50 results on '"Shinhye Cheon"'
Search Results
2. Insidious Onset Multifocal Chest Wall and Spinal Abscess Caused by Previous Candidemia: A Case Report
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Da Eun Kwon, Song Soo Kim, Shinhye Cheon, Jin Hwan Kim, and Hyeyoung Kwon
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abscess ,candidemia ,candida albicans ,computed tomography ,x-ray ,Medical physics. Medical radiology. Nuclear medicine ,R895-920 - Abstract
Abscess formation due to Candida albicans infection is extremely rare. Radiological diagnosis of an atypical abscess at an uncommon site is challenging. In this study, we present a case of insidious onset multifocal chest wall and spinal abscess after candidemia in a young woman in the intensive care unit due to postpartum bleeding.
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- 2023
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3. Dysregulated thrombospondin 1 and miRNA-29a-3p in severe COVID-19
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In Soo Kim, Sung-Gwon Lee, Seul Gi Shin, Hyeongseok Jeong, Kyung Mok Sohn, Ki-Sun Park, Prashanta Silwal, Shinhye Cheon, Jungok Kim, Sungmin Kym, Yeon-Sook Kim, Eun-Kyeong Jo, and Chungoo Park
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Medicine ,Science - Abstract
Abstract Although nearly a fifth of symptomatic COVID-19 patients suffers from severe pulmonary inflammation, the mechanism of developing severe illness is not yet fully understood. To identify significantly altered genes in severe COVID-19, we generated messenger RNA and micro-RNA profiling data of peripheral blood mononuclear cells (PBMCs) from five COVID-19 patients (2 severe and 3 mild patients) and three healthy controls (HC). For further evaluation, two publicly available RNA-Seq datasets (GSE157103 and GSE152418) and one single-cell RNA-Seq dataset (GSE174072) were employed. Based on RNA-Seq datasets, thrombospondin 1 (THBS1) and interleukin-17 receptor A (IL17RA) were significantly upregulated in severe COVID-19 patients’ blood. From single-cell RNA-sequencing data, IL17RA level is increased in monocytes and neutrophils, whereas THBS1 level is mainly increased in the platelets. Moreover, we identified three differentially expressed microRNAs in severe COVID-19 using micro-RNA sequencings. Intriguingly, hsa-miR-29a-3p significantly downregulated in severe COVID-19 was predicted to bind the 3′-untranslated regions of both IL17RA and THBS1 mRNAs. Further validation analysis of our cohort (8 HC, 7 severe and 8 mild patients) showed that THBS1, but not IL17RA, was significantly upregulated, whereas hsa-miR-29a-3p was downregulated, in PBMCs from severe patients. These findings strongly suggest that dysregulated expression of THBS1, IL17RA, and hsa-miR-29a-3p involves severe COVID-19.
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- 2022
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4. Risk factors for early mortality in patients with carbapenem-resistant Acinetobacter baumannii bacteraemia
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Chan Mi Lee, Chung-Jong Kim, Seong Eun Kim, Kyung-Hwa Park, Ji Yun Bae, Hee Jung Choi, Younghee Jung, Seung Soon Lee, Pyoeng Gyun Choe, Wan Beom Park, Eu Suk Kim, Je Eun Song, Yee Gyung Kwak, Sun Hee Lee, Shinwon Lee, Shinhye Cheon, Yeon Sook Kim, Yu Min Kang, Ji Hwan Bang, Sook-In Jung, Kyoung-Ho Song, and Hong Bin Kim
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Bacteraemia ,Carbapenem-resistant Acinetobacter baumannii ,Early mortality ,Risk factor ,Microbiology ,QR1-502 - Abstract
ABSTRACT: Objectives: Although many deaths due to carbapenem-resistant Acinetobacter baumannii (CRAB) bacteraemia occur within a few days after the onset of bacteraemia, risk factors for early mortality (EM) have not been deeply investigated. We aimed to determine the risk factors for EM and the difference between risk factors associated with EM and late mortality (LM) in CRAB bacteraemia. Methods: Clinical information on all patients with CRAB bacteraemia in 10 hospitals during a 1-year period was collected. Among the cases with mortality within 30 days, EM and LM were defined as death within 3 and more than 5 calendar days from the first positive blood culture, respectively. Results: In total, 212 CRAB bacteraemia cases were included in the analysis. Of 122 (57.5%) patients with 30-day mortality, EM was observed in 75 (61.5%) patients and LM in 39 (32.0%) patients. The proportion of severe sepsis or septic shock, Pitt score, and Sequential Organ Failure Assessment (SOFA) score was significantly higher in patients with EM than those with LM. Although urinary tract infection as the site of infection and the severity of illness were independent predictors of LM, only factors representing the severity of illness were independent risk factors for EM. Conclusion: Our results suggest that a large proportion of CRAB bacteraemia with high severity progresses to a rapidly fatal course, regardless of the underlying diseases or source of infection. Further studies might be needed to investigate the microbiological factors associated with CRAB and pathogen-host interaction in patients with EM.
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- 2022
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5. Different clinical characteristics and impact of carbapenem-resistance on outcomes between Acinetobacter baumannii and Pseudomonas aeruginosa bacteraemia: a prospective observational study
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Chan Mi Lee, Young-Jun Kim, Sook-In Jung, Seong Eun Kim, Wan Beom Park, Pyoeng Gyun Choe, Eu Suk Kim, Chung-Jong Kim, Hee Jung Choi, Shinwon Lee, Sun Hee Lee, Younghee Jung, Ji Hwan Bang, Shinhye Cheon, Yee Gyung Kwak, Yu Min Kang, Kyung-Hwa Park, Kyoung-Ho Song, Hong Bin Kim, and The Korea INfectious Diseases (KIND) Study Group
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Medicine ,Science - Abstract
Abstract This study aimed to evaluate the differences in clinical characteristics and impact of carbapenem resistance (CR) on outcomes between Acinetobacter baumannii (Ab) and Pseudomonas aeruginosa (Pa) bacteraemia. We prospectively identified all patients with Ab and Pa bacteraemia in 10 hospitals over 1 year. Treatment failure was defined as all-cause 30-day mortality, persistent bacteraemia, or recurrent bacteraemia within 30 days. We included 304 Ab and 241 Pa bacteraemia cases. CR was detected in 216 patients (71%) with Ab bacteraemia and 55 patients (23%) with Pa bacteraemia. Treatment failure was significantly higher in CR-Ab than in CR-Pa (60.6% vs. 34.5%, P = 0.001). In Ab, severe sepsis or septic shock and high Pitt bacteraemia score were independent risk factors for treatment failure in the inappropriate empirical antibiotics group. In Pa, hospital-acquired infection and high Pitt bacteraemia score were independent risk factors for treatment failure in both groups. CR was an independent risk factor in Ab for treatment failure in both groups, but not in Pa bacteraemia. We demonstrated significant differences in clinical characteristics and impact of CR on clinical outcomes between Ab and Pa bacteraemia, suggesting that different treatment approaches may be needed.
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- 2022
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6. Typhoid fever presenting with gastric ulcer bleeding
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Hong Jae Jeon, Jong Seo Lee, Byung Seok Lee, Seok Hyun Kim, Eaum Seok Lee, Jae Kyu Sung, Hee Seok Moon, Sun Hyung Kang, Hyun Seok Lee, Seongwoo Choi, Heon Sa-Kong, Shinhye Cheon, and Hyuk Soo Eun
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Typhoid fevers ,Salmonella enterica serovar Typhi ,Gastrointestinal hemorrhages ,Gastric ulcer ,Case report ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Abstract Background Enteric fever is a systemic disease caused by Salmonella enterica serovar Typhi or Salmonella enterica serovar Paratyphi, characterized by high fever and abdominal pain. Most patients with enteric fever improve within a few days after antibiotic treatment. However, some patients do not recover as easily and develop fatal life-threatening complications, including intestinal hemorrhage. Lower gastrointestinal bleeding has been reported in 10% of cases. However, upper gastrointestinal bleeding has rarely been reported in patients with enteric fever. We present a case of gastric ulcer hemorrhage caused by enteric fever. Case presentation A 32-year-old woman, complaining of fever lasting four days and right upper quadrant pain and melena that started one day before admission, consulted our hospital. Abdominal computed tomography revealed mild hepatomegaly and gastroscopy revealed multiple active gastric ulcers with flat black hemorrhagic spots. The melena of the patient stopped on the third day. On the fifth admission day, she developed hematochezia. At that time, Salmonella enterica serovar Typhi was isolated from the blood culture. The antibiotic regimen was switched to ceftriaxone. Her hematochezia spontaneously resolved the following day. Finally, the patient was discharged on the 12th admission day without clinical symptoms. However, her fever recurred one month after discharge, and she was readmitted and Salmonella enterica serovar Typhi was confirmed again via blood culture. She was treated with ceftriaxone for one month, and was discharged without complications. Conclusion Our case showed that although rare, active gastric ulcers can develop in patients with enteric fever. Therefore, upper and lower gastrointestinal bleeding should be suspected in patients with enteric fever, especially showing relapsing bacteremia.
