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A Prospective Cohort Study of Durations of Staphylococcus aureus Bacteremia According to Different Phenotypes and a New Concept of Persistent Bacteremia

Kang, Chang Kyung ; Song, Kyoung-Ho ; Kim, Seong Eun ; [et al.]

American Society for Microbiology ; 2019

In: Antimicrobial Agents and Chemotherapy Vol. 64, No. 1 ( 2019-12-20)

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In: Antimicrobial Agents and Chemotherapy, American Society for Microbiology, Vol. 64, No. 1 ( 2019-12-20)

Abstract: The purpose of this study was to describe and compare the duration of Staphylococcus aureus bacteremia (SAB) according to methicillin resistance and the primary foci of infection. We also aimed to newly define persistent SAB considering these results. Nonduplicated episodes of SAB in patients aged ≥15 years from 14 hospitals in the Republic of Korea were analyzed between January 2009 and February 2018. The duration of SAB was defined as the number of days from the time of administration of an antibiotic to which the isolate was susceptible after the onset of SAB to the last day of a positive blood culture for S. aureus . SAB durations were described and compared based on methicillin resistance and the primary foci of infection. Cases in the top quartile for the duration of bacteremia in the respective clinical context were classified as newly defined persistent SAB, and its association with in-hospital mortality was evaluated. A total of 1,917 cases were analyzed. The duration of SAB was longer in patients with methicillin-resistant SAB (MRSAB; n = 995) than in patients with methicillin-susceptible SAB (MSSAB; n = 922) (median duration, 1 day [interquartile range, 1 to 3 days] for MSSAB and 1 day [interquartile range, 0 to 5 days] for MRSAB; P 〈 0.001). The duration of bacteremia was longer in patients with endocarditis and bone and joint, endovascular, and surgical site infections and was shorter in patients with skin and soft tissue infections. Newly defined persistent SAB was independently associated with in-hospital mortality (adjusted odds ratio, 1.97; 95% confidence interval, 1.54 to 2.53; P 〈 0.001). The durations of SAB were dependent on methicillin resistance and the primary foci of infection, and considering these contexts, persistent SAB was significantly associated with in-hospital mortality.

Type of Medium: Online Resource

ISSN: 0066-4804 , 1098-6596

URL: Article

DOI: 10.1128/AAC.01656-19

RVK:

XA 24552

Language: English

Publisher: American Society for Microbiology

Publication Date: 2019

detail.hit.zdb_id: 1496156-8

SSG: 12

SSG: 15,3

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2

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Estimation of SARS-CoV-2 Neutralizing Activity and Protective Immunity in Different Vaccine Types Using Three Surrogate Virus Neutralization Test Assays and Two Semiquantitative Binding Assays Targeting the Receptor-Binding Domain

Lee, Beomki ; Ko, Jae-Hoon ; Lee, Kyoung Hwa ; [et al.]

American Society for Microbiology ; 2022

In: Microbiology Spectrum Vol. 10, No. 6 ( 2022-12-21)

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In: Microbiology Spectrum, American Society for Microbiology, Vol. 10, No. 6 ( 2022-12-21)

Abstract: Estimating neutralizing activity in vaccinees is crucial for predicting the protective effect against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). As the plaque reduction neutralization test (PRNT) requires a biosafety level 3 facility, it would be advantageous if surrogate virus neutralization test (sVNT) assays and binding assays could predict neutralizing activity. Here, five different assays were evaluated with respect to the PRNT in vaccinees: three sVNT assays from GenScript, Boditech Med, and SD Biosensor and two semiquantitative binding assays from Roche and Abbott. The vaccinees were subjected to three vaccination protocols: homologous ChAdOx1, homologous BNT162b2, and heterologous administration. The ability to predict a 50% neutralizing dose (ND 50 ) of ≥20 largely varied among the assays, with the binding assays showing substantial agreement (kappa, ~0.90) and the sVNT assays showing relatively poor performance, especially in the ChAdOx1 group (kappa, 0.33 to 0.97). The ability to predict an ND 50 value of ≥118.25, indicating a protective effect, was comparable among different assays. Applying optimal cutoffs based on Youden’s index, the kappa agreements were greater than 0.60 for all assays in the total group. Overall, relatively poor performance was demonstrated in the ChAdOx1 group, owing to low antibody titers. Although there were intra-assay differences related to the vaccination protocols, as well as interassay differences, all assays demonstrated fair performance in predicting the protective effect using the new cutoffs. This study demonstrates the need for a different cutoff for each assay to appropriately determine a higher neutralizing titer and suggests the clinical feasibility of using various assays for estimation of the protective effect. IMPORTANCE The coronavirus disease 2019 (COVID-19) pandemic continues to last, despite high COVID-19 vaccination rates. As many people experience breakthrough infection after prior infection and/or vaccination, estimating the neutralization activity and predicting the protective effect are major issues of concern. However, since standard neutralization tests are not available in most clinical laboratories, it would be beneficial if commercial assays could predict these aspects. In this study, we evaluated the performance of three sVNT assays and two semiquantitative binding assays targeting the receptor-binding domain with respect to the PRNT. Our results suggest that these assays could be used for predicting the protective effect by adjusting the cutoffs.

