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152. Comparison of 16S Ribosomal RNA Targeted Sequencing and Culture for Bacterial Identification in Normally Sterile Body Fluid Samples: Report of a 10-Year Clinical Laboratory Review

Author

Yoo, In Young, primary, Kang, On-Kyun, additional, Lee, Myoung-Keun, additional, Kim, Yae-Jean, additional, Cho, Sun Young, additional, Huh, Kyungmin, additional, Kang, Cheol-In, additional, Chung, Doo Ryeon, additional, Peck, Kyong Ran, additional, Huh, Hee Jae, additional, and Lee, Nam Yong, additional

Published
2020
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156. Predominance of an ST11 extended-spectrum β-lactamase-producing Klebsiella pneumoniae clone causing bacteraemia and urinary tract infections in Korea

Author

Ko, Kwan Soo, Lee, Ji-Young, Baek, Jin Yang, Suh, Ji-Yoeun, Lee, Mi Young, Choi, Ji Young, Yeom, Joon-Sup, Kim, Yeon-Sook, Jung, Sook-In, Shin, Sang Yop, Heo, Sang Taek, Kwon, Ki Tae, Son, Jun Seong, Kim, Shin-Woo, Chang, Hyun-Ha, Ki, Hyun Kyun, Chung, Doo Ryeon, Peck, Kyong Ran, and Song, Jae-Hoon

Published
2010
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158. Oral step-down therapy in patients with uncomplicated Staphylococcus aureusprimary bacteremia and catheter-related bloodstream infections

Author

Mun, Seok Jun, Kim, Si-Ho, Huh, Kyungmin, Cho, Sun Young, Kang, Cheol-In, Chung, Doo Ryeon, and Peck, Kyong Ran

Abstract

AbstractPatients with uncomplicated Staphylococcus aureusprimary bacteremia and catheter-related bloodstream infection (CRBSI) should be treated for at least 14 days. However, evidence for oral step-down therapy is lacking in these patients. A retrospective cohort was identified from 2013 to 2018 in a 1,950-bed tertiary hospital. An oral antimicrobial therapy (OAT) group was defined as patients treated with oral antibiotics following less than 10 days of intravenous antimicrobial therapy (IAT). Treatment failure was defined as any case of recurrence or death within 90 days. A total of 103 patients were included in the analysis, including 32 patients treated with OAT. Rates of treatment failure were 3.2% and 12.7% in the OAT and IAT groups (P = 0.113). The length of hospital stay was shorter in the OAT group. OAT was not an independent risk factor for treatment failure. OAT may reduce the duration of hospitalization without adverse effects in these patients.

Published
2022
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159. Rapid and label-free identification of individual bacterial pathogens exploiting three-dimensional quantitative phase imaging and deep learning

Author

Kim, Geon, Ahn, Daewoong, Kang, Minhee, Jo, YoungJu, Ryu, Donghun, Kim, Hyeonjung, Song, Jinyeop, Ryu, Jea Sung, Choi, Gunho, Chung, Hyun Jung, Kim, Kyuseok, Chung, Doo Ryeon, Yoo, In Young, Huh, Hee Jae, Min, Hyunseok, Lee, Nam Yong, and Park, YongKeun

Abstract

For appropriate treatments of infectious diseases, rapid identification of the pathogens is crucial. Here, we developed a rapid and label-free method for identifying common bacterial pathogens as individual bacteria by using three-dimensional quantitative phase imaging and deep learning. We achieved 95% accuracy in classifying 19 bacterial species by exploiting the rich information in three-dimensional refractive index tomograms with a convolutional neural network classifier. Extensive analysis of the features extracted by the trained classifier was carried out, which supported that our classifier is capable of learning species-dependent characteristics. We also confirmed that utilizing three-dimensional refractive index tomograms was crucial for identification ability compared to two-dimensional imaging. This method, which does not require time-consuming culture, shows high feasibility for diagnosing patients with infectious diseases who would benefit from immediate and adequate antibiotic treatment.

