Pub Date : 2010-12-01DOI: 10.5145/KJCM.2010.13.4.162
M. Cho, S. Noh, M. N. Kim, Kyoung Mo Kim
Background: Causative bacterial agents of infectious diarrheal disease were traditionally diagnosed by stool cultures. Stool culture, however, has a problem because of relatively low sensitivity and long turnaround time. In this study, we evaluated multiplex PCR applied on stool specimens directly to diagnose enteropathogenic bacteria. Methods: From June to September 2009, 173 diarrheal stools submitted for stool cultures were tested by SeeplexR Diarrhea ACE Detection kit (Seegene, Korea) to detect 10 enteropathogenic bacteria. Specimens were cultured for Salmonella, Shigella, Vibrio, and Yersinia. Late 50 specimens were also cultured for Campylobacter. The specimens positive for verotoxin-producing Escherichia coli (VTEC) were further subcultured for detecting enterohaemorrhagic Escherichia coli O157:H7. Electronic medical records were reviewed for clinical and laboratory findings. Results: Of 173 specimens, multiplex PCR and cultures identified enteropathogens in 36 (20.8%) and 8 specimens (4.6%), respectively. While multiplex PCR detected 5 Salmonella, 15 Campylobacter, 1 Vibrio, 4 Clostridium difficiles toxin B, 5 Clostridium perfringens, 1 Yersinia enterocolitica, 5 Aeromonas, and 2 VTEC, cultures detected 5 Salmonella, 1 Vibrio, 1 Y. enterocolitica, 1 Aeromonas, and 2 E. coli O157:H7. Conclusion: Multiplex PCR would be useful to detect Campylobacter, VTEC and C. perfringens, as well as have equivalent sensitivity to conventional culture for ordinary enteropathogens such as Salmonella, Shigella, Vibrio, Y. enterocolitica. Direct application of multiplex PCR combined with conventional cultures on stool warrants remarkable improvement of sensitivity to diagnose enteropathogenic bacteria. (Korean J Clin Microbiol 2010;13:162-168)
{"title":"Direct Application of Multiplex PCR on Stool Specimens for Detection of Enteropathogenic Bacteria","authors":"M. Cho, S. Noh, M. N. Kim, Kyoung Mo Kim","doi":"10.5145/KJCM.2010.13.4.162","DOIUrl":"https://doi.org/10.5145/KJCM.2010.13.4.162","url":null,"abstract":"Background: Causative bacterial agents of infectious diarrheal disease were traditionally diagnosed by stool cultures. Stool culture, however, has a problem because of relatively low sensitivity and long turnaround time. In this study, we evaluated multiplex PCR applied on stool specimens directly to diagnose enteropathogenic bacteria. Methods: From June to September 2009, 173 diarrheal stools submitted for stool cultures were tested by SeeplexR Diarrhea ACE Detection kit (Seegene, Korea) to detect 10 enteropathogenic bacteria. Specimens were cultured for Salmonella, Shigella, Vibrio, and Yersinia. Late 50 specimens were also cultured for Campylobacter. The specimens positive for verotoxin-producing Escherichia coli (VTEC) were further subcultured for detecting enterohaemorrhagic Escherichia coli O157:H7. Electronic medical records were reviewed for clinical and laboratory findings. Results: Of 173 specimens, multiplex PCR and cultures identified enteropathogens in 36 (20.8%) and 8 specimens (4.6%), respectively. While multiplex PCR detected 5 Salmonella, 15 Campylobacter, 1 Vibrio, 4 Clostridium difficiles toxin B, 5 Clostridium perfringens, 1 Yersinia enterocolitica, 5 Aeromonas, and 2 VTEC, cultures detected 5 Salmonella, 1 Vibrio, 1 Y. enterocolitica, 1 Aeromonas, and 2 E. coli O157:H7. Conclusion: Multiplex PCR would be useful to detect Campylobacter, VTEC and C. perfringens, as well as have equivalent sensitivity to conventional culture for ordinary enteropathogens such as Salmonella, Shigella, Vibrio, Y. enterocolitica. Direct application of multiplex PCR combined with conventional cultures on stool warrants remarkable improvement of sensitivity to diagnose enteropathogenic bacteria. (Korean J Clin Microbiol 2010;13:162-168)","PeriodicalId":143093,"journal":{"name":"Korean Journal of Clinical Microbiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122121227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-12-01DOI: 10.5145/KJCM.2010.13.4.178
Koung-Sun Lee, Do-Sim Park, J. Cho, Hak Yeol Kim, Young Jin Lee