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- 2022
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7. The microbiological characteristics of Staphylococcus aureus isolated from patients with native valve infective endocarditis
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Chung-Jong Kim, Kyoung-Ho Song, Pyoeng Gyun Choe, Wan Beom Park, Eu Suk Kim, Kyoung Un Park, Nam Joong Kim, Kyung-Hwa Park, Yee Gyung Kwak, Shinhye Cheon, Hee-Chang Jang, Young Keun Kim, Sun Hee Lee, Sung-Min Kiem, Shinwon Lee, Hong Bin Kim, and Myoung-don Oh
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staphylococcus aureus ,bacteremia ,infective endocarditis ,fibronectin ,single-nucleotide polymorphism ,virulence ,Infectious and parasitic diseases ,RC109-216 - Abstract
The microbiological characteristics of Staphylococcus aureus causing infective endocarditis (IE) have not been investigated thoroughly. We compared the characteristics of S. aureus isolates from patients with and without IE. Cases of S. aureus bacteremia (SAB) were collected from 10 hospitals over 7 years. Cases of native valve IE were matched with non-IE controls according to the following criteria: central-line-associated infection, community-acquired infection, methicillin susceptibility, and if possible, the primary site of infection. Genes coding virulence factors were analyzed using multiplex polymerase chain reactions. Fibrinogen and fibronectin-binding properties were assessed using in vitro binding assays. The fibronectin-binding protein A gene (fnbpA) was sequenced. Of 2,365 cases of SAB, 92 had IE. After matching, 37 pairs of S. aureus isolates from the IE cases and non-IE controls were compared; fnbpA was detected in 91.9% of the IE isolates and 100% of the non-IE isolates (p = 0.24). While the fibrinogen binding ratio was similar (1.07 ± 0.33 vs. 1.08 ± 0.26, p = 0.89), the fibronectin-binding ratio was significantly higher in the IE-group (1.31 ± 0.42 vs. 1.06 ± 0.31, p = 0.01). The proportions of major single-nucleotide polymorphisms in fnbpA were as follows: E652D (2.9% vs. 2.7%), H782Q (65.6% vs. 60.6%), and K786N (65.6% vs. 72.7%). The fibronectin-binding ratio was positively correlated with the number of SNPs present in IE cases (p < 0.001) but not in the non-IE controls (p = 0.124). Fibronectin-binding might play a key role in SAB IE. However, the degree of binding may be mediated by genetic variability between isolates.
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- 2019
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8. Correction to: Typhoid fever presenting with gastric ulcer bleeding
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Hong Jae Jeon, Jong Seo Lee, Byung Seok Lee, Seok Hyun Kim, Eaum Seok Lee, Jae Kyu Sung, Hee Seok Moon, Sun Hyung Kang, Hyun Seok Lee, Seongwoo Choi, Heon Sa-Kong, Shinhye Cheon, and Hyuk Soo Eun
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Diseases of the digestive system. Gastroenterology ,RC799-869 - Published
- 2022
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9. Spread of Mutant Middle East Respiratory Syndrome Coronavirus with Reduced Affinity to Human CD26 during the South Korean Outbreak
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Yuri Kim, Shinhye Cheon, Chan-Ki Min, Kyung Mok Sohn, Ying Jin Kang, Young-Je Cha, Ju-Il Kang, Seong Kyu Han, Na-Young Ha, Gwanghun Kim, Abdimadiyeva Aigerim, Hyun Mu Shin, Myung-Sik Choi, Sanguk Kim, Hyun-Soo Cho, Yeon-Sook Kim, and Nam-Hyuk Cho
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Microbiology ,QR1-502 - Abstract
ABSTRACT The newly emerging Middle East respiratory syndrome coronavirus (MERS-CoV) causes a severe respiratory infection with a high mortality rate (~35%). MERS-CoV has been a global threat due to continuous outbreaks in the Arabian peninsula and international spread by infected travelers since 2012. From May to July 2015, a large outbreak initiated by an infected traveler from the Arabian peninsula swept South Korea and resulted in 186 confirmed cases with 38 deaths (case fatality rate, 20.4%). Here, we show the rapid emergence and spread of a mutant MERS-CoV with reduced affinity to the human CD26 receptor during the South Korean outbreak. We isolated 13 new viral genomes from 14 infected patients treated at a hospital and found that 12 of these genomes possess a point mutation in the receptor-binding domain (RBD) of viral spike (S) protein. Specifically, 11 of these genomes have an I529T mutation in RBD, and 1 has a D510G mutation. Strikingly, both mutations result in reduced affinity of RBD to human CD26 compared to wild-type RBD, as measured by surface plasmon resonance analysis and cellular binding assay. Additionally, pseudotyped virus bearing an I529T mutation in S protein showed reduced entry into host cells compared to virus with wild-type S protein. These unexpected findings suggest that MERS-CoV adaptation during human-to-human spread may be driven by host immunological pressure such as neutralizing antibodies, resulting in reduced affinity to host receptor, and thereby impairs viral fitness and virulence, rather than positive selection for a better affinity to CD26. IMPORTANCE Recently, a large outbreak initiated by an MERS-CoV-infected traveler from the Middle East swept South Korea and resulted in 186 confirmed cases with 38 deaths. This is the largest outbreak outside the Middle East, and it raised strong concerns about the possible emergence of MERS-CoV mutations. Here, we isolated 13 new viral genomes and found that 12 of them possess a point mutation in the receptor-binding domain of viral spike protein, resulting in reduced affinity to the human cognate receptor, CD26, compared to the wild-type virus. These unexpected findings suggest that MERS-CoV adaptation in humans may be driven by host immunological pressure.
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- 2016
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10. Distinctive Dynamics and Functions of the CD4+CD25+FOXP3+ Regulatory T Cell Population in Patients with Severe and Mild COVID-19
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Heejin Nam, June-Young Koh, Jae Hyung Jung, Hyeongseok Jeong, Hye Won Jeong, Shinhye Cheon, Su-Hyung Park, Yeon-Sook Kim, and Eui-Cheol Shin
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Immunology ,Immunology and Allergy - Abstract
Although CD4+CD25+FOXP3+ regulatory T (TREG) cells have been studied in patients with COVID-19, changes in the TREG cell population have not been longitudinally examined during the course of COVID-19. In this study, we longitudinally investigated the quantitative and qualitative changes in the TREG cell population in patients with COVID-19. We found that the frequencies of total TREG cells and CD45RA−FOXP3hi activated TREG cells were significantly increased 15–28 d postsymptom onset in severe patients, but not in mild patients. TREG cells from severe patients exhibited not only increased proliferation but also enhanced apoptosis, suggesting functional derangement of the TREG cell population during severe COVID-19. The suppressive functions of the TREG cell population did not differ between patients with severe versus mild COVID-19. The frequency of TREG cells inversely correlated with SARS-CoV-2–specific cytokine production by CD4+ T cells and their polyfunctionality in patients with mild disease, suggesting that TREG cells are major regulators of virus-specific CD4+ T cell responses during mild COVID-19. However, such correlations were not observed in patients with severe disease. Thus, in this study, we describe distinctive changes in the TREG cell population in patients with severe and mild COVID-19. Our study provides a deep understanding of host immune responses upon SARS-CoV-2 infection in regard to TREG cells.
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- 2023
11. Longevity of seropositivity and neutralizing antibodies in recovered MERS patients: a 5-year follow-up study
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Abdimadiyeva Aigerim, Sang Won Park, Jooyeon Lee, Wan Beom Park, Jeong-Sun Yang, Yeon Sook Kim, Yuri Kim, Hyoree Park, Yen Thi Hai Nguyen, Ji-Young Rhee, Jae-Phil Choi, Nam Hyuk Cho, Shinhye Cheon, Dong-Gyun Lim, Yeonjae Kim, and Uni Park
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0301 basic medicine ,Microbiology (medical) ,Middle East respiratory syndrome coronavirus ,030106 microbiology ,Antibodies, Viral ,medicine.disease_cause ,03 medical and health sciences ,0302 clinical medicine ,Humans ,Medicine ,030212 general & internal medicine ,Seroconversion ,Neutralizing antibody ,biology ,business.industry ,Outbreak ,General Medicine ,medicine.disease ,Antibodies, Neutralizing ,Virology ,Pneumonia ,Titer ,Infectious Diseases ,Spike Glycoprotein, Coronavirus ,Middle East Respiratory Syndrome Coronavirus ,biology.protein ,Middle East respiratory syndrome ,Original Article ,Antibody ,Coronavirus Infections ,business ,Follow-Up Studies - Abstract
Objectives We aimed to assess the longevity of spike-specific antibody responses and neutralizing activity in the plasma of recovered Middle East respiratory syndrome (MERS) patients. Methods We traced the antibody responses and neutralizing activity against MERS coronavirus (MERS-CoV) in peripheral blood samples collected from 70 recovered MERS patients for 5 years after the 2015 MERS outbreak in South Korea. We also measured the half-life of neutralizing antibody titres in the longitudinal specimens. Results The seropositivity rate persisted for up to 4 years (50.7–56.1%), especially in MERS patients who suffered from severe pneumonia, and then decreased (35.9%) in the fifth year. Although the spike-specific antibody responses decreased gradually, the neutralizing antibody titres decreased more rapidly (half-life: 20 months) in 19 participants without showing negative seroconversion during the study period. Only five (26.3%) participants had neutralizing antibody titres greater than 1/1000 of PRNT50, and a high neutralizing antibody titre over 1/5000 was not detected in the participants at five years after infection. Discussion The seropositivity rate of the recovered MERS patients persisted up to 4 years after infection and significantly dropped in the fifth year, whereas the neutralizing antibody titres against MERS-CoV decreased more rapidly and were significantly reduced at 4 years after infection.
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- 2022
12. 1855. Risk factors for early mortality in patients with carbapenem-resistant Acinetobacter baumannii bacteremia
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Chan Mi Lee, Chung-Jong Kim, Seong Eun Kim, Kyung-Hwa Park, Ji Yun Bae, Hee Jung Choi, YoungHee Jung, Seung Soon Lee, Pyoeng Gyun Choe, Wan Beom Park, Eu Suk Kim, Je Eun Song, Yee Gyung Kwak, Sun Hee Lee, Shinwon Lee, Shinhye Cheon, Yeon Sook Kim, Yu Min Kang, Ji Hwan Bang, Sook-In Jung, Kyoung-Ho Song, and Hong Bin Kim
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Infectious Diseases ,Oncology - Abstract
Background Although many deaths due to carbapenem-resistant Acinetobacter baumannii (CRAB) bacteremia occur within a few days after the onset of bacteremia, risk factors for early mortality (EM) have not been deeply investigated. We aimed to determine the risk factors for EM and the difference between risk factors associated with EM and late mortality (LM) in CRAB bacteremia. Methods All patients with CRAB bacteremia in 10 hospitals during a 1-year study period were identified. We prospectively collected patients’ clinical data, including microbiological and demographic data, underlying comorbidities, origin of bacteremia, severity of illness, antibiotic therapy, and mortality. Among the cases with mortality within 30 days, EM and LM were defined as death within 3 and more than 5 calendar days from the first positive blood culture, respectively. Results A total of 212 CRAB bacteremia cases were included in the analysis. Of 122 (57.5%) patients with 30-day mortality, EM was observed in 75 (61.5%) patients and LM in 39 (32.0%) patients. The proportion of severe sepsis or septic shock, Pitt score, and Sequential Organ Failure Assessment (SOFA) score were significantly higher in 30-day deaths than 30-day survivors. These factors of clinical severity were also significantly higher in patients with EM than those with LM. While urinary tract infection as the factor of site of infection and the severity of illness were independent predictors of LM, only factors representing the severity of illness were independent risk factors for EM. Appropriate empirical antibiotic therapy was associated with reduced risk of EM. Conclusion The difference between risk factors for EM and LM was identified in this study. Our data suggest that a large proportion of CRAB bacteremia with high severity progress to a rapidly fatal course, regardless of the underlying diseases or source of infection. Further studies might be needed to investigate the microbiological factors associated with CRAB and pathogen-host interaction in patients with EM. Disclosures All Authors: No reported disclosures.
