26 results on '"Kwon, Ki Tae"'
Search Results
2. Analysis of microbiological tests in patients withholding or withdrawing life-sustaining treatment at the end stage of life in 2 Korean hospitals
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Bae, Sohyun, Kwon, Ki Tae, Hwang, Soyoon, Kim, Yoonjung, Chang, Hyun-Ha, Kim, Shin-Woo, Lee, Nan Young, Kim, Yu Kyoung, and Lee, Je Chul
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AbstractObjective:We evaluated the adequacy of microbiological tests in patients withholding or withdrawing life-sustaining treatment (WLST) at the end stage of life.Setting:The study was conducted at 2 tertiary-care referral hospitals in Daegu, Republic of Korea.Design:Retrospective cross-sectional study.Methods:Demographic findings, clinical and epidemiological characteristics, statistics of microbiological tests, and microbial species isolated from patients within 2 weeks before death were collected in 2 tertiary-care referral hospitals from January to December 2018. We also reviewed the antimicrobial treatment that was given within 3 days of microbiological testing in patients on WLST.Results:Of the 1,187 hospitalized patients included, 905 patients (76.2%) had WLST. The number of tests per 1,000 patient days was higher after WLST than before WLST (242.0 vs 202.4). Among the category of microbiological tests, blood cultures were performed most frequently, and their numbers per 1,000 patient days before and after WLST were 95.9 and 99.0, respectively. The positive rates of blood culture before and after WLST were 17.2% and 18.0%, respectively. Candidaspp. were the most common microbiological species in sputum (17.4%) and urine (48.2%), and Acinetobacterspp. were the most common in blood culture (17.3%). After WLST determination, 70.5% of microbiological tests did not lead to a change in antibiotic use.Conclusions:Many unnecessary microbiological tests are being performed in patients with WLST within 2 weeks of death. Microbiological testing should be performed carefully and in accordance with the patient’s treatment goals.
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- 2024
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3. Effect of Regdanvimab on Mortality in Patients Infected with SARS-CoV-2 Delta Variants: A Propensity Score-Matched Cohort Study
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Hwang, Soyoon, Lee, Nan Young, Nam, Eunkyung, Kim, Yu Kyung, Kim, Shin-Woo, Chang, Hyun-Ha, Kim, Yoonjung, Bae, Sohyun, Jeong, Juhwan, Shin, Jae-Ho, Jang, Guehwan, Lee, Changhee, and Kwon, Ki Tae
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Introduction: Regdanvimab, a monoclonal antibody pharmaceutical, is the first Korean drug approved for treating coronavirus disease 2019 (COVID-19). We analyzed the therapeutic efficacy of regdanvimab in patients with the COVID-19 delta variant infection. Methods: We retrospectively reviewed the electronic medical records of patients hospitalized at two Korean tertiary COVID-19 hospitals with COVID-19 delta variant infection between May 26, 2021, and January 30, 2022. To analyze the therapeutic efficacy of regdanvimab, the patients were divided into regdanvimab and non-regdanvimab groups and were 1:1 propensity-score (PS)-matched on age, severity at admission, and COVID-19 vaccination history. Results: Of 492 patients, 262 (53.3%) and 230 (46.7%) were in the regdanvimab and non-regdanvimab groups, respectively. After PS matching the groups on age, severity at admission, and COVID-19 vaccination history, each group comprised 189 patients. The 30-day hospital mortality rates (0.0% vs. 1.6%, p= 0.030), proportions of patients with exacerbated conditions to severe/critical/died (9.5% vs. 16.4%, p= 0.047), proportions who received oxygen therapy because of pneumonia exacerbation (7.4% vs. 16.4%, p= 0.007), and proportions with a daily National Early Warning Score ≥ 5 from hospital day 2 were significantly lower in the regdanvimab group. Conclusions: We showed that regdanvimab reduced the exacerbation rates of conditions and mortality in patients with the COVID-19 delta variant infection. Thus, it is recommended to streamline the drug approval system during epidemics of new variant viruses to improve the availability and usage of therapeutics for patients. To facilitate this, relevant institutional support is required.
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- 2024
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4. Safety and Effectiveness of Regdanvimab for COVID-19 Treatment: A Phase 4 Post-marketing Surveillance Study Conducted in South Korea.
