Evaluation of Two Commercial Kits for Rapid Pathogen Identification Directly From Positive Blood Cultures by Matrix-Associated Laser Desorption/Ionization Time-of-Flight Mass Spectrometry / 대한임상미생물학회지

Background@#A bloodstream infection is a life-threatening medical emergency, with a mortality rate of up to 30%. Matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) can be used to identify pathogens directly from positive blood cultures. Two commercial preparation kits, SepsiTyper (Bruker Daltonics, Germany) and SepsiPrep (ASTA Corp., Korea), and two MALDI-TOF MS systems, MALDI Biotyper Sirius (Bruker Daltonics, Germany) and VITEK MS PRIME (bioMérieux, France), are available in Korea. We examined these kits and MALDI-TOF MS systems to analyze their performance. @*Methods@#We assessed the effectiveness of direct identification using 47 blood cultures and 3 bile cultures positive for microbial growth. The VIRTUO system (bioMérieux, France) was used to incubate the samples after they were collected in Bact/ALERT aerobic and anaerobic bottles. The manufacturers’ protocols were followed for both the SepsiTyper and SepsiPrep kits. @*Results@#The SepsiTyper yielded considerably more accurate identifications than did the SepsiPrep, when utilized in MALDI-TOF MS systems (P = 0.0044). However, the SepsiPrep was easier to use and the results more quickly obtained than with the SepsiTyper. The MALDI Biotyper Sirius produced more accurate identifications with the SepsiTyper than did the VITEK MS PRIME (P = 0.0736). The SepsiTyper enabled the accurate identification of five of six polymicrobial cases, utilizing either the MALDI-TOF MS systems. @*Conclusions@#Among the pathogen ID kits tested in this study, the SepsiTyper with MALDI Biotyper Sirius performed the best. In clinical laboratories utilizing VITEK MS PRIME, it is recommended that the either the SepsiTyper or SepsiPrep kit be used for direct identification, while considering certain limitations in terms of performance.

Frequency and Clinicohematologic Characteristics of MPL W515 Mutations in Patients with Myeloproliferative Neoplasms

BACKGROUND: Recently, myeloproliferative leukemia (MPL) W515 mutations have been reported to be molecular markers for myeloproliferative neoplasms (MPNs). We studied the association between MPL W515 mutations and the clinico-hematological features of patients with MPNs. METHODS: Our study included 154 consecutive patients diagnosed with MPNs (31 had polycythemia vera [PV]; 106, essential thrombocythemia [ET]; and 17, primary myelofibrosis [PMF]). MPL W515 mutations were detected by real-time PCR and direct sequencing methods. RESULTS: The MPL W515L mutation was found in 4 patients and the MPL W515A mutation was detected in 1 patient. These 5 patients were diagnosed with JAK2 V617F-negative ET, and they accounted for 12.5% of patients with JAK2 V617F-negative ET. The patients with MPL W515-positive ET showed significantly lower hemoglobin levels and WBC counts than did patients with MPL W515-negative ET or JAK2 V617F-positive ET. CONCLUSIONS: MPL W515 mutation is a useful diagnostic marker for JAK2 V617F-negative MPNs and it is associated with specific hematologic characteristics such as lower hemoglobin levels and WBC counts.

First Case of Pulmonary Mycobacterium parascrofulaceum Infection in a Patient With Bronchiectasis in Korea

No abstract available.

Acute Cellulitis Caused by Neisseria skkuensis / 대한임상미생물학회지

A 73-year-old man visited our hospital because of pain with swelling and redness on the right foot dorsum. He was diagnosed with liver cirrhosis and nodular hepatic cellular carcinoma. Lower extremity CT scan and MRI showed abscess formation in the right foot dorsum. Gram-negative cocci were recovered from the culture of drained pus at the site and identified as Neisseria skkuensis by 16S rRNA gene sequencing. Here, we report the first case of cellulitis due to N. skkuensis and provide a literature review.

Transoral Fusion of the Odontoid Process Fracture

The Odontoid process fracture has been treated by prolonged external immobilization of by internal fixation and fusion. We reported congential and traumatic odontoid process fracture which were successfully treated by transoral fusion. Operative preparation, technique and postoperative management are described by in detail.

A Case of Spontaneous Thoracic Epidural Hematoma

Spontaneous thoracic epidural hematoma occur rarely. We present a case of spontaneous thoracic epidural hematoma without any identified etiology and discuss the symptoms, signs and pathophysiology of this disorder. Early diagnosis and treatment by surgery can result in good recovery.

A Case of Spontaneous Hematomyelia

This is a report of 23 year old soldier who developed sudden onset of flaccid paraplegia and loss of all sensory modalited below the level of T4. The clinical entities of hematomyelia were sudden onset of pain, repidly developing pyramidal signs and paraplegia. The mainly involving sites of this disease were cervical and thoracic regions. The causative factors were hemorrhagic diasthesis, vascular malformation and inflammatory process as well as trauma and neoplasms affecting the spinal cord. We experienced a case of hematomyelia which did not combine with vascular anomaly, inflammatory process, hemophilia or trauma history.