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- 2022
13. Clinical Characteristics and Risk Factors for Mortality in Critical Coronavirus Disease 2019 Patients 50 Years of Age or Younger During the Delta Wave: Comparison With Patients50 Years in Korea
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Hye Jin Shi, Eliel Nham, Bomi Kim, Eun-Jeong Joo, Hae Suk Cheong, Shin Hee Hong, Miri Hyun, Hyun ah Kim, Sukbin Jang, Ji-Young Rhee, Jungok Kim, Sungmin Kim, Hyun Kyu Cho, Yu Mi Wi, Shinhye Cheon, Yeon-Sook Kim, Seungjin Lim, Hyeri Seok, Sook In Jung, Joong Sik Eom, and Kyong Ran Peck
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Adult ,Male ,SARS-CoV-2 ,COVID-19 ,General Medicine ,Middle Aged ,Hospitalization ,Young Adult ,Age Distribution ,Risk Factors ,Humans ,Female ,Obesity ,Aged - Abstract
Numerous patients around the globe are dying from coronavirus disease 2019 (COVID-19). While age is a known risk factor, risk analysis in the young generation is lacking. The present study aimed to evaluate the clinical features and mortality risk factors in younger patients (≤ 50 years) with a critical case of COVID-19 in comparison with those among older patients (50 years) in Korea.We analyzed the data of adult patients only in critical condition (requiring high flow nasal cannula oxygen therapy or higher respiratory support) hospitalized with PCR-confirmed COVID-19 at 11 hospitals in Korea from July 1, 2021 to November 30, 2021 when the delta variant was a dominant strain. Patients' electronic medical records were reviewed to identify clinical characteristics.During the study period, 448 patients were enrolled. One hundred and forty-two were aged 50 years or younger (the younger group), while 306 were above 50 years of age (the older group). The most common pre-existing conditions in the younger group were diabetes mellitus and hypertension, and 69.7% of the patients had a body mass index (BMI)25 kg/m². Of 142 younger patients, 31 of 142 patients (21.8%, 19 women) did not have these pre-existing conditions. The overall case fatality rate among severity cases was 21.0%, and it differed according to age: 5.6% (n = 8/142) in the younger group, 28.1% in the older group, and 38% in the ≥ 65 years group. Age (odds ratio [OR], 7.902; 95% confidence interval [CI], 2.754-18.181), mechanical ventilation therapy (OR, 17.233; 95% CI, 8.439-35.192), highest creatinine1.5 mg/dL (OR, 17.631; 95% CI, 8.321-37.357), and combined blood stream infection (OR, 7.092; 95% CI, 1.061-18.181) were identified as independent predictors of mortality in total patients. Similar patterns were observed in age-specific analyses, but most results were statistically insignificant in multivariate analysis due to the low number of deaths in the younger group. The full vaccination rate was very low among study population (13.6%), and only three patients were fully vaccinated, with none of the patients who died having been fully vaccinated in the younger group. Seven of eight patients who died had a pre-existing condition or were obese (BMI25 kg/m²), and the one remaining patient died from a secondary infection.About 22% of the patients in the young critical group did not have an underlying disease or obesity, but the rate of obesity (BMI25 kg/m²) was high, with a fatality rate of 5.6%. The full vaccination rate was extremely low compared to the general population of the same age group, showing that non-vaccination has a grave impact on the progression of COVID-19 to a critical condition. The findings of this study highlight the need for measures to prevent critical progression of COVID-19, such as vaccinations and targeting young adults especially having risk factors.
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- 2022
14. Higher Risk for All-cause Mortality of Staphylococcus aureus Bacteremia in Patients with Non-Dialysis Dependent Chronic Kidney Disease
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Shinhye Cheon, Jungok Kim, Yeon Sook Kim, and Kyung Mok Sohn
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medicine.medical_specialty ,medicine.drug_class ,medicine.medical_treatment ,Antibiotics ,urologic and male genital diseases ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Chronic kidney disease ,medicine ,Pharmacology (medical) ,030212 general & internal medicine ,Mortality ,Dialysis ,0303 health sciences ,030306 microbiology ,business.industry ,Hazard ratio ,Retrospective cohort study ,Staphylococcus aureus bacteremia ,medicine.disease ,Confidence interval ,female genital diseases and pregnancy complications ,Infectious Diseases ,Bacteremia ,Original Article ,business ,Kidney disease - Abstract
BACKGROUND Staphylococcus aureus bacteremia (SAB) is a common and serious infection with a high mortality. Patients with chronic kidney disease (CKD) are vulnerable to SAB, but there have been few studies performed on the clinical characteristics and outcomes of SAB in CKD patients stratified by dialysis. We aimed to estimate the all-cause mortality and identify its predictors in patients with CKD. MATERIALS AND METHODS We conducted a retrospective study on the patients with SAB hospitalized in a tertiary care center in Korea between March 2014 and December 2018. Kaplan-Meier analysis was performed to compare all-cause mortality following SAB among patients with non-dialysis dependent CKD (ND-CKD), those receiving dialysis, and those without CKD (non-CKD). The predictors of mortality among CKD patients were analyzed by Cox proportional hazards regression. RESULTS As a total, 278 SAB of 43 ND-CKD (31 males), 58 dialysis (39 males), and 177 non-CKD (112 males) patients were included. The 30-day mortality was 39.5% in ND-CKD, 27.6% in dialysis, and 7.9% in non-CKD patients. The hazard ratio of all-cause mortality following SAB in ND-CKD was 2.335 (95% confidence interval, 1.203 - 4.531; P = 0.003), compared to non-CKD patients. For methicillin-resistant S. aureus bacteremia (MRSAB), the hazard ratio of all-cause mortality in ND-CKD was 2.628 (95% CI, 1.074 - 6.435; P = 0.011), compared to dialysis patients. Appropriate antibiotics
- Published
- 2020
15. Efficacy and Safety of Regdanvimab (CT-P59): A Phase 2/3 Randomized, Double-Blind, Placebo-Controlled Trial in Outpatients With Mild-to-Moderate Coronavirus Disease 2019
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Anca Streinu-Cercel, Oana Săndulescu, Liliana-Lucia Preotescu, Jin Yong Kim, Yeon-Sook Kim, Shinhye Cheon, Young Rock Jang, Sang Joon Lee, Sung Hyun Kim, Ilsung Chang, Jee Hye Suh, Seul Gi Lee, Mi Rim Kim, Da Rae Chung, Han Na Kim, Adrian Streinu-Cercel, and Joong Sik Eom
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Infectious Diseases ,Oncology - Abstract
Background Regdanvimab (CT-P59) is a monoclonal antibody with neutralizing activity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We report on part 1 of a 2-part randomized, placebo-controlled, double-blind study for patients with mild-to-moderate coronavirus disease 2019 (COVID-19). Methods Outpatients with mild-to-moderate COVID-19 received a single dose of regdanvimab 40 mg/kg (n = 100), regdanvimab 80 mg/kg (n = 103), or placebo (n = 104). The primary end points were time to negative conversion of SARS-CoV-2 from nasopharyngeal swab based on quantitative reverse transcription polymerase chain reaction (RT-qPCR) up to day 28 and time to clinical recovery up to day 14. Secondary end points included the proportion of patients requiring hospitalization, oxygen therapy, or mortality due to COVID-19. Results Median (95% CI) time to negative conversion of RT-qPCR was 12.8 (9.0–12.9) days with regdanvimab 40 mg/kg, 11.9 (8.9–12.9) days with regdanvimab 80 mg/kg, and 12.9 (12.7–13.9) days with placebo. Median (95% CI) time to clinical recovery was 5.3 (4.0–6.8) days with regdanvimab 40 mg/kg, 6.2 (5.5–7.9) days with regdanvimab 80 mg/kg, and 8.8 (6.8–11.6) days with placebo. The proportion (95% CI) of patients requiring hospitalization or oxygen therapy was lower with regdanvimab 40 mg/kg (4.0% [1.6%–9.8%]) and regdanvimab 80 mg/kg (4.9% [2.1%–10.9%]) vs placebo (8.7% [4.6%–15.6%]). No serious treatment-emergent adverse events or deaths occurred. Conclusions Regdanvimab showed a trend toward a minor decrease in time to negative conversion of RT-qPCR results compared with placebo and reduced the need for hospitalization and oxygen therapy in patients with mild-to-moderate COVID-19. Clinical trial registration. NCT04602000 and EudraCT 2020-003369-20.