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Lee, Ji Yeon, Bu, Seon Hee, Song, EunHyang, Cho, Seongcheol, Yu, Sungbong, Kim, Jungok, Kym, Sungmin, Seo, Kwang Won, Kwon, Ki Tae, Kim, Jin Yong, Kim, Sunghyun, Ahn, Keumyoung, Jung, Nahyun, Lee, Yeonmi, Jung, Yoobin, Hwang, Chankyoung, and Park, Sang Won
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- 2023
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5. Safety and Effectiveness of Regdanvimab for COVID-19 Treatment: A Phase 4 Post-marketing Surveillance Study Conducted in South Korea
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Lee, Ji Yeon, Bu, Seon Hee, Song, EunHyang, Cho, Seongcheol, Yu, Sungbong, Kim, Jungok, Kym, Sungmin, Seo, Kwang Won, Kwon, Ki Tae, Kim, Jin Yong, Kim, Sunghyun, Ahn, Keumyoung, Jung, Nahyun, Lee, Yeonmi, Jung, Yoobin, Hwang, Chankyoung, and Park, Sang Won
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Introduction: Regdanvimab, a neutralising monoclonal antibody (mAb) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), received approval for the treatment of coronavirus disease 2019 (COVID-19) in South Korea in 2021. The Ministry of Food and Drug Safety in South Korea mandate that new medications be re-examined for safety and effectiveness post-approval in at least 3000 individuals. This post-marketing surveillance (PMS) study was used to evaluate the safety and effectiveness of regdanvimab in real-world clinical care. Methods: This prospective, multicentre, phase 4 PMS study was conducted between February 2021 and March 2022 in South Korea. Eligible patients were aged ≥ 18 years with confirmed mild COVID-19 at high risk of disease progression or moderate COVID-19. Patients were hospitalised and treated with regdanvimab (40 mg/kg, day 1) and then monitored until discharge, with a follow-up call on day 28. Adverse events (AEs) were documented, and the COVID-19 disease progression rate was used to measure effectiveness. Results: Of the 3123 patients with COVID-19 infection identified, 3036 were eligible for inclusion. Approximately 80% and 5% of the eligible patients were diagnosed with COVID-19 during the delta- and omicron-dominant periods, respectively. Median (range) age was 57 (18–95) years, and 50.6% of patients were male. COVID-19 severity was assessed before treatment, and high-risk mild and moderate COVID-19 was diagnosed in 1030 (33.9%) and 2006 (66.1%) patients, respectively. AEs and adverse drug reactions (ADRs) were experienced by 684 (22.5%) and 363 (12.0%) patients, respectively. The most common ADR was increased liver function test (n= 62, 2.0%). Nine (0.3%) patients discontinued regdanvimab due to ADRs. Overall, 378 (12.5%) patients experienced disease progression after regdanvimab infusion, with extended hospitalisation/re-admission (n= 300, 9.9%) as the most common reason. Supplemental oxygen was required by 282 (9.3%) patients. Ten (0.3%) patients required intensive care monitoring and 3 (0.1%) died due to COVID-19. Conclusion: This large-scale PMS study demonstrated that regdanvimab was effective against COVID-19 progression and had an acceptable safety profile when used in real-world clinical practice.
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- 2023
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6. Proposal of Isolated Ultrasonography Room Model for the Examination of Pregnant Women With Confirmed Coronavirus Disease 2019
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Kim, Mi Ju, Kim, Hyun Mi, Cha, Hyun Hwa, Kwon, Ki Tae, and Seong, Won Joon
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- 2023
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7. Impact of vaccination and the omicron variant on COVID-19 severity in pregnant women.
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Kim, Haemin, Kim, Hyo-Shin, Kim, Hyun Mi, Kim, Mi Ju, Kwon, Ki Tae, Cha, Hyun-Hwa, and Seong, Won Joon
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• In Omicron era, the infectivity of COVID-19 was stronger than before Omicron. • The disease severity of COVID-19 was lower in Omicron era. • Vaccinated patients were better protected against COVID-19. We compared the clinical course of pregnant women with coronavirus disease 2019 (COVID-19) before and after the emergence of the omicron variant and based on vaccination status. We retrospectively reviewed the electronic medical charts of 224 patients and 82 deliveries from November 1, 2020, to March 7, 2022; of these, 42% were diagnosed during the omicron dominance period. Disease severity and morbidity of COVID-19 were significantly decreased during the omicron era. The vaccination rates among the patients were higher after omicron emergence (31.9%) than before (6.9%). Overall, 4.1% and 25% of patients had severe symptoms, and 2.6% and 16.2% required oxygen therapy in the vaccination and non-vaccination groups, respectively. Overall, patients had a more favorable clinical course in the omicron era; moreover, vaccinated patients were better protected than non-vaccinated patients, indicating the importance of vaccination against COVID-19. [ABSTRACT FROM AUTHOR]
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- 2023
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8. Clinical evaluation of an innovative isothermal amplification detection system for COVID-19 diagnosisElectronic supplementary information (ESI) available: Appendix A: supplementary material, Fig. S1–S5 and Tables S1–S3. See https://doi.org/10.1039/d2ay00815g
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Kim, Dami, Kim, Se Jin, Kim, Yu Kyung, Kwon, Ki Tae, and Kim, Sanghyo
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A pre-integrated system design intended for a point-of-care (POC) and sample-to-result diagnostic platform with nucleic acid amplification has been developed, which is equipment/electricity-free without any permanent instruments or manual sample processing. This semi-integrated system focuses on pandemic situations that are suitable for the Affordable, Sensitive, Specific, User-friendly, Robust and rapid, Equipment-free, and Deliverable to the end-user “ASSURED” concept recommended by the World Health Organization (WHO). Nucleic acid amplification is an essential rate-limiting factor in the performance of integrated systems that involve sample preparation and detection. The ORF1ab (RdRp) gene of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been targeted by RT-LAMP optimization and evaluation using a commercial hot-pack as a heat source that successfully achieves a femto-scale (<6.8 × 102copies per rxn) limit of detection (LOD) within 40 min (except for the RNA extraction step). Therefore, the prototype system was assessed using COVID-19-suspected clinical samples (eighty eight) and compared with the results of a commercial real-time reverse transcription polymerase chain reaction (RT-qPCR) assay (Allplex SARS-CoV-2 Assay kit (Seegene, Seoul, Republic of Korea)). These innovative approaches achieved over 95% sensitivity and specificity. In conclusion, the developed system using a hot-pack as a heat source is a promising tool that enables the rapid identification of infectious diseases in the real world.