Balantidium coli is the only largest ciliated protozoon known to infect human and nonhuman primates. Balantidiasis is a zoonotic disease and is acquired by humans via fecal-oral contact between pigs and humans. The clinical manifestation includes mainly gastrointestinal symptoms; diarrhea and abdominal pain, but in rare cases extraintestinal spread to lungs has been reported. A few reports of B. coli were found in vaginal secretion, skin, gastric juice, and omentum, but there have been no previous isolated cases in the respiratory tract in Korea. We reported that the first case of pneumonia caused by B. coli in Korea in an immunocompetent 40-year-old woman who displayed symptoms of chest discomfort and cough, and was cured with metronidazole. (Korean J Clin Microbiol 2010;13:178-181)
{"title":"A Case of Pneumonia Caused by Balantidium coli in an Immunocompetent Patient","authors":"Koung-Sun Lee, Do-Sim Park, J. Cho, Hak Yeol Kim, Young Jin Lee","doi":"10.5145/KJCM.2010.13.4.178","DOIUrl":"https://doi.org/10.5145/KJCM.2010.13.4.178","url":null,"abstract":"Balantidium coli is the only largest ciliated protozoon known to infect human and nonhuman primates. Balantidiasis is a zoonotic disease and is acquired by humans via fecal-oral contact between pigs and humans. The clinical manifestation includes mainly gastrointestinal symptoms; diarrhea and abdominal pain, but in rare cases extraintestinal spread to lungs has been reported. A few reports of B. coli were found in vaginal secretion, skin, gastric juice, and omentum, but there have been no previous isolated cases in the respiratory tract in Korea. We reported that the first case of pneumonia caused by B. coli in Korea in an immunocompetent 40-year-old woman who displayed symptoms of chest discomfort and cough, and was cured with metronidazole. (Korean J Clin Microbiol 2010;13:178-181)","PeriodicalId":143093,"journal":{"name":"Korean Journal of Clinical Microbiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129441170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-12-01DOI: 10.5145/KJCM.2010.13.4.182
Jeong Tae Kim, Jaehyeon Lee, Hye Soo Lee, Y. Cho, D. Kim, Sam-Im Choi, S. Cho
Microscopic examination of peripheral blood smear (PBS) for detection of microorganisms is simple method that can be used for doctors to confirm the septicemia more swiftly and to select more specific therapy. But it is unusual to find microorganisms in PBS. We report a case of gram negative bacteremia diagnosed by PBS in a severe thrombocytopenic pediatric surgical patient. A 6-month and 2 week old baby with cyanosis was diagnosed congenital heart diseases such as transposition of great arteries, atrial septal defect, and patent ductus arteriosus. The infant underwent surgical operations and the postoperative platelet count progressively decreased in spite of transfusion of multiple platelet concentrates. We performed routine examination of a PBS for evaluation of severe thrombocytopenia. The PBS revealed severe thrombocytopenia, leukopenia with left shifted and some extracellular bacilli. Toxic granulations, toxic vacuoles and some bacilli were observed in the neutrophils. The bacilli were identified as Pseudomonas aeruginosa and Serratia marcescens in blood culture. To our knowledge, this is the second case of bacteremia diagnosed by PBS before the positive blood culture in Korea. We suggest that a PBS is useful for the rapid detection of organisms in cases of septicemia with severe thrombocytopenic pediatric surgical patient. (Korean J Clin Microbiol 2010;13:182-186)
{"title":"Bacteremia Detected by a Peripheral Blood Smear in a Pediatric Surgical Patient with Thrombocytopenia","authors":"Jeong Tae Kim, Jaehyeon Lee, Hye Soo Lee, Y. Cho, D. Kim, Sam-Im Choi, S. Cho","doi":"10.5145/KJCM.2010.13.4.182","DOIUrl":"https://doi.org/10.5145/KJCM.2010.13.4.182","url":null,"abstract":"Microscopic examination of peripheral blood smear (PBS) for detection of microorganisms is simple method that can be used for doctors to confirm the septicemia more swiftly and to select more specific therapy. But it is unusual to find microorganisms in PBS. We report a case of gram negative bacteremia diagnosed by PBS in a severe thrombocytopenic pediatric surgical patient. A 6-month and 2 week old baby with cyanosis was diagnosed congenital heart diseases such as transposition of great arteries, atrial septal defect, and patent ductus arteriosus. The infant underwent surgical operations and the postoperative platelet count progressively