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Cheol-In Kang,
Jae-Hoon Song,
So Hyun Kim,
Doo Ryeon Chung,
Kyong Ran Peck,
Visanu Thamlikitkul,
Hui Wang,
Thomas Man-Kit So,
Po-Ren Hsueh,
Rohani Md Yasin,
Celia C Carlos, Pham Hung Van,
Jennifer Perera
[show abstract]
[hide abstract]
ABSTRACT: OBJECTIVE: This study was performed to identify risk factors for the development of bacteremic pneumonia and to evaluate the impact of bacteremia on the outcome of pneumococcal pneumonia. METHODS: Using a database from a surveillance study of community-acquired pneumococcal pneumonia, we compared data of the bacteremic group with that of the non-bacteremic group. RESULTS: Among 981 adult patients with pneumococcal pneumonia, 114 (11.6%) patients who had documented pneumococcal bacteremia were classified into the bacteremic group. In a multivariable analysis, use of immunosuppressant drugs, younger age (<65 years), and DM were independent risk factors associated with the development of bacteremic pneumonia among patients with pneumococcal pneumonia (all P < 0.05). The mortality rate was significantly higher in the bacteremic group than in the non-bacteremic group (28.6% vs. 8.5%; P < 0.001). The multivariable analysis revealed that concomitant bacteremia was one of the significant risk factors associated with mortality (OR, 2.57; 95% CI, 1.24-5.29), along with cerebrovascular disease and presentation with septic shock (all P < 0.05). CONCLUSIONS: Bacteremia was a common finding in pneumococcal pneumonia and was associated with a higher mortality rate. Several clinical variables may be useful for predicting bacteremic pneumonia among patients with pneumococcal pneumonia.
The Journal of infection 08/2012; · 4.13 Impact Factor
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Jae-Hoon Song,
Po-Ren Hsueh,
Doo Ryeon Chung,
Kwan Soo Ko,
Cheol-In Kang,
Kyong Ran Peck,
Joon-Sup Yeom,
Shin-Woo Kim,
Hyun-Ha Chang,
Yeon-Sook Kim, [......],
Shao-Guang Huang,
Hui Wang,
Quan Lu,
Celia C Carlos,
Jennifer A Perera,
Cheng-Hsun Chiu,
Jien-Wei Liu,
Anan Chongthaleong,
Visanu Thamlikitkul, Pham Hung Van
[show abstract]
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ABSTRACT: Methicillin-resistant Staphylococcus aureus (MRSA) is highly prevalent in hospitals in many Asian countries. Recent emergence of community-associated (CA) MRSA worldwide has added another serious concern to the epidemiology of S. aureus infections. To understand the changing epidemiology of S. aureus infections in Asian countries, we performed a prospective, multinational surveillance study with molecular typing analysis.
We evaluated the prevalence of methicillin resistance in S. aureus isolates in CA and healthcare-associated (HA) infections, and performed molecular characterization and antimicrobial susceptibility tests of MRSA isolates.
MRSA accounted for 25.5% of CA S. aureus infections and 67.4% of HA infections. Predominant clones of CA-MRSA isolates were ST59-MRSA-SCCmec type IV-spa type t437, ST30-MRSA-SCCmec type IV-spa type t019 and ST72-MRSA-SCCmec type IV-spa type t324. Previously established nosocomial MRSA strains including sequence type (ST) 239 and ST5 clones were found among CA-MRSA isolates from patients without any risk factors for HA-MRSA infection. CA-MRSA clones such as ST59, ST30 and ST72 were also isolated from patients with HA infections.
Our findings confirmed that MRSA infections in the community have been increasing in Asian countries. Data also suggest that various MRSA clones have spread between the community and hospitals as well as between countries.
Journal of Antimicrobial Chemotherapy 02/2011; 66(5):1061-9. · 5.07 Impact Factor
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Chen-Yen Kuo,
Lin-Hui Su,
Jennifer Perera,
Celia Carlos,
Ban Hock Tan,
Gamini Kumarasinghe,
Thomas So, Pham Hung Van,
Anan Chongthaleong,
Jae-Hoon Song,
Cheng-Hsun Chiu
[show abstract]
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ABSTRACT: Shigellosis is a major health problem in developing countries, causing 91 million episodes and 414,000 deaths in Asia annually. Because of increasing trends towards drug resistance, this study was undertaken to monitor local resistance patterns of Shigella isolates from 8 Asian countries.
