• Title/Summary/Keyword: Infectious Disease Medicine

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Failure of Ciprofloxacin Therapy in the Treatment of Community-Acquired Acute Pyelonephritis caused by In-Vitro Susceptible Escherichia coli Strain Producing CTX-Type Extended-Spectrum β-Lactamase

  • Seok, Hyeri;Cha, Min Kyeong;Kang, Cheol-In;Cho, Sun Young;Kim, So Hyun;Ha, Young Eun;Chung, Doo Ryeon;Peck, Kyong Ran;Song, Jae-Hoon
    • Infection and chemotherapy
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    • v.50 no.4
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    • pp.357-361
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    • 2018
  • While carbapenems are the drug of choice to treat extended-spectrum-${\beta}$-lactamase (ESBL)-producing strains, some alternative carbapenem-sparing regimens are suggested for antibiotic stewardship. We experienced a case of ciprofloxacin treatment failure for acute pyelonephritis caused by an apparently susceptible Escherichia coli. A 71-year-old woman presented the emergency department with fever for 7 days and bilateral flank pain for 2 days. The laboratory results and abdominopelvic computed tomography finding were compatible with acute pyelonephritis. During 3-day ciprofloxacin therapy, the patient remained febrile with persistent bacteremia. After the change in antibiotics to ertapenem, the patient's clinical course started to improve. ESBL-producing E. coli isolates were identified in all three consecutive blood samples. Pulsed-field gel electrophoresis (PFGE) patterns, serotypes, and sequence types showed the three isolates were derived from the identical strain. The isolates produced CTX-M-14 type ESBL belonging to the ST69 clonal group. Despite in vitro susceptibility, the failure was attributed to a gyrA point mutation encoding Ser83Leu within quinolone resistance-determining regions. This case suggests that ciprofloxacin should be used cautiously in the treatment of serious infections caused by ciprofloxacin-susceptible, ESBL-producing E. coli, even in acute pyelonephritis because in-vitro susceptibility tests could fail to detect certain genetic mutations.

Synthesis of Lysophosphatidylcholine Analogues Using D-Mannitol as a Chiral Template and Their Biological Activity for Sepsis

  • Heo, Hye Jin;Jung, Jun-Sub;Lee, Jung Ho;Han, Su Young;Bang, Hyun Bae;Song, Dong-Keun;Jun, Jong-Gab
    • Bulletin of the Korean Chemical Society
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    • v.27 no.8
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    • pp.1149-1153
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    • 2006
  • LPC analogues including natural and unnatural LPC, 3-L-2-PC, acetylated LPC and ethylene glycol derivative are prepared from D-mannitol using in convenient procedures by only changing the synthetic sequences, and their protective activities against cecal ligation and puncture (CLP)-induced severe sepsis are compared. The chirality at C2 position in LPC is found to be required as (S)-configuration for sepsis inhibition, comparing from the protection activity between LPC 6 and unnatural LPC 8. The hydroxyl functionality is also very important and required at C2 or C3 position as shown in the protection activities of ethylene glycol analogue 11 and 3-L-2-PC 9.

Risk Factor and Mortality in Patients with Pulmonary Embolism Combined with Infectious Disease

  • Lee, Gi Dong;Ju, Sunmi;Kim, Ju-Young;Kim, Tae Hoon;Yoo, Jung-Wan;Lee, Seung Jun;Cho, Yu Ji;Jeong, Yi Yeong;Jeon, Kyung Nyeo;Lee, Jong Deog;Kim, Ho Cheol
    • Tuberculosis and Respiratory Diseases
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    • v.83 no.2
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    • pp.157-166
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    • 2020
  • Background: Infectious conditions may increase the risk of venous thromboembolism. The purpose of this study was to evaluate the risk factor for combined infectious disease and its influence on mortality in patients with pulmonary embolism (PE). Methods: Patients with PE diagnosed based on spiral computed tomography findings of the chest were retrospectively analyzed. They were classified into two groups: patients who developed PE in the setting of infectious disease or those with PE without infection based on review of their medical charts. Results: Of 258 patients with PE, 67 (25.9%) were considered as having PE combined with infectious disease. The sites of infections were the respiratory tract in 52 patients (77.6%), genitourinary tract in three patients (4.5%), and hepatobiliary tract in three patients (4.5%). Underlying lung disease (odds ratio [OR], 3.69; 95% confidence interval [CI], 1.926-7.081; p<0.001), bed-ridden state (OR, 2.84; 95% CI, 1.390-5.811; p=0.004), and malignant disease (OR, 1.867; 95% CI, 1.017-3.425; p=0.044) were associated with combined infectious disease in patients with PE. In-hospital mortality was higher in patients with PE combined with infectious disease than in those with PE without infection (24.6% vs. 11.0%, p=0.006). In the multivariate analysis, combined infectious disease (OR, 4.189; 95% CI, 1.692-10.372; p=0.002) were associated with non-survivors in patients with PE. Conclusion: A substantial portion of patients with PE has concomitant infectious disease and it may contribute a mortality in patients with PE.