decreased in spite of transfusion of multiple platelet concentrates. We performed routine examination of a PBS for evaluation of severe thrombocytopenia. The PBS revealed severe thrombocytopenia, leukopenia with left shifted and some extracellular bacilli. Toxic granulations, toxic vacuoles and some bacilli were observed in the neutrophils. The bacilli were identified as Pseudomonas aeruginosa and Serratia marcescens in blood culture. To our knowledge, this is the second case of bacteremia diagnosed by PBS before the positive blood culture in Korea. We suggest that a PBS is useful for the rapid detection of organisms in cases of septicemia with severe thrombocytopenic pediatric surgical patient. (Korean J Clin Microbiol 2010;13:182-186)","PeriodicalId":143093,"journal":{"name":"Korean Journal of Clinical Microbiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128626216","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-12-01DOI: 10.5145/KJCM.2010.13.4.157
M. K. Kim, J. Hong, Miae Lee
Background: The Clinical and Laboratory Standards Institute (CLSI) recommends testing for inducible clindamycin resistance in clindamycin non-resistant and erythromycin resistant (CNR-ER) staphylococci by using a D-zone test. Recently, the VITEK2 system was developed to detect inducible clindamycin resistance in staphylococci. We evaluated the performance of the VITEK2 system by comparing it with a D-zone test. Methods: In detecting inducible clindamycin resistance, a total of 142 clinical isolates of staphylococci were tested by using the VITEK2 Antimicrobial Susceptibility Test (AST)-P601 card (bioMerieux, Marcy l’Etoile, France) and the D-zone test. Of the 142 isolates of staphylococci tested, 114 were CNR-ER staphylococci [40 coagulase-negative staphylococci (CoNS), 74 Staphylococcus aureus] and 28 were staphylococci, either resistant or susceptible to clindamycin and erythromycin (1 CoNS and 27 S. aureus). Results: Of the 114 CNR-ER staphylococci, 98.6% (73/74) of S. aureus and 32.5% (13/40) of CoNS were inducible clindamycin resistant according to the Dzone test. Overall sensitivity and specificity of the VITEK2 system were 98.8% (85/86) and 98.2% (55/56) respectively, and the agreement between the VITEK2 system and the D-zone test was 98.6% (140/142). Conclusion: The VITEK2 system shows high concordance with a D-zone test. The inducible clindamycin resistance in staphylococci can be detected easily and conveniently by the VITEK2 system. (Korean J Clin Microbiol 2010;13:157-161)
背景:临床和实验室标准协会(CLSI)推荐使用d区试验检测克林霉素非耐药和红霉素耐药(CNR-ER)葡萄球菌的诱导克林霉素耐药。最近，VITEK2系统被开发用于检测葡萄球菌诱导克林霉素耐药。我们通过将VITEK2系统与d区测试进行比较来评估其性能。方法:采用VITEK2药敏试验(AST)-P601卡(法国bioMerieux, Marcy l 'Etoile, France)和d区试验对142株临床分离的葡萄球菌进行诱导型抗生素耐药检测。142株葡萄球菌中，CNR-ER葡萄球菌114株[凝固酶阴性葡萄球菌(con) 40株，金黄色葡萄球菌74株]，对克林霉素和红霉素耐药或敏感的葡萄球菌28株(con 1株，金黄色葡萄球菌27株)。结果:114株CNR-ER葡萄球菌中，经Dzone试验，98.6%(73/74)的金黄色葡萄球菌和32.5%(13/40)的con均可诱导耐克林霉素。VITEK2系统的总体敏感性和特异性分别为98.8%(85/86)和98.2%(55/56)，与d区检测的一致性为98.6%(140/142)。结论:VITEK2系统与d区试验具有较高的一致性。VITEK2系统可方便、简便地检测葡萄球菌的诱导型克林霉素耐药。(中华临床微生物学杂志2010;13:157-161)
{"title":"Performance of the VITEK2 System for Detection of Inducible Clindamycin Resistance in Staphylococci","authors":"M. K. Kim, J. Hong, Miae Lee","doi":"10.5145/KJCM.2010.13.4.157","DOIUrl":"https://doi.org/10.5145/KJCM.2010.13.4.157","url":null,"abstract":"Background: The Clinical and Laboratory Standards Institute (CLSI) recommends testing for inducible clindamycin resistance in clindamycin non-resistant and erythromycin resistant (CNR-ER) staphylococci by using a D-zone test. Recently, the VITEK2 system was developed to detect inducible clindamycin resistance in staphylococci. We evaluated the performance of the VITEK2 system by comparing it with a D-zone test. Methods: In detecting inducible clindamycin resistance, a total of 142 clinical isolates of staphylococci were tested by using the VITEK2 Antimicrobial Susceptibility Test (AST)-P601 card (bioMerieux, Marcy l’Etoile, France) and the D-zone test. Of the 142 isolates of staphylococci tested, 114 were CNR-ER staphylococci [40 coagulase-negative staphylococci (CoNS), 74 Staphylococcus aureus] and 28 were staphylococci, either resistant or susceptible to clindamycin and erythromycin (1 CoNS and 27 S. aureus). Results: Of the 114 CNR-ER staphylococci, 98.6% (73/74) of S. aureus and 32.5% (13/40) of CoNS