Pub Date : 2020-01-01DOI: 10.14776/piv.2020.27.e18
Su Kyung Kim, Joon-sik Choi, Dongsub Kim, C. Kang, D. Chung, K. Peck, E. Kang, Yae-Jean Kim
Purpose: Epstein-Barr virus (EBV) infection is related to infectious mononucleosis or nasopharyngeal cancer, and its epidemiology may change according to the socioeconomic development of communities. This study aimed to evaluate the recent epidemiology of EBV seropositive rate in Korea. Methods: We retrospectively reviewed EBV serology test results obtained from a part of clinical care at Samsung Medical Center, Seoul, South Korea, from January 2000 to December 2017. Results: The EBV seropositive rate in 26,527 subjects during the study period was 81.0% (21,485/26,527): 44.4% (2,716/6,122) in subjects aged 0–9 years, 75.8% (2,077/2,739) in those aged 10–19 years, and 94.5% (16,692/17,666) in those aged ≥20 years. The EBV seropositive rate decreased from 89.4% (8,592/9,616) in 2000–2008 to 76.2% (12,893/16,911) in 2009– 2017 ( P <0.001). Especially, the EBV seropositive rate in subjects aged 0–19 years significantly decreased from 2000–2008 to 2009–2017 (0–9 years, 62.8% [1,172/1,866] in 2000–2008 and 36.3% [1,544/4,256] in 2009–2017; 10–19 years, 83.8% [745/858] in 2000–2008 and 70.8% (1,332/1,881) in 2009–2017) ( P <0.001). Conclusions: The EBV seropositive rate in children has decreased in the last 20 years. As the age of patients with primary EBV infection increased, there is a need for interest in clinical manifestation, such as infectious mononucleosis, in adolescents and young adults.
{"title":"Analysis of the Change in Seropositive Rate of Epstein-Barr Virus in Koreans: A Single-Center Study","authors":"Su Kyung Kim, Joon-sik Choi, Dongsub Kim, C. Kang, D. Chung, K. Peck, E. Kang, Yae-Jean Kim","doi":"10.14776/piv.2020.27.e18","DOIUrl":"https://doi.org/10.14776/piv.2020.27.e18","url":null,"abstract":"Purpose: Epstein-Barr virus (EBV) infection is related to infectious mononucleosis or nasopharyngeal cancer, and its epidemiology may change according to the socioeconomic development of communities. This study aimed to evaluate the recent epidemiology of EBV seropositive rate in Korea. Methods: We retrospectively reviewed EBV serology test results obtained from a part of clinical care at Samsung Medical Center, Seoul, South Korea, from January 2000 to December 2017. Results: The EBV seropositive rate in 26,527 subjects during the study period was 81.0% (21,485/26,527): 44.4% (2,716/6,122) in subjects aged 0–9 years, 75.8% (2,077/2,739) in those aged 10–19 years, and 94.5% (16,692/17,666) in those aged ≥20 years. The EBV seropositive rate decreased from 89.4% (8,592/9,616) in 2000–2008 to 76.2% (12,893/16,911) in 2009– 2017 ( P <0.001). Especially, the EBV seropositive rate in subjects aged 0–19 years significantly decreased from 2000–2008 to 2009–2017 (0–9 years, 62.8% [1,172/1,866] in 2000–2008 and 36.3% [1,544/4,256] in 2009–2017; 10–19 years, 83.8% [745/858] in 2000–2008 and 70.8% (1,332/1,881) in 2009–2017) ( P <0.001). Conclusions: The EBV seropositive rate in children has decreased in the last 20 years. As the age of patients with primary EBV infection increased, there is a need for interest in clinical manifestation, such as infectious mononucleosis, in adolescents and young adults.","PeriodicalId":37997,"journal":{"name":"Pediatric Infection and Vaccine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66641986","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 : 2020-01-01DOI: 10.14776/piv.2020.27.e25
Euntaek Lee, Sera Park, Mina Kim, Jina Lee
147 ABSTRACT Purpose: We investigated the trend of antibiotic susceptibility of Haemophilus influenzae over 5 consecutive years. Methods: We analyzed the antibiotic susceptibility of H. influenzae isolated from children aged <18 years, who were admitted to the Asan Medical Center Children's Hospital from March 2014 to April 2019. Antibiotic susceptibility of H. influenzae was determined by the disk diffusion test according to the European Committee on Antimicrobial Susceptibility Testing guidelines. Results: Excluding duplicates, 69 isolates were obtained over the past 5 years. The median age of the patients was 5 years (range, 2.8–8.6 years). The antibiotic susceptibility patterns were as follows: ampicillin (AMP)-susceptible/amoxicillin-clavulanate (AMC)-susceptible (AS/ACS; n=15 [21.7%]), AMP-resistant/AMC-susceptible (AR/ACS; n=21 [30.4%]), and AMP-resistant/ AMC-resistant (AR/ACR; n=33 [47.8%]). The prevalence of isolates with AR/ACR phenotype tended to increase from 42.1% in 2014–2015 to 54.5% in 2018–2019 ( P =0.342). Compared to 2014–2015, the resistance rates to cefuroxime and ceftriaxone in 2018–2019 increased from 31.6% to 77.3% and from 0.0% to 59.1%, respectively ( P =0.003 and P <0.001, respectively). Conclusions: Over the last 5 years, H. influenzae isolates with AR/ACR phenotype and ceftriaxone resistance were frequently observed at our institute. The incidence of resistance to cefuroxime and ceftriaxone has increased significantly.
