Genotypic shift in rotavirus associated with neonatal outbreaks in Seoul, Korea.

BACKGROUND: Rotavirus group A (RVA) is a causative agent of acute gastroenteritis among young children worldwide, despite the global expansion of rotavirus vaccination. In Korea, although the prevalence of RVA has been reduced among young children owing to vaccination, nosocomial infections still occur among neonates. OBJECTIVES: The aim of this study was to investigate the molecular epidemiology of RVA strains associated with several neonatal outbreaks in Seoul from 2017 to 2020. STUDY DESIGN: Clinical and environmental samples were collected and screened for the presence of RVA using ELISA and PCR targeting VP6, respectively. RVA-positive strains were genotyped via RT-PCR and subsequent sequencing of VP4 and VP7 and were phylogenetically compared with RVA strains from other countries. RESULTS: During 2017-2020, a total of 15 RVA outbreaks occurred at neonatal facilities (six in hospital neonatal wards and nine in postpartum care centers) in Seoul, and only two RVA genotypes were detected: G4P[6] and G8P[6]. G8P[6] emerged in Seoul November 2018 and immediately became the predominant genotype among neonates, at least up to 2020. Phylogenetic analysis revealed that the G8P[6] genotype in this study was closely related to G8P[6] strains first identified in Korea in 2017, but differed from G8P[6] strains detected in Africa. CONCLUSIONS: A novel G8P[6] genotype of RVA strains has emerged and caused outbreaks among neonates in Seoul. Continued surveillance for circulating RVA genotypes is imperative to monitor genotype changes and their potential risks to public health.

Dissemination of an international high-risk clone of Escherichia coli ST410 co-producing NDM-5 and OXA-181 carbapenemases in Seoul, Republic of Korea.

The rapid increase in carbapenemase-producing Enterobacterales is a global health concern. During 2017-2020, a total of 44 Escherichia coli isolates co-harbouring blaNDM-5 and blaOXA-181 were collected from patients at 17 hospitals in Seoul and characterized based on antimicrobial susceptibility, resistance genes and plasmid replicons detected using polymerase chain reaction (PCR). Clonal relatedness was estimated using pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). All isolates had an identical multidrug resistance profile, including resistance to carbapenems, cephalosporins, ciprofloxacin, tetracycline, and trimethoprim/sulfamethoxazole, and susceptibility to amikacin, colistin, and tigecycline. Resistance genes (blaCTX-M-15, blaCMY-2, blaTEM-1B, blaOXA-1, aac(6')-Ib-cr, and qnrS) and plasmid replicons (IncFIA, IncFIB, and IncX3) was observed in almost all isolates. All isolates belonged to ST410 and were genetically similar (>88% similarity), with some PFGE types shared among isolates from different hospitals. Analysis of the whole genome revealed that the isolates clustered together with other strains of the international high-risk clone ST410 B4/H24RxC from other countries. These findings underline the ongoing spread of the high-risk clone of NDM-5- and OXA-181-producing E. coli ST410 B4/H24RxC among hospitals in Seoul. Continuous monitoring and implementation of infection control measures are crucial to track and prevent further spread of these resistant strains.

Distribution of mcr genes among carbapenem-resistant Enterobacterales clinical isolates: high prevalence of mcr-positive Enterobacter cloacae complex in Seoul, Republic of Korea.

Colistin is often used as a drug of last resort against infections caused by multi-drug-resistant Gram-negative bacteria, including carbapenem-resistant Enterobacterales (CRE). Recently, the acquisition of mobile colistin resistance (mcr) genes by CRE has become a cause for concern. This study investigated the prevalence of mcr genes in CRE isolates in Seoul, Republic of Korea. In total, 3675 CRE strains were collected from patients between 2018 and 2019, and initially screened for mcr genes using multiplex polymerase chain reaction assays. Upon the identification of mcr-harbouring strains, colistin susceptibility tests, identification of carbapenemase and ß-lactamase genes, and plasmid replicon typing were performed. Clonal analysis was conducted using pulsed-field gel electrophoresis. mcr genes were detected in 2.2% (80/3675) of CRE strains. There were three mcr-1 carriers, one mcr-4.3 carrier, one mcr-4.3/mcr-9 carrier, 58 mcr-9 carriers, one mcr-9/mcr-10 carrier and 16 mcr-10 carriers among various Enterobacterales species, of which 60 were Enterobacter cloacae complex (ECC) strains. The prevalence of mcr genes in ECC strains was 20.5%. Molecular detection confirmed that 21.3% and 13.8% of mcr-harbouring strains shared blaNDM-1 or blaKPC-2, respectively. In addition, an IncHI2 replicon was identified in 71.7% of mcr-9 strains. Comparative analysis revealed not only a notable diversity of mcr carriers, but also clonal spreading or nosocomial outbreaks of some ECC strains. These findings revealed a silent distribution of mcr genes in CRE strains with high genetic heterogeneity in Seoul, underscoring the urgent need for timely intervention to control and prevent mcr dissemination.

