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Critical care medicine 05/2013; 41(5):e50. · 6.37 Impact Factor
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Critical care medicine 05/2013; 41(5):e51-e52. · 6.37 Impact Factor
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Dae Won Park, Byung Chul Chun,
June Myung Kim,
Jang Wook Sohn,
Kyong Ran Peck,
Yang Soo Kim,
Young Hwa Choi,
Jun Yong Choi,
Sang Il Kim,
Joong Sik Eom,
Hyo Youl Kim,
Joon Young Song,
Young Goo Song,
Hee Jung Choi,
Min Ja Kim
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ABSTRACT: A prospective multicenter observational study was performed to investigate the epidemiology and outcomes of community-acquired severe sepsis and septic shock. Subjects included 1,192 adult patients admitted to the 22 participating intensive care units (ICUs) of 12 university hospitals in the Korean Sepsis Registry System from April, 2005 through February, 2009. Male accounted for 656 (55%) patients. Mean age was 65.0 ± 14.2 yr. Septic shock developed in 740 (62.1%) patients. Bacteremia was present in 422 (35.4%) patients. The 28-day and in-hospital mortality rates were 23.0% and 28.0%, respectively. Men were more likely to have comorbid illnesses and acute organ dysfunctions, and had higher mortality and clinical severity compared to women. While respiratory sources of sepsis were common in men, urinary sources were predominant in women. In the multivariate logistic regression analysis, cancer (odds ratio 1.89; 95% confidence interval 1.13-3.17), urinary tract infection (0.25; 0.13-0.46), APACHE II score (1.05; 1.02-1.09), SOFA score on day 1 (1.13; 1.06-1.21) and metabolic dysfunction (2.24, 1.45-3.45) were independent clinical factors for gender-related in-hospital mortality. This study provided epidemiological and clinical characteristics of community-acquired severe sepsis and septic shock in ICUs in Korea, and demonstrated the impact of clinical factors on gender difference in mortality.
Journal of Korean medical science 11/2012; 27(11):1308-14. · 0.84 Impact Factor
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Dae Won Park, Byung-Chul Chun,
Soon-Sun Kwon,
Young Kyung Yoon,
Won Suk Choi,
Jang Wook Sohn,
Kyong Ran Peck,
Yang Soo Kim,
Young Hwa Choi,
Jun Yong Choi,
Sang Il Kim,
Joong Sik Eom,
Hyo Youl Kim,
Hee Jin Cheong,
Young Goo Song,
Hee Jung Choi,
June Myung Kim,
Min Ja Kim
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ABSTRACT: OBJECTIVES:: To evaluate the effects of transfusions in patients with severe sepsis and septic shock on mortality. DESIGN:: Propensity-matched analysis of a prospective observational database (April 2005 to February 2009). SETTING:: Twenty-two medical and surgical intensive care units in 12 teaching hospitals in Korea. PATIENTS:: One thousand fifty-four patients with community-acquired severe sepsis and septic shock. INTERVENTIONS:: None. MEASUREMENTS AND MAIN RESULTS:: Of the 1,054 patients, 407 (38.6%) received a blood transfusion. The mean pretransfusion hemoglobin level was 7.7 ± 1.2 g/dL. Transfused patients had higher 28-day and in-hospital mortality rates (32.7% vs. 17.3%; p < .001, 41.3% vs. 20.3%; p < .001, respectively) and a longer duration of hospital stay (21 [interquartile range, 10-35] vs. 13 [interquartile range, 8-24] days; p < .001), but were more severely ill at admission (lower systolic blood pressure, higher Acute Physiology and Chronic Health Evaluation II score, and Sequential Organ Failure Assessment score at admission). In 152 pairs matched according to the propensity score depending on patient transfusion status, transfused patients had a lower risk of 7-day (9.2% vs. 27.0%; p < .001), 28-day (24.3% vs. 38.8%; p = .007), and in-hospital mortality rates (31.6% vs. 42.8%; p = .044). After adjusting for blood transfusion as a time-dependent variable in multivariable analysis, blood transfusion was independently associated with lower risk of 7-day (hazard ratio 0.42, 95% confidence interval 0.19-0.50, p = .026), 28-day (hazard ratio 0.43, 95% confidence interval 0.29-0.62, p < .001), and in-hospital mortality (hazard ratio 0.51, 95% confidence interval 0.39-0.69, p < .001). CONCLUSIONS:: In this observational study of patients with community-acquired severe sepsis and septic shock, red blood cell transfusions were associated with lower risk of mortality.