Type of Medium: Online Resource

ISSN: 2165-0497

URL: Article

DOI: 10.1128/spectrum.02669-22

Language: English

Publisher: American Society for Microbiology

Publication Date: 2022

detail.hit.zdb_id: 2807133-5

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3

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Empirical Use of Ciprofloxacin for Acute Uncomplicated Pyelonephritis Caused by Escherichia coli in Communities Where the Prevalence of Fluoroquinolone Resistance Is High

Jeon, Jae Hyun ; Kim, Kyuseok ; Han, Woong Dae ; [et al.]

American Society for Microbiology ; 2012

In: Antimicrobial Agents and Chemotherapy Vol. 56, No. 6 ( 2012-06), p. 3043-3046

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In: Antimicrobial Agents and Chemotherapy, American Society for Microbiology, Vol. 56, No. 6 ( 2012-06), p. 3043-3046

Abstract: There is little information about the effectiveness of ciprofloxacin in regions where ciprofloxacin-resistant Escherichia coli is prevalent. This study was conducted to evaluate whether ciprofloxacin is effective as the initial empirical antibiotic for treatment of uncomplicated acute pyelonephritis (APN) due to ciprofloxacin-resistant E. coli . A total of 255 women with clinical diagnoses of uncomplicated APN due to E. coli were enrolled in the emergency department between March 2005 and December 2008. All enrolled patients were initially treated with ciprofloxacin. Patients were followed up 4 to 7 days after the start of therapy and 14 to 21 days after its completion. At the first follow-up visit, ciprofloxacin was changed to the appropriate antibiotic when necessary, depending on the antibiotic susceptibility results. Not only improvement of symptoms and signs but also microbiologic eradication was assessed at each visit. Fifteen percent (39/255) of the E. coli isolates were resistant to ciprofloxacin. There was no statistically significant difference between the clinical cure rates of the ciprofloxacin-susceptible group and the ciprofloxacin-resistant group at the first follow-up (87.0% versus 76.9%, P = 0.135) or the second follow-up (98.6% versus 94.9%, P = 0.177). However, there was a lower microbiologic cure rate in the ciprofloxacin-resistant group than in the ciprofloxacin-susceptible group (92.4% versus 41.7%, P = 0.000) at the first follow-up visit. No complications occurred in the ciprofloxacin-resistant group during the follow-up period. Our findings indicate that ciprofloxacin is an appropriate choice for empirical therapy of uncomplicated APN and has no serious adverse outcomes, if it is tailored appropriately, even for women infected with ciprofloxacin-resistant E. coli .

Type of Medium: Online Resource

ISSN: 0066-4804 , 1098-6596

URL: Article

DOI: 10.1128/AAC.06212-11

RVK:

XA 24552

Language: English

Publisher: American Society for Microbiology

Publication Date: 2012

detail.hit.zdb_id: 1496156-8

SSG: 12

SSG: 15,3

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4

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Stepwise Expansion of Antimicrobial Stewardship Programs and Its Impact on Antibiotic Use and Resistance Rates at a Tertiary Care Hospital in Korea

Shin, Dong Hoon ; Kim, Hyung-Sook ; Heo, Eunjeong ; [et al.]