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- 2021
16. Different Clinical Characteristics and Impacts of Carbapenem-Resistance on Outcomes Between Acinetobacter Baumannii and Pseudomonas Aeruginosa Bacteraemia: A Multicentre Prospective Observational Study
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Hee Jung Choi, Hong Bin Kim, Eu Suk Kim, Yu Min Kang, Pyoeng Gyun Choe, Ji Hwan Bang, Kyung Hwa Park, Shinhye Cheon, Younghee Jung, Chan Mi Lee, Shinwon Lee, Seong-Eun Kim, Chung Jong Kim, Sook-In Jung, Wan Beom Park, Young-Jun Kim, Yee Gyung Kwak, Kyoung Ho Song, and Sun Hee Lee
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medicine.medical_specialty ,biology ,Pseudomonas aeruginosa ,business.industry ,Internal medicine ,medicine ,Observational study ,bacterial infections and mycoses ,biology.organism_classification ,medicine.disease_cause ,business ,Acinetobacter baumannii ,Carbapenem resistance - Abstract
Background: Carbapenem-resistance (CR) causes poor clinical outcomes and has limited treatment options. We aim to evaluate the differences in clinical characteristics and impact of carbapenem-resistance on outcomes between Acinetobacter baumannii (ABA) and Pseudomonas aeruginosa (PAE) bacteraemia. Methods: We prospectively identified all patients with ABA and PAE bacteraemia in 10 hospitals over a 1-year period and collected their detailed clinical information. Treatment failure was defined as all-cause 30-day mortality, persistent bacteraemia, or recurrence within 30 days.Results: We included 304 ABA and 241 PAE bacteraemia cases. CR was detected in 216 ABA (71%) and 55 PAE (23%). Treatment failure was significantly higher in CR-ABA than in CR-PAE (60.6% vs. 34.5%, P = 0.001). Multivariate analyses were stratified by patient data according to CR and the appropriateness of empirical therapy. For ABA patients, severe sepsis or septic shock and high Pitt bacteraemia score were independent risk factors for treatment failure in the inappropriate empirical antibiotics group. Pneumonia was a significant risk factor in the appropriate group. For PAE patients, hospital-acquired infection and high Pitt bacteraemia score were independent risk factors for treatment failure in both groups. CR was an independent risk factor in ABA for treatment failure in both the inappropriate (adjusted odds ratio [aOR]: 6.17, 95% confidence interval [CI]: 1.13-33.75, P = 0.036) and appropriate empirical treatment groups (aOR: 4.15, 95% CI: 1.16-14.84, P = 0.029), but not for patients with PAE bacteraemia. Conclusions: We demonstrated significant differences in the clinical characteristics and impact of CR on the clinical outcomes between ABA and PAE bacteraemia. Our findings suggest that different approaches may be needed to treat ABA and PAE bacteraemia.
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- 2021
17. Abnormality in the NK cell population is prolonged in severe COVID-19 patients
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Yeon Sook Kim, Seongjin Choi, Ho-Young Lee, Shinhye Cheon, Hye Won Jeong, Su-Hyung Park, Hyeongseok Jeong, Seongju Jeong, Eui-Soon Kim, Eui-Cheol Shin, and Galam Leem
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Male ,IL-1, interleukin-1 ,STAT3, signal transducer and activator of transcription 3 ,PID, pathway interaction database ,cCD56dim, conventional CD56dimCD16pos ,Cell ,NK cells ,Lymphocyte Activation ,GSVA, gene set variation analysis ,GSEA, gene set enrichment analysis ,Immunology and Allergy ,Longitudinal Studies ,Prospective Studies ,RNA-Seq ,Cytotoxicity ,innate immunity ,COVID-19, coronavirus disease 2019 ,education.field_of_study ,EBV, Epstein-Barr virus ,tp53, tumor protein p53 ,TCPTP, T-cell protein tyrosine phosphatase ,Middle Aged ,Killer Cells, Natural ,medicine.anatomical_structure ,TNFA, tumor necrosis factor alpha ,CRP, C-reactive protein ,cytotoxicity ,KIRs, inhibitory killer-cell immunoglobulin-like receptors ,NK, natural killer ,WBC, white blood cell ,Adult ,PBMC, peripheral blood mononuclear cell ,TIGIT, T cell immunoglobulin and ITIM domain ,uCD56dim, unconventional CD56dimCD16neg ,Immunology ,Population ,HLH, hemophagocytic lymphohistiocytosis ,Peripheral blood mononuclear cell ,SARS-CoV-2, severe acute respiratory syndrome coronavirus 2 ,KEGG, Kyoto Encyclopedia of Genes and Genomes ,Article ,Proinflammatory cytokine ,PPI, protein-protein interaction ,Immune system ,medicine ,Humans ,IFN, interferon ,cCD56bright, conventional CD56brightCD16neg ,education ,ARDS, acute respiratory distress syndrome ,GO, gene ontology ,Hemophagocytic lymphohistiocytosis ,Innate immune system ,business.industry ,SARS-CoV-2 ,ILC, innate lymphoid cells ,RNA-seq, RNA sequencing ,COVID-19 ,medicine.disease ,unconventional CD56dimCD16neg NK cells ,business ,NFKB1, nuclear factor kappa B subunit 1 - Abstract
Background Our understanding of adaptive immune responses in COVID-19 patients is rapidly evolving, but information on the innate immune responses by natural killer (NK) cells is still insufficient. Objective We aimed to examine the phenotypic and functional status of NK cells and their changes during the course of mild and severe COVID-19. Methods We performed RNA sequencing (RNA-seq) and flow cytometric analysis of NK cells from patients with mild and severe COVID-19 at multiple time points in the course of the disease using cryopreserved peripheral blood mononuclear cells (PBMCs). Results In RNA-seq analysis, the NK cells exhibited distinctive features compared to healthy donors, with significant enrichment of pro-inflammatory cytokine-mediated signaling pathways. Intriguingly, we found that the unconventional CD56dimCD16neg (uCD56dim) NK cell population expanded in cryopreserved PBMCs from COVID-19 patients regardless of disease severity, accompanied by decreased NK cell cytotoxicity. The NK cell population was rapidly normalized alongside the disappearance of uCD56dim NK cells and the recovery of NK cell cytotoxicity in mild COVID-19 patients, but this occurred slowly in severe COVID-19 patients. Conclusion The current longitudinal study provides a deep understanding of the NK cell biology in COVID-19., Graphical abstract
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- 2021
18. Impact of high MIC of fluconazole on outcomes of Candida glabrata bloodstream infection: a retrospective multicenter cohort study
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Doo Ryeon Chung, Shinhye Cheon, Hyun Ah Kim, Seong Yeol Ryu, Nam Yong Lee, Ji Yeon Lee, Jae-Hoon Ko, Sun Young Cho, Cheol-In Kang, Young Eun Ha, Kyong Ran Peck, Sook-In Jung, Eun-Jeong Joo, Shin Woo Kim, Jae-Hoon Song, Dong Sik Jung, and Yeon Sook Kim
- Subjects
Male ,0301 basic medicine ,Microbiology (medical) ,medicine.medical_specialty ,Antifungal Agents ,Neutropenia ,030106 microbiology ,Candida glabrata ,Microbial Sensitivity Tests ,Cohort Studies ,03 medical and health sciences ,Minimum inhibitory concentration ,Internal medicine ,Republic of Korea ,Humans ,Medicine ,Fluconazole ,Aged ,Retrospective Studies ,chemistry.chemical_classification ,biology ,business.industry ,Hazard ratio ,Candidiasis ,Retrospective cohort study ,General Medicine ,Middle Aged ,biology.organism_classification ,medicine.disease ,Infectious Diseases ,chemistry ,Azole ,Female ,business ,medicine.drug ,Cohort study - Abstract
To evaluate the impacts of fluconazole minimum inhibitory concentration (MIC) according to primary antifungal agents on Candida glabrata bloodstream infection (BSI), a multicenter retrospective cohort study was conducted in Korea, concerning the time period from January 2010 to February 2016. A total of 197 adult patients with C. glabrata BSI were included in the study, and neutropenia (P = 0.026), APACHE II score (P = 0.004), and fluconazole resistance (HR 3.960, 95% CI 1.395-11.246, P = 0.010) were associated with 30-day mortality in multivariate analysis. In subgroup analysis, fluconazole MIC = 32 μg/mL in the azole-treated group (HR 6.691, 95% CI 1.569-28.542, P = 0.010) and fluconazole MIC ≥ 64 μg/mL in the non-azole-treated group (HR 3.337, 95% CI 1.183-9.411, P = 0.023) showed the highest hazard ratio (HR) for 30-day mortality. Increased fluconazole MIC was associated with poor outcome both in azole- and non-azole-treated patients with C. glabrata BSI.