were inducible clindamycin resistant according to the Dzone test. Overall sensitivity and specificity of the VITEK2 system were 98.8% (85/86) and 98.2% (55/56) respectively, and the agreement between the VITEK2 system and the D-zone test was 98.6% (140/142). Conclusion: The VITEK2 system shows high concordance with a D-zone test. The inducible clindamycin resistance in staphylococci can be detected easily and conveniently by the VITEK2 system. (Korean J Clin Microbiol 2010;13:157-161)","PeriodicalId":143093,"journal":{"name":"Korean Journal of Clinical Microbiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126221648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-09-01DOI: 10.5145/KJCM.2010.13.3.109
Aerin Kwon, Jae-Seok Kim, H. Kim, W. Song, J. Park, H. Cho, K. Lee
id antigen test and rRT-PCR. A total of 124 (10.1%) patients showed a discrepancy between the two tests. Among them, 116 (9.4%) were only positive for rRT-PCR and 8 (0.7%) were only positive for the rapid antigen test. The latter 8 patients all showed negative H1/M2 results in rRT-PCR. There were significant differences in detection rates of the rapid antigen test between different H1 Ct (threshold cycle) interval groups and for different age groups (P ＜0.05). Conclusion: Although the rapid antigen test is easy to perform and provides fast results, its limits as a screening test for detection of novel swine influenza (H1N1) due to its low sensitivity compared to rRTPCR need to be considered in practical situations. (Korean J Clin Microbiol 2010;13:109-113)
{"title":"Comparison of Rapid Antigen Test and Real-Time Reverse Transcriptase PCR for Diagnosing Novel Swine Influenza A (H1N1)","authors":"Aerin Kwon, Jae-Seok Kim, H. Kim, W. Song, J. Park, H. Cho, K. Lee","doi":"10.5145/KJCM.2010.13.3.109","DOIUrl":"https://doi.org/10.5145/KJCM.2010.13.3.109","url":null,"abstract":"id antigen test and rRT-PCR. A total of 124 (10.1%) patients showed a discrepancy between the two tests. Among them, 116 (9.4%) were only positive for rRT-PCR and 8 (0.7%) were only positive for the rapid antigen test. The latter 8 patients all showed negative H1/M2 results in rRT-PCR. There were significant differences in detection rates of the rapid antigen test between different H1 Ct (threshold cycle) interval groups and for different age groups (P ＜0.05). Conclusion: Although the rapid antigen test is easy to perform and provides fast results, its limits as a screening test for detection of novel swine influenza (H1N1) due to its low sensitivity compared to rRTPCR need to be considered in practical situations. (Korean J Clin Microbiol 2010;13:109-113)","PeriodicalId":143093,"journal":{"name":"Korean Journal of Clinical Microbiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131976929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-09-01DOI: 10.5145/KJCM.2010.13.3.103
S. Yoo, C. Noh, H. Yoo, W. Shin, Soo-Jeon Choi, Baek-Nam Kim, Chang Keun Kim, M. Chey, Kyunam Kim, Sang Lae Lee, E. Kuak, B. Shin
Background: The aim of this study is to clarify the epidemiology of swine-origin influenza A (H1N1) virus 2009 (S-OIV) during the first month of outbreak at one of influenza clinic in Seoul, Korea. Methods: We documented the epidemiologic and clinical features of S-OIV-confirmed cases who visited a university hospital in Northeastern Seoul between August 21 and September 20, 2009. Nasopharyngeal swab of patients with acute febrile respiratory illnesses were evaluated with rapid influenza antigen tests and multiplex RT-PCR for S-OIV and seasonal influenza A. Results: A total of 5,322 patients with acute febrile respiratory illnesses were identified at our influenza clinic for the study period. S-OIV was confirmed in 309 patients by RT-PCR. The patients ranged from 2 months to 61 years of age and 189 patients (61.2%) were teenagers. Eighty-one patients had known contact with S-OIV-confirmed patients in schools (N=61), households (N=15), and healthcare facilities (N=3). Frequent symptoms were fever (94.5%), cough (73.1%), sore throat (52.1%), and rhinorrhea (50.5%). Gastrointestinal symptoms were also present in 10 patients (4.9%). Ten patients (4.9%) required hospitalizations. Seventy patients (22.7%) could not take oseltamivir at the first visits, however, all of them recovered without complication. Rapid antigen tests showed the sensitivity of 44.4% (130/294). Patients with positive antigen tests, compared with negative antigen tests, showed higher frequencies of rhinorrhea (60.8% vs 43.3%, P=0.004) and stuffy nose (33.8% vs 20.1%, P=0.012). Conclusion: S-OIV infections spread predominately in school-aged children during the early accelerating phase of the outbreak. Rapid influenza antigen tests were correlated with nasal discharge and obstruction. (Korean J Clin Microbiol 2010;13:103-108)