Critical care medicine 09/2012; · 6.37 Impact Factor
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Byung-Chul Chun,
Min-Ja Kim,
Jang Wook Sohn,
Hee Jin Cheong,
Dae Won Park,
Hee Jung Choi,
Yang Ree Kim,
Kyong Ran Peck,
Yang Soo Kim,
Young Hwa Choi,
Hyo Youl Kim,
Jun Yong Choi,
Young Goo Song,
June Myung Kim
Critical Care 04/2012; 12:1-1. · 4.93 Impact Factor
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ABSTRACT: Community-acquired pneumonia (CAP) is generally considered to be a major cause of morbidity and mortality. There is much controversy regarding the optimal choice of antibiotics for patients with CAP. The aim of this study was to identify the antibiotics prescribed for adults hospitalized with CAP in Korea during a calendar year.
This population-based, descriptive epidemiological study was performed using data from nationwide health insurance claims from 1 January 2004 to 31 December 2004. The study population was adults (≥18 years old), who had been hospitalized with CAP as determined by discharge diagnosis, and who had been treated with antibiotics for ≥3 days. The exclusion criteria were tuberculosis, underlying malignancies and potential nosocomial pneumonia, based on the department providing care, or surgery reports during the admission.
Of the 5592 adults hospitalized with CAP, data for 3662 (65.5%) patients was eligible for inclusion in the analysis. This included data for 1899 (51.9%) males, and 2045 (55.8%) patients ≥65 years of age. The most frequently prescribed antimicrobial regimen was β-lactam/β-lactamase inhibitors and fluoroquinolones in combination (31.0%), followed by β-lactam/β-lactamase inhibitors plus macrolides (30.2%), monotherapy (17.0%), β-lactam/β-lactamase inhibitors plus aminoglycosides (12.9%), β-lactam/β-lactamase inhibitors plus clindamycin (4.9%), and cephalosporins plus fluoroquinolones (2.5%). Monotherapy included, in decreasing order of use, cephalosporins (6.0%), fluoroquinolones (3.5%), β-lactam/β-lactamase inhibitors (2.3%) and macrolides (2.2%).
In this study, patterns of antimicrobial prescription for patients hospitalized with CAP were assessed for the first time in Korea. There was divergence from the 2009 Korean guidelines for the treatment of CAP, reinforcing the need for assessment of physicians' adherence to the guidelines.
Respirology 01/2012; 17(1):172-9. · 2.42 Impact Factor
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ABSTRACT: Although hepatitis A is a major health problem worldwide, it has not yet been clarified whether or not viral factors affect the clinical characteristics. This study aimed to investigate if a genotype of hepatitis A virus (HAV) affects disease severity among adolescent and adult populations. Clinical data and specimens were collected from patients ≥16-years-of-age with acute hepatitis A at two university hospitals in Korea during the two study periods: 1998 and 1999 (n = 45), and 2009 (n = 66). Nucleotide sequencing of the complete VP1 region of the HAV isolates was performed for phylogenetic analysis and genotyping. Clinical parameters related to disease severity were compared by HAV genotype to determine its clinical relevance. Of the 87 patients, 47 were male and the mean age was 29.8 ± 8.1 years. The genotype IIIA (93.0%, 53/57) was predominant in the year 2009, whereas IA (93.3%, 28/30) was the major genotype in 1998 and 1999. When comparing disease severity between the two HAV genotypes, the patients with genotype IIIA were older and had higher alanine aminotransferase (ALT) levels, prolonged prothrombin times and lower serum albumin levels. In a multivariate logistic regression model, higher ALT levels ≥ 1,000 IU/L (odds ratio [OR] 11.7, 95% confidence interval [CI] 2.5-54.0) and longer hospitalization (OR 22.49, 95%CI 4.6-132.5) were associated independently with genotype IIIA. In conclusion, this study indicates that HAV genotype might be one of the viral factors responsible for the disease severity of hepatitis A.