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- 2022
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9. The impact of infection control cost reimbursement policy on central line–associated bloodstream infections.
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Park, Ji Young, Kwon, Ki Tae, Lee, Won Kee, Kim, Hye In, Kim, Min Jung, Song, Do Young, Yu, Mi Hyae, Park, Hyun Ju, Lee, Kyeong Hee, and Chae, Hyun Ju
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• Korean National Health Insurance has begun reimbursing infection control costs. • This policy strengthens the infection control team in a supported hospital. • The compliance with infection prevention bundles improve in a supported hospital. • Central line–associated bloodstream infection decreased in a supported hospital. In September 2016, the Korean National Health Insurance Service began reimbursing infection control (IC) costs on the condition that a certain number of doctors and full-time nurses for IC be allocated to supported hospitals. We analyzed the impact of the IC cost reimbursement policy on central line–associated bloodstream infections (CLABSIs). A before-and-after study that analyzed the CLABSI rate trends between preintervention (January 2016 to February 2017) and intervention (March to December 2017) periods using autoregression time series analysis was performed in intensive care units (ICUs) at a 750-bed, secondary care hospital in Daegu, Republic of Korea. The enhanced IC team visited ICUs daily, monitored the implementation of CLABSI prevention bundles, and educated all personnel involved in catheter insertion and maintenance from March 2017. Autoregressive analysis revealed that the CLABSI rates per month in the preintervention and intervention periods were −0.256 (95% confidence interval, −0.613 to 0.101; P =.15) and −0.602 (95% confidence interval, −0.972 to −0.232; P =.008), respectively. The rates of compliance with maximal barrier precautions significantly improved from the preintervention (36.2%) to the intervention (77.9%) period (χ² test, P <.001). The IC cost reimbursement policy accelerated the decline in CLABSI rates significantly in monitored ICUs. A nationwide study to evaluate the effectiveness of the IC cost reimbursement policy for various health care–associated infections is warranted. [ABSTRACT FROM AUTHOR]
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- 2020
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10. Strategy for salvaging infected breast implants: lessons from the recovery of seven consecutive patients
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Yeo, Hyeonjung, Lee, Dongkyu, Kim, Jin Soo, Eo, Pil Seon, Kim, Dong Kyu, Lee, Joon Seok, Kwon, Ki Tae, Lee, Jeeyeon, Park, Ho Yong, and Yang, Jung Dug
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- 2021
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11. How to keep patients and staff safe from accidental SARS-CoV-2 exposure in the emergency room: Lessons from South Korea’s explosive COVID-19 outbreak
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Kim, Yun Jeong, Choe, Jae Young, Kwon, Ki Tae, Hwang, Soyoon, Choi, Gyu-Seog, Sohn, Jin Ho, Kim, Jong Kun, Yeo, In Hwan, Cho, Yeon Joo, Ham, Ji Yeon, Song, Kyung Eun, and Lee, Nan Young
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AbstractObjectives:We report our experience with an emergency room (ER) shutdown related to an accidental exposure to a patient with coronavirus disease 2019 (COVID-19) who had not been isolated.Setting:A 635-bed, tertiary-care hospital in Daegu, South Korea.Methods:To prevent nosocomial transmission of the disease, we subsequently isolated patients with suspected symptoms, relevant radiographic findings, or epidemiology. Severe acute respiratory coronavirus 2 (SARS-CoV-2) reverse-transcriptase polymerase chain reaction assays (RT-PCR) were performed for most patients requiring hospitalization. A universal mask policy and comprehensive use of personal protective equipment (PPE) were implemented. We analyzed effects of these interventions.Results:From the pre-shutdown period (February 10–25, 2020) to the post-shutdown period (February 28 to March 16, 2020), the mean hourly turnaround time decreased from 23:31 ±6:43 hours to 9:27 ±3:41 hours (P < .001). As a result, the proportion of the patients tested increased from 5.8% (N=1,037) to 64.6% (N=690) (P < .001) and the average number of tests per day increased from 3.8±4.3 to 24.7±5.0 (P < .001). All 23 patients with COVID-19 in the post-shutdown period were isolated in the ER without any problematic accidental exposure or nosocomial transmission. After the shutdown, several metrics increased. The median duration of stay in the ER among hospitalized patients increased from 4:30 hours (interquartile range [IQR], 2:17–9:48) to 14:33 hours (IQR, 6:55–24:50) (P < .001). Rates of intensive care unit admissions increased from 1.4% to 2.9% (P = .023), and mortality increased from 0.9% to 3.0% (P = .001).Conclusions:Problematic accidental exposure and nosocomial transmission of COVID-19 can be successfully prevented through active isolation and surveillance policies and comprehensive PPE use despite longer ER stays and the presence of more severely ill patients during a severe COVID-19 outbreak.