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- 2018
19. Acute Kidney Injury and Kidney Damage in COVID-19 Patients
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Ki Ryang Na, Jae Wan Jeon, Jungok Kim, Dae Eun Choi, Hyeongseok Jeong, Jae Young Moon, Sungmin Kim, Kang Wook Lee, Hae Ri Kim, Yeon Sook Kim, Kyung Mok Sohn, Young-Rok Ham, and Shinhye Cheon
- Subjects
Male ,medicine.medical_specialty ,Urinalysis ,medicine.medical_treatment ,Pneumonia, Viral ,Renal function ,Kidney Function Tests ,Gastroenterology ,Coronavirus Disease 2019 ,03 medical and health sciences ,chemistry.chemical_compound ,Betacoronavirus ,0302 clinical medicine ,Internal medicine ,Albumins ,Republic of Korea ,medicine ,Albuminuria ,Humans ,030212 general & internal medicine ,Pandemics ,Aged ,Kidney ,Creatinine ,Proteinuria ,medicine.diagnostic_test ,business.industry ,SARS-CoV-2 ,Acute kidney injury ,COVID-19 ,General Medicine ,Acute Kidney Injury ,Middle Aged ,Severe Acute Respiratory Syndrome Coronavirus 2 ,medicine.disease ,medicine.anatomical_structure ,chemistry ,Nephrology ,Female ,Original Article ,Hemodialysis ,medicine.symptom ,business ,Coronavirus Infections ,Glomerular Filtration Rate - Abstract
Background Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. This disease, which is quickly spreading worldwide, has high potential for infection and causes rapid progression of lung lesions, resulting in a high mortality rate. This study aimed to investigate the effects of SARS-CoV-2 infection on renal function in patients with COVID-19. Methods From February 21 to April 24, 2020, 66 patients diagnosed with COVID-19 at Chungnam National University Hospital were analyzed; all patients underwent routine urinalysis and were tested for serum creatinine, urine protein to creatinine ratio (PCR), and urine albumin to creatinine ratio (ACR). Results Acute kidney injury (AKI) occurred in 3 (4.5%) of the 66 patients, and 1 patient with AKI stage 3 underwent hemodialysis. Upon follow-up, all 3 patients recovered normal renal function. Compared with patients with mild COVID-19, AKI (n = 3) occurred in patients with severe COVID-19, of whom both urine PCR and ACR were markedly increased. Conclusion The incidence of AKI was not high in COVID-19 patients. The lower mortality rate in SARS-CoV-2 infection compared with previous Middle East respiratory syndrome and SARS-CoV infections is thought to be associated with a low incidence of dysfunction in organs other than the lungs., Graphical Abstract
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- 2020
20. Poor prognosis of Candida tropicalis among non-albicans candidemia: a retrospective multicenter cohort study, Korea
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Kyong Ran Peck, Ji Yeon Lee, Eun-Jeong Joo, Dong Sik Jung, Shinhye Cheon, Hyun Ah Kim, Shin Woo Kim, Yeon Sook Kim, Sook-In Jung, Sun Young Cho, Jae-Hoon Ko, Cheol-In Kang, Doo Ryeon Chung, Seong Yeol Ryu, and Nam Yong Lee
- Subjects
0301 basic medicine ,Microbiology (medical) ,Male ,medicine.medical_specialty ,Poor prognosis ,Multivariate analysis ,Antifungal Agents ,030106 microbiology ,Candida tropicalis ,Hospitals, University ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Internal medicine ,Republic of Korea ,medicine ,Humans ,030212 general & internal medicine ,APACHE ,Aged ,Candida ,Retrospective Studies ,biology ,business.industry ,C-reactive protein ,Candidemia ,General Medicine ,Middle Aged ,bacterial infections and mycoses ,University hospital ,biology.organism_classification ,Prognosis ,Survival Rate ,Infectious Diseases ,Health evaluation ,Non albicans candida ,biology.protein ,Female ,business ,Cohort study - Abstract
To evaluate clinical features and prognostic factors of non-albicans candidemia, we conducted a retrospective multicenter cohort study at 7 university hospitals in Korea from January 2010 to February 2016. A total of 721 patients with non-albicans candidemia were included in the analysis. C. tropicalis was most commonly identified (36.5%), followed by C. glabrata (27.2%), C. parapsilosis (25.7%), and C. krusei (2.4%). Clinical presentation of C. tropicalis candidemia was most severe with highest median C-reactive protein level (10.1 mg/dL) and Acute Physiology and Chronic Health Evaluation II score (14, both P ≪ 0.05). C. tropicalis showed the highest 14- and 30-day mortality (28.9% and 44.1%). In multivariate analysis, C. tropicalis infection was significantly related with 14- (P = 0.005) and 30-day mortality (P = 0.033). In conclusion, C. tropicalis infection presented most severely and showed worst clinical outcome among non-albicans candidemia.
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- 2019
21. The microbiological characteristics of Staphylococcus aureus isolated from patients with native valve infective endocarditis
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Myoung Don Oh, Kyoung Un Park, Wan Beom Park, Hong Bin Kim, Young Keun Kim, Kyung Hwa Park, Sun Hee Lee, Hee-Chang Jang, Pyoeng Gyun Choe, Nam Joong Kim, Shinhye Cheon, Chung Jong Kim, Eu Suk Kim, Sung min Kiem, Kyoung Ho Song, Yee Gyung Kwak, and Shinwon Lee
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Microbiology (medical) ,staphylococcus aureus ,Immunology ,Virulence ,Biology ,medicine.disease_cause ,Microbiology ,lcsh:Infectious and parasitic diseases ,03 medical and health sciences ,fibronectin ,medicine ,lcsh:RC109-216 ,bacteremia ,030304 developmental biology ,0303 health sciences ,030306 microbiology ,infective endocarditis ,single-nucleotide polymorphism ,medicine.disease ,virulence ,Infectious Diseases ,Staphylococcus aureus ,Native valve ,Infective endocarditis ,Bacteremia ,Parasitology - Abstract
The microbiological characteristics of Staphylococcus aureus causing infective endocarditis (IE) have not been investigated thoroughly. We compared the characteristics of S. aureus isolates from patients with and without IE. Cases of S. aureus bacteremia (SAB) were collected from 10 hospitals over 7 years. Cases of native valve IE were matched with non-IE controls according to the following criteria: central-line-associated infection, community-acquired infection, methicillin susceptibility, and if possible, the primary site of infection. Genes coding virulence factors were analyzed using multiplex polymerase chain reactions. Fibrinogen and fibronectin-binding properties were assessed using in vitro binding assays. The fibronectin-binding protein A gene (fnbpA) was sequenced. Of 2,365 cases of SAB, 92 had IE. After matching, 37 pairs of S. aureus isolates from the IE cases and non-IE controls were compared; fnbpA was detected in 91.9% of the IE isolates and 100% of the non-IE isolates (p = 0.24). While the fibrinogen binding ratio was similar (1.07 ± 0.33 vs. 1.08 ± 0.26, p = 0.89), the fibronectin-binding ratio was significantly higher in the IE-group (1.31 ± 0.42 vs. 1.06 ± 0.31, p = 0.01). The proportions of major single-nucleotide polymorphisms in fnbpA were as follows: E652D (2.9% vs. 2.7%), H782Q (65.6% vs. 60.6%), and K786N (65.6% vs. 72.7%). The fibronectin-binding ratio was positively correlated with the number of SNPs present in IE cases (p < 0.001) but not in the non-IE controls (p = 0.124). Fibronectin-binding might play a key role in SAB IE. However, the degree of binding may be mediated by genetic variability between isolates.
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- 2019
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22. Experimental and Mathematical Optimization of a Pooling Test for Detection of SARS-CoV-2 in a Population with Low Viral Load
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Shinhye Cheon, Yeon Sook Kim, Sungmin Kym, Jungok Kim, Hyeongseok Jeong, Jooyeon Lee, and Kyung Mok Sohn
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Optimization ,Coronavirus disease 2019 (COVID-19) ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Pooling ,Population ,Sample (statistics) ,03 medical and health sciences ,0302 clinical medicine ,Statistics ,Medicine ,Pharmacology (medical) ,030212 general & internal medicine ,education ,Mass screening ,0303 health sciences ,education.field_of_study ,SARS-CoV-2 ,030306 microbiology ,business.industry ,Pool size ,Pooling test ,Test (assessment) ,Infectious Diseases ,Original Article ,business ,Viral load - Abstract
Background: A pooling test is a useful tool for mass screening of coronavirus disease 2019 (COVID-19) in the pandemic era We aimed to optimize a simple two-step pooling test by estimating the optimal pool size using experimental and mathematical validation Materials and Methods: Experimental pools were created by mixing one positive respiratory sample with various numbers of negative samples We selected positive samples with cycle threshold (Ct) values greater than 32 to validate the efficiency of the pooling test assuming a high likelihood of false-negative results due to low viral loads The positivities of the experimental pools were investigated with a single reverse-transcription polymerase chain reaction (RT-PCR) using the U-TOP™ COVID-19 Detection Kit Plus (Seasun Biomaterials, Daejeon, Korea) We used the Dorfman equation to calculate the optimal size of a pooling test mathematically Results: Viral RNA could be detected in a pool with a size up to 11, even if the Ct value of a positive sample was about 35 The Dorfman equation showed that the optimal number of samples in a pool was 11 when the prevalence was assumed to be 0 66% based on the test positivity in Daejeon, Korea from April 1, 2020 to November 10, 2020 The efficiency of the pooling test was 6 2, which can save 83 9 of 100 individual tests Conclusion: Eleven samples in a pool were validated optimal experimentally assuming a prevalence of 0 66% The pool size needs modification as the pandemic progresses;thus, the prevalence should be carefully estimated before pooling tests are conducted Copyright © 2021 by The Korean Society of Infectious Diseases
- Published
- 2021
23. Subdural Empyema Caused by Nontyphoidal Salmonella in a Patient with a Previous Evacuation of Subdural Hematoma
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Seon Hwan Kim, Shinhye Cheon, Min Seong Kim, Yeon Sook Kim, Chang Hun Song, and Kyung Mok Sohn
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Subdural empyema ,medicine.medical_specialty ,Salmonella ,business.industry ,030232 urology & nephrology ,medicine.disease ,medicine.disease_cause ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,Hematoma ,Medicine ,030211 gastroenterology & hepatology ,business - Published
- 2016
24. Outbreaks of Middle East Respiratory Syndrome in Two Hospitals Initiated by a Single Patient in Daejeon, South Korea
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Jung Yeon Heo, Ji Hyun Yoon, Sun Hee Park, Hye Won Jeong, Soo Young Choi, Shinhye Cheon, Younghee Jung, Jacob Lee, Kyung Mok Sohn, Yeon Sook Kim, and Nam Hyuk Cho
- Subjects
0301 basic medicine ,Pediatrics ,medicine.medical_specialty ,2019-20 coronavirus outbreak ,Coronavirus disease 2019 (COVID-19) ,Middle East respiratory syndrome coronavirus ,viruses ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,medicine.disease_cause ,03 medical and health sciences ,Hospital ,0302 clinical medicine ,South Korea ,Medicine ,Pharmacology (medical) ,Daejeon ,030212 general & internal medicine ,business.industry ,Transmission (medicine) ,virus diseases ,Outbreak ,medicine.disease ,Single patient ,030104 developmental biology ,Infectious Diseases ,Superspreading ,Middle East respiratory syndrome ,Original Article ,business ,Middle East Respiratory Syndrome coronavirus - Abstract
Background A Middle East Respiratory Syndrome coronavirus (MERS-CoV) outbreak in South Korea in 2015 started by a single imported case and was amplified by intra- and inter-hospital transmission. We describe two hospital outbreaks of MERS-CoV infection in Daejeon caused by a single patient who was infected by the first Korean case of MERS. Materials and Methods Demographic and clinical information involving MERS cases in the Daejeon cluster were retrospectively collected and potential contacts and exposures were assessed. The incubation periods and serial intervals were estimated. Viral RNAs were extracted from respiratory tract samples obtained from the index case, four secondary cases and one tertiary case from each hospital. The partial S2 domain of the MERS-CoV spike was sequenced. Results In Daejeon, a MERS patient (the index case) was hospitalized at Hospital A in the first week of illness and was transferred to Hospital B because of pneumonia progression in the second week of illness, where he received a bronchoscopic examination and nebulizer therapy. A total of 23 secondary cases (10 in Hospital A and 13 in Hospital B) were detected among patients and caregivers who stayed on the same ward with the index case. There were no secondary cases among healthcare workers. Among close hospital contacts, the secondary attack rate was 15.8% (12/76) in Hospital A and 14.3% (10/70) in Hospital B. However, considering the exposure duration, the incidence rate was higher in Hospital B (7.7/100 exposure-days) than Hospital A (3.4/100 exposure-days). In Hospital B, the median incubation period was shorter (4.6 days vs. 10.8 days), the median time to pneumonia development was faster (3 days vs. 6 days) and mortality was higher (70% vs. 30.8%) than in Hospital A. MERS-CoV isolates from 11 cases formed a single monophyletic clade, with the closest similarity to strains from Riyadh. Conclusion Exposure to the MERS case in the late stage (2nd week) of diseases appeared to increase the risk of transmission and was associated with shorter incubation periods and rapid disease progression among those infected. Early detection and isolation of cases is critical in preventing the spread of MERS in the hospital and decreasing the disease severity among those infected.