Journal of Medical Virology 08/2011; 83(8):1308-14. · 2.82 Impact Factor
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Young Kyung Yoon,
Hye Won Cheong,
Hyunjoo Pai,
Kyoung Ho Roh,
Jeong Yeon Kim,
Dae Won Park,
Jang Wook Sohn,
Seung Eun Lee, Byung Chul Chun,
Hee Sun Sim,
Min Ja Kim
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ABSTRACT: The study investigated molecular mechanisms for prolonged nosocomial spread of multidrug-resistant Klebsiella pneumoniae co-producing plasmid-mediated AmpC β-lactamase DHA-1 and extended-spectrum β-lactamase SHV-12. Forty-eight clinical isolates of K. pneumonia, resistant to the extended-spectrum cepha-losporins, were collected in a 750-bed university hospital over a year. The isolates were characterized for PCR-based β-lactamase genotypes, isoelectric focusing and pulsed-field gel electrophoresis (PFGE) profiles. Resistance transfer was performed by plasmid conjugation and confirmed by a duplex-PCR and Southern hybridization. On β-lactamase typing, the strains producing only the DHA-1 enzyme (n=17) or co-producing DHA-1 and SHV-12 enzymes (n=15) were predominant. Judging from a one year-distribution of PFGE profiles, the co-producer was spread primarily with single clonal expansion of the PFGE-type A with subtypes (n=14), whereas the strains producing only DHA-1 enzyme were spread simultaneously with the PFGE-type A (n=ll) and other PFGE types (n=6). Transconjugants of the co-producers were confirmed to harbor either both bla (DHA-1) and bla (SHV-12) or only the bla (DHA-1). In conclusion, this study indicated that the persistent nosocomial spread of multidrug-resistant K. pneumoniae strains was primarily associated with expansion of a clone harboring both the bla (DHA-1) and bla (SHV-12) or the bla (DHA-1) only, and to a lesser extent with the horizontal transfer of the resistant plasmids. Our observations have clinical implication for the control and prevention of nosocomial dissemination of multidrug-resistant K. pneumoniae strains.
The Journal of Microbiology 06/2011; 49(3):363-8. · 1.10 Impact Factor
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Young Kyung Yoon, Byung Chul Chun,
Ha Kyung Lee,
Yeon Seok Seo,
Jung Ho Shin,
Yoon Sik Hong,
Hee Sun Sim,
Jeoung Yeon Kim,
Jeong Yeon Kim,
Yoon Seon Park,
Dae Won Park,
Jang Wook Sohn,
Min Ja Kim
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ABSTRACT: The epidemiological shift of hepatitis A has contributed to a sustained community-wide outbreak in Korea during 2008.
To assess the risk factors associated with hepatitis A virus (HAV) propagation, and to analyze the circulating genotype in the sustained community-wide outbreak.
The hospital-based case-control study was conducted in an 850-bed university hospital in Seoul from April to August, 2008. For molecular analysis of HAV isolates, a 488-bp gene fragment of the VP1 region was amplified and sequenced.
In the multivariated logistic regression model, the risk factors of HAV infection adjusted by age were contacts with hepatitis A case (OR 3.98, 95% CI: 1.36-11.66), residence with child aged <or=5 years (OR 3.43, 95% CI: 1.32-8.87), consuming uncooked lettuce (OR 3.98, 95% CI: 1.83-8.68) or carrot (OR 2.38, 95% CI: 2.38-5.09), drinking tap water (OR 3.68, 95% CI: 1.62-8.37) or portable spring water (OR 2.71, 95% CI: 1.11-6.62) supplied by water purifiers, and eating out (OR 3.87, 95% CI: 1.53-9.78). All isolates analyzed belonged to genotype IIIA. There were 42 nucleotide differences in the sequenced VP1 region among the isolates. Amino acid sequences were identical with each other.
