A Case of Aeromonas hydrophila Necrotizing fasciitis in Patient on Hemodialysis / 감염과화학요법

Aeromonas hydrophila is a facultative, anaerobic gram-negative bacillus. It's a member of the family Vibrionaceae. Aeromonas, which is known to cause gastroenteritis and wound infections ranging from mild cellulitis to fulminant myonecrosis. It is responsible for opportunistic infections in patients with compromised immune function due to an underlying disease such as malignant hematological disorders, liver cirrhosis, and malignant neoplasm. We report a case of 72-year-old woman who recovered from necrotizing fasciitis caused by A. hydrophila. The patient had undergone prolonged hemodialysis and had no history of trauma.

A Case of Aeromonas hydrophila Necrotizing fasciitis in Patient on Hemodialysis / 감염과화학요법

Aeromonas hydrophila is a facultative, anaerobic gram-negative bacillus. It's a member of the family Vibrionaceae. Aeromonas, which is known to cause gastroenteritis and wound infections ranging from mild cellulitis to fulminant myonecrosis. It is responsible for opportunistic infections in patients with compromised immune function due to an underlying disease such as malignant hematological disorders, liver cirrhosis, and malignant neoplasm. We report a case of 72-year-old woman who recovered from necrotizing fasciitis caused by A. hydrophila. The patient had undergone prolonged hemodialysis and had no history of trauma.

Trend of Isolation and Genotypes of Vancomycin-esistant Enterococci Isolated from Tertiary Care Hospital in Wonju Area / 대한임상병리학회지

BACKGROUND: Vancomycin-esistant enterococci (VRE) were first recovered from clinical isolates in Korea in 1992, and the incidence has been steadily increasing. The goal of this study was to determine the isolation trend of VRE by year and genotypes of VRE isolated from clinical specimens in Wonju area. METHODS: We investigated the patients' medical records to determine the incidence of VRE among enterococci isolated from 1995 to 1999 in Wonju Christian Hospital, performed antimicrobial susceptibility tests to vancomycin and teicoplanin by agar dilution methods, and genotyped them with multiplex polymerase chain reaction for 117 cryopreserved VRE isolates. RESULTS: VRE were first isolated in December 1995. Overall incidence of VRE during the period of 1996 to 1999 was 6.1% (164/2,682). The annual incidence of VRE was 1.9% in 1996, 5.5% in 1997, 6.7% in 1998, and 9.7% in 1999. The species of VRE included 115 (69.7%) E. faecium, 11 (6.7%) E. faecalis, 17 (10.3%) E. casseliflavus, 10 (6.1%) E. gallinarum, and 12 (7.3%) Enterococcus species. Of 117 VRE, E. faecium and E. faecalis strains were phenotyped as VanA, and genotyped as vanA with the exception of five VRE which the genotypes were not identified. All E. gallinarum and E. casseliflavus strains were genotyped as vanC- and vanC-, respectively. CONCLUSIONS: VRE were first isolated in 1995. And the isolation rate of VRE were increasing trend from 1.9% in 1996 and 9.7% in 1998. Most of VRE were E. faecium with vanA genotype.

Trend of Isolation and Genotypes of Vancomycin-esistant Enterococci Isolated from Tertiary Care Hospital in Wonju Area / 대한임상병리학회지

BACKGROUND: Vancomycin-esistant enterococci (VRE) were first recovered from clinical isolates in Korea in 1992, and the incidence has been steadily increasing. The goal of this study was to determine the isolation trend of VRE by year and genotypes of VRE isolated from clinical specimens in Wonju area. METHODS: We investigated the patients' medical records to determine the incidence of VRE among enterococci isolated from 1995 to 1999 in Wonju Christian Hospital, performed antimicrobial susceptibility tests to vancomycin and teicoplanin by agar dilution methods, and genotyped them with multiplex polymerase chain reaction for 117 cryopreserved VRE isolates. RESULTS: VRE were first isolated in December 1995. Overall incidence of VRE during the period of 1996 to 1999 was 6.1% (164/2,682). The annual incidence of VRE was 1.9% in 1996, 5.5% in 1997, 6.7% in 1998, and 9.7% in 1999. The species of VRE included 115 (69.7%) E. faecium, 11 (6.7%) E. faecalis, 17 (10.3%) E. casseliflavus, 10 (6.1%) E. gallinarum, and 12 (7.3%) Enterococcus species. Of 117 VRE, E. faecium and E. faecalis strains were phenotyped as VanA, and genotyped as vanA with the exception of five VRE which the genotypes were not identified. All E. gallinarum and E. casseliflavus strains were genotyped as vanC- and vanC-, respectively. CONCLUSIONS: VRE were first isolated in 1995. And the isolation rate of VRE were increasing trend from 1.9% in 1996 and 9.7% in 1998. Most of VRE were E. faecium with vanA genotype.

