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This study was conducted to assess emergence of daptomycin-nonsusceptible (DAP-NS) phenotype in DAP-naive patients with invasive Staphylococcus aureus (ISA) infections in Korea. A total of 208 S. aureus clinical isolates were selected from a previous prospective study on ISA infections and evaluated for DAP-NS. Although DAP has never been introduced in Korea, five DAP-NS S. aureus strains (2.4%) were identified among 208 S. aureus strains collected from ISA infections. The DAP-NS phenotype was observed only in methicillin-resistant S. aureus (MRSA) strains, but not in methicillin-susceptible S. aureus strains. One DAP-NS MRSA strain belonged to sequence type 72 (ST72) and four were ST5 MRSA strains, three of which were heteroresistant vancomycin (VAN)-intermediate S. aureus. All these five DAP-NS MRSA strains were from healthcare-associated infections without prior exposure to VAN within 30 days. While the ST72 MRSA strain exhibited DAP-NS phenotype via charge repulsion mechanism, four ST5 DAP-NS S. aureus strains had charge-independent DAP-NS mechanism. None of the five DAP-NS strains displayed significant increase in cell wall thickness, indicating that altered cell wall thickness was not associated with the observed DAP-NS phenotype. [ABSTRACT FROM AUTHOR]

Objective:Ascitic fluid infections (AFI) in cirrhotic patients can be classified into two groups: spontaneous bacterial peritonitis (SBP) and culture-negative neutrocytic ascites (CNNA). The aim of this study was to compare the clinical characteristics and outcomes of the two groups of patients with AFI. Methods:We retrospectively reviewed the medical records of cirrhotic patients with AFI. We evaluated demographic data, clinical presentations of AFI, laboratory findings, liver function, and mortality rates. Results:Between January 2005 and December 2014, 533 patients with AFI were evaluated; 259 (48.6%) had SBP and 274 (51.4%) CNNA. Ascites neutrophil count (4410/mm3versus 1046/mm3,p < .001) and the blood culture positive rate (38.1% versus 20.1%,p < .001) were higher in the SBP group, which also had a higher MELD score (24.29 versus 22.05,p = .004). Seven-day mortality was higher in the SBP group (9.4% versus 4.5%,p = .027) but there was no significant difference in 30-day (22.1% versus 17.5%) or 90-day mortality rate (36.1% versus 36.4%). Conclusions:Patients in the SBP group had a higher MELD score, ascites neutrophil count, and positive blood culture rate. Although seven-day mortality rate was higher in the SBP group, the 30-day and 90-day mortality rates were similar in the two groups. [ABSTRACT FROM PUBLISHER]

A letter to the editor regarding the use of interferon-gamma release assay (IGRA) in the prediction of the development of tuberculosis (TB) in patients with HIV infections in Korea, is presented.

The current study focuses on proposing a double-flash geothermal system with a dual-pressure organic Rankine cycle that utilizes zeotropic mixtures. This system aims to harness the geothermal energy efficiently and sustainably. The performance of the system is evaluated using the exergy, exergoeconomic, and exergoenvironmental approaches, taking into account the utilization of different mass fractions of the R123/R142b mixture. The results of the analysis indicate that the designed system is capable of producing a net power output of 6336.04 kW with an exergetic efficiency of 66.70%. The payback period of the system is estimated to be 3.48 years, indicating its economic viability. Moreover, the electricity sale price has a substantial impact on the system's payback period and revenue, surpassing the influence of the geofluid purchase cost. Through the application of triple-objective optimization scenarios, the best optimum state of the system is determined to achieve a 66.96% exergetic efficiency, 3017.82 mPts/h exergoenvironmental impacts, and a payback period of 3.38 years. Furthermore, this state yields a revenue of 11.1 M$. Overall, the study highlights the potential of the proposed double-flash geothermal system with a dual-pressure organic Rankine cycle utilizing zeotropic mixtures for sustainable power generation. • Proposal of a double-flash binary geothermal system coupled with dual-pressure organic Rankine cycle. • Using zeotropic mixture in dual-pressure organic Rankine cycle for performance enhancement. • Performing energy, exergy, economic, and environmental analyses for performance evaluation. • Application of different muli-objective optimization scenarios using PSO algorithm. • Achieving 66.96% exergetic efficiency with a 3.38 payback period at the optimum state. [ABSTRACT FROM AUTHOR]

The article focuses on description of the Middle East respiratory syndrome coronavirus (MERS-CoV) infection outbreak in South Korea. It states observation of changes in viral loads infections among patients of MERS with increment in mortality of patients. It mentions categorization of the MERS patients under illustration of severe diseases. It highlights on increment in prolonged viral shedding among patients along with respiratory secretions with absence of viral RNA detection.

Background and Objectives : Korean and traditional Chinese medicine state that pyrite is effective for fracture treatment, but supporting clinical data are limited. This systematic review aimed to investigate the therapeutic role of Chinese patent medicine containing pyrite (CPMP) in clinical treatment for fractures. Materials and Methods : Seven electronic databases were searched using the keywords "pyrite", "pyritum", and "zirantong" between inception and December 2022, yielding 29 published clinical studies. Randomized controlled trials that included CPMP were considered eligible regardless of the fracture type. Quality assessment and meta-analysis of the included RCTs were also performed. Results : Most studies showed high heterogeneity (I 2 > 50%) and significant results ( p < 0.05). Compared to the results of the control group, CPMP was more effective in terms of the primary outcome related to the efficacy rate, including the total effective rate, callus growth rate, bone union, and edema disappearance time (all p < 0.00001) and in terms of secondary outcomes related to pain reduction, namely pain intensity and pain disappearance time, than the control group (both p < 0.01). CPMP was more effective than the control group in terms of erythrocyte sedimentation rate ( p < 0.01), hematocrit ( p < 0.01), erythrocyte aggregation ( p < 0.05), and plasma viscosity ( p < 0.05). CPMP did not cause serious side effects, and the incidence of complications was significantly less than that in the control group. Conclusions : CPMP may be a safe and effective alternative treatment for fractures and may be beneficial in preventing postoperative complications, reducing pain, relieving symptoms, and accelerating healing.