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ABSTRACT: A computerized alert system (CAS) has been introduced to notify bacteremia in real time. We evaluated the impact of the CAS on the administration of appropriate antibiotics in patients with Staphylococcus aureus bloodstream infections (BSIs). We retrospectively reviewed the medical records of patients with S. aureus BSI for each 1-year control and intervention periods, before and after the implementation of the CAS. The proportions of appropriate antibiotic treatment were compared between the control and intervention periods. The 30-day mortality of S. aureus bacteremia was also assessed in the study population. A total of 313 patients were included in the study. Appropriate antibiotics were initiated 7 h earlier in the intervention period (mean time, 13.5 h vs. 20.0 h; p = 0.136). The administration of appropriate antibiotics within the 24 h after blood acquisition was similar between the two periods, but this significantly increased from 3.3 % in the control period to 10.6 % in the intervention during the 24-36 h interval (p = 0.012). In the subgroup analysis, similar trends were observed in patients with methicillin-resistant isolates (6.7 % vs. 18.2 %; p = 0.032) and hospital-onset infection (3.5 % vs. 17.1 %; p = 0.004). The independent risk factors for 30-day mortality of S. aureus bacteremia were age, a high Pitt bacteremia score, an increased Charlson's weighted index of comorbidity, and hospital-onset infection, although the appropriateness of antibiotic therapy within 36 h and the CAS were not identified as predictors. The CAS increased the proportion of appropriate antimicrobial therapy during the 24-36 h interval after bacteremia onset in patients with S. aureus BSIs.
European Journal of Clinical Microbiology 01/2013; · 2.86 Impact Factor
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E-J Joo,
D R Chung,
Y E Ha,
S Y Park,
S-J Kang,
S H Kim,
C-I Kang,
K R Peck,
N Y Lee,
K S Ko, J-H Song
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ABSTRACT: Community-associated meticillin-resistant Staphylococcus aureus (CA-MRSA) has emerged as an important pathogen worldwide in a continent-specific manner. Clinical characteristics of infections caused by CA-MRSA other than USA300, especially in healthcare settings, have not been well established.
To conduct a retrospective cohort study to determine the clinical characteristics of infections caused by Panton-Valentine leukocidin (PVL)-negative, multilocus sequence type (ST) 72 staphylococcal cassette chromosome mec (SCCmec) type IV, a major CA-MRSA clone in Korea.
ST72-IV isolates, which were susceptible to fluoroquinolones, gentamicin, rifampicin, and cotrimoxazole, were presumptively identified among 4667 MRSA isolates and then confirmed by SCCmec typing and multilocus sequence typing. A total of 124 cases of ST72-IV infections were analysed.
The annual incidence of infections by ST72-IV per 100,000 admissions increased from 45.5 to 66.3 cases during 2007-2009. The most frequently occurring type of infection was skin and soft tissue infection (SSTI) (46.0%), followed by pneumonia (27.4%) and bone and joint infection (9.7%). Surgical site infection accounted for 22.6% and 32.5% of community-onset (CO) healthcare-associated infection and hospital-onset (HO) infection, respectively. Pneumonia was most frequent (45.0%) among HO infection. Multivariate analysis showed that pneumonia increased the odds of all-cause mortality (odds ratio: 18.8; 95% confidence interval: 2.6-133.9) compared with other types of infection.
Increasing trends were observed in annual incidence of CO and HO infections by ST72-IV in Korea. Pneumonia was the most frequent among HO infection and was associated with higher mortality. These findings pose important implications for successful antibiotic therapy and infection control in the era of CA-MRSA.
The Journal of hospital infection 05/2012; 81(3):149-55. · 3.01 Impact Factor
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ABSTRACT: BACKGROUND: The purpose of this study was to investigate the incidence, risk factors, and treatment outcome of tuberculosis (TB) in solid organ transplant (SOT) recipients treated with rifampicin. METHODS: The incidence density of TB was calculated by a retrospective cohort study. Risk factors for TB were analyzed by a nested case-control study. Treatment outcome and effects of anti-TB drugs on immunosuppressants and allograft were compared between patients whose initial 2-month intensive regimen included rifampicin and those whose intensive regimen did not. RESULTS: Among the 2144 SOT recipients over 16 years, 40 cases of TB were found (1.7%). The incidence density was 372 cases per 10(5) patient years (95% confidence interval [CI], 270-503), which was 4 times higher than for the general Korean population (90 cases per 10(5) person years). The median time to the development of TB was 234 days (range, 33-3940 days). The use of tacrolimus (odds ratio [OR] 4.90; 95% CI, 1.74-13.80; P = 0.003) and cytomegalovirus (CMV) infection within the prior 3 months (OR 4.62; 95% CI, 1.44-14.87; P = 0.01) were found to be risk factors for TB. Patients whose intensive regimen included rifampicin were more likely to have an increased dose of calcineurin inhibitors than patients whose intensive regimen did not include rifampicin (13/15 [86.7%] vs. 3/14 [21.4%], P = 0.001). Graft rejection and mortality did not differ between the 2 groups. CONCLUSIONS: Use of tacrolimus and CMV infection were major risk factors for TB in SOT recipients. The graft outcome and mortality did not differ whether rifampicin was used or not during the first 2-month intensive phase.