{"title":"Trend of Antibiotic Susceptibility of Haemophilus influenzae Isolated from Children, 2014–2019","authors":"Euntaek Lee, Sera Park, Mina Kim, Jina Lee","doi":"10.14776/piv.2020.27.e25","DOIUrl":"https://doi.org/10.14776/piv.2020.27.e25","url":null,"abstract":"147 ABSTRACT Purpose: We investigated the trend of antibiotic susceptibility of Haemophilus influenzae over 5 consecutive years. Methods: We analyzed the antibiotic susceptibility of H. influenzae isolated from children aged <18 years, who were admitted to the Asan Medical Center Children's Hospital from March 2014 to April 2019. Antibiotic susceptibility of H. influenzae was determined by the disk diffusion test according to the European Committee on Antimicrobial Susceptibility Testing guidelines. Results: Excluding duplicates, 69 isolates were obtained over the past 5 years. The median age of the patients was 5 years (range, 2.8–8.6 years). The antibiotic susceptibility patterns were as follows: ampicillin (AMP)-susceptible/amoxicillin-clavulanate (AMC)-susceptible (AS/ACS; n=15 [21.7%]), AMP-resistant/AMC-susceptible (AR/ACS; n=21 [30.4%]), and AMP-resistant/ AMC-resistant (AR/ACR; n=33 [47.8%]). The prevalence of isolates with AR/ACR phenotype tended to increase from 42.1% in 2014–2015 to 54.5% in 2018–2019 ( P =0.342). Compared to 2014–2015, the resistance rates to cefuroxime and ceftriaxone in 2018–2019 increased from 31.6% to 77.3% and from 0.0% to 59.1%, respectively ( P =0.003 and P <0.001, respectively). Conclusions: Over the last 5 years, H. influenzae isolates with AR/ACR phenotype and ceftriaxone resistance were frequently observed at our institute. The incidence of resistance to cefuroxime and ceftriaxone has increased significantly.","PeriodicalId":37997,"journal":{"name":"Pediatric Infection and Vaccine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66642081","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 : 2020-01-01DOI: 10.14776/piv.2020.27.e24
H. Jeong, Ji‐Man Kang, Jong Gyun Ahn
Purpose: We evaluated the incidence and characteristics of Clostridioides difficile infection (CDI) in Korean children. Methods: Medical records of patients aged 2–18 years and diagnosed with CDI at a tertiary hospital between 2009 and 2018 were analyzed. The patients were classified into three CDI groups: community-acquired (CA), community onset-health care facility-associated (COHCFA), and healthcare facility onset (HO). Results: The incidence of CDI increased from 1.00 to 10.01 cases per 10,000 admissions from 2009 to 2018 (P<0.001). As compared to the CA group, the HO group had a higher frequency of operation and malignancy as predisposing factors (40.4% vs. 0.0%, P=0.001; and 27.7% vs. 0.0%, P=0.027, respectively), frequency and number of previous antibiotic use (97.9% vs. 31.3%, P<0.001; and 2 vs. 0, P<0.001, respectively), and median postdiagnosis hospital stay (13 vs. 5 days, P=0.008). The CO-HCFA group had a lower median age and higher frequency of malignancy than the CA group (5 vs. 13 years, P=0.012; and 30.8% vs. 0.0%, P=0.030, respectively). As compared to the HO group, the CA group had a higher frequency of abdominal pain and hematochezia (56.3% vs. 10.6%, P=0.001; and 50.0% vs. 10.6%, P=0.002, respectively), inflammatory bowel disease (68.8% vs. 2.1%, P=0.001), and intravenous metronidazole treatment (37.5% vs. 2.1%, P=0.001). Conclusions: With the increasing incidence of pediatric CDI, awareness regarding its epidemiology and clinical characteristics is important to manage nosocomial infections.