American Society for Microbiology ; 2022

In: Microbiology Spectrum Vol. 10, No. 3 ( 2022-06-29)

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In: Microbiology Spectrum, American Society for Microbiology, Vol. 10, No. 3 ( 2022-06-29)

Abstract: To optimize antibiotic use, the US CDC has outlined core elements of antimicrobial stewardship programs (ASP). However, they are difficult to implement in limited-resource settings. We report on the successful implementation of a series of ASP with insufficient number of infectious diseases specialists. We retrospectively collected data regarding antibiotic administration and culture results of all patients admitted to a tertiary care teaching hospital, Seoul National University Bundang Hospital (SNUBH), from January 2010 to December 2019. Trends of antibiotic use and antibiotic resistance rates were compared with those from Korean national data. Trend analyses were performed using nonparametric, two-sided, correlated seasonal Mann–Kendall tests. Total antibiotic agent usage has significantly decreased with ASP implementation at SNUBH since 2010. National claim data from tertiary care hospitals have revealed an increase in the use of all broad-spectrum antibiotics except for third-generation cephalosporins (3GC). In contrast, at SNUBH, glycopeptide and fluoroquinolone use gradually decreased, and 3GC and carbapenem use did not significantly change. Furthermore, the rate of colonization with methicillin-resistant Staphylococcus aureus showed a consistently decreasing trend, while that with 3GC- and fluoroquinolone-resistant Escherichia coli significantly increased. Unlike the national rate, the rate of colonization with antibiotic resistant- Klebsiella pneumoniae did not increase and that of 3GC- and fluoroquinolone-resistant Pseudomonas aeruginosa significantly decreased. Stepwise implementation of core ASP elements was effective in reducing antibiotic use despite a lack of sufficient manpower. Long-term multidisciplinary teamwork is necessary for successful and sustainable ASP implementation. IMPORTANCE Antimicrobial stewardship programs aimed to optimize antibiotic use are difficult to implement in limited-resource settings. Our study indicates that stepwise implementation of core antimicrobial stewardship program elements was effective in reducing antibiotic use in a tertiary care hospital despite the lack of sufficient manpower.

Type of Medium: Online Resource

ISSN: 2165-0497

URL: Article

DOI: 10.1128/spectrum.00335-22

Language: English

Publisher: American Society for Microbiology

Publication Date: 2022

detail.hit.zdb_id: 2807133-5

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5

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Clinical and Molecular Characterization of Invasive Heteroresistant Vancomycin-Intermediate Staphylococcus aureus Infections in Korean Hospitals

Kim, Eu Suk ; Bae, In-Gyu ; Cho, Jeong Eun ; [et al.]

American Society for Microbiology ; 2016

In: Journal of Clinical Microbiology Vol. 54, No. 3 ( 2016-03), p. 760-763

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In: Journal of Clinical Microbiology, American Society for Microbiology, Vol. 54, No. 3 ( 2016-03), p. 760-763

Abstract: Invasive heteroresistant vancomycin-intermediate Staphylococcus aureus (h-VISA) isolates were identified and characterized in 10 Korean hospitals from July 2009 to June 2011. The prevalence of h-VISA infections was 3.3% (42/1,289). Most (41/42) were health care-associated infections caused by strains belonging to sequence type 5. Cases of persistent bacteremia were frequent (17/42), and 30-day mortality was high (16/40).

Type of Medium: Online Resource

ISSN: 0095-1137 , 1098-660X

URL: Article

DOI: 10.1128/JCM.02595-15

RVK:

XA 10000

Language: English

Publisher: American Society for Microbiology

Publication Date: 2016

detail.hit.zdb_id: 1498353-9

SSG: 12

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6

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agr Dysfunction Affects Staphylococcal Cassette Chromosome mec Type-Dependent Clinical Outcomes in Methicillin-Resistant Staphylococcus aureus Bacteremia

Kang, Chang Kyung ; Cho, Jeong Eun ; Choi, Yoon Jeong ; [et al.]

American Society for Microbiology ; 2015

In: Antimicrobial Agents and Chemotherapy Vol. 59, No. 6 ( 2015-06), p. 3125-3132

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In: Antimicrobial Agents and Chemotherapy, American Society for Microbiology, Vol. 59, No. 6 ( 2015-06), p. 3125-3132

