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  • Oxford University Press (OUP)  (58)
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  • 1
    Online Resource
    Online Resource
    Clinical Characteristics and Treatment Outcomes of Patients with Sternoclavicular Septic Arthritis Caused by Staphylococcus aureus
    Oxford University Press (OUP) ; 2017
    In:  Open Forum Infectious Diseases Vol. 4, No. suppl_1 ( 2017-10-01), p. S96-S96
    Details
    In: Open Forum Infectious Diseases, Oxford University Press (OUP), Vol. 4, No. suppl_1 ( 2017-10-01), p. S96-S96
    Abstract: Aggressive surgical therapy such as en-bloc resection of the joint is favored in the treatment of sternoclavicular (SC) septic arthritis. However, this practice is based on expert opinion and small case series. We analyzed the clinical characteristics and treatment outcomes of patients with S. aureus SC septic arthritis treated with medical therapy alone or with limited surgical therapy. Methods All adult patients with SC septic arthritis caused by S. aureus at the Asan Medical Center between September 2009 and December 2016 were retrospectively reviewed. Demographic characteristics, laboratory results, underlying diseases/conditions, patient management, and treatment outcomes were assessed. SC septic arthritis due to S. aureus was defined if patients had positive cultures of specimens from the SC joint, or if blood cultures yielded S. aureus, together with physical findings and imaging studies supporting the diagnosis of SC septic arthritis. Limited surgical therapy was defined as simple incision, drainage, and debridement of infected SC joint. Results In total, 22 cases of S. aureus SC septic arthritis were enrolled. Of these 22 patients, 11 received medical therapy alone, 11 underwent limited surgical therapy, and none underwent aggressive surgery. Most patients (73%) had underlying predisposing conditions such as infection at a distant site, diabetes, and liver cirrhosis, and none had IV drug abuse or HIV infection. Complications such as chest wall and/or neck abscess, clavicular and/or sternal osteomyelitis were identified in 18 patients (82%). Patients with chest wall and/or neck abscess had a tendency to be treated with limited surgery than patients without them (73% vs. 27%, P = 0.09). The median duration of intravenous antibiotics in all patients was 35 days (IQR 25–46 days). After a median follow-up of 31 months (IQR 2–40 months), there was no relapse of SC septic arthritis or deterioration of joint function. Conclusion Medical therapy alone or with limited surgical therapy appears to be a successful therapeutic strategy for the complicated S. aureus SC septic arthritis in a selected patient. Disclosures All authors: No reported disclosures.
    Type of Medium: Online Resource
    ISSN: 2328-8957
    URL: Article
    DOI: 10.1093/ofid/ofx163.071
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2017
    detail.hit.zdb_id: 2757767-3
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  • 2
    Online Resource
    Online Resource
    Rapid Diagnosis of Tick-Borne Illnesses by Use of One-Step Isothermal Nucleic Acid Amplification and Bio-Optical Sensor Detection
    Oxford University Press (OUP) ; 2018
    In:  Clinical Chemistry Vol. 64, No. 3 ( 2018-03-01), p. 556-565
    Details
    In: Clinical Chemistry, Oxford University Press (OUP), Vol. 64, No. 3 ( 2018-03-01), p. 556-565
    Abstract: Scrub typhus and severe fever with thrombocytopenia syndrome (SFTS) are the most common tick-borne illnesses in South Korea. Early differentiation of SFTS from scrub typhus in emergency departments is essential but difficult because of their overlapping epidemiology, shared risk factors, and similar clinical manifestations. METHODS We compared the diagnostic performance of one-step isothermal nucleic acid amplification with bio-optical sensor detection (iNAD) under isothermal conditions, which is rapid (20–30 min), with that of real-time PCR, in patients with a confirmed tick-borne illness. Fifteen patients with confirmed SFTS who provided a total of 15 initial blood samples and 5 follow-up blood samples, and 21 patients with confirmed scrub typhus, were evaluated. RESULTS The clinical sensitivity of iNAD (100%; 95% CI, 83–100) for SFTS was significantly higher than that of real-time PCR (75%; 95% CI, 51–91; P = 0.047), while its clinical specificity (86%; 95% CI, 65–97) was similar to that of real-time PCR (95%; 95% CI, 77–99; P = 0.61). The clinical sensitivity of iNAD for scrub typhus (100%; 95% CI, 81–100) was significantly higher than that of real-time PCR for scrub typhus (67%; 95% CI, 43–85; P = 0.009), while its clinical specificity (90%; 95% CI, 67–98) was similar to that of real-time PCR (95%; 95% CI, 73–100; P & gt; 0.99). CONCLUSIONS iNAD is a valuable, rapid method of detecting SFTS virus and Orientia tsutsugamushi with high clinical sensitivity and specificity.
