Prevention of Mother-to-child Transmission of HIV: Experiences from an University Teaching Hospital / 감염과화학요법

The number of HIV infected women continues to rise sharply these days and 58% of these women were childbearing age. The increase in the number of AIDS cases among childbearing women has led to an increase in the maternal - infant transmission of human acquired immunodeficiency virus. The aim of our study is to assess the available evidence for preventing mother-to-infant transmission of HIV infection by experience from University Teaching Hospital. Four pregnant women with HIV infection delivered in Pusan National University Hospital from 1999 to 2005 years. Three women visitied at 3rd trimester, only one woman delivered by planned perinatal care. They received antiretroviral therapy during pregnancy, labor, after delivery, and infant received antiretroviral therapy by consideration of their situation. They were compliant with treatment and had a sustained virologic response below the detectable level. Just 2% of infants were trasmitted by human acquired immunodeficiency virus, if HIV infected women had an appropriate prophylaxis. Therefore HIV infected women must be identified early for prevention of maternal-infant transmission, they must receive effective antiretrovirus therapy.

Antiretroviral drug resistance among drug-naive HIV-1 infected patients / 대한내과학회지

BACKGROUND: The prevalence of HIV drug resistance mutations in drug-naive patients has been shown to differ with geographic origin. The purpose of this study is to assess the prevalence of transmitted antiretroviral drug resistance mutations in drug-naive patients in Korea. METHODS: Genotypic resistance was determined by the use of the Viroseq Genotyping System in 42 antiretroviral treatment naive HIV-infected patients between March 2005 and July 2006. Transmitted drug resistance was estimated according to the IAS-USA 2005 definition, taking into account only major mutations in the protease and all mutations in the reverse transcriptase, including revertant mutations at codon 215. RESULTS: The median age of the patients was 42 years and 37 (88%) were male. The median CD4+T cell count was 136/mm3 and the mean plasma RNA level was 4.98 log copies/mL. Among 42 patients studied, 37 (88%) were newly diagnosed patients. None of the patients were recent seroconverters; 38 patients (90%) were infected with subtype B and 4 patients were infected (10%) with the non-B subtype strains (2 patients with CRF01-AE 1 as CRF02-AG; 1 patient with subtype A). Of the 42 subjects tested, we found 2 (4.8%) mutations in NRTI (V118I), but did not find a mutation in NNRTI as well as in the PI region. CONCLUSIONS: The prevalence of transmitted antiretroviral drug resistance in drug-naive patients is still low in Korean patients.

Prevention of Mother-to-child Transmission of HIV: Experiences from an University Teaching Hospital / 감염과화학요법

The number of HIV infected women continues to rise sharply these days and 58% of these women were childbearing age. The increase in the number of AIDS cases among childbearing women has led to an increase in the maternal - infant transmission of human acquired immunodeficiency virus. The aim of our study is to assess the available evidence for preventing mother-to-infant transmission of HIV infection by experience from University Teaching Hospital. Four pregnant women with HIV infection delivered in Pusan National University Hospital from 1999 to 2005 years. Three women visitied at 3rd trimester, only one woman delivered by planned perinatal care. They received antiretroviral therapy during pregnancy, labor, after delivery, and infant received antiretroviral therapy by consideration of their situation. They were compliant with treatment and had a sustained virologic response below the detectable level. Just 2% of infants were trasmitted by human acquired immunodeficiency virus, if HIV infected women had an appropriate prophylaxis. Therefore HIV infected women must be identified early for prevention of maternal-infant transmission, they must receive effective antiretrovirus therapy.

Antimicrobial Resistance of Staphylococcus aureus among Patients with Vancomycin Resistant Enterococcus / 감염과화학요법

BACKGROUND: The transfer of vancomycin resistance from vancomycin-resistant enterococci (VRE) to Staphylococcus aureus has been predicted. The purpose of this study is to determine the prevalence and antibiotics resistance of S. aureus among patients colonized with VRE. METHODS: Between January 2001 and December 2001, a prospective study was performed at Pusan National University Hospital on 27 patients. Surveillance swabs from nasal cavity, axilla, perineum, and rectum were obtained at weekly intervals. Methicillin susceptability of S. aureus was determined by oxacillin disk diffusion test and minimum inhibitory concentration (MIC) for vancomycin by microdilution broth test. RESULTS: Total of 292 swab cultures were performed and 67 S. aureus isolates were collected. 64 isolates (95.5%) were resistant to methicillin. The prevalence of nasal MRSA carrier in 19 patients colonized with VRE was higher than that in 8 patients not colonized with VRE (58% vs. 37.5%). In 64 MRSA isolates, MIC (microgram/mL) for vancomycin ranged from 0.5 to 2. No isolates with MIC >2 microgram/mL were observed. MIC of 1 microgram/mL was shown (observed) in 54 isolates, 2 microgram/mL in 6 isolates, and 0.5 microgram/mL in 4 isolates. CONCLUSION: The prevalence of S. aureus with colonization of VRE is higher than that without colonization of VRE. Most of S. aureus isolates were resistant to methicillin. VRSA isolates were not observed.

Antimicrobial Resistance of Staphylococcus aureus among Patients with Vancomycin Resistant Enterococcus / 감염과화학요법

BACKGROUND: The transfer of vancomycin resistance from vancomycin-resistant enterococci (VRE) to Staphylococcus aureus has been predicted. The purpose of this study is to determine the prevalence and antibiotics resistance of S. aureus among patients colonized with VRE. METHODS: Between January 2001 and December 2001, a prospective study was performed at Pusan National University Hospital on 27 patients. Surveillance swabs from nasal cavity, axilla, perineum, and rectum were obtained at weekly intervals. Methicillin susceptability of S. aureus was determined by oxacillin disk diffusion test and minimum inhibitory concentration (MIC) for vancomycin by microdilution broth test. RESULTS: Total of 292 swab cultures were performed and 67 S. aureus isolates were collected. 64 isolates (95.5%) were resistant to methicillin. The prevalence of nasal MRSA carrier in 19 patients colonized with VRE was higher than that in 8 patients not colonized with VRE (58% vs. 37.5%). In 64 MRSA isolates, MIC (microgram/mL) for vancomycin ranged from 0.5 to 2. No isolates with MIC >2 microgram/mL were observed. MIC of 1 microgram/mL was shown (observed) in 54 isolates, 2 microgram/mL in 6 isolates, and 0.5 microgram/mL in 4 isolates. CONCLUSION: The prevalence of S. aureus with colonization of VRE is higher than that without colonization of VRE. Most of S. aureus isolates were resistant to methicillin. VRSA isolates were not observed.

A case of thrombotic thrombocytopenic purpura in systemic lupus erythematosus / 대한내과학회지

Thrombotic thrombocytopenic purpura (TTP) rarely may be seen in association with autoimmune processes such as scleroderma, rheumatoid arthritis, polyarteritis nodosa, Sj gren's syndrome, and systemic lupus erythematosusus (SLE). The diagnosis of TTP as a syndrome distinct from SLE may be challenging, because both processes may present with some or all elements of the classic pentad considered pathognomonic of the former: microangiopathic hemolytic anemia, fever, thrombocytopenia, neurological deficits, and renal abnormalities. We describe a patient with synchronous TTP and SLE, and review the literature.