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- 2016
25. Vertebral Osteomyelitis due toMycobacterium intracellularein an Immunocompetent Elderly Patient After Vertebroplasty
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Shinhye Cheon, Yeon Sook Kim, Chang Hun Song, Min Seong Kim, Chan Keol Park, and Kyung Mok Sohn
- Subjects
medicine.medical_specialty ,biology ,business.industry ,Osteomyelitis ,Mycobacterium avium-intracellulare infection ,Disease ,medicine.disease ,biology.organism_classification ,Surgery ,03 medical and health sciences ,0302 clinical medicine ,Immunity ,medicine ,Vertebral osteomyelitis ,030211 gastroenterology & hepatology ,Disseminated disease ,Nontuberculous mycobacteria ,business ,030217 neurology & neurosurgery ,Mycobacterium - Abstract
Mycobacterium avium complex (MAC) comprises M. intracellulare and M. avium. MAC usually causes pulmonary diseases in individuals with intact immunity, disseminated disease in patients with acquired immunodeficiency syndrome, and cer- vical lymphadenitis. It can also cause cutaneous disease, but musculoskeletal infection is rare. Herein, we present a case of vertebral osteomyelitis due to M. intracellulare in an elderly immunocompetent patient who underwent vertebroplasty. The patient was successfully treated with antimycobacterial drugs without surgical intervention. MAC should be considered as a causative pathogen of vertebral osteomyelitis when the patient has a history of vertebroplasty.
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- 2016
26. Controlling endemic multidrug-resistant Acinetobacter baumannii in Intensive Care Units using antimicrobial stewardship and infection control
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Seon Jin Yun, Mi Ja Kim, Shinhye Cheon, Jae Young Moon, and Yeon Sook Kim
- Subjects
0301 basic medicine ,medicine.medical_specialty ,Carbapenem ,biology ,Isolation (health care) ,business.industry ,Incidence (epidemiology) ,030106 microbiology ,Odds ratio ,030501 epidemiology ,biology.organism_classification ,Acinetobacter baumannii ,03 medical and health sciences ,Internal medicine ,Intensive care ,medicine ,Infection control ,Antimicrobial stewardship ,0305 other medical science ,Intensive care medicine ,business ,medicine.drug - Abstract
BACKGROUND/AIMS Nosocomial infections caused by multidrug-resistant (MDR) Acinetobacter baumannii have become public-health problem. However, few studies have evaluated the control of endemic MDR A. baumannii in Intensive Care Units (ICUs). Therefore, we investigated the effectiveness of antimicrobial stewardship and comprehensive intensified infection control measures for controlling endemic MDR A. baumannii in ICUs at a tertiary care center. METHODS Carbapenem use was strictly restricted through antimicrobial stewardship. Environmental cleaning and disinfection was performed at least 3 times per day in addition to basic infection control measures. Isolation using plastic curtains and contact precautions were applied to patients who were colonized or infected with MDR A. baumannii. The outcome was measured as the incidence density rate of hospital-onset MDR A. baumannii among patients in the ICUs. RESULTS The incidence density rate of hospital-onset MDR A. baumannii decreased from 22.82 cases per 1,000 patient-days to 2.68 cases per 1,000 patient-days after the interventions were implemented (odds ratio, 0.12; 95% confidence interval, 0.03 to 0.4; p < 0.001). The mean monthly use of carbapenems also decreased from 134.99 ± 82.26 defined daily doses per 1,000 patient-days to 94.85 ± 50.98 defined daily doses per 1,000 patient-days (p = 0.016). CONCLUSIONS Concomitant implementation of strict antimicrobial stewardship and comprehensive infection control measures effectively controlled endemic MDR A. baumannii in our ICUs within 1 year.
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- 2016
27. Impact of antimicrobial treatment duration on outcome of Staphylococcus aureus bacteraemia: a cohort study
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Sungmin Kiem, D.-K. Kim, C.R. Cho, Shinhye Cheon, H.S. Song, J.H. Jeon, Young Ho Lee, Jae-Gook Shin, Wan Beom Park, Hong Bin Kim, Yee Gyung Kwak, Pyeong Gyun Choe, J.I. Park, Hee-Chang Jang, Yongsun Kim, Myoung Don Oh, M.S. Han, Ki-Jeong Park, H.Y. Kim, Myoung Joo Kang, Sook-In Jung, M. Kim, Hyukjae Choi, H.-I. Kim, Nam Joong Kim, Y.J. Choi, Sanghyuk Lee, Chung Jong Kim, Myung Jin Lee, Yeon Sook Kim, Seung-Ji Kang, Eun Sun Kim, Kyoung Ho Song, S.-A. Song, J.E. Cho, Kye-Hyung Kim, Nak Hyun Kim, K.T. Kwon, and Hee Kyoung Choi
- Subjects
0301 basic medicine ,Microbiology (medical) ,Adult ,Male ,medicine.medical_specialty ,Staphylococcus aureus ,Multivariate analysis ,Time Factors ,Adolescent ,medicine.drug_class ,medicine.medical_treatment ,030106 microbiology ,Antibiotics ,Bacteremia ,Prosthesis ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Anti-Infective Agents ,Recurrence ,Internal medicine ,Medicine ,Endocarditis ,Humans ,030212 general & internal medicine ,Prospective Studies ,Aged ,First episode ,Aged, 80 and over ,business.industry ,General Medicine ,Middle Aged ,Staphylococcal Infections ,medicine.disease ,Survival Analysis ,Confidence interval ,Pneumonia ,Infectious Diseases ,Treatment Outcome ,Female ,business ,Cohort study - Abstract
To assess the outcome of Staphylococcus aureus bacteraemia (SAB) according to factors associated with necessity for longer treatment in conjunction with the duration of treatment.We prospectively collected the data of patients with SAB consecutively during 12 to 39 months from 11 hospitals. If multiple episodes of SAB occurred in one patient, only the first episode was enrolled. Factors associated with necessity for longer treatment were defined as follows: persistent bacteraemia, metastatic infection, prosthesis and endocarditis. If any of the factors were present, then the case was defined as longer antibiotic treatment warranted (LW) group; those without any factors were defined as shorter antibiotic treatment sufficient (SS) group. Poor outcome was defined as a composite of 90-day mortality or 30-day recurrence. Duration of antibiotic administration was classified as14 or ≥14 days in the SS group and28 or ≥28 days in the LW group.Among 2098 cases, the outcome was analysed in 1866 cases, of which 591 showed poor outcome. The SS group accounted for 964 cases and the LW group for 852. On multivariate analysis, age over 65 years, pneumonia, higher Sequential Organ Failure Assessment (SOFA) score and chronic liver diseases were risk factors for poor outcome. Administration of antibiotics less than the recommendation was associated with poor outcome, but this significance was observed only in the LW group (adjusted odds ratio = 1.68; 95% confidence interval, 1.00-2.83; p 0.05).Inappropriately short antibiotic treatment was associated with poor outcome in the LW group. Vigilant evaluation for risk factors to determine the duration of treatment may improve the outcome among patients with SAB.
- Published
- 2018
28. Septic Knee Arthritis Caused by Staphylococcus lugdunensis After Intraarticular Injection Therapy
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Shinhye Cheon, Sun Hoe Koo, Yeon Sook Kim, Chang Hun Song, Min Seong Kim, Kyung Mok Sohn, and Yong Bum Joo
- Subjects
Knee arthritis ,medicine.medical_specialty ,biology ,business.industry ,General surgery ,Injection therapy ,Creative commons ,Staphylococcus lugdunensis ,Knee Joint ,biology.organism_classification ,University hospital ,medicine.disease ,Knee prosthesis ,Infectious arthritis ,medicine ,business - Abstract
Copyright©2015 Korean Geriatric Society This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/). ▸Received: April 6, 2015 ▸Revised: April 27, 2015 ▸Accepted: May 8, 2015 Address for correspondence: Kyung Mok Sohn, MD Division of Infectious Diseases, Department of Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, 282 Munhwa-ro, Jung-gu, Daejeon 301-721, Korea Tel: +82-42-280-7126, Fax: +82-42-280-8125 E-mail: medone@cnuh.co.kr 관절 내 주사 치료 후 발생한 Staphylococcus lugdunensis에 의한 화농성 슬관절염
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- 2015
29. Experimental and Mathematical Optimization of a Pooling Test for Detection of SARS-CoV-2 in a Population with Low Viral Load.
