assay results showed good agreement (range, 86.2-89.7%). CONCLUSIONS: Fungi as well as bacteria should be considered for the investigation of vaginal microbiome. The intermediate and vaginitis Nugent score groups were indistinguishable in NGS. NGS is a promising diagnostic tool of the vaginal microbiome and vaginitis, although some problems need to be resolved.

First Korean Case of Cedecea lapagei Pneumonia in a Patient With Chronic Obstructive Pulmonary Disease

No abstract available.

In Vitro Activity of Tedizolid Against Gram-Positive Bacteria in Patients With Skin and Skin Structure Infections and Hospital-Acquired Pneumonia: A Korean Multicenter Study

We compared the activities of tedizolid to those of linezolid and other commonly used antimicrobial agents against gram-positive cocci recovered from patients with skin and skin structure infections (SSSIs) and hospital-acquired pneumonia (HAP) in Korean hospitals. Gram-positive isolates were collected from 356 patients with SSSIs and 144 patients with HAP at eight hospitals in Korea from 2011 to 2014. SSSIs included impetigo, cellulitis, erysipelas, furuncles, abscesses, and infected burns. Antimicrobial susceptibility was tested by using the CLSI agar dilution method. All of the gram-positive isolates were inhibited by < or =1 microg/mL tedizolid. The minimum inhibitory concentration [MIC]90 of tedizolid was 0.5 microg/mL for methicillin-resistant Staphylococcus aureus, which was 4-fold lower than that of linezolid. Tedizolid may become a useful option for the treatment of SSSIs and HAP caused by gram-positive bacteria.

Establishing Quality Control Ranges for Antimicrobial Susceptibility Testing of Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus: A Cornerstone to Develop Reference Strains for Korean Clinical Microbiology Laboratories

Quality control (QC) processes are being performed in the majority of clinical microbiology laboratories to ensure the performance of microbial identification and antimicrobial susceptibility testing by using ATCC strains. To obtain these ATCC strains, some inconveniences are encountered concerning the purchase cost of the strains and the shipping time required. This study was focused on constructing a database of reference strains for QC processes using domestic bacterial strains, concentrating primarily on antimicrobial susceptibility testing. Three strains (Escherichia coli, Pseudomonas aeruginosa, and Staphylococcus aureus) that showed legible results in preliminary testing were selected. The minimal inhibitory concentrations (MICs) and zone diameters (ZDs) of eight antimicrobials for each strain were determined according to the CLSI M23. All resulting MIC and ZD ranges included at least 95% of the data. The ZD QC ranges obtained by using the CLSI method were less than 12 mm, and the MIC QC ranges extended no more than five dilutions. This study is a preliminary attempt to construct a bank of Korean QC strains. With further studies, a positive outcome toward cost and time reduction can be anticipated.

Campylobacter hyointestinalis Isolated From a Human Stool Specimen

No abstract available.

First Korean Case of Mycobacterium arupense Tenosynovitis

No abstract available.

Capnocytophaga sputigena Bacteremia in a Patient with Chronic Lymphocytic Leukemia

No abstract available.

First Korean Case of Helcococcus kunzii Bacteremia in a Patient with Diabetes

No abstract available.

The First Case of Eggerthella lenta Bacteremia in Korea

No abstract available.

Spontaneous Bacterial Peritonitis with Septicemia with Providencia rettgeri and Clostridium perfringens / 대한임상미생물학회지

We report a suspicious case of spontaneous bacterial peritonitis (SBP) caused by Providencia rettgeri and Clostridium perfringens in a patient with alcoholic cirrhosis. The patient presented with altered mentality and was taken to the emergency room. He was diagnosed with SBP after abdominal paracentesis and computed tomography and was treated with ceftriaxone and metronidazole. The pathogens were identified under suspicion of polymicrobial infection because of Gram-staining discrepancies between broth from blood culture bottles and colonies on solid media. He died of septic shock despite transfer to the intensive care unit. Although we could not conclude which organism had the leading role in this case of SBP and septicemia, we did verify the importance of Gram staining in a microbiology laboratory in terms of quality assurance.

The First Korean Case of Moraxella osloensis Bacteremia in a Patient with Acute Myeloid Leukemia

No abstract available.

First Case of Mycobacterium longobardum Infection

Mycobacterium longobardum is a slow-growing, nontuberculous mycobacterium that was first characterized from the M. terrae complex in 2012. We report a case of M. longobardum induced chronic osteomyelitis. A 71-yr-old man presented with inflammation in the left elbow and he underwent a surgery under the suspicion of tuberculous osteomyelitis. The pathologic tissue culture grew M. longobardum which was identified by analysis of the 65-kDa heat shock protein and full-length 16S rRNA genes. The patient was cured with the medication of clarithromycin and ethambutol without further complications. To the best of our knowledge, this is the first report of a M. longobardum infection worldwide.

