Seroprevalence of Toxoplasmosis in Pregnant Women in Daejeon, Korea

BACKGROUND: Toxoplasma gondii can cause devastating disease in the fetus and newborn infant. Serologic testing of pregnant women for Toxoplasma-specific antibodies can be used to identify those women at risk of transmitting Toxoplasma gondii infection. In Korea, despite a few reports on the seroprevalence of Toxoplasma (Toxo) antibody, the incidence of acute or chronic toxoplasma infection during pregnancy has not been well established. We performed a prospective screening for Toxoplasma antibodies to obtain a basic epidemiological data on the seroprevalence of acute and chronic toxoplasma infection. METHODS: During a 6-month period, 787 pregnant women at various weeks of gestation were enrolled in the prospective study. Toxo IgG and IgM antibodies were determined by the Abbott AxSYM Toxo IgG and IgM assays. Serum specimens showing positive results of both IgG and IgM antibodies were further tested using the Abbott ARCHITECT Toxo IgG Avidity test. RESULTS: The seropositivities of Toxo-specific IgG and IgM antibodies in this cohort were 2.3% (18/787) and 0.1% (1/787), respectively. No woman showed positive results for both Toxoplasma IgG and IgM antibodies. One specimen showing IgG positive and IgM grayzone results was tested by Toxo IgG avidity test and a low avidity test result (9%) was obtained, suggesting a possible acute primary infection. CONCLUSIONS: This study was the first trial on the investigation of the seroprevalence of both IgG and IgM antibodies in Korea, and we found that the seroprevalence of the antibodies was lower than that previously reported.

Evaluation of the Automated QWALYS-3 System for ABO and RhD Grouping and Unexpected Antibody Screening / 대한수혈학회지

BACKGROUND: One hundred years after the discovery of the ABO blood group system by Landsteiner, agglutination is still the most widely used method for determining the blood grouping and for antibody detection. Yet the demand for suitable automated systems is obvious in the field of transfusion. QWALYS-3 (DIAGAST, Loos Cedex, France) is a fully automated system for determining the ABO and RhD grouping and for antibody screening. We evaluated the ABO and RhD grouping and antibody screening test of the QWALYS-3. METHODS: The ABO and RhD grouping and the antibody screening test were performed by the QWALYS-3 system and the results were compared to the manual methods for the ABO and RhD grouping and to the micro column agglutination method (DiaMed-ID system) for antibody screening. RESULTS: For 574 of 574 clinical samples, there was complete concordance between the QWALYS-3 and the manual methods for determining the ABO and RhD grouping. The concordance rate between the QWALYS-3 and the micro column agglutination method for antibody screening in 210 clinical samples was 97.1%. CONCLUSION: The QWALYS-3 system had a good concordance rate compared to the manual method and the micro column agglutination method. The QWALYS-3 system was robust and it gave accurate results during this evaluation. The QWALYS-3 system will contribute to achieving full automation of all the necessary blood bank tests.

Analysis of Acquired Resistance Genes in Stenotrophomonas maltophilia / 대한진단검사의학회지

BACKGROUND: Stenotrophomonas maltophilia is a gram-negative bacillus and a nosocomial pathogen in immunocompromised patients. Trimethoprim/sulfamethoxazole (TMP/SMX) is the drug of choice for treating S. maltophilia infection; however, resistance to TMP/SMX is increasing. In this study, we investigated the relationship between the incidence of TMP/SMX resistance and the presence of sul genes and mobile elements. METHODS: A total of 120 S. maltophilia isolates were collected from 3 university hospitals between April 2007 and April 2009. Antimicrobial susceptibilities were determined using the disk diffusion method. PCR and DNA sequencing were conducted for the detection of sul1, sul2, class 1 integron, and ISCR2 element. Repetitive extragenic palindromic sequence-based PCR (REP-PCR) was carried out to evaluate the genetic relatedness. RESULTS: The TMP/SMX-resistant (R) isolates harbored a significantly higher proportion of sul1 gene and class 1 integron than TMP/SMX-susceptible (S) isolates (P<0.001). Seventeen of 28 isolates with sul1 also had a class 1 integron, but none of the isolates without sul1 had a class 1 integron. The identified gene cassettes within class 1 integrons include aacA4, aadA1, aac6'-II, and qac. None of the 120 isolates carried sul2, glmM, or ISCR2 element. REP-PCR did not show any genetic relatedness among the isolates. CONCLUSIONS: In Korea, the resistance of S. maltophilia isolates to TMP/SMX is due to sul1 within a class 1 integron rather than to sul2. The class 1 integron also harbors multiple antibiotic resistance genes in addition to sul1, and therefore it could mediate multidrug resistance in S. maltophilia.