Our study suggests that sporadically contaminated food- or water-borne sources as well as person-to-person transmission might lead a sustained community-wide HAV outbreak and pre-existing dominant genotype IA might be replaced with genotype IIIA as a major epidemic strain in Korea. Our findings urge the health authority to make public guidelines for HAV vaccination and outbreak control.
Journal of clinical virology: the official publication of the Pan American Society for Clinical Virology 09/2009; 46(2):184-8. · 3.12 Impact Factor
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ABSTRACT: Bioterrorism (BT) preparedness and response plans are particularly important among healthcare workers who will be among the first involved in the outbreak situations. This study was conducted to evaluate the current status of education for BT preparedness and response in healthcare-related colleges/junior colleges and to develop learning objectives for use in their regular curricula.
We surveyed all medical colleges/schools, colleges/junior colleges that train nurses, emergency medical technicians or clinical pathologists, and 10% (randomly selected) of them that train general hygienists in Korea. The survey was conducted via mail from March to July of 2007. We surveyed 35 experts to determine if there was a consensus of learning objectives among healthcare workers.
Only 31.3% of medical colleges/schools and 13.3% of nursing colleges/junior colleges had education programs that included BT preparedness and responses in their curricula. The most common reason given for the lack of BT educational programs was 'There is not much need for education regarding BT preparedness and response in Korea'. None of the colleges/junior colleges that train clinical pathologists, or general hygienists had an education program for BT response. After evaluating the expert opinions, we developed individual learning objectives designed specifically for educational institutions.
There were only a few colleges/junior colleges that enforce the requirement to provide education for BT preparedness and response in curricula. It is necessary to raise the perception of BT preparedness and response to induce the schools to provide such programs.
Journal of Preventive Medicine and Public Health 08/2008; 41(4):225-31.
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ABSTRACT: The aim of this study was to examine the geographical difference of cancer mortality to determine any potential associations between cancer mortality and farming in South Korea.
We calculated standardized mortality ratios (SMRs) based on age- and gender-specific cancer mortality rates for 245 geographic areas, using the registered death data from 2000 to 2004 that were obtained from the Korea National Statistical Office. Using the data from the Agriculture Census in 1995, we obtained the farming index. Poisson regression analysis was used to evaluate the associations between cancer mortality and farming after adjustment for socioeconomic factors.
The SMR analyses based on 62,403 annual average cancer deaths yielded regional variations for all cancers combined in men (SMR = 70-192) and women (SMR = 80-132). With increasing farming index we found significantly elevated cancer mortality of esophagus, stomach, brain, and leukemia for men, and of esophagus and stomach for women, whereas the SMR for colorectal and gall bladder cancers were inversely associated with farming. The results were similar when the analyses were repeated after the exclusion of metropolitan areas.
Our findings suggest a possible association between farming and mortality from a few cancer sites in South Korea.
Cancer Causes and Control 07/2008; 19(5):505-13. · 2.88 Impact Factor
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ABSTRACT: This survey was performed to assess the level of influenza vaccine coverage, to understand the driving forces and barriers to vaccination and determine vaccination interventions for the following year in Korean population.
A national sample of 1720 community dwelling adults of age 18 and older were surveyed by individual visits during April 2005. Demographics, state of influenza vaccination, reasons for vaccination or non-vaccination and perceptions on vaccinations were asked by questionnaire.
Influenza vaccination coverage in general population and high risk group was 34.3% and 61.3%, respectively. Predictors for vaccination were > or =65 of age, performance of regular exercise, vaccination in the previous season, experience of influenza-like illness, belief that vaccine can prevent common cold and opinion that vaccine must be taken annually. The most common reason for vaccination for both whole population and high risk groups was to prevent both influenza and common cold, while the most common reason for non-vaccination was the thought that he/she was healthy enough not to be in need for vaccination. Having more information on influenza and vaccination as well as doctor's recommendation for vaccination appeared to be the most important modus operandi to encourage influenza vaccination among non-vaccinees.