{"title":"Outbreak of Swine-Origin Influenza A (H1N1); Experience of a Regional Center in Seoul during a Month, August-September 2009","authors":"S. Yoo, C. Noh, H. Yoo, W. Shin, Soo-Jeon Choi, Baek-Nam Kim, Chang Keun Kim, M. Chey, Kyunam Kim, Sang Lae Lee, E. Kuak, B. Shin","doi":"10.5145/KJCM.2010.13.3.103","DOIUrl":"https://doi.org/10.5145/KJCM.2010.13.3.103","url":null,"abstract":"Background: The aim of this study is to clarify the epidemiology of swine-origin influenza A (H1N1) virus 2009 (S-OIV) during the first month of outbreak at one of influenza clinic in Seoul, Korea. Methods: We documented the epidemiologic and clinical features of S-OIV-confirmed cases who visited a university hospital in Northeastern Seoul between August 21 and September 20, 2009. Nasopharyngeal swab of patients with acute febrile respiratory illnesses were evaluated with rapid influenza antigen tests and multiplex RT-PCR for S-OIV and seasonal influenza A. Results: A total of 5,322 patients with acute febrile respiratory illnesses were identified at our influenza clinic for the study period. S-OIV was confirmed in 309 patients by RT-PCR. The patients ranged from 2 months to 61 years of age and 189 patients (61.2%) were teenagers. Eighty-one patients had known contact with S-OIV-confirmed patients in schools (N=61), households (N=15), and healthcare facilities (N=3). Frequent symptoms were fever (94.5%), cough (73.1%), sore throat (52.1%), and rhinorrhea (50.5%). Gastrointestinal symptoms were also present in 10 patients (4.9%). Ten patients (4.9%) required hospitalizations. Seventy patients (22.7%) could not take oseltamivir at the first visits, however, all of them recovered without complication. Rapid antigen tests showed the sensitivity of 44.4% (130/294). Patients with positive antigen tests, compared with negative antigen tests, showed higher frequencies of rhinorrhea (60.8% vs 43.3%, P=0.004) and stuffy nose (33.8% vs 20.1%, P=0.012). Conclusion: S-OIV infections spread predominately in school-aged children during the early accelerating phase of the outbreak. Rapid influenza antigen tests were correlated with nasal discharge and obstruction. (Korean J Clin Microbiol 2010;13:103-108)","PeriodicalId":143093,"journal":{"name":"Korean Journal of Clinical Microbiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114496014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-09-01DOI: 10.5145/KJCM.2010.13.3.114
Soon-Deok Park, Y. Uh, I. Jang, K. Yoon, Jong‐Hee Shin
Background: The VITEK-2 yeast susceptibility test (AST-YS01; bioMerieux, Hazelwood, MO, USA) has recently been introduced as a fully automated, commercial antifungal susceptibility test system that determines MIC endpoints spectrophotometrically, thereby eliminating subjective errors. We compared the ATB FUNGUS 2 (bioMe rieux) and VITEK-2 (ASTYS01) systems to the CLSI M27 method for susceptibility testing of Candida isolates. Methods: We tested 59 Candida species that were isolated from blood cultures at Wonju Christian Hospital between September 2008 and August 2009. We compared MIC results for amphotericin B, flucytosine, fluconazole and voriconazole using the ATB FUNGUS 2 and VITEK-2 (AST-YS01) tests to those obtained by the CLSI M27 broth microdilution method. Results: Within two-fold dilutions of MICs, the agreement of the ATB FUNGUS 2 and VITEK-2 (ASTYS01) tests with the CLSI method according to antifungal agents were: amphotericin B, 100% vs. 100% flucytosine, 100% vs. 100% fluconazole, 83.6% vs. 98.3% and voriconazole, 83.6% vs. 96.7%, respectively. The categorical discrepancies for fluconazole and voriconazole were 20.4% and 18.6% for ATB FUNGUS 2, and 6.8% and 0% for VITEK-2 (ASTYS01). There were no major errors for fluconazole and voriconazole in either ATB FUNGUS 2 or VITEK-2 (ASTYS01) tests. Conclusion: The VITEK-2 system (AST-YS01) appears to be rapid and highly correlative with the CLSI method, suggesting that it is effective for antifungal susceptibility testing for Candida species in clinical settings. (Korean J Clin Microbiol 2010;13: 114-120)