目的:评估韩国儿童艰难梭菌感染(CDI)的发生率和特点。方法:对某三级医院2009 - 2018年2-18岁CDI患者的病历进行分析。患者被分为三个CDI组:社区获得性(CA)、社区发病-卫生保健机构相关(COHCFA)和卫生保健机构发病(HO)。结果:2009年至2018年，CDI发生率从1.00 /万上升至10.01 /万(P<0.001)。与CA组相比，HO组的手术频率和恶性肿瘤为高危因素(40.4%比0.0%，P=0.001;和27.7%比0.0%，P=0.027)，既往抗生素使用频率和次数(97.9%比31.3%，P<0.001;和2对0,P<0.001)，以及诊断后住院时间中位数(13对5天，P=0.008)。CO-HCFA组的中位年龄低于CA组，恶性肿瘤发生率高于CA组(5岁vs. 13岁，P=0.012;30.8% vs. 0.0%， P=0.030)。与HO组相比，CA组出现腹痛和便血的频率更高(56.3%比10.6%，P=0.001;和50.0%对10.6%，P=0.002)，炎症性肠病(68.8%对2.1%，P=0.001)，静脉注射甲硝唑治疗(37.5%对2.1%，P=0.001)。结论:随着小儿CDI发病率的上升，了解其流行病学和临床特点对医院感染的管理具有重要意义。
{"title":"Incidence and Characteristics of Clostridioides difficile Infection in Children","authors":"H. Jeong, Ji‐Man Kang, Jong Gyun Ahn","doi":"10.14776/piv.2020.27.e24","DOIUrl":"https://doi.org/10.14776/piv.2020.27.e24","url":null,"abstract":"Purpose: We evaluated the incidence and characteristics of Clostridioides difficile infection (CDI) in Korean children. Methods: Medical records of patients aged 2–18 years and diagnosed with CDI at a tertiary hospital between 2009 and 2018 were analyzed. The patients were classified into three CDI groups: community-acquired (CA), community onset-health care facility-associated (COHCFA), and healthcare facility onset (HO). Results: The incidence of CDI increased from 1.00 to 10.01 cases per 10,000 admissions from 2009 to 2018 (P<0.001). As compared to the CA group, the HO group had a higher frequency of operation and malignancy as predisposing factors (40.4% vs. 0.0%, P=0.001; and 27.7% vs. 0.0%, P=0.027, respectively), frequency and number of previous antibiotic use (97.9% vs. 31.3%, P<0.001; and 2 vs. 0, P<0.001, respectively), and median postdiagnosis hospital stay (13 vs. 5 days, P=0.008). The CO-HCFA group had a lower median age and higher frequency of malignancy than the CA group (5 vs. 13 years, P=0.012; and 30.8% vs. 0.0%, P=0.030, respectively). As compared to the HO group, the CA group had a higher frequency of abdominal pain and hematochezia (56.3% vs. 10.6%, P=0.001; and 50.0% vs. 10.6%, P=0.002, respectively), inflammatory bowel disease (68.8% vs. 2.1%, P=0.001), and intravenous metronidazole treatment (37.5% vs. 2.1%, P=0.001). Conclusions: With the increasing incidence of pediatric CDI, awareness regarding its epidemiology and clinical characteristics is important to manage nosocomial infections.","PeriodicalId":37997,"journal":{"name":"Pediatric Infection and Vaccine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66642037","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 : 2019-12-01DOI: 10.14776/PIV.2019.26.E18
Seah Kang, Dong Ho Kim, B. Eun, N. Kim, E. Kang, B. Lee, Y. Kim
목적: 본 연구는 국내 소아청소년에서 인플루엔자 분할백신 접종군과 인플루엔자 아단위백신 접종군 간 면역원성 및 안전성을 파악하기 위해 시행하였다. 방법: 2008년 10월부터 12월까지 서울과 경기도 지역의 여섯 개의 병원에 방문한 202명의 건강한 만 36개월에서 18세 미만의 소아청소년을 대상으로 하였으며 이들은 인플루엔자 분할백신 또는 아단위백신을 접종받았다. H1N1, H3N2, 그리고 B형의 인플루엔자 바이러스 항원의 면역원성을 평가하기 위해 접종 후 혈구응집억제 항체가가 1:40 이상인 피험자의 비율, 항체 양전률, 그리고 geometric mean titer를 계산하였다. 모든 접종자들에서 국소 그리고 전신 이상반응을 관찰하였다. 결과: 분할백신 접종군과 아단위백신 접종군에서 H1N1, H3N2, B형 항원에 대하여 항체가가 1:40 이상으로 나타난 피험자의 비율은 유사하였다(95.9%, 94.9%, 96.9% vs. 96.0%, 90.9%, 87.9%). 36개월 이상 72개월 미만의 소아에서 두 접종군 간 항체가가 1:40 이상으로 나타난 피험자의 비율은 유사하게 나타났다. 72개월 이상 18세 미만의 소아에서는 H1N1, H3N2, 그리고 B에 대해 항체가가 1:40 이상으로 나타난 피험자의 비율은 모두 높게 나타났으나 (98.4%, 98.4%, 98.4% vs. 97.0%, 95.5%, 91.0%), 항체 양전율은 상대적으로 낮았다 (39.1%, 73.4%, 35.9% vs. 34.3%, 55.2%, 38.8%). 또한 분할백신 접종군에서 아단위백신 접종군에서보다 국소 및 전신 이상반응의 비율이 더 높았으나 두 접종군 모두에서 중대한 이상반응은 나타나지 않았다. 결론: 인플루엔자 분할백신 접종군과 아단위백신 접종군 모두에서 3세 이상 18세 미만의 연령군에서 적절한 면역원성을 보였다. 또한 두 접종군에서 모두 중대한 이상반응은 발생하지 않았다.