Development of Nucleic Acid Lateral Flow Immunoassay for Rapid and Accurate Detection of Chikungunya Virus in Indonesia

  • Ajie, Mandala;Pascapurnama, Dyshelly Nurkartika;Prodjosoewojo, Susantina;Kusumawardani, Shinta;Djauhari, Hofiya;Handali, Sukwan;Alisjahbana, Bachti;Chaidir, Lidya
    • Journal of Microbiology and Biotechnology
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    • v.31 no.12
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    • pp.1716-1721
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    • 2021
  • Chikungunya fever is an arboviral disease caused by the Chikungunya virus (CHIKV). The disease has similar clinical manifestations with other acute febrile illnesses which complicates differential diagnosis in low-resource settings. We aimed to develop a rapid test for CHIKV detection based on the nucleic acid lateral flow immunoassay technology. The system consists of a primer set that recognizes the E1 region of the CHIKV genome and test strips in an enclosed cassette which are used to detect amplicons labeled with FITC/biotin. Amplification of the viral genome was done using open-source PCR, a low-cost open-source thermal cycler. Assay performance was evaluated using a panel of RNA isolated from patients' blood with confirmed CHIKV (n = 8) and dengue virus (n = 20) infection. The open-source PCR-NALFIA platform had a limit of detection of 10 RNA copies/ml. The assay had a sensitivity and specificity of 100% (95% CI: 67.56% - 100%) and 100% (95% CI: 83.89% - 100%), respectively, compared to reference standards of any positive virus culture on C6/36 cell lines and/or qRT-PCR. Further evaluation of its performance using a larger sample size may provide important data to extend its usefulness, especially its utilization in the peripheral healthcare facilities with scarce resources and outbreak situations.

Lumpy skin disease as an emerging infectious disease

  • Hye Jin Eom;Eun-Seo Lee;Han Sang Yoo
    • Journal of Veterinary Science
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    • v.24 no.3
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    • pp.42.1-42.6
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    • 2023
  • Lumpy skin disease (LSD) is one of the most important emerging transboundary diseases. Recently, LSD has emerged in many countries in the northern hemisphere. The LSD virus has a huge genome and is highly resistant to environmental conditions. The virus is also host-specific and large ruminants, such as cattle and domestic water buffalo, are particularly susceptible. In addition, wild ruminants can serve as potential reservoirs for spreading the LSD virus. The emergence might be related to climate change in various regions because LSD is an arthropod-borne infectious disease. This disease causes enormous economic losses, such as leather damage, decreased milk production, abortion, and death in infected ruminants. The economic importance of LSD in the bovine industry has forced countries to develop and implement control strategies against the disease. With the recent global spread and the economic impact, LSD will be discussed intensively. In addition, effective preventive measures are suggested based on the presence or absence of LSD outbreaks.

Virulence factors, antimicrobial resistance patterns, and genetic characteristics of hydrogen sulfide-producing Escherichia coli isolated from swine

  • Park, Hyun-Eui;Shin, Min-Kyoung;Park, Hong-Tae;Shin, Seung Won;Jung, Myunghwan;Im, Young Bin;Yoo, Han Sang
    • Korean Journal of Veterinary Research
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    • v.55 no.3
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    • pp.191-197
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    • 2015
  • Escherichia (E.) coli is commensal bacteria found in the intestine; however, some pathogenic strains cause diseases in animals and humans. Although E. coli does not typically produce hydrogen sulfide ($H_2S$), $H_2S$-producing strains of E. coli have been identified worldwide. The relationship between virulence and $H_2S$ production has not yet been determined. Therefore, characteristics of $H_2S$-producing isolates obtained from swine feces were evaluated including antibiotic resistance patterns, virulence gene expression, and genetic relatedness. Rates of antibiotic resistance of the $H_2S$-producing E. coli varied according to antibiotic. Only the EAST1 gene was detected as a virulence gene in five $H_2S$-producing E. coli strains. Genes conferring $H_2S$ production were not transmissible although the sseA gene encoding 3-mercaptopyruvate sulfurtransferase was detected in all $H_2S$-producing E. coli strains. Sequences of the sseA gene motif CGSVTA around Cys238 were also identical in all $H_2S$- producing E. coli strains. Diverse genetic relatedness among the isolates was observed by pulsed-field gel electrophoresis analysis. These results suggested that $H_2S$-producing E. coli strains were not derived from a specific clone and $H_2S$ production in E. coli is not associated with virulence genes.

Nationwide Surveillance Study of Vancomycin-Intermediate Staphylococcus aureus Strains in Korean Hospitals from 2001 to 2006

  • Chung, Gyung-Tae;Cha, Jeong-Ok;Han, Sun-Young;Jang, Hee-Sun;Lee, Kyeong-Min;Yoo, Jae-Il;Yoo, Jeong-Sik;Kim, Hong-Bin;Eun, Soo-Hoon;Kim, Bong-Su;Park, Ok;Lee, Yeong-Seon
    • Journal of Microbiology and Biotechnology
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    • v.20 no.3
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    • pp.637-642
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    • 2010
  • We investigated the prevalence and the molecular characteristics of vancomycin-intermediate Staphylococcus aureus (VISA) among methicillin-resistant Staphylococcus aureus (MRSA) strains isolated from clinical samples at tertiary or general hospitals participating in a nationwide surveillance program for VISA and vancomycin-resistant Staphylococcus aureus (VRSA) in Korea during an 8-week period in each year from 2001 to 2006. Of 41,639 MRSAs isolated, 37,856 were screened and 169 grew on brain heart infusion agar supplemented with 4 ${\mu}g/ml$ vancomycin. A vancomycin MIC of 4 ${\mu}g/ml$ was confirmed for 33 VISA isolates of the 169 isolates. Eighteen of the 33 isolates were classified as hetero-VISA (hVISA) by the population analysis profile (PAP) method. All VISA isolates were susceptible to linezolid, tigecycline, and quinupristin-dalfopristin. Most VISA isolates (MIC 4 ${\mu}g/ml$) showed a PFGE C pattern with sec, seg, and sei enterotoxin genes, including ST5-SCCmec type II, or a PFGE A pattern with sea, including ST239-SCCmec type III.