Abstract: Staphylococcal cassette chromosome mec element (SCC mec ) type-dependent clinical outcomes may vary due to geographical variation in the presence of virulence determinants. We compared the microbiological factors and mortality attributed to methicillin-resistant Staphylococcus aureus (MRSA) bacteremia between SCC mec types II/III and type IV. All episodes of MRSA bacteremia in a tertiary-care hospital (South Korea) over a 4.5-year period were reviewed. We studied the microbiological factors associated with all blood MRSA isolates, including spa type, agr type, agr dysfunction, and the genes for Panton-Valentine leukocidin (PVL) and phenol-soluble modulin (PSM)-mec, in addition to SCC mec type. Of 195 cases, 137 involved SCC mec types II/III, and 58 involved type IV. The mortality attributed to MRSA bacteremia was less frequent among the SCC mec type IV (5/58) than that among types II/III (39/137, P = 0.002). This difference remained significant when adjusted for clinical factors (adjusted odds ratio [aOR], 0.14; 95% confidence interval [CI] , 0.04 to 0.49; P = 0.002). Of the microbiological factors tested, agr dysfunction was the only significant factor that showed different positivity between the SCC mec types, and it was independently associated with MRSA bacteremia-attributed mortality (aOR, 4.71; 95% CI, 1.72 to 12.92; P = 0.003). SCC mec type IV is associated with lower MRSA bacteremia-attributed mortality than are types II/III, which might be explained by the high rate of agr dysfunction in SCC mec types II/III in South Korea.

Type of Medium: Online Resource

ISSN: 0066-4804 , 1098-6596

URL: Article

DOI: 10.1128/AAC.04962-14

RVK:

XA 24552

Language: English

Publisher: American Society for Microbiology

Publication Date: 2015

detail.hit.zdb_id: 1496156-8

SSG: 12

SSG: 15,3

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7

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Molecular Characterization of Methicillin-Resistant Staphylococcus aureus Isolates in Korea

Kim, Eu Suk ; Lee, Hye Jin ; Chung, Gyung-Tae ; [et al.]

American Society for Microbiology ; 2011

In: Journal of Clinical Microbiology Vol. 49, No. 5 ( 2011-05), p. 1979-1982

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In: Journal of Clinical Microbiology, American Society for Microbiology, Vol. 49, No. 5 ( 2011-05), p. 1979-1982

Abstract: We used several molecular typing methods to analyze 196 methicillin-resistant Staphylococcus aureus (MRSA) and 139 methicillin-susceptible S. aureus (MSSA) isolates collected between 1996 and 2005. The sequence type 72 MRSA has increased in frequency in the community in the Republic of Korea and in hospitals in recent years.

Type of Medium: Online Resource

ISSN: 0095-1137 , 1098-660X

URL: Article

DOI: 10.1128/JCM.00098-11

RVK:

XA 10000

Language: English

Publisher: American Society for Microbiology

Publication Date: 2011

detail.hit.zdb_id: 1498353-9

SSG: 12

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8

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Diagnosis of Central Nervous System Tuberculosis by T-Cell-Based Assays on Peripheral Blood and Cerebrospinal Fluid Mononuclear Cells

Kim, Sung-Han ; Chu, Kon ; Choi, Su-Jin ; [et al.]

American Society for Microbiology ; 2008

In: Clinical and Vaccine Immunology Vol. 15, No. 9 ( 2008-09), p. 1356-1362

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In: Clinical and Vaccine Immunology, American Society for Microbiology, Vol. 15, No. 9 ( 2008-09), p. 1356-1362

Abstract: In active tuberculosis (TB), Mycobacterium tuberculosis -specific T cells are compartmentalized more to the site of infection than to the circulating blood. Therefore, an M. tuberculosis -specific enzyme-linked immunospot (ELISPOT) assay with samples from the site of infection may permit a more sensitive or specific diagnosis of active central nervous system (CNS) TB than that achieved by the assay with blood alone. Therefore, we prospectively evaluated the usefulness of circulating and compartmentalized mononuclear cell (MC; i.e., peripheral blood mononuclear cell [PBMC] and cerebrospinal fluid [CSF] MC)-based ELISPOT assays (i.e., the T-SPOT.TB test) for the diagnosis of active TB in patients with suspected CNS TB. The clinical categories of CNS TB were classified as described previously (G. E. Thwaites, T. T. Chau, K. Stepniewska, N. H. Phu, L. V. Chuong, D. X. Sinh, N. J. White, C. M. Parry, and J. J. Farrar, Lancet 360:1287-1292, 2002). Thirty-seven patients with suspected CNS TB were enrolled over a 12-month period. Of these, 31 (84%) showed clinical manifestations of suspected TB meningitis and 6 (16%) gave indications of intracranial tuberculoma with disseminated TB. The final clinical categories of the 37 patients with suspected CNS TB were as follows: 12 (32%) were classified as having CNS TB (7 with confirmed TB, 3 with probable TB, and 2 with possible TB) and 25 (68%) were classified as not having active TB. The sensitivity and specificity of the PBMC ELISPOT assay were 91% (95% confidence interval [CI] , 59% to 100%) and 63% (95% CI, 41% to 81%), respectively. By comparison, the sensitivity and specificity of the CSF MC ELISPOT assay were 75% (95% CI, 19% to 99%) and 75% (95% CI, 43% to 95%), respectively. When the ratio of the CSF MC ELISPOT assay results to the PBMC ELISPOT results was 2 or more, the sensitivity and specificity were 50% (95% CI, 7% to 93%) and 100% (95% CI, 74% to 100%), respectively. The ELISPOT assay with PBMCs and CSF MCs is a useful adjunct to the current tests for the diagnosis of CNS TB.