目的：本研究旨在了解国内小儿青少年中流感分割疫苗接种群和流感亚单位疫苗接种群之间的免疫原性及安全性。方法：2008年10月至12月期间，对访问首尔和京畿道地区六家医院的202名健康未满36个月至18岁的小儿青少年进行了以下调查。他们接种了流感分割疫苗或亚单位疫苗。为了评价H1N1、H3N2和乙型流感病毒抗原的免疫原性，计算了接种后血球凝集抑制抗体价在1:40以上的受试者比例、抗体阳转率和geometric mean titer。所有接种者均观察到局部及全身异常反应。结果：在分割疫苗接种群和亚单位疫苗接种群中，H1N1、H3N2；对于B型抗原，抗体价在1:40以上的受试者比例类似（95.9%、94.9%、96.9%vs.96.0%、90.9%、87.9%）。在36个月以上72个月以下的小儿中，两个接种群间抗体价在1:40以上的受试者比例类似。在72个月以上18岁以下的小儿中，H1N1、H3N2和B的抗体价均在1:40以上的受试者比例较高（98.4%、98.4%、98.4%vs.97.0%、95.5%、91.0%）；抗体阳转率相对较低（39.1%、73.4%、35.9%vs.34.3%、55.2%、38.8%）此外，在分割疫苗接种群中，局部及全身异常反应的比例比亚单位疫苗接种群中更高，但两个接种群均未出现重大异常反应。结论：在流感分割疫苗接种群和亚单位疫苗接种群中，3岁以上18岁以下年龄组均表现出适当的免疫原性。此外，两个接种群均未发生重大异常反应。
{"title":"Comparison of Split versus Subunit Seasonal Influenza Vaccine in Korean Children over 3 to under 18 Years of Age","authors":"Seah Kang, Dong Ho Kim, B. Eun, N. Kim, E. Kang, B. Lee, Y. Kim","doi":"10.14776/PIV.2019.26.E18","DOIUrl":"https://doi.org/10.14776/PIV.2019.26.E18","url":null,"abstract":"목적: 본 연구는 국내 소아청소년에서 인플루엔자 분할백신 접종군과 인플루엔자 아단위백신 접종군 간 면역원성 및 안전성을 파악하기 위해 시행하였다.\u0000방법: 2008년 10월부터 12월까지 서울과 경기도 지역의 여섯 개의 병원에 방문한 202명의 건강한 만 36개월에서 18세 미만의 소아청소년을 대상으로 하였으며 이들은 인플루엔자 분할백신 또는 아단위백신을 접종받았다. H1N1, H3N2, 그리고 B형의 인플루엔자 바이러스 항원의 면역원성을 평가하기 위해 접종 후 혈구응집억제 항체가가 1:40 이상인 피험자의 비율, 항체 양전률, 그리고 geometric mean titer를 계산하였다. 모든 접종자들에서 국소 그리고 전신 이상반응을 관찰하였다.\u0000결과: 분할백신 접종군과 아단위백신 접종군에서 H1N1, H3N2, B형 항원에 대하여 항체가가 1:40 이상으로 나타난 피험자의 비율은 유사하였다(95.9%, 94.9%, 96.9% vs. 96.0%, 90.9%, 87.9%). 36개월 이상 72개월 미만의 소아에서 두 접종군 간 항체가가 1:40 이상으로 나타난 피험자의 비율은 유사하게 나타났다. 72개월 이상 18세 미만의 소아에서는 H1N1, H3N2, 그리고 B에 대해 항체가가 1:40 이상으로 나타난 피험자의 비율은 모두 높게 나타났으나 (98.4%, 98.4%, 98.4% vs. 97.0%, 95.5%, 91.0%), 항체 양전율은 상대적으로 낮았다 (39.1%, 73.4%, 35.9% vs. 34.3%, 55.2%, 38.8%). 또한 분할백신 접종군에서 아단위백신 접종군에서보다 국소 및 전신 이상반응의 비율이 더 높았으나 두 접종군 모두에서 중대한 이상반응은 나타나지 않았다.\u0000결론: 인플루엔자 분할백신 접종군과 아단위백신 접종군 모두에서 3세 이상 18세 미만의 연령군에서 적절한 면역원성을 보였다. 또한 두 접종군에서 모두 중대한 이상반응은 발생하지 않았다.","PeriodicalId":37997,"journal":{"name":"Pediatric Infection and Vaccine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47059959","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 : 2019-12-01DOI: 10.14776/piv.2019.26.e23
H. Kang, K. Park, Kyung-Yil Lee, Joonhong Park, S. Park, Dong‐Gun Lee, Jong Hyun Kim
목적: 본 연구에서는 신생아실과 신생아 중환자실에서 발생한 methicillin-resistant Staphylococcus aureus (MRSA) 유행에서 환자와 보균자에서 분리된 MRSA의 분자역학적 연관성을 조사하여 유행의 감염원과 전파경로를 파악하고자 하였다. 방법: MRSA 유행기간인 2017년 8월부터 9월까지 피부감염 및 패혈증 환자들과 보균자로부터 분리된 MRSA 균주를 대상으로 유전형 및 병원성 인자를 분석하고 항생제 감수성 결과를 수집하였다. 결과: 연구기간 동안 신생아실(n=27)과 신생아 중환자실(n=14)에 총 41명의 신생아들이 입원하였다. 그 중, 7명(피부감염[n=6], 패혈증[n=1])에서 MRSA 감염이 확진되었고, 보균자 4명이 발견되었다. 신생아와 접촉이 있는 의료진 32명 중 3명이 MRSA를 비강에 보균하였다. 피부감염 유행 원인 균주는 Staphylococcal chromosomal cassette mec (SCCmec) type II, se quence type (ST) 89, spa type t375였고, 뮤피로신 저농도 내성을 포함하여 항생제 다제내성을 보였다. 패혈증을 일으킨 균주는 SCCmec type IVa, ST 72, 새로운 spa type인 t17879였다. 신생아 4명에게 집락된 MRSA 균주들은 다양하였으나 SCCmec type IVa, ST 72, spa type t664가 의료진과 신생아 2명에서 공통적으로 분리되었다. Panton-Valentine leukocidin (PVL) toxin 유전자가 신생아에게 집락된 모든 균주에서 발견되었다. 결론: 피부감염 유행을 일으킨 MRSA 균주는 항생제 다제내성을 보이는 균주였다. 신생아 MRSA 보균자에게서 분리된 균주는 모두 PVL 독소 유전자를 보유하였다. 유행기간 동안 다양한 MRSA 균주가 신생아들에게서 분리되기 때문에, 효과적인 감염 관리 및 추가 환자발생의 차단을 위하여 분자역학조사를 통하여 원인균을 확인하고 전파경로를 파악하는 것이 중요하다.