Doctor's recommendation was the most important factor in encouraging people to be vaccinated against influenza. Doctors should be geared up with precise information and actively encourage high risk population in order to increase vaccination coverage.
The Journal of infection 09/2007; 55(3):273-81. · 4.13 Impact Factor
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ABSTRACT: The aim of this study was to determine the risk factors for the recovery of low-level mupirocin-resistant (mup(r)) or -susceptible (mup(s)) MRSA from patients in intensive care units (ICUs).
A case-case-control study was conducted from November 2003 to April 2004. Two case groups consisted of patients with low-level mup(r) MRSA and mup(s) MRSA. A control group was frequency matched.
Mup(r) MRSA and mup(s) MRSA were isolated from 20 to 51 patients, respectively, during a six-month period. Risk factors identified for mup(r) MRSA were as follows: exposure to piperacillin-tazobactam (odds ratio [OR] 13.8; 95% confidence intervals [CI], 1.8-105.0), third-generation cephalosporins (OR, 5.0; 95% CI, 1.6-15.5) and quinolones (OR, 3.4; 95% CI, 1.1-10.7). Risk factors identified for mup(s) MRSA were as follows: length of ICU stay (OR, 1.1; 95% CI, 1.0-1.1), surgery (OR, 3.7; 95% CI, 1.5-9.0), exposure to third-generation cephalosporins (OR, 8.4; 95% CI, 3.3-21.7) and quinolones (OR, 7.7; 95% CI, 2.8-21.3).
Our results suggest that nosocomial isolation of low-level mup(r) MRSA may be affected by piperacillin-tazobactam.
The Journal of infection 05/2007; 54(4):337-42. · 4.13 Impact Factor
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Dae Won Park,
Jang Wook Sohn,
Eung-Ha Kim,
Dong-Il Cho,
Jung-Hee Lee,
Ki-Tack Kim,
Kee-Yong Ha,
Chang-Hoon Jeon,
Dae-Moo Shim,
Jin-Soo Lee,
Jang-Bo Lee, Byung Chul Chun,
Min Ja Kim
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ABSTRACT: A retrospective study examining the clinical features, management, and treatment outcome of patients with spinal tuberculosis (TB).
To determine the influence of disease severity and treatment modality on outcome of patients with spinal TB.
Although anti-TB chemotherapy is now the mainstay treatment for spinal TB, it may not be applicable to all situations, especially in patients with risk of deformity, instability, and progression of neurologic deficit.
In this retrospective study (1994-2003), medical records and radiographic findings of patients with spinal TB were reviewed at 7 teaching hospitals in South Korea. The duration of triple chemotherapy with isoniazid, rifampin, and ethambutol, disease severity, operative procedures, and outcome were analyzed. The outcome was assessed as both favorable and unfavorable according to predefined criteria.
A total of 137 patients were diagnosed with spinal TB during the study period. Twenty-one patients were lost to follow-up and excluded from analysis. The mean age was 44.07 +/- 16.57 years. The most common vertebral area involved was the lumbar (44.8%). The mean number of vertebra involved was 2.25. The mean angle of kyphosis was 21.58 degrees. Forty-seven patients (35.1%) had severe symptoms. Radical surgery was carried out in 84 (62.2%) patients. Twenty patients were treated with short-term chemotherapy, while 96 under long-term. At the end of chemotherapy, 94 patients had achieved a favorable status and 22 an unfavorable one. Statistically, there was no significant difference between the 2 groups in terms of gender, chemotherapy duration, or the severity of spinal TB; however, age (P = 0.025; odds ratio = 0.963; 95% confidence interval 0.932-0.995) and radical surgery (P = 0.043; odds ratio = 3.047; 95% confidence interval 1.038-8.942) were significantly related to a favorable outcome by logistic analysis.