    Type of Medium: Online Resource
    ISSN: 0009-9147 , 1530-8561
    URL: Article
    DOI: 10.1373/clinchem.2017.280230
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2018
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  • 3
    Online Resource
    Online Resource
    Clinical characteristics and outcomes of patients with chronic disseminated candidiasis who need adjuvant corticosteroid therapy
    Oxford University Press (OUP) ; 2018
    In:  Medical Mycology Vol. 56, No. 6 ( 2018-08-01), p. 782-786
    Details
    In: Medical Mycology, Oxford University Press (OUP), Vol. 56, No. 6 ( 2018-08-01), p. 782-786
    Type of Medium: Online Resource
    ISSN: 1369-3786 , 1460-2709
    URL: Article
    DOI: 10.1093/mmy/myx110
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2018
    detail.hit.zdb_id: 2020733-5
    SSG: 12
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  • 4
    Online Resource
    Online Resource
    Differences in Gene Expression Levels of Methicillin-Resistant Staphylococcus aureus Genes Between Persistent and Resolving Bacteremia
    Oxford University Press (OUP) ; 2017
    In:  Open Forum Infectious Diseases Vol. 4, No. suppl_1 ( 2017), p. S230-S230
    Details
    In: Open Forum Infectious Diseases, Oxford University Press (OUP), Vol. 4, No. suppl_1 ( 2017), p. S230-S230
    Type of Medium: Online Resource
    ISSN: 2328-8957
    URL: Article
    DOI: 10.1093/ofid/ofx163.482
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2017
    detail.hit.zdb_id: 2757767-3
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  • 5
    Online Resource
    Online Resource
    Community-associated MRSA strain ST72-SCC mec IV causing bloodstream infections: clinical outcomes and bacterial virulence factors
    Oxford University Press (OUP) ; 2015
    In:  Journal of Antimicrobial Chemotherapy Vol. 70, No. 4 ( 2015-04-01), p. 1185-1192
    Details
    In: Journal of Antimicrobial Chemotherapy, Oxford University Press (OUP), Vol. 70, No. 4 ( 2015-04-01), p. 1185-1192
    Abstract: 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  & lt; 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.
    Type of Medium: Online Resource
    ISSN: 1460-2091 , 0305-7453
    URL: Article
    DOI: 10.1093/jac/dku475
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2015
    detail.hit.zdb_id: 1467478-6
    SSG: 15,3
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  • 6
    Online Resource
    Online Resource
    Clinical Characteristics and Radiologic Features of Immunocompromised Patients With Pauci-Bacillary Pulmonary Tuberculosis Receiving Delayed Diagnosis and Treatment
    Oxford University Press (OUP) ; 2019
    In:  Open Forum Infectious Diseases Vol. 6, No. 2 ( 2019-02-01)
    Details
    In: Open Forum Infectious Diseases, Oxford University Press (OUP), Vol. 6, No. 2 ( 2019-02-01)
    Abstract: Pauci-bacillary pulmonary tuberculosis (TB) can be delayed to diagnose and start anti-TB therapy, especially in immunocompromised patients. We therefore evaluated the clinical and radiologic features of these delayed cases. Methods Immunocompromised adult patients with pauci-bacillary pulmonary TB were retrospectively enrolled in a tertiary hospital in an intermediate–TB burden country over a 5-year period. We defined “missed TB” or “not-missed TB” patients as those who started anti-TB therapy after or before positive mycobacterial culture results, respectively. Results Of 258 patients, 134 (52%) were classified in the missed TB group, and 124 (48%) in the not-missed TB group. Positive results of molecular tests including MTB polymerase chain reaction and/or Xpert TB/RIF were only obtained in the not-missed TB group (54/106, 54%). The median diagnostic delay in the missed TB group was longer than in the other group (30 vs 6 days; P & lt; .001). In the missed TB group, the most common working diagnoses were pneumonia (46, 34%) and lung metastasis of malignancy (40, 30%). Typical radiologic findings for TB, such as upper lobe predominance and centrilobular nodules with tree-in-bud appearance, were less common in the missed TB group than in the other group. Old age (odds ratio [OR], 1.03), solid organ transplant (OR, 3.46), solid tumor (OR, 3.83), and hematologic malignancy (OR, 4.04) were independently associated with missed TB. Conclusions Care is needed to differentiate pauci-bacillary TB, especially in immunocompromised patients with the mentioned risk factors, even without the usual radiologic features of TB. Additional rapid diagnostic tests to rule out pauci-bacillary TB are urgently needed.