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- 2021
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12. Development of a Predictive Model Using Endoscopic Features for Gastric Cytomegalovirus Infection in Renal Transplant Patients
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Yeo, Seong Jae, Kwon, Ki Tae, Kim, Eun Soo, Jung, Min Kyu, Kim, Sung Kook, Lee, Hyun Seok, Lee, Jun Seop, Lee, Sang Won, Lee, Yoo Jin, Kwak, Sang Gyu, and Han, Seungyeup
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Supplemental Digital Content is available in the text.
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- 2019
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13. The acceptable duration between occupational exposure to hepatitis B virus and hepatitis B immunoglobulin injection: Results from a Korean nationwide, multicenter study.
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Chang, Hyun-Ha, Lee, Won Kee, Moon, Chisook, Choi, Won Suk, Yoon, Hee-Jung, Kim, Jieun, Ryu, Seong Yeol, Kim, Hyun Ah, Jo, Yu Mi, Kwon, Ki Tae, Kim, Hye In, Sohn, Jang Wook, Yoon, Young Kyung, Jung, Sook In, Park, Kyung-Hwa, Kwon, Hyun Hee, Lee, Mi Suk, Kim, Young-Keun, Kim, Yeon Sook, and Hur, Jian
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Background Postexposure prophylaxis for occupational exposure to hepatitis B virus (HBV) plays an important role in the prevention of HBV infections in health care workers (HCWs). We examined data concerning the acceptable duration between occupational exposure and administration of a hepatitis B immunoglobulin (HBIG) injection in an occupational clinical setting. Methods A retrospective analysis was conducted with data from 143 cases of HCWs exposed to HBV in 15 secondary and tertiary teaching hospitals between January 2005 and June 2013. Data were taken from the infection control records of each hospital. Results Active vaccination after HBV exposure was started in 119 cases (83.2%) and postvaccination testing for hepatitis B antibody showed positive seroconversion in 93% of cases. In 98 cases (68.5%), HBIG was administered within 24 hours after HBV exposure; however, 45 HCWs (31.5%) received an HBIG injection more than 24 hours postexposure and 2 among the 45 received an injection after 7 days. Although 31.5% received an HBIG injection more than 24 hours postexposure, no cases of seroconversion to hepatitis b antibody positivity occurred. Conclusions For susceptible HCWs, HBIG administered between 24 hours and 7 days postexposure may be as effective as administration within 24 hours in preventing occupational HBV infection. [ABSTRACT FROM AUTHOR]
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- 2016
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14. 9-2: Integrated a-Si Gate Driver for Touchscreen Technology Known as AIT
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Cho, Seung-wan, So, Byeong-seong, Cho, Young-sung, Kim, Ji-ah, Kwon, Ki-tae, Kim, Kyu-jin, Park, Ki-bok, Jun, Myung-chul, and Kang, In-byeong
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We propose a new integrated a-Si Gate Driver for Advanced In-cell Touch(AIT). When the frame period divide in the display period and the touch period, abnormal gate signal due to the Q-node discharging during the touch period make the horizontal dim line in panel. The proposed gate driver improves the Q-node discharging during the touch period. We have succeeded in developing the gate driver circuit for advanced in-cell touch panel which is 12.5inch FHD for notebook.
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- 2017
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15. Association between Type A blaZGene Polymorphism and Cefazolin Inoculum Effect in Methicillin-Susceptible Staphylococcus aureus
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Lee, Sun Hee, Park, Wan Beom, Lee, Shinwon, Park, Sohee, Kim, Shin Woo, Lee, Jong-Myung, Chang, Hyun Ha, Kwon, Ki Tae, Choe, Pyoeng Gyun, Kim, Nam Joong, Kim, Hong Bin, and Oh, Myoung-Don
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ABSTRACTSome proportion of type A blaZgene-positive methicillin-susceptible Staphylococcus aureusstrains exhibit the cefazolin inoculum effect (CIE). The type A blaZgene was divided into two groups by single nucleotide polymorphisms (SNPs) at Ser226Pro and Cys229Tyr. The median cefazolin MICs at a high inoculum concentration were 5.69 μg/ml for the Ser-Cys group and 40.32 μg/ml for the Pro-Tyr group (P= 0.01). The SNPs at codons 226 and 229 in the amino acid sequence encoded by the blaZgene were closely associated with the CIE.