Characteristics of aac(6')-Ib-cr Gene in Extended-Spectrum beta-Lactamase-Producing Escherichia coli and Klebsiella pneumoniae Isolated from Chungnam Area / 대한진단검사의학회지

BACKGROUND: Concomitant quinolone resistance in extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae is a crucial problem in the clinical management of infections. In foreign countries, the fluoroquinolone acetylating aminoglycoside-(6)-N-acetyltransferase (aac[6']-Ib-cr) gene, a novel plasmid-mediated quinolone resistance determinant has been reported to occur in conjunction with qnr. We aim to investigate the prevalence and characteristics of concomitant aac(6')-Ib-cr and qnr expression in ESBL-producing Escherichia coli and Klebsiella pneumoniae in Korea. METHODS: Between December 2007 and April 2008, we collected 60 and 69 clonally unrelated non-repetitive clinical isolates of ESBL-producing E. coli and K. pneumoniae, respectively. We studied the expressions of 11 types of ESBL-encoding genes, 4 types of 16s rRNA methylase genes; rmtA, rmtB, rmtC and armA, 3 types of qnr genes; qnrA, qnrB, qnrS and aac(6')-Ib. The presence of aac(6')-Ib-cr variants was detected by sequencing. The involvement of integrons was studied using multiplex PCR and sequencing of gene-cassette arrays. Conjugation experiments were performed to confirm plasmid-mediated resistance and the relationships among coharbored genes. RESULTS: We observed a high prevalence of the cr variant (61.1%) of aac(6')-Ib, and the prevalence of this variant in qnr and aac(6')-Ib-coharboring isolates (67.4%) was higher than in qnr-negative isolates (51.7%). The high prevalence of the cr variant was significantly related to the high minimum inhibitory concentrations (MICs) of ciprofloxacin, tobramycin, and amikacin and indicated the statistically significant roles of qnrB, qnrS, rmtA, and rmtB in quinolone and aminoglycoside resistance. CONCLUSIONS: The aac(6')-Ib-cr variants were widespread and showed significant relation to the high-level quinolone and aminoglycoside resistance in ESBL-producing E. coli and K. pneumoniae.

12 Cases of Hansen's Disease(New case & Relapse) / 나학회지

In 2005, we find 7 new cases and 5 relapse cases, diagnosis by the clinical finding, skin smear, skin biopsy, lepromin test, ELISA for PGL-I antibody, and DNA-PCR. The results obtained were summarized as follows: 1. In new cases, the mean age is 54.6, mean BI is 4.1+,and mean O.D. of PGL-I antibody is 0.866, and numbers of TTC repeat are 10(3 cases), 12(3 cases), and 11(1 case), and of GACATC repeats are 4(all Korean 5 cases) and 3(all foreigners 2cases). 2. In relapse case, the mean age is 65.0, mean BI is 4.6+,and mean O.D. of PGL-I antibody is 1.19, and numbers of TTC repeat are 11(2 cases), 12(1 cases), 13(1 case) and unknown(1 case), and of GACATC repeats are 4(all Korean 4 cases) and unknown(1 case).

Hepatic and hematological adverse reactions associated with the use of multidrug therapy in leprosy / 나학회지

One of the risks of combination therapy is probably the collective side effects. Fortunately, side effects reported worldwide after the use of MDT in thousands of patients remain mild and rare. This study analyses retrospectively some of the risks associated with the use of WHO-multidrug therapy (MDT) in Korea. Case records of 40 new cases of leprosy attending the Institute for Leprosy Research during 1991-2000, were analysed for adverse drug reactions involving the liver and blood. There were only some reports of suspected hematological adverse reactions(RBC count, hematocrit &, platelet count) associated with the use of MDT, but we could not find the clinical association of that finding. So we sustain that the MDT, recommended by KCDC, is relatively safe.