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Hyeongseok Jeong, Jooyeon Lee, Shinhye Cheon, Kyung Mok Sohn, Jungok Kim, Sungmin Kym, and Yeon-Sook Kim
- Subjects
COVID-19 ,MATHEMATICAL optimization ,SARS-CoV-2 ,VIRAL load ,POLYMERASE chain reaction - Abstract
Background: A pooling test is a useful tool for mass screening of coronavirus disease 2019 (COVID-19) in the pandemic era. We aimed to optimize a simple two-step pooling test by estimating the optimal pool size using experimental and mathematical validation. Materials and Methods: Experimental pools were created by mixing one positive respiratory sample with various numbers of negative samples. We selected positive samples with cycle threshold (Ct) values greater than 32 to validate the efficiency of the pooling test assuming a high likelihood of false-negative results due to low viral loads. The positivities of the experimental pools were investigated with a single reverse-transcription polymerase chain reaction (RT-PCR) using the U-TOP™ COVID-19 Detection Kit Plus (Seasun Biomaterials, Daejeon, Korea). We used the Dorfman equation to calculate the optimal size of a pooling test mathematically. Results: Viral RNA could be detected in a pool with a size up to 11, even if the Ct value of a positive sample was about 35. The Dorfman equation showed that the optimal number of samples in a pool was 11 when the prevalence was assumed to be 0.66% based on the test positivity in Daejeon, Korea from April 1, 2020 to November 10, 2020. The efficiency of the pooling test was 6.2, which can save 83.9 of 100 individual tests. Conclusion: Eleven samples in a pool were validated optimal experimentally assuming a prevalence of 0.66%. The pool size needs modification as the pandemic progresses; thus, the prevalence should be carefully estimated before pooling tests are conducted. [ABSTRACT FROM AUTHOR]
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- 2021
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30. Evaluation and Clinical Validation of Two Field-Deployable Reverse Transcription-Insulated Isothermal PCR Assays for the Detection of the Middle East Respiratory Syndrome-Coronavirus
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Hwa Tang Thomas Wang, Yun Long Tsai, Shinhye Cheon, Yun Young Go, Pei Yu Alison Lee, Nam Hyuk Cho, Yeon Sook Kim, Hyun Park, Keun Bon Ku, Udeni B. R. Balasuriya, Sangwoo Nam, Meehyein Kim, and Yu Chun Lin
- Subjects
0301 basic medicine ,Middle East respiratory syndrome coronavirus ,Pcr assay ,medicine.disease_cause ,Real-Time Polymerase Chain Reaction ,Article ,Pathology and Forensic Medicine ,03 medical and health sciences ,Republic of Korea ,medicine ,Humans ,business.industry ,Respiratory disease ,Outbreak ,Reverse Transcription ,medicine.disease ,Virology ,Reverse transcriptase ,030104 developmental biology ,Real-time polymerase chain reaction ,Middle East Respiratory Syndrome Coronavirus ,Molecular Medicine ,Sputum ,Middle East respiratory syndrome ,RNA, Viral ,medicine.symptom ,business ,Coronavirus Infections - Abstract
Middle East respiratory syndrome (MERS) is an emerging zoonotic viral respiratory disease that was first identified in Saudi Arabia in 2012. In 2015, the largest MERS outbreak outside of the Middle East region occurred in the Republic of Korea. The rapid nosocomial transmission of MERS-coronavirus (MERS-CoV) in Korean health care settings highlighted the importance and urgent need for a rapid and reliable on-site diagnostic assay to implement effective control and preventive measures. Here, the evaluation and validation of two newly developed reverse transcription–insulated isothermal PCR (RT-iiPCR) methods targeting the ORF1a and upE genes of MERS-CoV are described. Compared with World Health Organization-recommended singleplex real-time quantitative RT-PCR (RT-qPCR) assays, both RT-iiPCR assays had comparable analytical sensitivity for the detection of MERS-CoV RNA in tissue culture fluid and in sputum samples spiked with infectious virus. Furthermore, clinical evaluation was performed with sputum samples collected from subjects with acute and chronic respiratory illnesses, including patients infected with MERS-CoV. The overall agreement values between the two RT-iiPCR assays and the reference RT-qPCR assays were 98.06% (95% CI, 94.43%–100%; κ = 0.96) and 99.03% (95% CI, 95.88%–100%; κ = 0.99) for ORF1a and upE assays, respectively. The ORF1a and upE MERS-CoV RT-iiPCR assays coupled with a field-deployable system provide a platform for a highly sensitive and specific on-site tool for diagnosis of MERS-CoV infections.
- Published
- 2017
31. Vertebral Osteomyelitis caused byBurkholderia cepaciain an Immunocompetent Elderly Patient After Acupuncture
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Shinhye Cheon, Jin-Young Youm, Sun Hoe Koo, Yeon Sook Kim, Ki Dae Kim, Chang Hun Song, and Kyung Mok Sohn
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medicine.medical_specialty ,biology ,business.industry ,Osteomyelitis ,biology.organism_classification ,medicine.disease ,University hospital ,Surgery ,Burkholderia ,Internal medicine ,Acupuncture ,medicine ,Vertebral osteomyelitis ,business ,Elderly patient ,Spondylitis - Abstract
Vertebral Osteomyelitis caused by Burkholderia cepacia in an Immunocompetent Elderly Patient After Acupuncture Ki Dae Kim, MD, Kyung Mok Sohn, MD, Yeon-Sook Kim, MD, Shinhye Cheon, MD, Chang Hun Song, MD, Jin-Young Youm, MD, Sun Hoe Koo, MD Division of Infectious Diseases, Departments of Neurosurgery, and Laboratory Medicine, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea
- Published
- 2014
32. Can Fecal Microbiota Transplantation (FMT) Eradicate Fecal Colonization With Vancomycin-Resistant Enterococci (VRE)?
- Author
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Yeon Sook Kim, Shinhye Cheon, and Kyung Mok Sohn
- Subjects
0301 basic medicine ,Microbiology (medical) ,Epidemiology ,business.industry ,030106 microbiology ,Enterococcus faecium ,Vancomycin-Resistant Enterococci ,Fecal bacteriotherapy ,Fecal Microbiota Transplantation ,Microbiology ,03 medical and health sciences ,Feces ,0302 clinical medicine ,Infectious Diseases ,Treatment Outcome ,Medicine ,Humans ,Colonization ,Female ,030212 general & internal medicine ,business ,Gram-Positive Bacterial Infections ,Aged - Published
- 2016
33. Higher Risk for All-cause Mortality of Staphylococcus aureus Bacteremia in Patients with Non-Dialysis Dependent Chronic Kidney Disease.
- Author
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Yeon-Sook Kim, Jungok Kim, Shinhye Cheon, and Kyung Mok Sohn
- Subjects
ERYTHROPOIETIN receptors ,CHRONIC kidney failure ,STAPHYLOCOCCUS aureus ,BACTEREMIA ,MORTALITY ,HEMODIALYSIS patients - Abstract
Background: Staphylococcus aureus bacteremia (SAB) is a common and serious infection with a high mortality. Patients with chronic kidney disease (CKD) are vulnerable to SAB, but there have been few studies performed on the clinical characteristics and outcomes of SAB in CKD patients stratified by dialysis. We aimed to estimate the all-cause mortality and identify its predictors in patients with CKD. Materials and Methods: We conducted a retrospective study on the patients with SAB hospitalized in a tertiary care center in Korea between March 2014 and December 2018. Kaplan-Meier analysis was performed to compare all-cause mortality following SAB among patients with non-dialysis dependent CKD (ND-CKD), those receiving dialysis, and those without CKD (non-CKD). The predictors of mortality among CKD patients were analyzed by Cox proportional hazards regression. Results: As a total, 278 SAB of 43 ND-CKD (31 males), 58 dialysis (39 males), and 177 non- CKD (112 males) patients were included. The 30-day mortality was 39.5% in ND-CKD, 27.6% in dialysis, and 7.9% in non-CKD patients. The hazard ratio of all-cause mortality following SAB in ND-CKD was 2.335 (95% confidence interval, 1.203 - 4.531; P = 0.003), compared to non-CKD patients. For methicillin-resistant S. aureus bacteremia (MRSAB), the hazard ratio of all-cause mortality in ND-CKD was 2.628 (95% CI, 1.074 - 6.435; P = 0.011), compared to dialysis patients. Appropriate antibiotics <48 h was independently related to improved survival following SAB among ND-CKD (adjusted HR, 0.304; 95% CI, 0,108 - 0.857; P = 0.024) and dialysis (adjusted HR, 0.323; 95% CI, 0,116 - 0.897; P = 0.030) patients. Conclusion: ND-CKD patients demonstrated poor outcome following SAB and administration of appropriate antibiotics within 48 h could reduce the risk for mortality. [ABSTRACT FROM AUTHOR]
- Published
- 2020
- Full Text
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34. Catheter-related bacteremia caused by Kocuria salsicia: The first case
- Author
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Jin-Yang Baek, Kyung Mok Sohn, So Hyun Kim, Shinhye Cheon, and Yeon Sook Kim
- Subjects
Microbiology (medical) ,Micrococcaceae ,Bacteremia ,Microbial Sensitivity Tests ,Catheter related bacteremia ,Microbiology ,Vancomycin ,medicine ,Humans ,Pharmacology (medical) ,Aged ,biology ,business.industry ,medicine.disease ,Short bowel syndrome ,biology.organism_classification ,Kocuria salsicia ,Anti-Bacterial Agents ,Kocuria ,Catheter ,Infectious Diseases ,Catheter-Related Infections ,Female ,business ,Actinomycetales Infections ,medicine.drug - Abstract
We report the first case of catheter-related bacteremia caused by Kocuria salsicia in a patient with short bowel syndrome. The pathogen was initially identified as Kocuria varians by a Vitek 2-based assessment, but its 16S rRNA gene sequence showed 100% similarity to K. salsicia. The patient was successfully treated with vancomycin and removal of the catheter.