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- 2016
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16. Comparison of the clinical characteristics of diabetic and non-diabetic women with community-acquired acute pyelonephritis: A multicenter study.
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Kim, Yeonjae, Wie, Seong-Heon, Chang, U-Im, Kim, Jieun, Ki, Moran, Young Kyun Cho, Seung-Kwan Lim, Jin Seo Lee, Kwon, Ki Tae, Hyuck Lee, Hee Jin Cheong, Park, Dae Won, Ryu, Seong Yeol, Moon-Hyun Chung, and Pai, Hyunjoo
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Objectives Purpose of this study was to compare clinical characteristics and treatment outcomes in diabetic and non-diabetic women with community-acquired APN (CA-APN). Methods We prospectively collected and analyzed clinical data of women with CA-APN who attended 11 hospitals in South Korea from March 2010 to February 2012. Results Of a total of 775 patients, 246 (31.7%) were diabetic and 529 (68.3%) non-diabetic. Fewer of the diabetic patients had flank pain (27.6% vs. 37.2% P = 0.009), symptoms of lower urinary tract infection (57.3% vs. 69.6% P = 0.001) and costovertebral angle tenderness (54.9% vs. 72.2% P < 0.001). However, more of them had C-reactive protein ≥20 mg/dL (40.7% vs. 27.4% P < 0.001), azotemia (29.3% vs. 13.4% P < 0.001) and bacteremia (53.7% vs. 38.2% P < 0.001). Final clinical failure rates and deaths did not differ between the two groups: 6.9% vs. 4.5%, P = 0.169; 2.0% vs. 1.7%, P = 0.747. However, hospitalization was longer in the diabetics than the non-diabetics (median 9.0 days vs. 7.0 days, P < 0.001). In logistic regression, diabetes was independently associated with longer hospitalization (OR 1.7, CI 1.1-2.7, P = 0.011), together with nausea/vomiting, history of admission within 1 year, bacteremia, azotemia, and dementia, as well as extended-spectrum β-lactamase (ESBL)-positivity and fluoroquinolone resistance of uropathogens. Conclusions CA-APN patients with diabetes have more severe disease manifestations and require longer hospitalization than non-diabetic patients although their clinical findings are less clear than those of non-diabetic patients. [ABSTRACT FROM AUTHOR]
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- 2014
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17. Liver cirrhosis as a risk factor for mortality in a national cohort of patients with bacteremia.
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Kang, Cheol-In, Song, Jae-Hoon, Chung, Doo Ryeon, Peck, Kyong Ran, Yeom, Joon-Sup, Ki, Hyun Kyun, Son, Jun Seong, Lee, Jin Seo, Kim, Yeon-Sook, Jung, Sook-In, Kim, Shin-Woo, Chang, Hyun-Ha, Ryu, Seong Yeol, Kwon, Ki Tae, Lee, Hyuck, Jung, Dong Sik, Moon, Chisook, Heo, Sang Taek, Kim, Eu Suk, and Rhee, Ji-Young
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CIRRHOSIS of the liver ,MORTALITY risk factors ,BACTEREMIA ,HEALTH outcome assessment ,STAPHYLOCOCCAL diseases ,SEPSIS ,PNEUMONIA ,COHORT analysis - Abstract
Summary: Objective: The purpose of this study was to evaluate clinical features and outcomes of bacteremia in patients with liver cirrhosis (LC) and determine whether underlying LC is an independent risk factor for mortality in a population of patients with different underlying diseases. Methods: From the database of nationwide surveillance studies for bacteremia, data regarding bacteremia in patients with LC were analyzed and compared with those in patients with other diseases. Results: A total of 195 patients with LC were compared with 1659 patients with other underlying diseases. As for the site of infection, intraabdominal infection was more frequent in the LC group (P < 0.001), while pneumonia, urinary tract bacteremia, and primary bacteremia were more prevalent in the other diseases group (all P < 0.05). Patients with LC were more likely to have Klebsiella pneumoniae bacteremia (20.1% vs. 14.3%, P = 0.018), but less likely to have coagulase-negative staphylococcal bacteremia (5.1% vs. 10.4%, P = 0.028). The 30-day mortality rate was significantly higher in the LC group compared to the other disease group (27.2% [53/195] vs. 20.3% [336/1659], P = 0.025). Multivariate analysis revealed underlying LC as a significant predictor for mortality (OR, 2.11; 95% CI, 1.43–3.13; P < 0.001), along with old age, nosocomial acquisition, pneumonia, severe sepsis, and a higher Pitt bacteremia score. Conclusions: The mortality rate of patients with LC was significantly higher than that of patients with other diseases when they developed bacteremia. Underlying LC was found to be one of the independent risk factors for mortality in patients with bacteremia. [ABSTRACT FROM AUTHOR]
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- 2011
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18. Risk factors and pathogenic significance of severe sepsis and septic shock in 2286 patients with gram-negative bacteremia.