背景:VITEK-2酵母药敏试验(AST-YS01;bioMerieux, Hazelwood, MO, USA)最近推出了一种全自动商用抗真菌药敏测试系统，可以分光光度法确定MIC端点，从而消除主观误差。我们比较了ATB FUNGUS 2 (bioMe rieux)和VITEK-2 (ASTYS01)系统与CLSI M27方法对念珠菌分离株的药敏试验。方法:对2008年9月~ 2009年8月元州基督教医院血培养分离的59种念珠菌进行检测。我们比较了ATB FUNGUS 2和VITEK-2 (AST-YS01)试验对两性霉素B、氟胞嘧啶、氟康唑和伏立康唑的MIC结果与CLSI M27肉汤微量稀释法获得的结果。结果:在mic的2倍稀释度范围内，ATB FUNGUS 2和VITEK-2 (ASTYS01)的CLSI法检测抗真菌药物的一致性分别为两性霉素B, 100% vs 100%氟胞嘧啶，100% vs 100%氟康唑，83.6% vs 98.3%，伏立康唑，83.6% vs 96.7%。氟康唑和伏立康唑对ATB FUNGUS 2的分类差异分别为20.4%和18.6%，对VITEK-2 (ASTYS01)的分类差异分别为6.8%和0%。氟康唑和伏立康唑在ATB FUNGUS 2和VITEK-2 (ASTYS01)试验中均无重大错误。结论:VITEK-2系统(AST-YS01)快速且与CLSI法高度相关，可用于临床假丝酵母菌的药敏检测。(中华临床微生物学杂志2010;13:114-120)
{"title":"Comparison of ATB FUNGUS 2 and VITEK-2 Antifungal Susceptibility (AST-YS01) Tests for Candida Species Isolated from Blood Culture","authors":"Soon-Deok Park, Y. Uh, I. Jang, K. Yoon, Jong‐Hee Shin","doi":"10.5145/KJCM.2010.13.3.114","DOIUrl":"https://doi.org/10.5145/KJCM.2010.13.3.114","url":null,"abstract":"Background: The VITEK-2 yeast susceptibility test (AST-YS01; bioMerieux, Hazelwood, MO, USA) has recently been introduced as a fully automated, commercial antifungal susceptibility test system that determines MIC endpoints spectrophotometrically, thereby eliminating subjective errors. We compared the ATB FUNGUS 2 (bioMe rieux) and VITEK-2 (ASTYS01) systems to the CLSI M27 method for susceptibility testing of Candida isolates. Methods: We tested 59 Candida species that were isolated from blood cultures at Wonju Christian Hospital between September 2008 and August 2009. We compared MIC results for amphotericin B, flucytosine, fluconazole and voriconazole using the ATB FUNGUS 2 and VITEK-2 (AST-YS01) tests to those obtained by the CLSI M27 broth microdilution method. Results: Within two-fold dilutions of MICs, the agreement of the ATB FUNGUS 2 and VITEK-2 (ASTYS01) tests with the CLSI method according to antifungal agents were: amphotericin B, 100% vs. 100% flucytosine, 100% vs. 100% fluconazole, 83.6% vs. 98.3% and voriconazole, 83.6% vs. 96.7%, respectively. The categorical discrepancies for fluconazole and voriconazole were 20.4% and 18.6% for ATB FUNGUS 2, and 6.8% and 0% for VITEK-2 (ASTYS01). There were no major errors for fluconazole and voriconazole in either ATB FUNGUS 2 or VITEK-2 (ASTYS01) tests. Conclusion: The VITEK-2 system (AST-YS01) appears to be rapid and highly correlative with the CLSI method, suggesting that it is effective for antifungal susceptibility testing for Candida species in clinical settings. (Korean J Clin Microbiol 2010;13: 114-120)","PeriodicalId":143093,"journal":{"name":"Korean Journal of Clinical Microbiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122484705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-09-01DOI: 10.5145/KJCM.2010.13.3.125
Yangsoon Lee, E. Koh, Myungsook Kim, D. Yong, S. Jeong, Kyungwon Lee, Y. Chong
Clostridium citroniae is a novel species reclassified from C. clostridioforme. Clostridium species are obligate anaerobes and spore-forming gram-positive rods. However, C. citroniae stains gram negative and does not consistently produce spores, making it difficult to identify. We isolated C. citroniae from the blood and peritoneal fluid of one patient, and from the blood of another patient, both of whom were undergoing cancer chemotherapy. (Korean J Clin Microbiol 2010;13:125-127)
{"title":"Two Cases of Clostridium citroniae Bacteremia in Cancer Patients","authors":"Yangsoon Lee, E. Koh, Myungsook Kim, D. Yong, S. Jeong, Kyungwon Lee, Y. Chong","doi":"10.5145/KJCM.2010.13.3.125","DOIUrl":"https://doi.org/10.5145/KJCM.2010.13.3.125","url":null,"abstract":"Clostridium citroniae is a novel species reclassified from C. clostridioforme. Clostridium species are obligate anaerobes and spore-forming gram-positive rods. However, C. citroniae stains gram negative and does not consistently produce spores, making it difficult to identify. We isolated C. citroniae from the blood and peritoneal fluid of one patient, and from the blood of another patient, both of whom were undergoing cancer chemotherapy. (Korean J Clin Microbiol 2010;13:125-127)","PeriodicalId":143093,"journal":{"name":"Korean Journal of Clinical Microbiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133699808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-09-01DOI: 10.5145/KJCM.2010.13.3.140