目的:本研究调查在新生儿室和新生儿重患者室发生的methicillin-resistant Staphylococcus aureus (MRSA)流行中，从患者和带菌者分离的MRSA的分子力学关联性，以掌握流行的传染源和传播途径。方法:在MRSA流行期间的2017年8月至9月，以皮肤感染及败血症患者和从带菌者分离的MRSA菌株为对象，分析典型及病原性因子，收集抗生素感受性结果。结果:研究期间新生儿室(n=27)和新生儿重患者室(n=14)共有41名新生儿住院。其中，7人(皮肤感染[n=6]，败血症[n=1])被确诊感染MRSA, 4名带菌者。与新生儿有接触的32名医疗人员中有3人将MRSA带到了鼻腔。皮肤感染流行原因菌株staphylococcal chromosomal cassette mec (sccmec) type ii, se quence type (st) 89、spa type t375,姆疲劳新低浓度的抗生素,包括内城看到我的耐性。引起败血症的菌株是SCCmec type IVa, ST 72，新的spa type t17879。4名新生儿的MRSA菌株种类繁多，但SCCmec type IVa、ST 72和spa type t664从医护人员和2名新生儿中共同分离。在新生儿缺失的所有菌株中都发现了Panton-Valentine leukocidin (PVL) toxin基因。结论:引起皮肤感染流行的MRSA菌株是抗生剂多剂耐药性菌株。从新生儿MRSA带菌者中分离出来的菌株都具有PVL毒素基因。在流行期间，多种MRSA菌株会从新生儿身上分离出来，因此为了有效的感染管理和阻止追加患者的发生，通过分子流行病学调查确认致病菌并掌握传播途径非常重要。
{"title":"Molecular Epidemiologic Study of a Methicillin-resistant Staphylococcus aureus Outbreak at a Newborn Nursery and Neonatal Intensive Care Unit","authors":"H. Kang, K. Park, Kyung-Yil Lee, Joonhong Park, S. Park, Dong‐Gun Lee, Jong Hyun Kim","doi":"10.14776/piv.2019.26.e23","DOIUrl":"https://doi.org/10.14776/piv.2019.26.e23","url":null,"abstract":"목적: 본 연구에서는 신생아실과 신생아 중환자실에서 발생한 methicillin-resistant Staphylococcus aureus (MRSA) 유행에서 환자와 보균자에서 분리된 MRSA의 분자역학적 연관성을 조사하여 유행의 감염원과 전파경로를 파악하고자 하였다.\u0000방법: MRSA 유행기간인 2017년 8월부터 9월까지 피부감염 및 패혈증 환자들과 보균자로부터 분리된 MRSA 균주를 대상으로 유전형 및 병원성 인자를 분석하고 항생제 감수성 결과를 수집하였다.\u0000결과: 연구기간 동안 신생아실(n=27)과 신생아 중환자실(n=14)에 총 41명의 신생아들이 입원하였다. 그 중, 7명(피부감염[n=6], 패혈증[n=1])에서 MRSA 감염이 확진되었고, 보균자 4명이 발견되었다. 신생아와 접촉이 있는 의료진 32명 중 3명이 MRSA를 비강에 보균하였다. 피부감염 유행 원인 균주는 Staphylococcal chromosomal cassette mec (SCCmec) type II, se\u001fquence type (ST) 89, spa type t375였고, 뮤피로신 저농도 내성을 포함하여 항생제 다제내성을 보였다. 패혈증을 일으킨 균주는 SCCmec type IVa, ST 72, 새로운 spa type인 t17879였다. 신생아 4명에게 집락된 MRSA 균주들은 다양하였으나 SCCmec type IVa, ST 72, spa type t664가 의료진과 신생아 2명에서 공통적으로 분리되었다. Panton-Valentine leukocidin (PVL) toxin 유전자가 신생아에게 집락된 모든 균주에서 발견되었다.\u0000결론: 피부감염 유행을 일으킨 MRSA 균주는 항생제 다제내성을 보이는 균주였다. 신생아 MRSA 보균자에게서 분리된 균주는 모두 PVL 독소 유전자를 보유하였다. 유행기간 동안 다양한 MRSA 균주가 신생아들에게서 분리되기 때문에, 효과적인 감염 관리 및 추가 환자발생의 차단을 위하여 분자역학조사를 통하여 원인균을 확인하고 전파경로를 파악하는 것이 중요하다.","PeriodicalId":37997,"journal":{"name":"Pediatric Infection and Vaccine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81561419","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 : 2019-12-01DOI: 10.14776/PIV.2019.26.E21
Ji-Man Kang, Jinhong Lee, Yoonseon Park, Yoon-hee Park, Y. Kwak, J. Song, Young Ju Choi
목적: 인플루엔자 예방접종은 인플루엔자 감염을 예방하고 병원 내 전파를 차단할 수 있는 가장 효과적인 방법이다. 본 연구자들은 국내 병원내 직원들의 인플루엔자 예방 접종률의 현황 및 접종률과 연관된 인자들을 살펴보고자 하였다. 방법: 2017-2018 인플루엔자 시즌 전, 경기도 고양시 내 3개 종합 병원의 인플루엔자 예방접종 캠페인 대상인 병원 직원들이 연구에 포함되었다. 연구대상자의 인구학적인 특성 및 직업적 특성을 후향적으로 수집하였다. 결과: 총 7,180명의 병원내 직원 중 6,994명(97%)이 연구에 포함되었으며 전체 예방 접종률은 85%였다. 의료직종 중에서는 간호직군이 92%로 가장 높았고, 의료기술직군(88%), 의사직군(84%), 비의료직군(79%) 순이었다(P<0.001). 비의료직군에서의 접종률은 환자와의 접촉 정도에 비해 서로 상이하였으며, 환자와 접촉이 빈번한 비의료직군의 접종률은 90%로 덜 빈번한 비의료직군의 73%보다 유의하게 높았다(P<0.001). 결론: 2017-2018 인플루엔자 시즌 병원내 직원의 예방접종률은 85%이었다. 이는 기존의 병원내 직원 대상으로 자발적인 예방접종을 진행하는 여러 국가들의 보고들과 비교했을 때 높은 편에 속한다. 병원내 직원의 특성에 따라 예방 접종률은 서로 상이하며, 병원내 직원의 예방 접종률을 보다 높이기 위해서는 이러한 요인들을 포함한 다각적인 접근을 고려해야한다.