Ninety eight Shigella isolates collected from 8 centers in 8 Asian countries from July 2001 to July 2004 were analyzed in terms of serogroup distribution and antimicrobial susceptibility.
The most common serogroup of Shigella isolates was Shigella flexneri (49/98, 50%), followed by Shigella sonnei (44/98, 45%). The highest resistance rate was found for trimethoprim-sulfamethoxazole (81%), followed by tetracycline (74%) and ampicillin (53%). Overall, 76 Shigella isolates (78%) were multidrug-resistant strains; S. flexneri had a higher multidrug resistance rate than S. sonnei (74% vs 23%). Increasing ciprofloxacin and ceftriaxone resistance was observed; approximately 10% and 5% of isolates were resistant to ciprofloxacin and ceftriaxone, respectively. Five ceftriaxone-non-susceptible strains (from Taiwan [3], Hong Kong [1] and The Philippines [1]) and 10 ciprofloxacin-non-susceptible strains (from Hong Kong [2], The Philippines [1], Korea [2], Vietnam [4] and Sri Lanka [1]) were isolated.
High rates of multidrug resistance and steady increases in ceftriaxone and ciprofloxacin resistance of Shigella are serious pubic health concerns in Asian countries. Continuous monitoring of resistance patterns among Shigella isolates is necessary.
Journal of microbiology, immunology, and infection = Wei mian yu gan ran za zhi 05/2008; 41(2):107-11. · 0.99 Impact Factor
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Jae-Hoon Song,
Won Sup Oh,
Cheol-In Kang,
Doo Ryeon Chung,
Kyong Ran Peck,
Kwan Soo Ko,
Joon Sup Yeom,
Choon Kwan Kim,
Shin Woo Kim,
Hyun-Ha Chang, [......],
Sook-In Jung,
Zhaohui Tong,
Qingtao Wang,
Shao-Guang Huang,
Jien-Wei Liu,
M K Lalitha,
Ban-Hock Tan, Pham Hung Van,
Celia C Carlos,
Thomas So
[show abstract]
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ABSTRACT: Appropriate antimicrobial treatment of community-acquired pneumonia (CAP) should be based on the distribution of aetiological pathogens, antimicrobial resistance of major pathogens, clinical characteristics and outcomes. We performed a prospective observational study of 955 cases of adult CAP in 14 hospitals in eight Asian countries. Microbiological evaluation to determine etiological pathogens as well as clinical evaluation was performed. Bronchopulmonary disease (29.9%) was the most frequent underlying disease, followed by cardiovascular diseases (19.9%), malignancy (11.7%) and neurological disorder (8.2%). Streptococcus pneumoniae (29.2%) was the most common isolate, followed by Klebsiella pneumoniae (15.4%) and Haemophilus influenzae (15.1%). Serological tests were positive for Mycoplasma pneumoniae (11.0%) and Chlamydia pneumoniae (13.4%). Only 1.1% was positive for Legionella pneumophila by urinary antigen test. Of the pneumococcal isolates, 56.1% were resistant to erythromycin and 52.6% were not susceptible to penicillin. Seventeen percent of CAP had mixed infection, especially S. pneumoniae with C. pneumoniae. The overall mortality rate was 7.3%, and nursing home residence, mechanical ventilation, malignancy, cardiovascular diseases, respiratory rate>30/min and hyponatraemia were significant independent risk factors for mortality by multivariate analysis (P<0.05). The current data provide relevant information about pathogen distribution and antimicrobial resistance of major pathogens of CAP as well as clinical outcomes of illness in Asian countries.