H. Choi, Jong‐Hee Shin, Kyung-Hwa Park, M. Shin, S. Suh, D. Ryang
Candida orthopsilosis is a recently described Candida species phenotypically indistinguishable from Candida parapsilosis. This new species can be identified only by using molecular methods. We describe here a fatal case of fungemia caused by C. orthopsilosis in a 75-year-old male patient who had panperitonitis after total gastrectomy with Roux-en-Y esophagojejunostomy. All 18 blood cultures obtained from admission day 16 to day 68 yielded the same Candida species. Both Vitek 2 (bioMerieux, Inc., Hazelwood, MO, USA) and API 20C (bioMerieux, Marcy-l'Etoile, France) failed to identify these isolates. However, DNA sequencing analysis of both D1/D2 domain and internal transcribed spacer region of rDNA showed 100% identity with C. orthopsilosis. The fungemia was persistent over 50 days despite of systemic antifungal therapy including fluconazole and caspofungin, and the patient expired on day 73 of his hospital stay. This represents the first reported case of fatal fungemia by C. orthopsilosis in Korea. (Korean J Clin Microbiol 2010;13:140-143)
{"title":"A Fatal Case of Candida orthopsilosis Fungemia","authors":"H. Choi, Jong‐Hee Shin, Kyung-Hwa Park, M. Shin, S. Suh, D. Ryang","doi":"10.5145/KJCM.2010.13.3.140","DOIUrl":"https://doi.org/10.5145/KJCM.2010.13.3.140","url":null,"abstract":"Candida orthopsilosis is a recently described Candida species phenotypically indistinguishable from Candida parapsilosis. This new species can be identified only by using molecular methods. We describe here a fatal case of fungemia caused by C. orthopsilosis in a 75-year-old male patient who had panperitonitis after total gastrectomy with Roux-en-Y esophagojejunostomy. All 18 blood cultures obtained from admission day 16 to day 68 yielded the same Candida species. Both Vitek 2 (bioMerieux, Inc., Hazelwood, MO, USA) and API 20C (bioMerieux, Marcy-l'Etoile, France) failed to identify these isolates. However, DNA sequencing analysis of both D1/D2 domain and internal transcribed spacer region of rDNA showed 100% identity with C. orthopsilosis. The fungemia was persistent over 50 days despite of systemic antifungal therapy including fluconazole and caspofungin, and the patient expired on day 73 of his hospital stay. This represents the first reported case of fatal fungemia by C. orthopsilosis in Korea. (Korean J Clin Microbiol 2010;13:140-143)","PeriodicalId":143093,"journal":{"name":"Korean Journal of Clinical Microbiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126957150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2010-09-01DOI: 10.5145/KJCM.2010.13.3.132
N. Ryoo, J. Ha, K. Song
A 13-year-old girl presented in a local clinic with intermittent left ankle pain for 3 months without any history of trauma. She often had discomfort in walking but with no altered sensation or swelling. The patient was transferred to our hospital for the persistent pain in her left ankle. Fever and other constitutional symptoms were absent at presentation. There was no family history of specific illness and no evidence of any underlying diseases. A physical examination revealed swelling and mild tenderness of her left ankle. She had no systolic murmur or other specific findings. She undertook simple radiography and magnetic resonance imaging (MRI). Preoperatively, blood examination revealed a leukocyte count of 6.0×10/L (reference range, 4.0∼10.0×10/L) with neutrophils in 54%, a hemoglobin level of 12.5 g/dL (reference range, 12∼14 g/dL) and a platelet count of 398×10/L (reference range, 140∼ 450×10/L). C-reactive protein level was at 0.08 mg/dL (reference range, 0∼0.5 mg/dL), and an erythrocyte sedimentation rate at 6 mm/hr (reference range, <25 mm/hr). A preoperative simple radiography of lower extremity showed well-defined lytic lesion in the metadiaphyseal region of the left distal tibia (Fig. 1). MRI of the left ankle using T1-weighted and T2-weighted MRI showed a well-defined and bilobed intramedullary cystic lesion in metadiaphysis of left distal tibia about 18 mm in diameter and 40 mm in length. This lesion revealed uniform rim enhancement, marrow edema and thin