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Kang, Cheol-In, Song, Jae-Hoon, Chung, Doo Ryeon, Peck, Kyong Ran, Ko, Kwan Soo, Yeom, Joon-Sup, Ki, Hyun Kyun, Son, Jun Seong, Lee, Seung Soon, Kim, Yeon-Sook, Jung, Sook-In, Kim, Shin-Woo, Chang, Hyun-Ha, Ryu, Seong Yeol, Kwon, Ki Tae, Lee, Hyuck, and Moon, Chisook
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SEPTIC shock ,GRAM-negative bacterial diseases ,BACTEREMIA ,TREATMENT effectiveness ,NEUTROPENIA ,MULTIVARIATE analysis ,KIDNEY diseases ,PATIENTS ,DISEASE risk factors - Abstract
Summary: Background: The aim of this study was to identify risk factors for development of severe sepsis or septic shock and to evaluate the clinical impact of severe sepsis on outcome in patients with gram-negative bacteremia (GNB). Methods: From the database of a nationwide surveillance for bacteremia, patients with GNB were analyzed. Data of patients with severe sepsis or septic shock were compared with those of patient with sepsis. Results: Of 2286 patients with GNB, 506 (22.1%) fulfilled the criteria of severe sepsis or septic shock. Factors associated with severe sepsis or septic shock in the multivariate analysis included renal disease, indwelling urinary catheter, hematologic malignancy, and neutropenia. The 30-day mortality of patients with severe sepsis or septic shock was significantly higher than that of patients with sepsis (39.5% [172/435] vs. 7.4% [86/1170]; P < 0.001). Multivariable analysis revealed that solid tumor, liver disease, pulmonary disease, pneumonia, and pathogens other than Escherichia coli, which were risk factors of development of severe sepsis or septic shock, were also found to be strong predictors of mortality. Severe sepsis or septic shock was a significant factor associated with mortality (OR, 3.34; 95% CI, 2.35–4.74), after adjustment for other variables predicting poor prognosis. Conclusions: Severe sepsis or septic shock was a common finding in patients with GNB, predicting a higher mortality rate. Renal disease and indwelling urinary catheter were the most important risk factors significantly associated with severe sepsis or septic shock among patients with GNB. [ABSTRACT FROM AUTHOR]
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- 2011
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19. Impact of inappropriate antimicrobial therapy on outcome in patients with hospital-acquired pneumonia caused by Acinetobacter baumannii.
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Joung, Mi Kyong, Kwon, Ki Tae, Kang, Cheol-In, Cheong, Hae Suk, Rhee, Ji-young, Jung, Dong Sik, Chung, Seung Min, Lee, Jeong A., Moon, Soo-youn, Ko, Kwan Soo, Chung, Doo Ryeon, Lee, Nam Yong, Song, Jae-Hoon, and Peck, Kyong Ran
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ANTI-infective agents ,CLINICAL drug trials ,PNEUMONIA ,ACINETOBACTER infections ,DRUG resistance ,DEATH rate ,NOSOCOMIAL infections - Abstract
Summary: Objectives: The purpose of this study was to evaluate the impact of inappropriate antimicrobial therapy on the outcome of patients with hospital-acquired pneumonia (HAP) caused by Acinetobacter baumannii. Methods: All cases of HAP caused by A. baumannii from January 2000 to March 2006 at the Samsung Medical Center (Seoul, Korea) were analyzed retrospectively. Results: A total of 116 patients with clinically significant Acinetobacter HAP were enrolled. Among the A. baumannii isolates, 60.3% showed multi-drug resistance (MDR), 16.4% were found to have imipenem resistance, and 15.5% had pan-drug resistance (PDR). The mean APACHE II score of the patients was 22.3 ± 7.9. The overall in-hospital and pneumonia-related mortality rates were 47.4% and 37.9%, respectively. The univariate analysis showed that the factors associated with pneumonia-related mortality were: MDR, PDR, high APACHE II score, inappropriate empirical antimicrobial therapy, and inappropriate definitive antimicrobial treatment (All p < 0.05). Among these, a high APACHE II score and inappropriate definitive antimicrobial therapy were found to be independent factors associated with a high mortality, after adjustment for other variables. Conclusions: The appropriate definitive antimicrobial therapy should be provided in patients with HAP caused by A. baumannii. [ABSTRACT FROM AUTHOR]
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- 2010
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20. Dissemination of ST131 and ST393 community-onset, ciprofloxacin-resistant Escherichia coli clones causing urinary tract infections in Korea.