Transplant Infectious Disease 02/2012; · 2.22 Impact Factor
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ABSTRACT: Preemptive therapy is used to prevent cytomegalovirus (CMV) disease in transplant recipients. The CMV antigenemia assay, which has been commonly used as a predictive marker for preemptive therapy, requires intensive labor and immediate processing. We compared the cutoff value of plasma CMV polymerase chain reaction (PCR) with CMV antigenemia in kidney transplant recipients.
We compared two diagnostic methods for CMV infection in kidney transplant recipients: quantitative PCR (qPCR) versus antigenemia. We evaluated the optimal cutoff value of plasma CMV qPCR by using receiver-operating characteristic curves for specific antigenemia values. All kidney transplant recipients from January 2004 to January 2005 were enrolled and followed with CMV antigenemia and plasma CMV qPCR.
The analyses were performed on 899 samples collected from 111 patients in the early posttransplant period, matching 84.1% of patients for the results of CMV antigenemia and plasma CMV qPCR. For patients with symptomatic CMV infection and disease, who showed ≥25 positive cells in the antigenemia assay, the cutoff value for qPCR was 17.8 copies/μL with a sensitivity of 97.1%, a specificity of 89.1%, and a positive predictive value of 26.6%.
Diagnostic assays for CMV such as CMV antigenemia and quantitative plasma PCR, showed similar diagnostic values. They are the methods of choice for the diagnosis and monitoring of active CMV infection after kidney transplantation. However, because of the relatively low positive predictive value of qPCR, this test may lead to unnecessary preemptive treatment in kidney transplant recipients.
Transplantation Proceedings 09/2011; 43(7):2624-9. · 1.00 Impact Factor
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D R Chung,
H Lee,
M H Park,
S-I Jung,
H-H Chang,
Y-S Kim,
J S Son,
C Moon,
K T Kwon,
S Y Ryu,
S Y Shin,
K S Ko,
C-I Kang,
K R Peck, J-H Song
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ABSTRACT: We determined the fecal carriage rate of serotype K1 Klebsiella pneumoniae in healthy Koreans and studied their genetic relationship with liver abscess isolates. We compared the carriage according to the country of residence. The stool specimens were collected through health promotion programs in Korea. K. pneumoniae strains were selected and tested for K1 by PCR. Serotype K1 isolates were characterized by multilocus sequence typing and pulsed field gel electrophoresis. A total of 248 K. pneumoniae isolates were obtained from 1,174 Koreans. Serotype K1 was identified in 57 (4.9%), of which 54 (94.7%) were ST 23 and were closely related to the liver abscess isolates. Participants aged >25 years showed a higher fecal carriage rate than those ≤ 25 (P = 0.007). The proportion of serotype K1 out of K. pneumoniae isolates in foreigners of Korean ethnicity who had lived in other countries was lower compared with those who had lived in Korea (5.6% vs 24.1%, P = 0.024). A substantial proportion of Koreans >25 years carries serotype K1 K. pneumoniae ST23 strains, which are closely related to liver abscess isolates. Differences in carriage rates by country of residence suggests that environmental factors might play an important role in the carriage of this strain.
European Journal of Clinical Microbiology 07/2011; 31(4):481-6. · 2.86 Impact Factor
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ABSTRACT: The purpose of this study was to evaluate the impact of inappropriate empiric antimicrobial therapy on the outcome of Pseudomonas aeruginosa bacteraemia according to the primary infection site.
A retrospective cohort study including 202 patients with P. aeruginosa bacteraemia was performed. High-risk sites of infection were defined as the lung, intra-abdominal non-hepatobiliary tract or unknown source.
