Prevalence and Risk Factors of Vancomycin-Resistant Enterococci (VRE) Colonization in Neonates / 소아과

PURPOSE: Vancomycin-resistant enterococci (VRE) are now nosocomial pathogens in Korea. But little is known about the prevalence of stool colonization with VRE in neonates in Korea. So we studied the prevalence and risk factors of VRE colonization in the Neonatal Intensive Care Unit (NICU). METHODS: From January 2000 to December 2004, the medical records of 294 neonates (127 cases of VRE group and 167 cases of non-VRE group, according to the results of stool culture) were reviewed retrospectively. We studied the annual prevalence of VRE and risk factors of VRE colonization in neonates. RESULTS: From 2000 to 2003, the prevalence rate of VRE in NICU increased. After preventing VRE transmission, the prevalence rate of VRE has decreased. CONCLUSION: VRE colonization increased recently. Risk factors of VRE colonization were prematurity, lower birth weight, longer hospitalization and use of vancomycin or 3rd generation cephalosporin, compared with the non-VRE group. To prevent VRE transmission among newborns, aggressive infection control strategies by NICU staffs must be implemented immediately for all babies.

A Case of Eosinophilic Gastroenteritis / 대한소아소화기영양학회지

Eosinophilic gastroenteritis is a rare condition of unknown etiology characterized by peripheral eosinophilia, eosinophilic infiltration of the gastrointestinal tract, and gastrointestinal symptoms. Eosinophilic gastroenteritis is generally classified according to the Klain classification: predominant mucosal, muscular, and subserosal disease. Mucosal involvement may result in abdominal pain, nausea, vomiting, diarrhea, weight loss, anemia, protein-losing enteropathy, and intestinal perforation. Patients with muscular layer disease generally have obstructive symptoms. Subserosal eosinophilic infiltration may result in development of eosinophilic ascites. Most commonly, the stomach, duodenum, and small bowel are involved. A 13-year-old girl came to our hospital presenting with chronic, intermittent abdominal pain. She showed peripheral eosinophilia and biopsy specimen of the duodenum revealed eosinophilic infiltration of the mucosal layer. We here report a case of eosinophilic gastroenteritis.

Radiation and Chemotherapy on Pregnant Women with Breast Cancer: A Case Report / 대한주산의학회잡지

The occurrence of malignancies during pregnancy has increased over the last decades. Risks of cancer surgery during pregnancy include spontaneous abortion and preterm labor. Radiation therapy especially during the first trimester generally is not offered because it poses high risks : teratogenecity, induction of childhood malignancies and hematologocal disorders. All chemotherapeutic agents used in the treatment of breast cancer are pregnancy category D, meaning that teratogenic effects have occurred in humans. We report a baby of a 33-year-old pregnant woman with breast cancer. She was treated with modified radical mastectomy one month before the pregnancy and full-dose adriamycin, cyclophosphamide and taxol since the first trimester, and 5,400 cGy of radiation therapy in the second trimester. The infant was delivered at 33+6 weeks of gestation and showed no evidence of malformation or abnormalities and developed normally until 8 months of corrected age.

Multifocal Brain Infarction and Intraventricular Hemorrhage in an Infant during Treatment of Diabetic Ketoacidosis / 대한소아내분비학회지

Fatal complications including cerebral edema and neurologic collapse occur during treatment of diabetic ketoacidosis(DKA). A 6-week-old female infant with fever, dehydration and drowsy mental status was diagnosed as DKA and neurologically deteriorated during treatment. The cranial computed tomography scan revealed multifocal brain infarctions of the left caudate nucleus, bilateral frontal periventricular white matter, and right parietal cortex. A moderate amount of hemorrhage was also noted in both lateral ventricles. She recovered rapidly with supportive treatment over time. The clinical course and radiologic findings of this patient emphasize the importance of brain infarction as a cause of persistent neurologic loss in children with DKA.