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Lee, Mi Young, Choi, Hyeon Jin, Choi, Ji Young, Song, Minsuk, Song, Yoosuk, Kim, Shin-Woo, Chang, Hyun-Ha, Jung, Sook-In, Kim, Yeon-Sook, Ki, Hyun Kyun, Son, Jun Seong, Kwon, Ki Tae, Heo, Sang Taek, Yeom, Joon-Sup, Shin, Sang Yop, Chung, Doo Ryeon, Peck, Kyong Ran, Song, Jae-Hoon, and Ko, Kwan Soo
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DRUG resistance in microorganisms ,CIPROFLOXACIN ,ESCHERICHIA coli ,PHYLOGENY ,MICROBIAL virulence ,URINARY tract infections ,NUCLEOTIDE sequence ,HEALTH surveys - Abstract
Summary: Objective: Ciprofloxacin-resistant Escherichia coli is growing concern in clinical settings. In this study, we investigated the distribution of virulence determinants and phylogenetic groups among community-onset, ciprofloxacin-resistant E. coli isolates causing urinary tract infections (UTIs) in Korea. In addition, the evidence of clonal spread in the community was also examined. Methods: From November 2006 to August 2007, 543 community-onset E. coli isolates causing UTIs were collected as part of a multicenter surveillance study. In vitro susceptibility testing was performed using broth microdilution method. Distribution of virulence determinants and phylogenetic groupings were examined. In addition, multilocus sequence typing (MLST) analysis was performed. Results: In vitro antimicrobial susceptibility testing revealed that 154 isolates (28.4%) were ciprofloxacin-resistant. Of these, 129 ciprofloxacin-resistant E. coli isolates were further characterized. As a result of phylogenetic subgrouping, we found that phylogenetic subgroup D was the most predominant (46 isolates, 35.7%), followed by B2 (44 isolates, 34.1%), A (21 isolates, 16.3%), and B1 (18 isolates, 14.0%). MLST analysis showed 48 sequence types (STs). The most prevalent ST was ST131 (32 isolates, 24.8%), followed by ST393 (23 isolates, 17.8%). While all ST131 isolates belonged to phylogenetic subgroup B2, which is known to be a highly virulent, all ST393 isolates belonged to subgroup D. ST131 and ST393 showed different profiles of virulence factors; papA, papG allele III, and traT genes were significantly more prevalent in ST131 than in ST393 (p values, <0.001). Conclusions: Based on genotyping, it is suggested that epidemic and virulent ciprofloxacin-resistant E. coli clones such as ST131 and ST393 have disseminated in Korea. However, the diversity of CTX-M genes in ST131 isolates may indicate that ESBL genes have been acquired independently or several ESBL-producing, ciprofloxacin-resistant E. coli clones may have disseminated in the Korean community. [Copyright &y& Elsevier]
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- 2010
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21. Changes in the characteristics of community-onset fluoroquinolone-resistant Escherichia coliisolates causing community-acquired acute pyelonephritis in South Korea
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Kim, Bongyoung, Kim, Jeoungyeon, Jo, Hyun-uk, Kwon, Ki Tae, Ryu, Seong-yeol, Wie, Seong-Heon, Kim, Jieun, Park, Se Yoon, Hong, Kyung-Wook, Kim, Hye In, Kim, Hyun ah, Kim, Mi-Hee, Bae, Mi Hyun, Sohn, Yong-Hak, Kim, Jieun, Lee, Yangsoon, and Pai, Hyunjoo
- Abstract
This study aimed to examine the changes in the characteristics of community-onset fluoroquinolone-resistant (FQ-R) Escherichia coliisolates causing community-acquired acute pyelonephritis (APN) in South Korea.
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- 2022
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22. Association of Polymorphisms in Interferon Regulatory Factor 5 Gene with Rheumatoid Arthritis: A Metaanalysis
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HAN, SEUNG WOO, LEE, WON KI, KWON, KI TAE, LEE, BYUNG KI, NAM, EON JEONG, and KIM, GUN WOO
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OBJECTIVE: We investigated potential associations between rheumatoid arthritis (RA) and interferon regulatory factor 5 (IRF5) polymorphisms in a metaanalysis. METHODS: This metaanalysis included 5 case-control studies, which provided a total of 6582 RA cases and 5375 controls. Odds ratios (OR) were employed to evaluate the risk of RA according to the 4 single-nucleotide polymorphisms (SNP) in IRF5 (rs729302, rs2004640, rs752637, and rs2280714) and data were analyzed in respect to association between alleles. RESULTS: Among 4 candidate SNP, rs729302, rs2004640, and rs2280714 were statistically significant; both allele C of rs729302 and allele G of rs2004640 within the promoter region of IRF5 were associated with a protective effect [random-effects (RE) OR 0.889, 95% confidence interval (CI) 0.803–0.977, p = 0.015 for rs729302; and RE OR 0.905, 95% CI 0.848–0.965, p = 0.002 for rs2004640]. Similar results were also obtained in T allele of rs2280714 in the 3’-untranslated region (RE OR 0.927, 95% CI 0.866–0.992, p = 0.029). There was no evidence of publication bias from funnel-plot asymmetry and Egger’s regression test. CONCLUSION: Our metaanalysis supported the evidence of the significant role of IRF5 polymorphisms in RA.