Of the 202 patients with P. aeruginosa bacteraemia, 80 (39.6%) had received inappropriate empiric antimicrobial therapy. No significant difference in the 30-day mortality rate was found between the inappropriate therapy group and the appropriate therapy group (19/80 [23.8%] vs. 32/122 [26.2%], P = 0.692). Patients with pneumonia or non-hepatobiliary tract intra-abdominal infection showed significant association with high mortality, while those with urinary tract or hepatobiliary tract infection showed negative associations with mortality. In the subgroup analysis including 98 patients with high-risk sites of infection, the mortality rate of the inappropriate therapy group was significantly higher than that of the appropriate therapy group (14/26 [53.8%] vs. 23/72 [31.9%], P = 0.035). Inappropriate empiric antimicrobial therapy was also found to be one of the independent risk factors for mortality in patients with high-risk sites of infection (odds ratio [OR] 8.69; 95% confidence interval [CI] 1.86-40.59), along with renal disease, corticosteroid use, polymicrobial infection and higher Pitt bacteraemia score.
Inappropriate empiric antimicrobial therapy adversely affected the outcome of P. aeruginosa bacteraemia in patients with high-risk sites of infection. Our data suggest that the impact of inappropriate antimicrobial therapy on the outcome of P. aeruginosa bacteraemia may be dependent on the primary site of infection.
Infection 05/2011; 39(4):309-18. · 2.66 Impact Factor
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S-Y Moon,
D R Chung,
S-W Kim,
H H Chang,
H Lee,
D S Jung,
Y-S Kim,
S I Jung,
S Y Ryu,
S T Heo, [......],
K T Kwon,
S Y Shin,
J S Lee,
S S Lee,
J-Y Rhee,
J-A Lee,
M K Joung,
H S Cheong,
K R Peck, J-H Song
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ABSTRACT: Epidemiologic data on the etiologic organisms is important for appropriate empirical antibiotic treatment of bacterial meningitis. We identified the etiologies of community-acquired bacterial meningitis in Korean adults and the associated epidemiological factors. A retrospective, multicenter nationwide study was carried out. Patients 18 years of age or older with community-acquired bacterial meningitis with a confirmed pathogen were enrolled. Demographic, clinical, and microbiological data were collected. One hundred and ninety-five cases were collected. Streptococcus pneumoniae was the most common pathogen (50.8%), followed by Staphylococcus aureus (10.3%), Klebsiella pneumoniae (7.7%), Listeria monocytogenes (6.7%), and group B Streptococcus (3.1%). The penicillin resistance rate of the S. pneumoniae was 60.3%; 40.0% of the organisms were not susceptible to third-generation cephalosporins. The combination of third-generation cephalosporin with vancomycin was used in 76.3% of cases. Steroids were given before or with the first dose of antibiotics in 37.4% of patients. The 30-day mortality rate was 20.5% and neurological sequelae developed in 15.6% of cases. S. pneumoniae was the most common organism identified in community-acquired bacterial meningitis among Korean adults. S. aureus, K. pneumoniae, L. monocytogenes, and group B Streptococcus were also common. S. pneumoniae had high rates of resistance to penicillin and third-generation cephalosporins.
European Journal of Clinical Microbiology 07/2010; 29(7):793-800. · 2.86 Impact Factor
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ABSTRACT: This study was performed to identify the risk factors for mortality and evaluate the effect of inappropriate initial antimicrobial therapy on the outcomes of patients with community-onset Pseudomonas aeruginosa bacteraemia in an emergency department (ER) setting. All cases with P. aeruginosa bacteraemia occurring within 48 h after ER visit from January 2000 to December 2005 were retrospectively analysed. A total of 106 community-onset P. aeruginosa bacteraemia cases in the ER were included (mean age, 57.61 +/- 14.44 years old; M:F, 58:48). Although P. aeruginosa bacteraemia was diagnosed in the ER, most of the cases of P. aeruginosa bacteraemia were healthcare-associated (88.7%). Malignancy (n = 83, 78.3%) was the most common underlying disorder. Fifty patients (47.2%) were neutropaenic and 56 patients (52.8%) had septic shock. The overall 30-day mortality rate was 26.4% (28/106). In the univariate analysis, underlying malignancy, high Charlson's weighted index of comorbidity (> or = 3), high Pitt bacteraemia score (> or = 4), indwelling central venous catheter and inappropriate initial therapy were significantly associated with 30-day mortality (all P < 0.05). In the multivariate analysis, high Pitt bacteraemia score (OR, 17.03; 95% CI, 4.60-63.15; P < 0.001) and inappropriate initial antimicrobial therapy (OR, 4.29; 95% CI, 1.39-13.24; P = 0.011) were found to be significant risk factors for 30-day mortality. The 30-day mortality rate was significantly higher in the inappropriate therapy group (18/51, 35.3%) than in the appropriate therapy group (10/55, 18.2%) (P = 0.046). This study demonstrated that inappropriate initial antimicrobial therapy was significantly associated with unfavourable outcomes in patients with community-onset P. aeruginosa bacteraemia. As P. aeruginosa bacteraemia can be a fatal infection, even when community-onset, inappropriate antimicrobial therapy should be avoided in suspected cases of P. aeruginosa bacteraemia.