Our results showed that a younger age and radical surgery in conjunction with anti-TB chemotherapy were significant favorable prognostic factors.
Spine 03/2007; 32(4):E130-5. · 2.08 Impact Factor
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ABSTRACT: We conducted an epidemiologic study to understand temporal and spatial patterns of hemorrhagic fever with renal syndrome (HFRS) in the Republic of Korea (ROK). We estimated the incidence among civilians in endemic areas through the active surveillance system during the major epidemic periods, from September to December, between 1996 and 1998. We also estimated the prevalence among Korean military personnel from 1995 to 1998. In addition, we assessed seroprevalence, subclinical infection rate, and vaccination rates in both civilians and military personnel. The incidence in civilians ranged from 2.1 to 6.6 per 100, 000 person-months. The annual prevalence in the military personnel was 40-64 per 100, 000 military populations, and remained generally constant throughout the study period with seasonal variation. This is the prospective epidemiologic data set on HFRS in the ROK since the inactivated Hantaan virus vaccine was licensed for use in the late 1990s. These results will be invaluable in establishing a national immunization program against HFRS.
Journal of Korean Medical Science 09/2006; 21(4):614-20. · 0.99 Impact Factor
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ABSTRACT: The preventive medicine learning objectives, first developed in 1977 and subsequently supplemented, underwent necessary revision of the contents for the fourth time to create the fifth revision. However, the required educational contents of health promotion and disease prevention have been changed by the new trends of medical education such as PBL and integrated curriculum, the rapid change of the health and medical environment and the globalization of medicine. The Korean Society of Preventive Medicine formed a task force, led by the Undergraduate Education Committee in 2003, which surveyed all the medical colleges to describe the state of preventive medicine education in Korea, analyzed the changing education demand according to the change of health environment and quantitatively measured the validity and usefulness of each learning objective in the previous curriculum. Based on these data, some temporary objectives were formed and promulgated to all the medical schools. After multiple revisions, an almost completely new series of learning objectives for preventive medicine was created. The objectives comprised 4 classifications and 1 supplement: 1) health and disease, 2) epidemiology and its application, 3) environment and health, 4) patient-doctor-society, and supplementary clinical occupational health. The total number of learning objectives, contained within 13 sub-classifications, was 221 (including 35 of supplementary clinical occupational health). Future studies of the learning process and ongoing development of teaching materials according to the new learning objectives should be undertaken with persistence in order to ensure the progress of preventive medicine education.
Journal of Preventive Medicine and Public Health 08/2006; 39(4):293-301.
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Byung-Chul Chun
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ABSTRACT: The impact of the next influenza pandemic is difficult to predict. It is dependent on how virulent the virus is, how rapidly it spreads from population to population, and the effectiveness of prevention and response efforts. Despite the uncertainty about the magnitude of the next pandemic, estimates of the health and economic impact remain important to aid public health policy decisions and guide pandemic planning for health and emergency sectors. Planning ahead in preparation for an influenza pandemic, with its potentially very high morbidity and mortality rates, is essential for hospital administrators and public health officials. The estimation of pandemic impact is based on the previous pandemics--we had experienced at least 3 pandemics in 20th century. But the epidemiological characteristics--ie, start season, the impact of 1st wave, pathogenicity and virulence of the viruses and the primary victims of population were quite different from one another. I reviewed methodology for estimation and modelling of pandemic impact and described some nations's results using them in their national preparedness plans. And then I showed the estimates of pandemic influenza impact in Korea with FluSurge and FluAid. And, I described the results of pandemic modelling with parameters of 1918 pandemic for the sake of education and training of the first-line responder health officials to the epidemics. In preparing influenza pandemics, the simulation and modelling are the keys to reduce the uncertainty of the future and to make proper policies to manage and control the pandemics.
Journal of Preventive Medicine and Public Health 12/2005; 38(4):379-85.
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ABSTRACT: To identify the relationship between the internet addiction of adolescents and their Health Promotion Lifestyle Profile and Perceived Health Status, and thereby to detect the impact of internet addiction on the health of adolescents, produce the basic information necessary to develop a prevention program for internet addiction and to plan for a health promotion program.