periosteal reaction, and no definite cortical disruption nor soft tissue mass was noted (Fig. 2). A percutaneous needle biopsy of the lesion showed an intracortical lytic lesion with a tiny, hyperdense focus at its center and revealed chronic inflammatory tissue reaction. She underwent a surgery for the debridement of Brodie’s abscess. Aspirates of abscess during the operation were cultured sequentially and yielded Salmonealla spp., group E by performing Gram stain, Salmonella/Shigella and triple sugar iron agar findings, and antisera grouping with no other pathogenic colonies. S. enterica serovar Senftenberg was finally identified by conventional and molecular identification methods at the Institute of Health and Environment in Daegu. Antimicrobial susceptibility test was done by VITEK system (bioMerieux VITEK, Hazelwood, MO, USA) and revealed susceptible to ampicillin, cefotaxime and ciprofloxacin except trimethoprim-sulfamethoxazole. The infection was successfully treated with operational curettage and intravenous cefotaxime. After 2 weeks of the treatment, cefotaxime was changed to per oral and she returned to outpatient clinic.
{"title":"Brodie's Abscess Caused by Salmonella enteritica serovar Senftenberg in a Healthy Child","authors":"N. Ryoo, J. Ha, K. Song","doi":"10.5145/KJCM.2010.13.3.132","DOIUrl":"https://doi.org/10.5145/KJCM.2010.13.3.132","url":null,"abstract":"A 13-year-old girl presented in a local clinic with intermittent left ankle pain for 3 months without any history of trauma. She often had discomfort in walking but with no altered sensation or swelling. The patient was transferred to our hospital for the persistent pain in her left ankle. Fever and other constitutional symptoms were absent at presentation. There was no family history of specific illness and no evidence of any underlying diseases. A physical examination revealed swelling and mild tenderness of her left ankle. She had no systolic murmur or other specific findings. She undertook simple radiography and magnetic resonance imaging (MRI). Preoperatively, blood examination revealed a leukocyte count of 6.0×10/L (reference range, 4.0∼10.0×10/L) with neutrophils in 54%, a hemoglobin level of 12.5 g/dL (reference range, 12∼14 g/dL) and a platelet count of 398×10/L (reference range, 140∼ 450×10/L). C-reactive protein level was at 0.08 mg/dL (reference range, 0∼0.5 mg/dL), and an erythrocyte sedimentation rate at 6 mm/hr (reference range, <25 mm/hr). A preoperative simple radiography of lower extremity showed well-defined lytic lesion in the metadiaphyseal region of the left distal tibia (Fig. 1). MRI of the left ankle using T1-weighted and T2-weighted MRI showed a well-defined and bilobed intramedullary cystic lesion in metadiaphysis of left distal tibia about 18 mm in diameter and 40 mm in length. This lesion revealed uniform rim enhancement, marrow edema and thin periosteal reaction, and no definite cortical disruption nor soft tissue mass was noted (Fig. 2). A percutaneous needle biopsy of the lesion showed an intracortical lytic lesion with a tiny, hyperdense focus at its center and revealed chronic inflammatory tissue reaction. She underwent a surgery for the debridement of Brodie’s abscess. Aspirates of abscess during the operation were cultured sequentially and yielded Salmonealla spp., group E by performing Gram stain, Salmonella/Shigella and triple sugar iron agar findings, and antisera grouping with no other pathogenic colonies. S. enterica serovar Senftenberg was finally identified by conventional and molecular identification methods at the Institute of Health and Environment in Daegu. Antimicrobial susceptibility test was done by VITEK system (bioMerieux VITEK, Hazelwood, MO, USA) and revealed susceptible to ampicillin, cefotaxime and ciprofloxacin except trimethoprim-sulfamethoxazole. The infection was successfully treated with operational curettage and intravenous cefotaxime. After 2 weeks of the treatment, cefotaxime was changed to per oral and she returned to outpatient clinic.","PeriodicalId":143093,"journal":{"name":"Korean Journal of Clinical Microbiology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2010-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120994935","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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