European Journal of Clinical Microbiology 07/2008; 27(12):1219-25. · 2.86 Impact Factor
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C-H Chuang,
L-H Su,
J Perera,
C Carlos,
B H Tan,
G Kumarasinghe,
T So,
P H VAN,
A Chongthaleong,
P-R Hsueh,
J-W Liu, J-H Song,
C-H Chiu
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ABSTRACT: Two hundred and four Salmonella enterica serotype Typhi (S. Typhi) isolates were collected from seven Asian countries during 2002-2004. Multidrug-resistant S. Typhi (resistant to > or = 3 antibiotics) was detected in 84 (41.2%) isolates and 142 (69.6%) showed reduced susceptibility to ciprofloxacin (minimum inhibitory concentration=0.125-1.0 mg/l). This study highlights the worsening situation of antimicrobial resistance of S. Typhi in Asia.
Epidemiology and Infection 06/2008; 137(2):266-9. · 2.84 Impact Factor
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ABSTRACT: This study was conducted to evaluate the epidemiology and clinical features of bloodstream infections caused by extended-spectrum beta-lactamase-producing E. coli (ESBL-EC) in community-onset bacteremia. Of 929 episodes of community-onset E. coli bacteremia, 4.1% (38/929) had bacteremia with ESBL producers. Of these, 63.2% (24/38) were further classified as healthcare-associated infections. Although most patients had risk factors for infection due to ESBL producers, three patients with urinary tract infection, four patients with cholangitis, and one patient with a liver abscess had no identified predisposing risk factors. The 30-day mortality was 21.1% (8/38). ESBL-EC is a significant cause of bloodstream infection, even in patients with community-onset infection.
European Journal of Clinical Microbiology 02/2008; 27(1):85-8. · 2.86 Impact Factor
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ABSTRACT: To identify specific risk factors and clinical outcomes of community-acquired pneumonia (CAP) caused by gram-negative bacilli
(GNB), we compared the clinical features and outcomes of patients with CAP due to GNB with those of patients with non-GNB
pneumonia. We performed a prospective observational study of 912 cases of adult CAP in Asian countries from January 2002 to
December 2004. Systemic laboratory evaluation for determining the etiology and clinical evaluation were performed. Of 912
cases with CAP, 93 (10.1%) cases were caused by GNB: 59 with K. pneumoniae, 25 P. aeruginosa, 7 Enterobacter species, 1 Acinetobacter baumannii, and 1 Serratia marcescens. CAP caused by GNB was more frequently associated with septic shock, malignancy, cardiovascular diseases, smoking, hyponatremia,
and dyspnea, according to multivariate analysis (P < 0.05). Overall 30-day mortality rate was 7.3% (65/885). Mortality was significantly higher in the GNB group than in the
non-GNB group [18.3% (17/93) vs. 6.1% (48/792); P < 0.001]. GNB as a causative microorganism was found to be one of the independent risk factors for mortality (adjusted OR = 2.63,
95% CI 1.02–6.78, P = 0.046) with nursing home residence, mechanical ventilation, cardiovascular disease, respiratory rate > 30/min, and hyponatremia
(all P < 0.05). GNB was not only a frequent etiology of severe CAP but also an independent risk factor for mortality. Data suggest
that an initial empirical antimicrobial coverage of GNB including P. aeruginosa should be seriously considered in cases of severe pneumonia, especially in patients with underlying malignancy, underlying
cardiovascular diseases, smoking, septic shock, and hyponatremia.
European Journal of Clinical Microbiology 01/2008; 27(8):657-661. · 2.86 Impact Factor
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K W Lee,
J W Joh,
S J Kim,
J H Park,
S E Chon,
S H Choi,
J S Heo, J H Song,
S M Kim,
K R Peck,
Y I Kim,
B B Lee,
S K Lee
Transplantation Proceedings 03/2003; 35(1):66-7. · 1.00 Impact Factor
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ABSTRACT: Epidemiological typing of Streptococcus pneumoniae is necessary to study genetic relatedness among strains. The Box A PCR assay, a good epidemiological tool for high resolution typing of pneumococcal isolates, was used for comparison of strains of S. pneumoniae from Korea, an area of high penicillin resistance and India with low resistance to penicillin.