This study was designed as a cross-sectional study, and the subjects were the second-grade students of three junior-high and three high schools located in the city of K in Kyung Gi Province. Out of 769 subjects, 764 completed the questionnaires (99.3%); 369 (48.3%) junior-high school students and 395 (51.7%) high school students. The questionnaires were composed of Young's Internet Addiction, Health Promotion Lifestyle Profile, Perceived Health Status, and general characteristics. We used t-test, ANOVA in means comparison between groups, chi2-test in frequency analysis, and multiple regression analysis in multivariate analysis, using the SAS 8.1 program.
There was a statistically significant difference in Health Promotion Lifestyle Profile according to internet addiction status (severe addiction vs. other status, P < 0.0001). The Perceived Health Status scores was lowest in the severe addiction group (P < 0.001). There was also a significant negative correlation between internet addiction and Health Promotion Lifestyle Profile (P < 0.0001). The results of multiple regression showed that Young's Addiction Score was significant for the subjects' Health Promotion Lifestyle Profile after controlling for other variables (P < 0.0001).
This study showed that the severe internet addiction group had the lowest score in Health Promotion Lifestyle Profile and Perceived Health Status, which suggests that the addiction could have a negative effect on the health status of adolescents.
Journal of Preventive Medicine and Public Health 02/2005; 38(1):53-60.
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ABSTRACT: We have previously identified the Legionella 19-kDa peptidoglycan-associated lipoprotein (PAL) as a species-common immunodominant antigen. We describe here for the first time the excretion and detection of the PAL antigen in infected urine specimens, which is useful for the diagnosis of Legionnaires' disease. Rabbit anti-PAL immunoglobulin G (IgG) antibody was produced by immunization with the purified, recombinant PAL of Legionella pneumophila serogroup 1 and used in the PAL antigen capture enzyme-linked immunosorbent assay (ELISA) to detect urinary PAL antigen. A soluble-antigen capture ELISA using rabbit IgG antibodies against Legionella soluble antigens was prepared independently and used as a broad-spectrum standard test to detect soluble antigens of several Legionella species. Urine samples were obtained from guinea pigs experimentally infected with each of L. pneumophila serogroups 1, 3, and 6, and other Legionella species. The absorbance values of the PAL antigen ELISA highly correlated with those of the soluble-antigen ELISA in infected urine samples, with a correlation coefficient of 0.84 (P < 0.01). When applied to 17 infected urine samples and 67 negative controls from guinea pigs, the sensitivity and specificity of the PAL antigen capture ELISA were 88.2 and 95.5%, respectively. Compared to the commercial Biotest enzyme immunoassay, the PAL antigen ELISA was more efficient for detecting pneumophila non-serogroup 1 and nonpneumophila species. None of the 161 control human urine specimens obtained from healthy adults and patients with either non-Legionella pneumonia or urinary tract infections tested positive in the PAL antigen ELISA. The present study shows that the Legionella PAL is a very useful broad-spectrum antigen for urinary diagnostic testing. Moreover, since recombinant PAL antigen can be produced more efficiently than the soluble antigens, the development of a broad-spectrum diagnostic immunoassay based on the detection of the PAL antigen appears to be warranted.
Journal of Clinical Microbiology 08/2003; 41(7):2974-9. · 4.15 Impact Factor
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Jun Yong Choi,
Hee-Jin Cheong, Byung Chul Chun,
Hye Kyung Park,
Han Sung Lee,
Hagyung Lee,
Sang Il Kim,
Minja Kim,
Sung Soo Kim,
Hyun-Ha Chang, [......],
Dae Won Park,
Young Hwa Choi,
Eun Ju Choo,
Hye Won Jeong,
Hee Jung Yoon,
Min-Hyukjeon,
Young Keun Kim,
Hyo Youl Kim,
Sang Yop Shin,
June Myung Kim
Public Health Reports 124(6):883-8; discussion 883. · 1.27 Impact Factor