Rapid Detection of Mycobacteria usin Mycobacteria Growith Indicator tube(MGIT)and Ogawa Media / 대한임상미생물학회지

BACKGROUND: As many as several weeks of incubation may be necessary for the recovery of mycobacteria when conventional culture media are used. Previous studies evaluating Mycobacteria Growth Indicator Tube (MGIT) as a rapid for the growth and detection of mycobacteria from clinical specimens have been reported. We compared MGIT with Ogawa media for the recovery of mycobacteria from clinical specimens. METHODS: Ninety nine clinical specimens received in the laboratory of Wonju Christian Hospital from June to September 199 were used for this study. The specimens from nonsterile body sites were digested, decontaminated, and concentrated, for culture and Ziehl-Neelsen stain, and specimen were inoculated onto MGIT tube and 3% Ogawa egg medium, and cultured for 8 weeks. RESULTS: Of the 38 specimens culture-positive for mycobacteria, 3 grew isolates in MGIT medium only, 8 grew isolates in Ogawa media only, and 27 grew isolates in both media. Mean (median, range) times to detection of mycobacteria were 13.7 (5.5, 2-48) days with MGIT and 19.6 (18, 13-37) days with Ogawa (P>0.05). The number recovered with MGIT plus Ogawa media was 24 (63.2%) within 14 days of receipt of specimen, and 31 (81.6%) within 21 days. The contamination rates were 31 % for MGIT and 1 % for Ogawa media. CONCLUSIONS: MGIT appears useful to quickly detect and identify mycobacteria from clinical specimens. However, because the number of culture-positive specimen in MGIT was not greater than those recovered with Ogawa media, MGIT should be used in combination with solid media to reduce turnaround times and increase the isolation rate.

Rapid Detection of Mycobacteria usin Mycobacteria Growith Indicator tube(MGIT)and Ogawa Media / 대한임상미생물학회지

BACKGROUND: As many as several weeks of incubation may be necessary for the recovery of mycobacteria when conventional culture media are used. Previous studies evaluating Mycobacteria Growth Indicator Tube (MGIT) as a rapid for the growth and detection of mycobacteria from clinical specimens have been reported. We compared MGIT with Ogawa media for the recovery of mycobacteria from clinical specimens. METHODS: Ninety nine clinical specimens received in the laboratory of Wonju Christian Hospital from June to September 199 were used for this study. The specimens from nonsterile body sites were digested, decontaminated, and concentrated, for culture and Ziehl-Neelsen stain, and specimen were inoculated onto MGIT tube and 3% Ogawa egg medium, and cultured for 8 weeks. RESULTS: Of the 38 specimens culture-positive for mycobacteria, 3 grew isolates in MGIT medium only, 8 grew isolates in Ogawa media only, and 27 grew isolates in both media. Mean (median, range) times to detection of mycobacteria were 13.7 (5.5, 2-48) days with MGIT and 19.6 (18, 13-37) days with Ogawa (P>0.05). The number recovered with MGIT plus Ogawa media was 24 (63.2%) within 14 days of receipt of specimen, and 31 (81.6%) within 21 days. The contamination rates were 31 % for MGIT and 1 % for Ogawa media. CONCLUSIONS: MGIT appears useful to quickly detect and identify mycobacteria from clinical specimens. However, because the number of culture-positive specimen in MGIT was not greater than those recovered with Ogawa media, MGIT should be used in combination with solid media to reduce turnaround times and increase the isolation rate.

Erythromycin Resistance Phenotype of Streptococcus pyogenes / 대한임상미생물학회지

BACKGROUND: The erythromycin-resistance rate and phenotype distribution of Streptococcus propenes are quite different by geographical variation and study period. The aim of the present study was to determine the evolution of resistance to erythromycin and the frequency of erythromycin resistance phenotype of S. pyogenes isolated from Wonju Christian Hospital. METHODS: The minimal inhibitory concentrations (MICs) of erythromycin and clindamycin for 94 S. pyogenes isolated from clinical specimens between 1990 to 1998 were investigated. Double disk test of erythromycin (78microgram) and clindamycin (25microgram) were performed for 15 isolates of erythromycin resistant S. pyogenes to evaluate the erythromycin resistance phenotype. RESULTS: The resistance rates of 94 isolates of S. pyogenes were 16%(15/94) to erythromycin and 4%(4/94) to clindamycin. The frequency of erythromycin resistance phenotype in decreasing order were M phenotype (47%), inducible resistance phenotype (40%), and constitutive resistance phenotype (13%). Erythromycin-resistant S. pyogenes did not exist until 1993, but was isolated since 1994, and ranged from 14.0% to 24.0% during the period of 1994-1998. CONCLUSIONS: Our finding documents the emergence of high resistance rates to erythromycin in S. pyogenes at Wonju area since 1994. The M phenotype (47%) and inducible resistance phenotype (40%) account for the majority of erythromycin-resistant S. pyogenes.

A Case of Non-secretory Plasma Cell Leukemia with Complex Chromosomal Abnormalities / 대한혈액학회지

We report a case of non-secretory plasma cell leukemia with complex chromosomal abnormalities including t (11;14)(q13;q32). A 57-year-old man was admitted to hospital due to anemia, thrombocytopenia and renal insufficiency. Bone marrow examination and peripheral blood smear revealed a large number of immature plasma cells with positivity for CD38. Monoclonal gammopathy or abnormal paraproteins were not observed in serum protein electrophoresis and immunofixation. The cytogenetic analysis showed complex chromosomal abnormalities [45, XY, -1, t (11;14)(q13;q32), t (12;17)(p13;q21)]. He was died of adult respiratory distress syndrome on the 6th hospital day.