International Journal of Antimicrobial Agents 02/2008; 31(2):107-14. · 4.13 Impact Factor
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Jae-Hoon Song,
Sook-In Jung,
Kwan Soo Ko,
Na Young Kim,
Jun Seong Son,
Hyun-Ha Chang,
Hyun Kyun Ki,
Won Sup Oh,
Ji Yoeun Suh,
Kyong Ran Peck, [......],
Ti Teow Yee,
Gamini Kumarasinghe,
Farida Jamal,
Adeeba Kamarulzaman,
Navaratnam Parasakthi, Pham Hung Van,
Celia Carlos,
Thomas So,
Tak Keung Ng,
Atef Shibl
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ABSTRACT: A total of 685 clinical Streptococcus pneumoniae isolates from patients with pneumococcal diseases were collected from 14 centers in 11 Asian countries from January 2000 to June 2001. The in vitro susceptibilities of the isolates to 14 antimicrobial agents were determined by the broth microdilution test. Among the isolates tested, 483 (52.4%) were not susceptible to penicillin, 23% were intermediate, and 29.4% were penicillin resistant (MICs >/= 2 mg/liter). Isolates from Vietnam showed the highest prevalence of penicillin resistance (71.4%), followed by those from Korea (54.8%), Hong Kong (43.2%), and Taiwan (38.6%). The penicillin MICs at which 90% of isolates are inhibited (MIC(90)s) were 4 mg/liter among isolates from Vietnam, Hong Kong, Korea, and Taiwan. The prevalence of erythromycin resistance was also very high in Vietnam (92.1%), Taiwan (86%), Korea (80.6%), Hong Kong (76.8%), and China (73.9%). The MIC(90)s of erythromycin were >32 mg/liter among isolates from Korea, Vietnam, China, Taiwan, Singapore, Malaysia, and Hong Kong. Isolates from Hong Kong showed the highest rate of ciprofloxacin resistance (11.8%), followed by isolates from Sri Lanka (9.5%), the Philippines (9.1%), and Korea (6.5%). Multilocus sequence typing showed that the spread of the Taiwan(19F) clone and the Spain(23F) clone could be one of the major reasons for the rapid increases in antimicrobial resistance among S. pneumoniae isolates in Asia. Data from the multinational surveillance study clearly documented distinctive increases in the prevalence rates and the levels of antimicrobial resistance among S. pneumoniae isolates in many Asian countries, which are among the highest in the world published to date.
Antimicrobial Agents and Chemotherapy 07/2004; 48(6):2101-7. · 4.84 Impact Factor
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Jae-Hoon Song,
Hyun-Ha Chang,
Ji Yoeun Suh,
Kwan Soo Ko,
Sook-In Jung,
Won Sup Oh,
Kyong Ran Peck,
Nam Yong Lee,
Yonghong Yang,
Anan Chongthaleong, [......],
M K Lalitha,
Jennifer Perera,
Ti Teow Yee,
Gamini Kumararasinghe,
Farida Jamal,
Adeeba Kamarulazaman,
Navaratnam Parasakthi, Pham Hung Van,
Thomas So,
Tak Keung Ng
[show abstract]
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ABSTRACT: To characterize mechanisms of macrolide resistance among Streptococcus pneumoniae from 10 Asian countries during 1998-2001.
Phenotypic and genotypic characterization of the isolates and their resistance mechanisms.
Of 555 isolates studied, 216 (38.9%) were susceptible, 10 (1.8%) were intermediate and 329 (59.3%) were resistant to erythromycin. Vietnam had the highest prevalence of erythromycin resistance (88.3%), followed by Taiwan (87.2%), Korea (85.1%), Hong Kong (76.5%) and China (75.6%). Ribosomal methylation encoded by erm(B) was the most common mechanism of erythromycin resistance in China, Taiwan, Sri Lanka and Korea. In Hong Kong, Singapore, Thailand and Malaysia, efflux encoded by mef(A) was the more common in erythromycin-resistant isolates. In most Asian countries except Hong Kong, Malaysia and Singapore, erm(B) was found in >50% of pneumococcal isolates either alone or in combination with mef(A). The level of erythromycin resistance among pneumococcal isolates in most Asian countries except Thailand and India was very high with MIC(90)s of >128 mg/L. Molecular epidemiological studies suggest the horizontal transfer of the erm(B) gene and clonal dissemination of resistant strains in the Asian region.
Data confirm that macrolide resistance in pneumococci is a serious problem in many Asian countries.
Journal of Antimicrobial Chemotherapy 03/2004; 53(3):457-63. · 5.07 Impact Factor