The pneumococcal strains from Indian and Korean sources included in the study belonged to serotypes 19F, 23F, 6A & 6B. The penicillin susceptibility of the strains was confirmed by determination of minimum inhibitory concentration values. The strains were then fingerprinted using the Box A PCR protocol and the results were further analysed by Molecular Analyst Software.
The Box fingerprinting technique produced sharp, clear and reproducible banding patterns for strains of S. pneumoniae included in the study. There was no similarity between Indian and Korean strains at the genetic level. Among the Korean strains with similar serotypes, the level of similarity varied. Except for one pair (serotype 23F), that showed a level of homology of about 90 per cent, almost all the others showed less than 80 per cent homology. It was also seen that there was a high percentage of homology (> 90% in nasopharyngeal isolates from India belonging to serotype 19F) between isolates from similar source. Comparison of the Indian and Korean isolates of similar serotype showed low homology, except for one cluster of two strains with serotype 6B which showed 84 per cent homology (blood isolates from India and Korea).
Box A PCR is a highly discriminatory and useful method for typing S. pneumoniae. The results of the study have shown low levels of homology between strains from within India and also between two geographically distinct areas.
The Indian journal of medical research 11/2002; 116:177-85. · 1.84 Impact Factor
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ABSTRACT: Although Pseudomonas aeruginosa is not generally considered as a cause of antibiotic-associated diarrhea, several cases of diarrhea caused by P. aeruginosa have been reported. We experienced seven cases of nosocomial diarrhea presumably caused by P. aeruginosa, which was the predominant organism isolated from stool cultures. Clostridium difficile toxin was also positive in one patient. No other potential or recognized enteropathogens were identified from stools. All patients had underlying diseases and had been receiving antibiotics before the diarrheal onset. All of the seven P. aeruginosa isolates were resistant to previously given antibiotics. Diarrhea stopped three days after withdrawal of probable offending antibiotics without specific treatment in two patients. The other five patients having continuous diarrhea despite withdrawal of probable offending antibiotics, were successfully treated with antipseudomonal agents. The median duration of diarrhea after the initiation of treatment was 6.3 days. These data suggest that P. aeruginosa can be a potential cause of antibiotic-associated diarrhea. Further investigations are warranted to evaluate the possible etiologic role of P. aeruginosa in antibiotic-associated diarrhea.
Journal of Korean Medical Science 01/2002; 16(6):742-4. · 0.99 Impact Factor
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N Y Lee, J H Song,
S Kim,
K R Peck,
K M Ahn,
S I Lee,
Y Yang,
J Li,
A Chongthaleong,
S Tiengrim, [......],
T Cherian,
J Perera,
T T Yee,
F Jamal,
U C Warsa,
P H Van,
C C Carlos,
A M Shibl,
M R Jacobs,
P C Appelbaum
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ABSTRACT: To investigate the nasal carriage of antibiotic-resistant pneumococci by children, anterior nasal swabs were done for 4963 children <5 years old in 11 countries in Asia and the Middle East. In total, 1105 pneumococci isolates (carriage rate, 22.3%) were collected, 35.8% of which were found to be nonsusceptible to penicillin. Prevalence of penicillin nonsusceptibility was highest in Taiwan (91.3%), followed by Korea (85.8%), Sri Lanka (76.5%), and Vietnam (70.4%). Penicillin resistance was related to residence in urban areas, enrollment in day care, and a history of otitis media. The most common serogroups were 6 (21.5%), 23 (16.5%), and 19 (15.7%). The most common clone, as assessed by pulsed-field gel electrophoresis, was identical to the Spanish 23F clone and to strains of invasive isolates from adult patients. Data in this study documented the high rate of penicillin or multidrug resistance among isolates of pneumococci carried nasally in children in Asia and the Middle East and showed that this is due to the spread of a few predominant clones in the region.