{"title":"Non-Mandatory Influenza Vaccination Rates among Healthcare Workers during the 2017–2018 Influenza Season: a Multicenter Study in Korea","authors":"Ji-Man Kang, Jinhong Lee, Yoonseon Park, Yoon-hee Park, Y. Kwak, J. Song, Young Ju Choi","doi":"10.14776/PIV.2019.26.E21","DOIUrl":"https://doi.org/10.14776/PIV.2019.26.E21","url":null,"abstract":"목적: 인플루엔자 예방접종은 인플루엔자 감염을 예방하고 병원 내 전파를 차단할 수 있는 가장 효과적인 방법이다. 본 연구자들은 국내 병원내 직원들의 인플루엔자 예방 접종률의 현황 및 접종률과 연관된 인자들을 살펴보고자 하였다.\u0000방법: 2017-2018 인플루엔자 시즌 전, 경기도 고양시 내 3개 종합 병원의 인플루엔자 예방접종 캠페인 대상인 병원 직원들이 연구에 포함되었다. 연구대상자의 인구학적인 특성 및 직업적 특성을 후향적으로 수집하였다.\u0000결과: 총 7,180명의 병원내 직원 중 6,994명(97%)이 연구에 포함되었으며 전체 예방 접종률은 85%였다. 의료직종 중에서는 간호직군이 92%로 가장 높았고, 의료기술직군(88%), 의사직군(84%), 비의료직군(79%) 순이었다(P<0.001). 비의료직군에서의 접종률은 환자와의 접촉 정도에 비해 서로 상이하였으며, 환자와 접촉이 빈번한 비의료직군의 접종률은 90%로 덜 빈번한 비의료직군의 73%보다 유의하게 높았다(P<0.001).\u0000결론: 2017-2018 인플루엔자 시즌 병원내 직원의 예방접종률은 85%이었다. 이는 기존의 병원내 직원 대상으로 자발적인 예방접종을 진행하는 여러 국가들의 보고들과 비교했을 때 높은 편에 속한다. 병원내 직원의 특성에 따라 예방 접종률은 서로 상이하며, 병원내 직원의 예방 접종률을 보다 높이기 위해서는 이러한 요인들을 포함한 다각적인 접근을 고려해야한다.","PeriodicalId":37997,"journal":{"name":"Pediatric Infection and Vaccine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44622877","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 : 2019-12-01DOI: 10.14776/PIV.2019.26.E16
So Ra Lee, S. Y. Ko, S. Yoon, Yeon Kyung Lee, S. Shin
Enteroviral infections are common in neonates. One important infection pathway is vertical transmission from an infected mother to her neonate. Here, we report the early detection and successful treatment of a vertically transmitted fulminant enteroviral infection associated with myocarditis and hepatitis. The patient had a sudden onset of high fever on the 4th day of life and showed severe, rapidly progressing symptoms of disseminated intravascular coagulopathy (DIC), hepatitis, and myocarditis accompanied by tachyarrhythmia. As it was the peak season for enteroviral infections and both the mother and the patient's 36-month-old sibling had a high fever around the time of delivery, we suspected enteroviral infection. Thus, we began prompt evaluation for enteroviral infection, as well as close observation and intensive care of the neonate. We strongly recommend evaluation for the possibility of enterovirus vertical infection in neonates when the mother is suspected of having a viral infection (e.g., high fever and negative results from bacterial infectious studies) around the time of delivery and when the neonate shows some early indication of infectious diseases such as thrombocytopenia, DIC, hepatitis, and myocarditis. Early detection of enteroviral infections and prompt implementation of proper treatment are key to reducing the risk of complications and mortality associated with enteroviral infections in neonates.