Type of Medium: Online Resource

ISSN: 1556-6811 , 1556-679X

URL: Article

DOI: 10.1128/CVI.00040-08

Language: English

Publisher: American Society for Microbiology

Publication Date: 2008

detail.hit.zdb_id: 1496863-0

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9

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The Genetic Polymorphism UGT1A4*3 Is Associated with Low Posaconazole Plasma Concentrations in Hematological Malignancy Patients Receiving the Oral Suspension

Suh, Hyeon Jeong ; Yoon, Seo Hyun ; Yu, Kyung-Sang ; [et al.]

American Society for Microbiology ; 2018

In: Antimicrobial Agents and Chemotherapy Vol. 62, No. 7 ( 2018-07)

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In: Antimicrobial Agents and Chemotherapy, American Society for Microbiology, Vol. 62, No. 7 ( 2018-07)

Abstract: The metabolism of posaconazole is mediated mainly by uridine 5′-diphospho-glucuronosyltransferase (UGT) enzymes, especially UGT1A4. The aim of this study was to investigate the effects of genetic polymorphisms on the posaconazole plasma concentration (PPC). This prospective study was conducted from September 2014 to August 2016. We enrolled patients with acute myeloid leukemia or myelodysplastic syndrome treated with posaconazole oral suspension (200 mg) three times daily for fungal prophylaxis. The patients were examined for the multidrug resistance gene 1 3435C 〉 T and 2677G 〉 T/A variations and the UGT1A4*3 allele by direct sequencing of DNA from peripheral whole-blood samples. We defined poor absorbers to be those with PPCs of 〈 200 ng/ml and the optimal PPC to be ≥700 ng/ml on day 8. The associations between genetic polymorphisms and the PPC were evaluated using multivariate logistic regression analysis including clinical variables. During the study period, 132 patients were enrolled. Six patients (4.5%) were defined as poor absorbers, and 49 patients (37.1%) did not reach the optimal PPC on day 8. In multivariate analysis, the independent risk factors for a poor absorber were at least one UGT1A4*3 allele (adjusted odds ratio [aOR], 18.81; 95% confidence interval [CI] , 1.09 to 324.44; P = 0.043) and poor oral food intake (aOR per −100 kcal, 1.44; 95% CI, 1.04 to 1.99; P = 0.029). There was no statistically significant association between the genetic polymorphisms and achievement of the optimal PPC on day 8. The UGT1A4*3 polymorphism is an independent risk factor for being a poor absorber of posaconazole oral suspension in patients with hematological malignancies.

Type of Medium: Online Resource

ISSN: 0066-4804 , 1098-6596

URL: Article

DOI: 10.1128/AAC.02230-17

RVK:

XA 24552

Language: English

Publisher: American Society for Microbiology

Publication Date: 2018

detail.hit.zdb_id: 1496156-8

SSG: 12

SSG: 15,3

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10

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Erratum for Kim et al., Inappropriate Continued Empirical Vancomycin Use in a Hospital with a High Prevalence of Methicillin-Resistant Staphylococcus aureus

Kim, Nak-Hyun ; Koo, Hei Lim ; Choe, Pyoeng Gyun ; [et al.]

American Society for Microbiology ; 2015

In: Antimicrobial Agents and Chemotherapy Vol. 59, No. 4 ( 2015-04), p. 2478-2478

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In: Antimicrobial Agents and Chemotherapy, American Society for Microbiology, Vol. 59, No. 4 ( 2015-04), p. 2478-2478

Type of Medium: Online Resource

ISSN: 0066-4804 , 1098-6596

URL: Article

DOI: 10.1128/AAC.00241-15

RVK:

XA 24552

Language: English

Publisher: American Society for Microbiology

Publication Date: 2015

detail.hit.zdb_id: 1496156-8

SSG: 12

SSG: 15,3

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