Clinical Infectious Diseases 05/2001; 32(10):1463-9. · 9.15 Impact Factor
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ABSTRACT: This study was performed to evaluate the effect of granulocyte-colony stimulating factor on neutrophil functions in diabetic patients with active foot infections in vitro. Twelve diabetic patients with foot infections and 12 normal volunteers were enrolled. Neutrophils from peripheral blood were incubated with granulocyte colony-stimulating factor (G-CSF, 50 ng/mL) for 20 min. Superoxide production of neutrophils was measured by the reduction of ferricytochrome C. Neutrophil phagocytosis was assayed using Staphylococcus aureus and the weighted phagocytic index was calculated. Superoxide production of neutrophils in diabetic patients with foot infections was 7.7 (unit: nmol/2 x 10(5) cells/60 min), which was significantly lower than that in controls (12.0) (p<0.05). G-CSF increased neutrophil superoxide production to 12.1 in diabetic patients with foot infections and to 19.8 in controls (p<0.05 for each). Weighted phagocytic index in diabetic patients with foot infections was 0.77, which was not significantly different from that of the controls (0.69). Weighted phagocytic index was increased significantly by G-CSF to 0.88 in diabetic patients with foot infections and to 0.79 in controls (p<0.05 for each). In conclusion, G-CSF significantly enhanced neutrophil functions in diabetic patients with foot infections in vitro.
Journal of Korean Medical Science 02/2001; 16(1):39-44. · 0.99 Impact Factor
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J M Kim,
E S Park,
J S Jeong,
K M Kim,
H S Oh,
S W Yoon,
H S Chang,
K H Chang,
S I Lee,
M S Lee, J H Song,
M W Kang,
S C Park,
K W Choe,
C H Pai
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ABSTRACT: The goals of a surveillance for nosocomial infections (NIs) are to observe the magnitude and characteristics of NIs and to plan and evaluate policies and guidelines of infection control. This study was designed to determine the rate and distribution of NIs and their causative pathogens in Korean hospitals.
Prospective surveillance was performed at 15 acute care hospitals with more than 500 beds during a 3-month period from June to August 1996. The case-finding methods were laboratory-based surveillance for patients in the general wards and a direct review of medical charts done regularly for all the patients in the intensive care units.
A total of 3162 NIs were found among 85,547 discharged patients, with an overall nosocomial infection rate of 3.70 per 100 patients discharged. Urinary tract infections constituted 30.3% of all NIs. Other infections were pneumonias, 17.2%, surgical site infections, 15.5%, and primary bloodstream infections, 14.5%. The infection rate was the highest in neurosurgery (14.21), followed by neurology (8. 62) and ontology services (6.70). The infection rate in intensive care units was higher than it was in the general wards (10.74 vs 2. 57, P =.001). The commonly isolated organisms were Staphylococcus aureus (17.2%), Pseudomonas aeruginosa (13.8%), and Escherichia coli (12.3%).
This first multicenter surveillance study provided extensive information on the current status and trends of NIs in major hospitals in Korea. The results may contribute to the evaluation of infection control programs and the development of effective strategies in these hospitals.
American Journal of Infection Control 01/2001; 28(6):454-8. · 2.40 Impact Factor
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I S Choi,
J B Park,
S J Kim,
J W Joh,
S K Lee,
W S Huh,
H Y Oh,
S M Kim,
K R Peck, J H Song,
M K Kim,
Y H Ko,
B B Lee
Transplantation Proceedings 12/2000; 32(7):1957-8. · 1.00 Impact Factor
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S K Lee,
J H Park,
J W Joh,
S J Kim,
I S Choi,
S H Choi,
J S Heo,
W Y Lee,
T S Sohn,
Y I Kim,
S W Paik,
K C Koh,
J H Lee,
S M Kim,
K R Peck, J H Song,
B B Lee
Transplantation Proceedings 12/2000; 32(7):2248-9. · 1.00 Impact Factor
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J H Song,
J W Yang,
J H Jin,
S W Kim,
C K Kim,
H Lee,
K R Peck,
S Kim,
N Y Lee,
M R Jacobs,
P C Appelbaum
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ABSTRACT: Pulsed-field gel electrophoresis, ribotyping, and fingerprinting analysis of 22 invasive isolates of multidrug-resistant (MDR) pneumococci from Korea showed that 59 to 82% were genetically related. DNA sequencing of the PBP 2B gene showed relatively uniform alterations in nucleotides (5.4 to 7.8%) and amino acids (3.0 to 4. 3%), while Asn-276-->Lys, Arg-285-->Cys and Ser-305-->Phe substitutions were unique to Korean MDR strains, suggesting the spread of a few epidemic clones of resistant pneumococci within Korea.
Journal of Clinical Microbiology 04/2000; 38(4):1641-4. · 4.15 Impact Factor