{"title":"Early Detection and Successful Treatment of Vertically Transmitted Fulminant Enteroviral Infection Associated with Various Forms of Arrhythmia and Severe Hepatitis with Coagulopathy","authors":"So Ra Lee, S. Y. Ko, S. Yoon, Yeon Kyung Lee, S. Shin","doi":"10.14776/PIV.2019.26.E16","DOIUrl":"https://doi.org/10.14776/PIV.2019.26.E16","url":null,"abstract":"Enteroviral infections are common in neonates. One important infection pathway is vertical transmission from an infected mother to her neonate. Here, we report the early detection and successful treatment of a vertically transmitted fulminant enteroviral infection associated with myocarditis and hepatitis. The patient had a sudden onset of high fever on the 4th day of life and showed severe, rapidly progressing symptoms of disseminated intravascular coagulopathy (DIC), hepatitis, and myocarditis accompanied by tachyarrhythmia. As it was the peak season for enteroviral infections and both the mother and the patient's 36-month-old sibling had a high fever around the time of delivery, we suspected enteroviral infection. Thus, we began prompt evaluation for enteroviral infection, as well as close observation and intensive care of the neonate. We strongly recommend evaluation for the possibility of enterovirus vertical infection in neonates when the mother is suspected of having a viral infection (e.g., high fever and negative results from bacterial infectious studies) around the time of delivery and when the neonate shows some early indication of infectious diseases such as thrombocytopenia, DIC, hepatitis, and myocarditis. Early detection of enteroviral infections and prompt implementation of proper treatment are key to reducing the risk of complications and mortality associated with enteroviral infections in neonates.","PeriodicalId":37997,"journal":{"name":"Pediatric Infection and Vaccine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48615126","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 : 2019-12-01DOI: 10.14776/PIV.2019.26.E19
H. Han, Kyung Jae Lee, H. Yu
b형 헤모필루스 인플루엔자균 예방접종이 시행된 이후 b형 헤모필루스 인플루엔자균에 의한 감염률은 급격히 감소하였으나, non-b형 헤모필루스 인플루엔자균에 의한 감염의 비율이 증가하는 추세이다. 대뇌 정맥동 혈전증은 드물지만 세균성 수막염의 합병증 중 하나로 발생할 수 있다. 대뇌 정맥동 혈전증이 동반된 f형 헤모필루스 인플루엔자균에 의한 뇌수막염 환자를 진단 및 치료하였기에 보고하는 바이다.
{"title":"Cerebral Venous Sinus Thrombosis with Meningitis and Septicemia due to Haemophilus influenzae Type f in an Immunocompetent Child","authors":"H. Han, Kyung Jae Lee, H. Yu","doi":"10.14776/PIV.2019.26.E19","DOIUrl":"https://doi.org/10.14776/PIV.2019.26.E19","url":null,"abstract":"b형 헤모필루스 인플루엔자균 예방접종이 시행된 이후 b형 헤모필루스 인플루엔자균에 의한 감염률은 급격히 감소하였으나, non-b형 헤모필루스 인플루엔자균에 의한 감염의 비율이 증가하는 추세이다. 대뇌 정맥동 혈전증은 드물지만 세균성 수막염의 합병증 중 하나로 발생할 수 있다. 대뇌 정맥동 혈전증이 동반된 f형 헤모필루스 인플루엔자균에 의한 뇌수막염 환자를 진단 및 치료하였기에 보고하는 바이다.","PeriodicalId":37997,"journal":{"name":"Pediatric Infection and Vaccine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48279344","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 : 2019-08-01DOI: 10.14776/PIV.2019.26.E15
Jong Woo Hahn, H. Ju, Meerim Park, E. Yi, B. Park, S. Shin, Sang-Hyun Lee, H. Park, Ji‐Man Kang
의료관련 뇌실염/수막염(Healthcare-associated ventriculitis and meningitis)은 지역사회 수막염과 다른 역학적 특성과 병 리 기전을 가진다. 일부에서는 전신 항생제투여 방법만으로 치료 반응이 불충분할 수 있으며, 이러한 경우 뇌실내로 적절한 항생제를 직접 주입하는 치료를 시도해 볼 수 있다. 본 저자들은 기존의 전신 항생제치료에 불응하는 Bacillus cereus에 의 한 의료관련 뇌실염/수막염 환자를 뇌실내 반코마이신 주입요법으로 주요 부작용없이 성공적으로 치료하여 이를 보고하는 바이다.