Published
2019
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163. The impact of vancomycin-resistant Enterococcus(VRE) screening policy change on the incidence of healthcare-associated VRE bacteremia

Author

Cho, Sun Young, Kim, Hye Mee, Chung, Doo Ryeon, Choi, Jong Rim, Lee, Myeong-A, Huh, Hee Jae, Lee, Nam Yong, Huh, Kyungmin, Kang, Cheol-In, and Peck, Kyong Ran

Abstract

AbstractObjective:To evaluate the impact of a vancomycin-resistant Enterococcus(VRE) screening policy change on the incidence of healthcare-associated (HA)-VRE bacteremia in an endemic hospital setting.Design:A quasi-experimental before-and-after study.Setting:A 1,989-bed tertiary-care referral center in Seoul, Republic of Korea.Methods:Since May 2010, our hospital has diminished VRE screening for admitted patients transferred from other healthcare facilities. We assessed the impact of this policy change on the incidence of HA-VRE bacteremia using segmented autoregression analysis of interrupted time series from January 2006 to December 2014 at the hospital and unit levels. In addition, we compared the molecular characteristics of VRE blood isolates collected before and after the screening policy change using multilocus sequence typing and pulsed-field gel electrophoresis.Results:After the VRE screening policy change, the incidence of hospital-wide HA-VRE bacteremia increased, although no significant changes of level or slope were observed. In addition, a significant slope change in the incidence of HA-VRE bacteremia (change in slope, 0.007; 95% CI, 0.001–0.013; P= .02) was observed in the hemato-oncology department. Molecular analysis revealed that various VRE sequence types appeared after the policy change and that clonally related strains became more predominant (increasing from 26.1% to 59.3%).Conclusions:The incidence of HA-VRE bacteremia increased significantly after VRE screening policy change, and this increase was mainly driven by high-risk patient populations. When planning VRE control programs in hospitals, different approaches that consider risk for severe VRE infection in patients may be required.

Published
2022
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164. Extreme drug resistance in Acinetobacter baumannii infections in intensive care units, South Korea

Author

Park, Young Kyoung, Peck, Kyong Ran, Cheong, Hae Suk, Chung, Doo-Ryeon, Song, Jae-Hoon, and Ko, Kwan Soo

Subjects
Cross infection -- Causes of, Cross infection -- Diagnosis, Cross infection -- Care and treatment, Nosocomial infections -- Causes of, Nosocomial infections -- Diagnosis, Nosocomial infections -- Care and treatment, Gram-negative bacteria -- Health aspects, Drug resistance in microorganisms -- Complications and side effects
Abstract

To the Editor: Acinetobacter spp. have emerged as a cause of nosocomial infections, especially in intensive care units (ICUs). In South Korea, Acinetobacter spp. was ranked as the third most [...]

Published
2009
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173. Rapid label-free identification of pathogenic bacteria species from a minute quantity exploiting three-dimensional quantitative phase imaging and artificial neural network

Author

Kim, Geon, primary, Ahn, Daewoong, additional, Kang, Minhee, additional, Park, Jinho, additional, Ryu, DongHun, additional, Jo, YoungJu, additional, Song, Jinyeop, additional, Ryu, Jea Sung, additional, Choi, Gunho, additional, Chung, Hyun Jung, additional, Kim, Kyuseok, additional, Chung, Doo Ryeon, additional, Yoo, In Young, additional, Huh, Hee Jae, additional, Min, Hyun-seok, additional, Lee, Nam Yong, additional, and Park, YongKeun, additional

Published
2019
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174. Comparative Evaluation Between the RealStarPneumocystis jiroveciiPCR Kit and the AmpliSensPneumocystis jirovecii(carinii)-FRT PCR Kit for DetectingP. jiroveciiin Non-HIV Immunocompromised Patients

Author

Huh, Hee Jae, primary, Lim, Kyoung Ree, additional, Ki, Chang-Seok, additional, Huh, Kyungmin, additional, Shim, Hyang Jin, additional, Song, Dong Joon, additional, Kim, Yae-Jean, additional, Chung, Doo Ryeon, additional, and Lee, Nam Yong, additional

Published
2019
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182. Impact of Difficult-to-Treat Resistance in Gram-negative Bacteremia on Mortality: Retrospective Analysis of Nationwide Surveillance Data.

Author

Huh, Kyungmin, Chung, Doo Ryeon, Ha, Young Eun, Ko, Jae-Hoon, Kim, Si-Ho, Kim, Min-Ji, Huh, Hee Jae, Lee, Nam Yong, Cho, Sun Young, Kang, Cheol-In, Peck, Kyong Ran, Song, Jae-Hoon, and Investigators, Korean Antimicrobial Resistance Surveillance Network (KARS-Net)

Subjects
*BACTEREMIA, *CONFIDENCE intervals, *DRUG resistance in microorganisms, *GRAM-negative bacterial diseases, *RETROSPECTIVE studies, *DESCRIPTIVE statistics, *ODDS ratio
Abstract