6 Cases of Hansen's Disease(New case & Relapse) / 나학회지

In 2003, we find 5 new cases and one relapse case, diagnosis by the clinical finding, skin smear, skin biopsy, lepromin test, ELISA for PGL-I antibody, and DNA-PCR. The results obtained were summarized as follows: 1. In new cases, the mean age is 52.5, mean BI is 3.4+,and mean O.D. of PGL-I antibody is 0.531, and numbers of TTC repeat are 12(2 cases), 13(2 cases), and 11(1 case), and of GACATC repeats are 4(all 6 cases). 2. In relapse case, a 58 years-old male patient is revealed that BI is 6+,and O.D. of PGL-I antibody is 0.873, numbers of TTC repeat are 11 GACATC repeats are 4.

A Study on Bacterial Index and Anti-PGL-I Antibody under Multidrug Therapy in Leprosy Patients / 나학회지

A study on the status of Mycobacterium leprae in the skin smear and the anti-PGL-I IgM antibody titers, examined by ELISA using ND-O-BSA against sera, the according to multidrug therapy (MDT) for 504 patients with leprosy including 224 new cases and 280 relapse cases in the institute was carried out and the following results were obtained. And the anti-PGL-I IgM antibody titers were examined by ELISA 752 contacts and 606 normal persons as control group. The results obtained were summerized as follows: 1. In 504 patients with leprosy, the mean bacterial index(BI) before starting MDT was 4.82 and the mean BI at 2, 5 and 10 years after starting MDT were 4.3, 2.8, and 1.5 respectively. So average BI declining rate per year was 1.1 2. In 504 patients with leprosy, the mean absorbance of anti-PGL-1 IgM antibody before starting MDT was 0.79287 and the mean absorbance at 2, 5 and 10 years after starting MDT were 0.58268, 0.38551 and 0.31003 respectively. So average absorbance declining rate per year was 0.48284. Between multibacillary (mean absorbance: 0.85762) and paucibacillary(mean absorbance: 0.35555) leprosy patients, the 3. In 504 patients with leprosy, the mean absorbance of anti-PGL-1 IgM antibody of the each bacterial index(BI)-0, 1+, 2+, 3+, 4+, 5+ and 6+ were 0.35555, 0.620, 0.72169, 0.74537, 0.81038, 0.89762, and 1.09664 respectively. The positive linear correlation between the bacterial index (BI) and anti-PGL-I IgM antibody was confirmed(F ratio: 10.49701, F critical point: 2.1168131 p=0.05, prediction trend line: y=107.42x + 389). 4. The mean absorbance of anti-PGL-1 IgM antibody was 0.79287 in patients with leprosy, 0.06027117 in contacts and 0.05021 in normal control persons. Between contacts and normal controls, the

11 Cases of Hansens Disease(New case & Relapse) / 나학회지

In 2003, we found 6 new cases and 5 relapse cases, diagnosis by the clinical finding, skin smear, skin biopsy, lepromin test, ELISA for PGL-I antibody, and DNA-PCR. The results obtained were summarized as follows: 1. In new cases, the mean age was 62.5, mean BI is 4+,and mean O.D. of PGL-I antibody was 0.678, and numbers of TTC repeat was 12(4 cases), 18(1 case), and 20(1 case), and of GACATC repeats are 4(5 cases, Koreans)and 3(1 case, Filipino). 2. In relapse cases, the mean age was 59.4, mean BI is 4.6+,and mean O.D. of PGL-I antibody was 0.772, and numbers of TTC repeat was 11(4 cases), 15(1 case), and of GACATC repeats are 4(4 case, Koreans)and 3(1 case, Korean).

A Study on the Information Monitoring System for Leprosy related Service / 나학회지

To improve and keep the competitiveness, it is necessary to keep pace with available changes in technology, and it is essential to establish the flexible and accurate information system about the disease. And for the accurate decision-making, target setting and prediction of movement, the estimating of the short- and long-term effects of the strategies of disease related service are required. But the limited informations, including all of knowledge of leprosy, make it difficult to estimate them properly. To achieve the more effective leprosy related service, we have to make the effort to crate the more accurate system. To proffer the idea for the development of information monitoring, we present the reviews of some articles about the information theories that used the leprosy related service.