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Objectives: Community-associated MRSA (CA-MRSA) has emerged in the community and has recently been spreading in healthcare settings. The objectives of this study were to evaluate the clinical outcomes and bacterial virulence factors of the Korean CA-MRSA (ST72-SCCmecIV) strain, which causes bloodstream infections., Methods: All adult patients with MRSA bacteraemia were prospectively enrolled. Clinical outcomes, microbiological characteristics and 40 bacterial virulence factors were evaluated., Results: Of the 352 typed MRSA isolates, 342 isolates (97.2%) belonged to three Panton-Valentine leucocidin-negative strains: ST5-SCCmecII (70.2%), ST72-SCCmecIV (22.4%) and ST239-SCCmecIII (4.6%). The remaining 10 (2.8%) isolates from minor strains were excluded from the final analysis. After controlling for several confounding factors, ST72-SCCmecIV was associated with the lowest mortality (compared with ST5-SCCmecII, adjusted OR=0.26; 95% CI=0.13-0.54). However, MRSA isolates with vancomycin MICs of ≥ 1.5 mg/L were more common in ST72-SCCmecIV compared with ST5-SCCmecII (84.8% versus 66.7%; P=0.002). Reduced vancomycin susceptibility and vancomycin heteroresistance were not associated with mortality. Compared with ST5-SCCmecII isolates, ST72-SCCmecIV isolates were less likely to harbour multiple virulence genes. Of these genes, three staphylococcal superantigen genes were associated with mortality: sec (OR=2.31; P=0.002), sel (OR=2.55; P=0.003) and tst (OR=2.76; P<0.001)., Conclusions: After controlling for confounding factors, ST72-SCCmecIV was independently associated with lower mortality compared with ST5-SCCmecII, suggesting this CA-MRSA strain to be of lower virulence. The lack of virulence genes, including staphylococcal superantigen genes, may play a role in the lower virulence of this strain., (© The Author 2014. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.)

Purpose: To investigate the prevalence of superior segmental optic nerve hypoplasia in Korea., Methods: We reviewed the fundus photographs of 3905 individuals who were 40 years old or older and who participated in the comprehensive medical examination program at the Health Promotion Center of Seoul National University Bundang Hospital from March 2003 to December 2006. A single glaucoma specialist reviewed all the photographs, and special attention was paid to the presence of superior segmental optic nerve hypoplasia. The reviewer was masked to information other than the fundus photographs., Results: Superior segmental optic nerve hypoplasia was detected in three eyes of three subjects, which was 0.08% of the 3905 subjects. All three eyes showed a corresponding visual field defect., Conclusion: Superior segmental optic nerve hypoplasia might be a rare condition in Korea.

Hexon sequences were analyzed in 29 epidemiologically unrelated adenovirus type 3 (Ad3) isolates from the 7 genome types to understand the molecular basis of the genome-type diversity of Ad3 associated with childhood pneumonia in Korea during the period 1991-1999. Nine nucleotide substitutions were observed among the 29 Ad3 strains. Five of the 9 involved amino acid changes in loops 1 (Gly to Val at codon 205 and Thr to Ile at 211) and loop 2 (His to Asn at 417, Thr to Ala at 429, and Ala to Asp at 439). The predicted hydropathic characteristics of this region have been affected by these amino acid changes. The region surrounding codons from 417 to 439 of Ad3a16 and Ad3a18 manifested greater hydrophobicity than the region of other genome types (Ad3a, Ad3a13, Ad3a14, Ad3a15, and Ad3a17). In particular, three amino acid changes in loop 2 were associated with two new genome types, namely, Ad3a16 and Ad3a18, which were recognized during later epidemics in 1998-1999. Phylogenetic relatedness revealed that these two genome types clustered into distinct lineages in the phylogenetic tree. This result suggests that the genetic heterogeneity of Ad3 hexon could play a potential role in the appearance of new genome types and that it could affect the antigenic characteristics of Ad3.