Background Clinically relevant categorization of antimicrobial resistance is critical to mitigating the threat it poses. Difficult-to-treat resistance (DTR) is a recently proposed category defined as nonsusceptibility to all first-line antibiotic agents. Methods A retrospective study was conducted with nonduplicate cases of gram-negative bloodstream infection (GNBSI) caused by 4 major taxa (Escherichia coli , Klebsiella pneumoniae , Pseudomonas aeruginosa , and Acinetobacter species) identified from a nationwide surveillance database. DTR was defined as nonsusceptibility to all the β-lactams and fluoroquinolones tested. Patient characteristics and mortality were compared between DTR GNBSI and GNBSI caused by carbapenem-resistant but not DTR and extended-spectrum cephalosporin–resistant but not DTR isolates using Centers for Disease Control and Prevention definitions. Adjusted odds ratios (aORs) for 30-day in-hospital mortality were examined for DTR in overall and in propensity score–matched cohorts. Results A total of 1167 episodes of monomicrobial GNBSI were identified, and 147 (12.6%) of the isolates were DTR. The majority of DTR isolates were Acinetobacter species (79.6%) and P. aeruginosa (17.7%). DTR infections were associated with previous antibiotic use, healthcare contact, ventilator use, and lower respiratory tract infection. Crude mortality for GNBSI caused by DTR was 50.3%. A multivariable model showed that only DTR, but not other categories, was significantly associated with mortality (adjusted odds ratio [aOR], 3.58 [95% confidence interval {CI}, 1.27–10.19]). DTR was also a significant predictor for mortality in the analysis of propensity score–matched cohorts (aOR, 3.48 [95% CI, 1.82–6.79]). Conclusions In patients with GNBSI, DTR was associated with higher mortality than those in other resistance categories. Our findings suggest that DTR could be useful for surveillance and prognostication. [ABSTRACT FROM AUTHOR]

Published
2020
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183. Clinical effectiveness of oral antimicrobial therapy for acute pyelonephritis caused by extended-spectrum β-lactamase-producing Enterobacteriales.

Author

Kim, Si-Ho, Lim, Kyoung Ree, Lee, Hyunju, Huh, Kyungmin, Cho, Sun Young, Kang, Cheol-In, Chung, Doo Ryeon, and Peck, Kyong Ran

Subjects
BETA lactamases, HYPOGLYCEMIC agents, OATS, PYELONEPHRITIS, PROPORTIONAL hazards models, PROPENSITY score matching, TREATMENT effectiveness
Abstract

Infections caused by extended-spectrum β-lactamase-producing Enterobacteriales (ESBL-PE) are commonly treated with intravenous antibiotics. This study investigated whether oral antimicrobial therapy (OAT) is as effective as intravenous antimicrobial therapy (IVT) for acute pyelonephritis (APN) caused by ESBL-PE. A retrospective cohort of patients with APN caused by ESBL-PE was studied at a tertiary-care hospital from January 2014 through December 2016. The OAT group comprised patients treated with an appropriate oral antimicrobial agent following 7 days or less of IVT. The primary endpoint was treatment failure defined as clinical and/or microbiological failure. The secondary endpoint was length of hospital stay and recurrences of APN within 2 months and within 1 year. Propensity score matching and multivariable Cox proportional hazard modeling were used to minimize bias. Among 238 eligible cases, Escherichia coli (83.6%) was the most common pathogen. Sixty patients received OAT after a median of four days of appropriate IVT, and 178 patients completed treatment with IVT. Fluoroquinolones (58.3%) were the most commonly prescribed OAT, followed by trimethoprim-sulfamethoxazole and amoxicillin-clavulanate. OAT was not associated with treatment failure (adjusted OR 0.66; 95% CI 0.18–2.44) and hospitalization length was shorter in the OAT group (6.2 days versus 10.7 days; P < 0.01). APN recurrence caused by ESBL-PE infection within 2 months was not associated with OAT (adjusted HR 0.56; 95% CI 0.16–2.00). OAT reduced hospital stay without adverse effects on treatment outcome. OAT could be safely applied as a carbapenem-saving option in treatment of APN. [ABSTRACT FROM AUTHOR]

Published
2020
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184. Antifungal prophylaxis with posaconazole tablet and oral suspension in patients with haematologic malignancy: Therapeutic drug monitoring, efficacy and risk factors for the suboptimal level.