脑膜炎/脑膜炎(Healthcare-associated ventriculitis and meningitis)具有与社区脑膜炎不同的病学特性和病理机制。在一些情况下，仅用全身抗生素治疗可能会导致治疗反应不充分，在这种情况下，可以尝试直接向脑室内注入适当抗生素的治疗。本文作者通过脑室内万古霉素注入疗法，成功治疗不接受全身抗生素治疗的Bacillus cereus引起的医疗相关脑膜炎/脑膜炎患者，并报告这一情况。
{"title":"Intraventricular Vancomycin Therapy for Intractable Bacillus cereus Ventriculitis","authors":"Jong Woo Hahn, H. Ju, Meerim Park, E. Yi, B. Park, S. Shin, Sang-Hyun Lee, H. Park, Ji‐Man Kang","doi":"10.14776/PIV.2019.26.E15","DOIUrl":"https://doi.org/10.14776/PIV.2019.26.E15","url":null,"abstract":"의료관련 뇌실염/수막염(Healthcare-associated ventriculitis and meningitis)은 지역사회 수막염과 다른 역학적 특성과 병 리 기전을 가진다. 일부에서는 전신 항생제투여 방법만으로 치료 반응이 불충분할 수 있으며, 이러한 경우 뇌실내로 적절한 항생제를 직접 주입하는 치료를 시도해 볼 수 있다. 본 저자들은 기존의 전신 항생제치료에 불응하는 Bacillus cereus에 의 한 의료관련 뇌실염/수막염 환자를 뇌실내 반코마이신 주입요법으로 주요 부작용없이 성공적으로 치료하여 이를 보고하는 바이다.","PeriodicalId":37997,"journal":{"name":"Pediatric Infection and Vaccine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46123662","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 : 2019-08-01DOI: 10.14776/PIV.2019.26.E13
Y. Kim, M. Han, Song I Yang, K. Yun, D. Han, Jae Yoon Kim, E. Choi
Eikenella corrodens rarely causes invasive head and neck infections in immunocompetent children. We report a case of epidural abscess caused by E. corrodens in a previously healthy 13-year-old boy who presented with fever, headache, and vomiting. On physical examination upon admission, there was no neck stiffness, but discharge from the right ear was observed. Brain magnetic resonance imaging (MRI) revealed approximately 4.5-cm-sized epidural empyema on the right temporal lobe as well as bilateral ethmoid and sphenoid sinusitis, right mastoiditis, and right otitis media. During treatment with vancomycin and cefotaxime, purulent ear discharge aggravated, and on follow-up brain MRI, the empyema size increased to 5.6×3.4 cm with interval development of an abscess at the right sphenoid sinus. Burr hole trephination was performed, and foul-smelling pus was aspirated from the epidural abscess near the right temporal lobe. Pus culture yielded E. corrodens. Endoscopic sphenoidotomy was also performed with massive pus drainage, and the same organism was grown. The patient was treated with intravenous cefotaxime for 3 weeks and recovered well with no other complications. Therefore, E. corrodens can cause serious complications in children with untreated sinusitis.
{"title":"Epidural Abscess Caused by Eikenella corrodens in a Previously Healthy Child","authors":"Y. Kim, M. Han, Song I Yang, K. Yun, D. Han, Jae Yoon Kim, E. Choi","doi":"10.14776/PIV.2019.26.E13","DOIUrl":"https://doi.org/10.14776/PIV.2019.26.E13","url":null,"abstract":"Eikenella corrodens rarely causes invasive head and neck infections in immunocompetent children. We report a case of epidural abscess caused by E. corrodens in a previously healthy 13-year-old boy who presented with fever, headache, and vomiting. On physical examination upon admission, there was no neck stiffness, but discharge from the right ear was observed. Brain magnetic resonance imaging (MRI) revealed approximately 4.5-cm-sized epidural empyema on the right temporal lobe as well as bilateral ethmoid and sphenoid sinusitis, right mastoiditis, and right otitis media. During treatment with vancomycin and cefotaxime, purulent ear discharge aggravated, and on follow-up brain MRI, the empyema size increased to 5.6×3.4 cm with interval development of an abscess at the right sphenoid sinus. Burr hole trephination was performed, and foul-smelling pus was aspirated from the epidural abscess near the right temporal lobe. Pus culture yielded E. corrodens. Endoscopic sphenoidotomy was also performed with massive pus drainage, and the same organism was grown. The patient was treated with intravenous cefotaxime for 3 weeks and recovered well with no other complications. Therefore, E. corrodens can cause serious complications in children with untreated sinusitis.","PeriodicalId":37997,"journal":{"name":"Pediatric Infection and Vaccine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45240706","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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