Active Surveillance for Multidrug-resistant Organisms / 대한임상미생물학회지

Infections and outbreaks of antimicrobial-resistant bacteria, such as methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant enterococcus (VRE), have been increasing. Detection methods for antimicrobial-resistant bacteria have been changed from traditional culture methods to chromogenic media culture and molecular methods. Strain-typing methods using various molecular technologies are essential tools for epidemiologic surveillance. Furthermore, outbreak detection, using syndromic surveillance as well as passive and active surveillance, has been applied. However, it is difficult to establish effective and robust guidelines and systems for using these various methods to control antimicrobial-resistant bacteria. Therefore, clinical microbiologists and policy makers must possess expertise in the control of antimicrobial resistant bacteria, discuss the issue sufficiently, and, finally, create a system to accomplish this control.

Vitamin D3 up-regulated protein 1 controls the priming phase of liver regeneration

Vitamin D3 up-regulated protein 1 (VDUP1) is a potent growth suppressor that inhibits tumor cell proliferation and cell cycle progression when overexpressed. In a previous study, we showed that VDUP1 knockout (KO) mice exhibited accelerated liver regeneration because such animals could effectively control the expression of cell cycle regulators that drive the G1-to-S phase progression. In the present study, we further investigated the role played by VDUP1 in initial priming of liver regeneration. To accomplish this, VDUP1 KO and wild-type (WT) mice were subjected to 70% partial hepatectomy (PH) and sacrificed at different times after surgery. The hepatic levels of TNF-alpha and IL-6 increased after PH, but there were no significant differences between VDUP1 KO and WT mice. Nuclear factor-kappaB (NF-kappaB), c-Jun-N-terminal kinase (JNK), and signal transducer and activator of transcription 3 (STAT-3) were activated much earlier and to a greater extent in VDUP1 KO mice after PH. A single injection of TNF-alpha or IL-6 caused rapid activation of JNK and STAT-3 expression in both mice, but the responses were stronger and more sustained in VDUP1 KO mice. In conclusion, our findings provide evidence that VDUP1 plays a role in initiation of liver regeneration.

Correlation between Carbapenem Prescription Trends and Imipenem Resistance in Acinetobacter baumannii at an Intensive Care Unit between 2006 and 2010

Carbapenem resistance in Acinetobacter baumannii has increased rapidly worldwide. It is generally assumed that carbapenem prescription in a hospital has a significant impact on imipenem resistance in A. baumannii. However, there are few studies validating these assumptions with statistical data. We performed a surveillance study to investigate the relationship between carbapenem prescription trends and the imipenem resistance rate of A. baumannii in an ICU. Carbapenem prescription data in the WHO anatomical therapeutic chemical (ATC)/defined daily dose (DDD) format for the period from 2006 to 2010 were obtained from the hospital electronic pharmacy records. In the same period, microbiologic data for the ICU were extracted from the laboratory information system. Imipenem resistance rates of A. baumannii increased from 4.3% in 2006 to 83.8% in 2010 (P <0.05; r2=0.85). Carbapenem prescription had increased from 19.71 DDD per 1,000 inpatient-days in 2006 to 36.99 DDD per 1,000 inpatient-days in 2010 (P <0.05; r2=0.95). Carbapenem prescription rate correlated with the imipenem resistance rate in A. baumannii (P <0.05; R=0.9). The results of our study demonstrated a correlation between carbapenem prescription trends and imipenem resistance in A. baumannii.

Subjective Quality of Life in Schizophrenic Patients Receiving Atypical Antipsychotics: Relationship to Psychopathology, Adverse Drug Effects and Subjective Response to Drug / 신경정신의학

OBJECTIVES: The purpose of this study was to evaluate the characteristics of psychopathology, adverse drug effects, and subjective response to drugs that have a significant impact on the subjective quality of life in schizophrenic patients receiving atypical antipsychotics. METHODS: One hundred and one schizophrenic patients, who were receiving maintenance treatment with atypical antipsychotics, were evaluated. Subjective quality of life was assessed using the standardized Korean modification of a self-rating scale to measure subjective well-being under neuroleptics (KmSWN). Patients' psychopathology was evaluated using the Positive and Negative Syndrome Scale. Adverse effects and subjective response to drug were evaluated using the Liverpool University Neuroleptic Side Effect Rating Scale and the Drug Attitude Inventory-10, respectively. Correlation analysis and stepwise multiple regression analysis were conducted. RESULTS: In psychopathology, the severity of depression and anxiety showed the most significant correlation with the score of KmSWN. In adverse drug effects, the severity of psychic side effect and extrapyramidal side effect showed the most significant correlation with the score of KmSWN. Regarding subjective response to drug, significant correlation was observed between the severity of subjective negative response and the score of KmSWN. Stepwise multiple regression analysis revealed that psychic side effect, extrapyramidal side effect, and depression contributed significantly to the total score of KmSWN. These variables accounted for 59.7% of the total variance. CONCLUSION: The results of the present study suggest that psychic side effect, extrapyramidal side effect and depressive symptom are the clinical characteristics that are significantly associated with the subjective quality of life. An effective management strategy for these variables should be established in developing a treatment program to enhance the quality of life of patients with schizophrenia.