Author

Oh, Jihyu, Kang, Cheol‐In, Kim, Si‐Ho, Huh, Kyungmin, Cho, Sun Young, Chung, Doo Ryeon, Lee, Soo‐Youn, Jung, Chul Won, and Peck, Kyong Ran

Subjects
DRUG monitoring, PREVENTIVE medicine, MYCOSES, CEFAZOLIN, ITRACONAZOLE
Abstract

Summary: Background: Posaconazole is used to prevent invasive fungal infections (IFIs) in patients with haematologic malignancy. In this study, we compared plasma posaconazole concentrations (PPCs) and the incidence of breakthrough IFIs between patients with haematologic malignancy receiving posaconazole oral suspension vs tablet. Methods: We retrospectively collected data on adult patients with haematologic malignancies who received posaconazole prophylaxis during chemotherapy from April 2014 through May 2018. A total of 242 cases with PPCs, 88 in the oral suspension group and 154 in the tablet group, were included in this study. Results: Patients receiving tablets achieved a significantly higher mean PPC than did those on oral suspension (1.631 ± 0.878 μg/mL in the tablet group vs. 0.879 ± 0.585 μg/mL in the oral suspension group). One hundred and thirty‐seven of 154 patients (89.0%) receiving tablets had PPCs of 0.7 μg/mL or more, while only 41 of 88 patients (46.6%) receiving oral suspension attained an optimal level (P <.001). The incidence of breakthrough IFIs was significantly higher in the oral suspension group compared with in the tablet group (14.8% of oral suspension vs. 4.5% of tablet; P =.005). In the analysis including patients receiving posaconazole tablets, hypoalbuminemia (< 3.5 g/dL) was found to be a risk factor associated with suboptimal levels (odds ratio: 8.872; 95% confidence interval: 3.011 ‐ 26.141; P <.001). Conclusions: Suboptimal PPCs in the tablet group were less common than those in the oral suspension group. Therapeutic drug monitoring may be still necessary even in patients receiving posaconazole tablets, especially in those with hypoalbuminemia. [ABSTRACT FROM AUTHOR]

Published
2020
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185. A contact investigation after exposure to a child with disseminated tuberculosis mimicking inflammatory bowel disease

Author

Kim, Dongsub, primary, Lee, Sodam, additional, Kang, Sang-Hee, additional, Park, Mi-Sun, additional, Yoo, So-Young, additional, Jeon, Tae Yeon, additional, Choi, Joon-Sik, additional, Kim, Bora, additional, Choi, Jong Rim, additional, Cho, Sun Young, additional, Chung, Doo Ryeon, additional, Choe, Yon Ho, additional, and Kim, Yae-Jean, additional

Published
2018
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196. Risk factors for poor prognosis in nosocomial infective endocarditis

Author

Hwang, Ji-won, primary, Park, Seung Woo, additional, Cho, Eun Jeong, additional, Lee, Ga Yeon, additional, Kim, Eun Kyoung, additional, Chang, Sung-A, additional, Park, Sung-Ji, additional, Lee, Sang-Chol, additional, Kang, Cheol-In, additional, Chung, Doo Ryeon, additional, Peck, Kyong Ran, additional, and Song, Jae-Hoon, additional

Published
2018
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197. 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

Author

Seok, Hyeri, primary, Cha, Min Kyeong, additional, Kang, Cheol-In, additional, Cho, Sun Young, additional, Kim, So Hyun, additional, Ha, Young Eun, additional, Chung, Doo Ryeon, additional, Peck, Kyong Ran, additional, and Song, Jae-Hoon, additional

Published
2018
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198. Safety and Effectiveness of Peramivir in Korean Adult Influenza Patients: Prospective Observational Study Based on Post-Marketing Surveillance Data

Author

Choi, Won Suk, primary, Ryu, Seong Yeol, additional, Lee, Jacob, additional, Hong, Sang-Bum, additional, Eom, Joong Sik, additional, Shin, Jonghwan, additional, Park, Ki Ho, additional, Ohk, Taekgeun, additional, Chung, Jin-Won, additional, Chung, Doo Ryeon, additional, Kim, Dong Kee, additional, Lee, Sang-Rok, additional, Kim, Pill Young, additional, Kim, Shin-Woo, additional, Noh, Ji Yun, additional, Song, Joon Young, additional, Cheong, Hee Jin, additional, and Kim, Woo Joo, additional

Published
2018
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199. Klebsiella pneumoniae co-producing NDM-5 and OXA-181 carbapenemases, South Korea

Author

Cho, Sun Young, Huh, Hee Jae, Baek, Jin Yang, Chung, Na Yeon, Ryu, Jae Geum, Ki, Chang-Seok, Chung, Doo Ryeon, Lee, Nam Yong, and Song, Jae-Hoon

Subjects
Beta lactamases -- Physiological aspects -- Genetic aspects -- Research, Klebsiella -- Health aspects -- Genetic aspects -- Distribution -- Research, Company distribution practices, Health
Abstract

To the Editor: Carbapenemase-producing Enterobacteriaceae are being reported worldwide. Travel, medical tourism, and cross-border transfer of patients might play a role in the spread of these bacteria (1,2). Klebsiella pneumoniae [...]

Published
2015

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