    Type of Medium: Online Resource
    ISSN: 2328-8957
    URL: Article
    DOI: 10.1093/ofid/ofz002
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2019
    detail.hit.zdb_id: 2757767-3
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  • 7
    Online Resource
    Online Resource
    348. Etiology of Eosinophilic Meningitis in Korea
    Oxford University Press (OUP) ; 2020
    In:  Open Forum Infectious Diseases Vol. 7, No. Supplement_1 ( 2020-12-31), p. S244-S244
    Details
    In: Open Forum Infectious Diseases, Oxford University Press (OUP), Vol. 7, No. Supplement_1 ( 2020-12-31), p. S244-S244
    Abstract: Eosinophilic meningitis is defined as the presence of more than 10 eosinophils per mm3 in the cerebrospinal fluid (CSF), or eosinophils accounting for more than 10 percent of CSF leukocytes in a patient with symptoms or signs suggestive of acute meningitis. Parasites are known to be the most common cause of eosinophilic meningitis worldwide, but there is limited research on patients in South Korea. Methods We retrospectively reviewed patients with eosinophilic meningitis at a tertiary hospital in Seoul, South Korea, from 2004 to 2018. Patients who were suspected of having a non-infectious cause were excluded. Etiology and clinical characteristics such as age, sex, risk factors, symptoms and signs, laboratory and radiologic findings, treatment, and prognosis were identified. Results Of the 35 patients included in this study, 11 (31.4%) had parasitic causes, with 8 (22.9%) diagnosed as neurocysticercosis, and 3 (8.6%) as toxocara meningitis. Four (11.4%) were diagnosed with fungal meningitis, and underlying immunodeficiency was found in 2 of these patients. Tuberculous meningitis was suspected in 4 (11.4%), while viral and bacterial meningitis were rare causes of eosinophilic meningitis, with 2 (5.7%) and 1 (2.9%) patients, respectively. One patient with neurocysticercosis and one patient with fungal meningitis died, while 8 (22.9%) had remaining neurologic sequelae. The etiology was unknown in 13 patients (37.1%). Four of these patients received empirical anti-tuberculosis therapy, while 5 were treated empirically with acyclovir. Conclusion Parasite infections, especially neurocysticercosis and toxocariasis, were the most common cause of eosinophilic meningitis in South Korean patients. Fungal meningitis, while relatively rare, is often aggressive and should always be considered when searching for the cause of eosinophilic meningitis. Disclosures All Authors: No reported disclosures
    Type of Medium: Online Resource
    ISSN: 2328-8957
    URL: Article
    DOI: 10.1093/ofid/ofaa439.543
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
    detail.hit.zdb_id: 2757767-3
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  • 8
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    Online Resource
    1082. Clinical Characteristics and Vertical Transmission of Pregnant Women with SARS-CoV-2 Infection and Their Neonates
    Oxford University Press (OUP) ; 2022
    In:  Open Forum Infectious Diseases Vol. 9, No. Supplement_2 ( 2022-12-15)
    Details
    In: Open Forum Infectious Diseases, Oxford University Press (OUP), Vol. 9, No. Supplement_2 ( 2022-12-15)
    Abstract: Pregnant women with SARS-CoV-2 infection are known to have a poor prognosis. In addition, the previous meta-analysis revealed that SARS-CoV-2 infection in neonates born from pregnant women with SARS-CoV-2 infection is about 2%. However, there are limited data on the clinical characteristics of pregnant women with SARS-CoV-2 infection and their neonates and the vertical transmission rate in South Korea. Methods Pregnant women confirmed as SARS-CoV-2 infection were retrospectively reviewed in Asan Medical Center from September 1 2020 to April 26 2022. All neonates from SARS-CoV-2-infected women underwent SARS-CoV-2 PCR within 24 hours after the birth and 48-hour interval if he or she stayed in the hospital. Results A total of 60 pregnant women gave birth by cesarean section (n=40, 67%) or vaginal delivery (n=20, 33%). Among them, three women gave birth to twins (63 neonates). Delivery was carried out at the average gestational age of 268 days (± 14.0), and 9 patients (15%) had underlying diseases. Of these 60 patients, 11 (18%) received