Emergence of a multidrug-resistant clinical isolate of Escherichia coli ST8499 strain producing NDM-13 carbapenemase in the Republic of Korea.

We described a carbapenem-resistant Escherichia coli ST8499 strain producing New Delhi metallo-ß-lactamase-13 (NDM-13) from patient in Korea. The isolate exhibited multidrug resistance, but remained susceptible to colistin and tigecycline. The blaNDM-13 gene was located on a 130-kb self-transmissible plasmid. This is the first report of NDM-13 carbapenemase in Korea.

Monitoring heavy metals, residual agricultural chemicals and sulfites in traditional herbal decoctions.

BACKGROUND: Asian traditional herbal preparations are frequently considered for the contamination with undeclared toxic or hazardous substances. The aim of this study was to determine the toxic heavy metals, pesticides and sulfur dioxide in decoctions that is a common form of final utilization in Korea. METHODS: A total of 155 decoctions composed of multi-ingredient traditional herbs were randomly sampled from Seoul in Korea between 2013 and 2014. For each decoction, the concentrations of four heavy metals (arsenic, cadmium, lead and mercury), 33 pesticides and sulfur dioxide were analyzed using inductively coupled plasma mass spectrometry (ICP-MS), mercury analyzer, gas chromatography/nitrogen phosphorous detector (GC/NPD), gas chromatography/micro electron capture detector (GC/µECD), and Monier-Williams method respectively. RESULTS: One hundred fifty-two of One hundred fifty-five decoctions (98.1%) contained one of three heavy metals (96.1% for As, 97.4% for Cd, and 90.3% for Pb, 0.0% for Hg). Their average concentrations (77.0 ± 79.7 ug/kg for As, 20.4 ± 23.7 ug/kg for Cd, and 68.8 ± 76.5 ug/kg for Pb) were approximately 20% of the maximum allowable limits of vegetable or ginseng beverage described in the Korean Food Standard Codex while their 95th percentile concentrations were below than the guideline for them. None of 33 pesticides was detected in 155 decoction samples, and only one sample showed over limit of detection for residual sulfites. CONCLUSIONS: This study support that the contained status of toxic heavy metals, pesticides and sulfur dioxide in herbal decoctions are currently within safe level in Korea, and provide a reference data for the further studies focused on the safety herbal preparations.

A potential risk assessment of a dengue outbreak in north central Texas, USA. (Part 1 of 2): Abundance and temporal variation of dengue vectors.

In response to three imported dengue cases in north central Texas as well as increased case numbers in Texas and adjoining Mexican states in 2005, the authors assessed the potential risk of a dengue outbreak in north central Texas by investigating abundance and temporal variation of dengue vectors in 2006. Dengue vector abundance was monitored from 54 sites in Dallas County, Texas, from June to November 2006, using oviposition traps. Both dengue vectors--the yellow fever mosquito, Aedes aegypti, and the Asian tiger mosquito, Aedes albopictus--were present. Of the two, Ae. albopictus was more abundant and its abundance appeared to be positively affected by temperature and precipitation. Potential risk of a dengue outbreak was predicted based on the abundance and temporal variation of dengue vectors and a long-term trend of breeding season precipitation and warmer winter temperatures.

Analysis of foodborne disease outbreaks for improvement of food safety programs in Seoul, Republic of Korea, from 2002 to 2006.

Foodborne disease (FBD) is a common food safety problem in Seoul, Republic of Korea. To identify target areas for improvement of the food safety programs, FBD outbreaks from 2002 to 2006 were analyzed with regard to facility, monthly occurrences, and causative agents. A total of 147 FBD outbreaks were reported, with an average of 29.4 FBD outbreaks per year and 49 cases per outbreak. Restaurants and school lunches were two main facilities associated with 76.2% of the outbreaks. A majority of FBD cases (73.1%) were from school lunches. The highest number of outbreaks and cases occurred in June, followed by March. Among the seven identified causative agents, norovirus was the most significant in the number of outbreaks and cases. Among the outbreaks and cases with causative agents identified, norovirus and Staphylococcus aureus were responsible for 61.7% of outbreaks and 81.5% of cases. The analysis indicates that the efficiency of current food safety programs could be enhanced if critical control points in school lunch programs are identified and incorporated in the training and inspection. Identifying risk factors for contamination of norovirus and Staphylococcus aureus would also be beneficial.