Infection and Chemotherapy最新文献

Paragonimiasis, most commonly caused by Paragonimus westermani, is endemic in East and Southeast Asia and commonly transmitted through ingestion of raw or undercooked freshwater crab or crayfish. While pulmonary manifestations predominate, extrapulmonary involvement such as cerebral paragonimiasis can occur. We describe three cases of imported familial pulmonary and extrapulmonary paragonimiasis from Southeast Asia and diagnosed in Korea. A 12-year-old boy presented with dizziness, headache, nausea, and vomiting. Brain magnetic resonance imaging revealed a hemorrhagic mass-like lesion with leptomeningeal enhancement, and chest tomography showed serpiginous tubular opacities with multifocal consolidations. Laboratory evaluation revealed marked eosinophilia (46.2%). Further history revealed habitual consumption of raw crayfish while residing in Cambodia. Serology was positive for P. westermani and Clonorchis sinensis IgG. Treatment with albendazole and praziquantel resulted in resolution of symptoms and normalization of eosinophil counts. Further evaluation identified similar findings in his parents who were misdiagnosed as tuberculosis and cerebral hemorrhage, and the family was treated with praziquantel. This familial cluster highlights the importance of detailed dietary and travel history in patients with eosinophilia and neurological symptoms. This case was discussed at the Clinical Grand Round of the Korean Society of Infectious Diseases on November 7, 2024.

Background: The coronavirus disease 2019 pandemic and associated infection control measures (lockdowns, masking) dramatically altered infectious disease epidemiology, including reduced invasive pneumococcal disease (IPD) incidence. This study aimed to assess the pandemic effects on IPD clinical features, outcomes, and antibiotic resistance in children.

Materials and methods: This study included pediatric patients (1 month to 18 years) diagnosed with IPD, comparing two distinct periods: the pre-pandemic era (March 2014-February 2020) and pandemic/post-pandemic era (March 2020-March 2024). Clinical characteristics and antibiotic resistance patterns of IPD patients were compared between the pre-pandemic and pandemic/post-pandemic periods.

Results: Among 61 cases (27 pre-pandemic, 34 pandemic/post-pandemic), age distribution remained similar (median 46 vs. 49 months, P=0.799). The distribution of IPD manifestations and vaccine failure rates (70.4% vs. 76.5%) were consistent between periods. Comparative analysis revealed significantly reduced susceptibility rates during the pandemic/post-pandemic period versus pre-pandemic for penicillin, ceftriaxone, and fluoroquinolones.

Conclusion: IPD remains a significant pediatric health concern. IPD continues to disproportionately affect children under five years of age, with no significant pandemic-related changes in age distribution, disease manifestations, or clinical outcomes. The concerning rise in resistance to first-line antibiotics during the pandemic underscores the urgent need for robust antimicrobial stewardship programs.

Background: Pneumococcal conjugate vaccine (PCV) was introduced as a part of national immunization program to prevent invasive pneumococcal diseases in Indonesia in 2022. This study aims to investigate the serotype distribution, antimicrobial susceptibility, and genome profile of Streptococcus pneumoniae isolated from hospitalized patients from different regions in Indonesia prior to PCV introduction in Indonesia.

Materials and methods: S. pneumoniae isolates were collected from blood, cerebrospinal fluid, and pleural fluid samples of hospitalised patients in three major referral hospitals located in Medan (North Sumatera), Semarang (Central Java), and Surabaya (East Java) from 2018-2021. Bacterial isolation and identification followed standard laboratory protocols. Serotyping was performed using conventional multiplex PCR and the Quellung reaction. Antimicrobial susceptibility testing (AST) was conducted by broth microdilution, and whole-genome sequencing (WGS) was carried out using the Illumina platform.

Results: S. pneumoniae isolates were recovered from 32 hospitalized patients. Serotype 19F (21.9%) was the most common followed by serotype 6B (12.5%) and 3 (9.4%). The serotypes of a high proportion of isolates (71.9%; 23/32) were included in the PCV13 vaccine. The majority of non-meningitis S. pneumoniae isolates were resistant to tetracycline (48.1%) followed by trimethoprim-sulfamethoxazole (33.3%), azithromycin and erythromycin (25.9% each), whereas penicillin resistant was found predominantly (60.0%) in meningitis isolates. We found AST and genomic prediction of antimicrobial resistance result was align in this study. We found 9 S. pneumoniae isolates (28.1%) were multidrug-resistant. Sequence type 1464 (n=5) and global pneumococcal sequence cluster 1 (n=7) was predominantly found in this study.

Conclusion: Serotype 19F were the most common among vaccine-type serotype strains isolated from hospitalized patients prior to PCV introduction in Indonesia.

This retrospective study analyzed data from 1,192 men living with HIV (MWH) between 2002 and 2023, and identified 76 anogenital wart cases (6.4%), which were predominantly anal (n=67). Among 20 individuals with anal warts who underwent biopsy, 25% had high-grade squamous intraepithelial lesions (SILs). Of 15 individuals with low-grade SILs, one progressed to high-grade SIL after 5 years, and two developed anal cancer at 5 and 15 years. High-risk human papillomavirus genotypes were detected in 42.9% of tested specimens. These findings highlight the importance of routine screening and early detection of precancerous lesions in MWH in Korea.

Background: Although human immunodeficiency virus (HIV) is a legally notifiable disease in Korea, surveillance data are reported in aggregate without regional breakdowns. This limits the ability of local governments to design targeted prevention and care strategies. The coronavirus disease 2019 pandemic underscored the importance of region-specific epidemiological data for timely public health responses. TORCH infections-comprising Toxoplasma gondii, Treponema pallidum, rubella virus, cytomegalovirus (CMV), and herpes simplex virus (HSV)-can cause severe complications in immunocompromised individuals, including those with HIV. Despite the clinical significance, no previous Korean study has comprehensively assessed the seroprevalence of TORCH infections among HIV-infected adults at the metropolitan level. This study aimed to investigate TORCH seroprevalence using residual serum from HIV-confirmed individuals tested at the Incheon Metropolitan City Research Institute of Public Health and Environment.

Materials and methods: Residual serum samples from 100 HIV-positive individuals, confirmed by the Incheon Metropolitan City Institute of Public Health and Environment between 2019 and 2021, were tested for IgG and IgM antibodies against T. gondii, T. pallidum, rubella, CMV, and HSV types 1 and 2 using enzyme-linked immunosorbent assay. A control group of 100 HIV-negative serum from the same period was analyzed for comparison. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to evaluate associations.

Results: HIV-positive individuals demonstrated significantly higher IgG seropositivity for T. gondii (11.1% vs. 3.0%, OR, 3.97, P=0.046), T. pallidum (29.0% vs. 1.0%, OR, 39.92, P<0.001), CMV (99.0% vs. 78.0%, OR, 27.60, P<0.001), HSV-1 (96.0% vs. 87.0%, OR, 3.56, P=0.039), and HSV-2 (89.0% vs. 69.0%, OR, 3.61, P<0.001). No significant differences were observed for rubella IgG or any IgM antibodies.

Conclusion: This is the first metropolitan-level seroepidemiological study in Korea to examine TORCH infections among HIV-positive adults. The markedly higher prevalence of certain TORCH pathogens in the HIV group highlights the urgent need for routine screening and targeted prevention strategies, particularly at the local government level where patient care and resource allocation are managed. These findings provide a essential evidence base for Incheon and may inform similar initiatives in other regions, strengthening both clinical management and public health policy for HIV-infected populations. the results underscore the importance of establishing periodic surveillance systems to monitor temporal trends and enable timely public health interventions.