COVID-19 vaccination. Pneumonia was confirmed by chest radiograph in 7 patients (12%), and 2 patient (3%) required supplemental oxygen therapy who eventually recovered. The mean weight of 63 newborns was 3137 g (± 558), and 8 neonate (13%) was a low-birth weight ( & lt; 2500 g), and 12 neonate (19%) was premature ( & lt; gestational age 37 weeks). Apgar score was 8.1 points (± 1.2) at 1 minute and 9.1 points (± 0.8) at 5 minutes. Five neonates (8%) required mechanical ventilation, who eventually recovered. All 63 neonates revealed negative SARS-CoV-2 PCR results with 24 hours after the birth. After 48 hours, 45 newborns exhibited negative SARS-CoV-2 PCR results. So, there was no vertical transmission among 63 neonates (0%, 95% CI 0-6). Conclusion Our experiences about pregnant women with SARS-CoV-2 infection revealed that obstetric outcomes were favorable and the vertical transmission risk was low. Balancing risks about the infection control of pregnant women and their neonates during the COVID-19 pandemic are needed. Disclosures All Authors: No reported disclosures.
    Type of Medium: Online Resource
    ISSN: 2328-8957
    URL: Article
    DOI: 10.1093/ofid/ofac492.923
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2022
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  • 9
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    False positive Aspergillus galactomannan assay results caused by specific parenteral nutrition
    Oxford University Press (OUP) ; 2023
    In:  Medical Mycology Vol. 61, No. 9 ( 2023-09-04)
    Details
    In: Medical Mycology, Oxford University Press (OUP), Vol. 61, No. 9 ( 2023-09-04)
    Abstract: In September 2022, the proportion of clinically false positive results with high index values for the galactomannan (GM) assay increased dramatically in our hospital and remained high until November 2022. We aimed to identify the possible causative agent that led to the dramatic increase in false positivity in GM assay. A case-control–control study was conducted, and patients admitted to two intensive care units between September and November 2022 were included. We defined each time point at which the GM assay was conducted in a patient as an episode and classified episodes into strong-positive (≥10.0 index; case), positive (control), and negative ( & lt;0.5 index; control) groups. We compared the medications administered in three groups and measured GM levels in relevant medications, including parenteral nutrition (PN). In total, 118 episodes in 33 patients were classified into three groups. There were 46 negative, 23 positive, and 49 strong-positive episodes, and there was a significant difference in the use of Winuf® PNs (P  & lt; .001) between the three groups. Forty episodes (82%) in the strong-positive group received Winuf®, compared with three (6.5%) in the negative group and one (4.3%) in the positive group (P  & lt; .001). All samples of Winuf® PNs used in the five patients whose GM results were repeatedly strong-positive were strongly positive for GM. False positivity in GM assay can be caused by the administration of specific PNs. A thorough investigation of prescribed medications should be considered when there is an abrupt increase in the proportion of strong-positive or positive GM results.
    Type of Medium: Online Resource
    ISSN: 1369-3786 , 1460-2709
    URL: Article
    DOI: 10.1093/mmy/myad094
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2023
    detail.hit.zdb_id: 2020733-5
    SSG: 12
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  • 10
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    Optimal Duration of Antibiotic Therapy in Patients With Hematogenous Vertebral Osteomyelitis at Low Risk and High Risk of Recurrence
    Oxford University Press (OUP) ; 2016
    In:  Clinical Infectious Diseases Vol. 62, No. 10 ( 2016-05-15), p. 1262-1269
    Details
    In: Clinical Infectious Diseases, Oxford University Press (OUP), Vol. 62, No. 10 ( 2016-05-15), p. 1262-1269
    Type of Medium: Online Resource
    ISSN: 1058-4838 , 1537-6591
    URL: Article
    DOI: 10.1093/cid/ciw098
    RVK:
    XA 10000
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2016
    detail.hit.zdb_id: 2002229-3
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