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- 2009
23. SCORING SYSTEMS FOR PREDICTION OF MORTALITY IN PATIENTS WITH INTENSIVE CARE UNIT-ACQUIRED SEPSIS
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Rhee, Ji-Young, Kwon, Ki Tae, Ki, Hyun Kyun, Shin, Sang Yop, Jung, Dong Sik, Chung, Doo-Ryeon, Ha, Byoung-Chun, Peck, Kyong Ran, and Song, Jae-Hoon
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This study compares the effectiveness of the Pitt bacteremia score, the Charlson weighted index of comorbidity, and the Acute Physiology and Chronic Health Evaluation II (APACHE II) scoring systems for the prediction of mortality in intensive care unit (ICU) patients with sepsis using the retrospective observational method on 134 patients with ICU-acquired sepsis. The statistical analyses show several important findings. First, Pitt bacteremia score is significantly correlated with the APACHE II scoring system (correlation coefficient = 0.738, P< 0.001). Second, the APACHE II scoring system, the Pitt bacteremia score, and the Charlson weighted index of comorbidity are independently correlated with mortality. Third, the Pitt bacteremia score and the APACHE II scores are positively related to mortality in patients with ICU-acquired sepsis. As the result of the analyses, the mortality rate in patients with sepsis in the ICU is better predicted with the Pitt bacteremia score because it provides better estimation of sensitivity and specificity than the APACHE II scoring system and the Charlson weighted index of comorbidity.
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- 2009
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24. A Prospective Cohort Study of Durations of Staphylococcus aureusBacteremia According to Different Phenotypes and a New Concept of Persistent Bacteremia
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Kang, Chang Kyung, Song, Kyoung-Ho, Kim, Seong Eun, Kim, Eu Suk, Park, Wan Beom, Park, Kyung-Hwa, Chun, Shin Hye, Lee, Shinwon, Cho, Chong Rae, Kang, Seung Ji, Oh, Myoung-don, Kim, Yeon-Sook, Lee, Sun Hee, Kwak, Yee Gyung, Jang, Hee-Chang, Kim, Chung-Jong, Kim, Young Keun, Bang, Ji-Hwan, Kiem, Sungmin, Kwon, Ki Tae, Jung, Younghee, Kang, Yu Min, Jung, Sook-In, and Kim, Hong Bin
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The purpose of this study was to describe and compare the duration of Staphylococcus aureusbacteremia (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.
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- 2019
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25. Occurrence of Diverse AbGRI1-Type Genomic Islands in Acinetobacter baumanniiGlobal Clone 2 Isolates from South Korea
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Kim, Dae Hun, Jung, Sook-In, Kwon, Ki Tae, and Ko, Kwan Soo
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ABSTRACTIn this study, we analyzed the frequency of the AbGRI1-type genomic island (GI) and its association with genotypes. We obtained 130 Acinetobacter baumanniiisolates causing bloodstream infections from patients in South Korea. Antimicrobial susceptibility testing and multilocus sequence typing were performed. The presence of AbGRI1-type GIs and their structures were determined by sequential PCR and sequencing. Ninety-eight isolates (75.3%) representing 14 sequence types (STs) belonged to clonal complex 208 (CC208), corresponding to global clone 2 (GC2). AbGRI1-type GIs interrupted the comMgene in 107 isolates (82.4%). Four types of GIs were identified: Tn6022(50 isolates; 46.7%), AbaR4 (23 isolates; 21.5%), Tn6166(10 isolates; 9.3%), and Tn6166/Tn2006(24 isolates; 22.4%). In the 50 isolates with Tn6022, Tn2006or Tn2008B, both containing ISAba1-blaOXA-23, was present in sites other than GIs in 3 or 28 isolates, respectively. In the 10 isolates with Tn6166, Tn2008Bwas identified in one isolate. AbGRI1-type GIs were identified nearly exclusively in CC208 isolates, with the exception of nine non-CC208 isolates (AbaR4 in eight ST229 isolates and Tn6022in one ST1244 isolate). Within CC208 isolates, there was evidence of frequent recombination events, in both housekeeping genes and AbGRI1-type GIs, contributing to genotype diversification and the emergence of carbapenem resistance.
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- 2016
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26. An outbreak of Burkholderia cenocepacia associated with contaminated chlorhexidine solutions prepared in the hospital.
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Lee, Shinwon, Han, Seung Woo, Kim, Gunwoo, Song, Do Young, Lee, Je Chul, and Kwon, Ki Tae
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From October to December 2007, an outbreak of Burkholderia cenocepacia occurred in a secondary care hospital. The 19 B cenocepacia isolated from the patients, the chlorhexidine solutions of each different ward, and the purified water that diluted these solutions exhibited an identical pulsed-field gel electrophoresis pattern. Inadequate preparation of chlorhexidine solutions diluted with contaminated purified water may have resulted in an outbreak of B cenocepacia. Adequate preparation of chlorhexidine solutions should be emphasized. [Copyright &y& Elsevier]
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- 2013
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