- Published
- 2015
35. Comparative and kinetic analysis of viral shedding and immunological responses in MERS patients representing a broad spectrum of disease severity
- Author
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Abdimadiyeva Aigerim, Kyung Mok Sohn, Shinhye Cheon, Ji Yeob Choi, Kyung-Soo Inn, Jae Young Moon, Yeon Sook Kim, Chan Ki Min, Yuri Kim, Hyun Mu Shin, Na Young Ha, Nam Hyuk Cho, Jin Hwan Kim, and Myung Sik Choi
- Subjects
0301 basic medicine ,Adult ,Male ,Middle East respiratory syndrome coronavirus ,Leukocytosis ,Lymphocyte ,medicine.disease_cause ,Severity of Illness Index ,Article ,03 medical and health sciences ,Immunity ,Lymphopenia ,Severity of illness ,Medicine ,Humans ,Viral shedding ,Aged ,Aged, 80 and over ,Multidisciplinary ,Epidermal Growth Factor ,business.industry ,Pneumonia ,Middle Aged ,Viral Load ,medicine.disease ,Thrombocytopenia ,Virus Shedding ,Kinetics ,030104 developmental biology ,medicine.anatomical_structure ,Immunology ,Middle East Respiratory Syndrome Coronavirus ,Cytokines ,Female ,medicine.symptom ,business ,Coronavirus Infections ,Viral load - Abstract
Despite the ongoing spread of MERS, there is limited knowledge of the factors affecting its severity and outcomes. We analyzed clinical data and specimens from fourteen MERS patients treated in a hospital who collectively represent a wide spectrum of disease severity, ranging from mild febrile illness to fatal pneumonia, and classified the patients into four groups based on severity and mortality. Comparative and kinetic analyses revealed that high viral loads, weak antibody responses, and lymphopenia accompanying thrombocytopenia were associated with disease mortality, whereas persistent and gradual increases in lymphocyte responses might be required for effective immunity against MERS-CoV infection. Leukocytosis, primarily due to increased neutrophils and monocytes, was generally observed in more severe and fatal cases. The blood levels of cytokines such as IL-10, IL-15, TGF-β, and EGF were either positively or negatively correlated with disease mortality. Robust induction of various chemokines with differential kinetics was more prominent in patients that recovered from pneumonia than in patients with mild febrile illness or deceased patients. The correlation of the virological and immunological responses with disease severity and mortality, as well as their responses to current antiviral therapy, may have prognostic significance during the early phase of MERS.
- Published
- 2016
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36. Spread of Mutant Middle East Respiratory Syndrome Coronavirus with Reduced Affinity to Human CD26 during the South Korean Outbreak
- Author
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Chan Ki Min, Hyun Soo Cho, Na Young Ha, Young Je Cha, Abdimadiyeva Aigerim, Yeon Sook Kim, Nam Hyuk Cho, Yuri Kim, Sanguk Kim, Seong Kyu Han, Hyun Mu Shin, Gwanghun Kim, Shinhye Cheon, Kyung Mok Sohn, Ying Jin Kang, Myung Sik Choi, and Ju Il Kang
- Subjects
0301 basic medicine ,Middle East respiratory syndrome coronavirus ,Dipeptidyl Peptidase 4 ,viruses ,Adaptation, Biological ,Mutation, Missense ,Virus Attachment ,Genome, Viral ,Biology ,medicine.disease_cause ,Microbiology ,Virus ,Disease Outbreaks ,03 medical and health sciences ,Virology ,Republic of Korea ,medicine ,Missense mutation ,Humans ,Point Mutation ,Selection, Genetic ,Mutation ,Point mutation ,Outbreak ,Respiratory infection ,Sequence Analysis, DNA ,Surface Plasmon Resonance ,Entry into host ,QR1-502 ,030104 developmental biology ,Spike Glycoprotein, Coronavirus ,Middle East Respiratory Syndrome Coronavirus ,Receptors, Virus ,Mutant Proteins ,Coronavirus Infections ,Protein Binding ,Research Article - Abstract
The newly emerging Middle East respiratory syndrome coronavirus (MERS-CoV) causes a severe respiratory infection with a high mortality rate (~35%). MERS-CoV has been a global threat due to continuous outbreaks in the Arabian peninsula and international spread by infected travelers since 2012. From May to July 2015, a large outbreak initiated by an infected traveler from the Arabian peninsula swept South Korea and resulted in 186 confirmed cases with 38 deaths (case fatality rate, 20.4%). Here, we show the rapid emergence and spread of a mutant MERS-CoV with reduced affinity to the human CD26 receptor during the South Korean outbreak. We isolated 13 new viral genomes from 14 infected patients treated at a hospital and found that 12 of these genomes possess a point mutation in the receptor-binding domain (RBD) of viral spike (S) protein. Specifically, 11 of these genomes have an I529T mutation in RBD, and 1 has a D510G mutation. Strikingly, both mutations result in reduced affinity of RBD to human CD26 compared to wild-type RBD, as measured by surface plasmon resonance analysis and cellular binding assay. Additionally, pseudotyped virus bearing an I529T mutation in S protein showed reduced entry into host cells compared to virus with wild-type S protein. These unexpected findings suggest that MERS-CoV adaptation during human-to-human spread may be driven by host immunological pressure such as neutralizing antibodies, resulting in reduced affinity to host receptor, and thereby impairs viral fitness and virulence, rather than positive selection for a better affinity to CD26., IMPORTANCE Recently, a large outbreak initiated by an MERS-CoV-infected traveler from the Middle East swept South Korea and resulted in 186 confirmed cases with 38 deaths. This is the largest outbreak outside the Middle East, and it raised strong concerns about the possible emergence of MERS-CoV mutations. Here, we isolated 13 new viral genomes and found that 12 of them possess a point mutation in the receptor-binding domain of viral spike protein, resulting in reduced affinity to the human cognate receptor, CD26, compared to the wild-type virus. These unexpected findings suggest that MERS-CoV adaptation in humans may be driven by host immunological pressure.
- Published
- 2016
37. Controlling endemic multidrug-resistant Acinetobacter baumannii in Intensive Care Units using antimicrobial stewardship and infection control
- Author
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Shinhye, Cheon, Mi-Ja, Kim, Seon-Jin, Yun, Jae Young, Moon, and Yeon-Sook, Kim
- Subjects
Acinetobacter baumannii ,Cross Infection ,Chi-Square Distribution ,Time Factors ,Endemic Diseases ,Incidence ,Infection control ,Microbial Sensitivity Tests ,Antimicrobial stewardship ,Anti-Bacterial Agents ,Disinfection ,Patient Isolation ,Tertiary Care Centers ,Treatment Outcome ,Infectious Diseases ,Carbapenems ,Risk Factors ,Drug Resistance, Multiple, Bacterial ,Republic of Korea ,Odds Ratio ,Humans ,Original Article ,Acinetobacter Infections ,Hand Disinfection ,Program Evaluation - Abstract
Background/Aims: Nosocomial infections caused by multidrug-resistant (MDR) Acinetobacter baumannii have become public-health problem. However, few studies have evaluated the control of endemic MDR A. baumannii in Intensive Care Units (ICUs). Therefore, we investigated the effectiveness of antimicrobial stewardship and comprehensive intensified infection control measures for controlling endemic MDR A. baumannii in ICUs at a tertiary care center. Methods: Carbapenem use was strictly restricted through antimicrobial stewardship. Environmental cleaning and disinfection was performed at least 3 times per day in addition to basic infection control measures. Isolation using plastic curtains and contact precautions were applied to patients who were colonized or infected with MDR A. baumannii. The outcome was measured as the incidence density rate of hospital-onset MDR A. baumannii among patients in the ICUs. Results: The incidence density rate of hospital-onset MDR A. baumannii decreased from 22.82 cases per 1,000 patient-days to 2.68 cases per 1,000 patient-days after the interventions were implemented (odds ratio, 0.12; 95% confidence interval, 0.03 to 0.4; p < 0.001). The mean monthly use of carbapenems also decreased from 134.99 ± 82.26 defined daily doses per 1,000 patient-days to 94.85 ± 50.98 defined daily doses per 1,000 patient-days (p = 0.016). Conclusions: Concomitant implementation of strict antimicrobial stewardship and comprehensive infection control measures effectively controlled endemic MDR A. baumannii in our ICUs within 1 year.
- Published
- 2015
38. Disseminated Aspergillosis in the Immunocompetent Host: A Case Report and Literature Review
- Author
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Hong Bin Kim, Se Joon Woo, Eu Suk Kim, Kyoung Ho Song, Min Kyu Yang, Kyoung Un Park, Taek Soo Kim, Chung Jong Kim, and Shinhye Cheon
- Subjects
Male ,medicine.medical_specialty ,Poor prognosis ,Antifungal Agents ,Veterinary (miscellaneous) ,Applied Microbiology and Biotechnology ,Microbiology ,Medical microbiology ,Endophthalmitis ,Medicine ,Aspergillosis ,Humans ,In patient ,Spondylitis ,Aged ,Aspergillus ,biology ,Lung Diseases, Fungal ,business.industry ,medicine.disease ,biology.organism_classification ,Disseminated aspergillosis ,Pneumonia ,Treatment Outcome ,Immunology ,business ,Agronomy and Crop Science - Abstract
Disseminated aspergillosis is very rare in immunocompetent hosts and is typically associated with a poor prognosis. We describe the case of a 66-year-old, immunocompetent man who developed pneumonia, endophthalmitis and probable spondylitis caused by Aspergillus species. The patient was successfully treated with antifungal drugs. We reviewed the English-language literature between 1980 and 2012 for disseminated aspergillosis cases in immunocompetent hosts, using the keywords “dissemin*” and “aspergillo*.” Disseminated aspergillosis in immunocompetent hosts is very rare in the literature. However, awareness of possible dissemination of Aspergillus spp. is necessary in patients who have a probable lung lesion and in cases with unusual presentation of a disseminated infection, even if the patient has no risk factors.
- Published
- 2015
39. Inappropriate continued empirical vancomycin use in a hospital with a high prevalence of methicillin-resistant Staphylococcus aureus
- Author
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Nak-Hyun, Kim, Hei Lim, Koo, Pyoeng Gyun, Choe, Pyeong Gyun, Choe, Shinhye, Cheon, Moonsuk, Kim, Moon Suk, Kim, Myung Jin, Lee, Younghee, Jung, Young Hee, Jung, Wan Beom, Park, Kyoung-Ho, Song, Eu Suk, Kim, Ji Hwan, Bang, Hong Bin, Kim, Sang Won, Park, Nam Joong, Kim, Myoung-don, Oh, and Eui Chong, Kim
- Subjects
Male ,Methicillin-Resistant Staphylococcus aureus ,Pediatrics ,medicine.medical_specialty ,Clinical Therapeutics ,Logistic regression ,medicine.disease_cause ,Risk Factors ,Vancomycin ,medicine ,Prevalence ,Humans ,Pharmacology (medical) ,Medical prescription ,Retrospective Studies ,Pharmacology ,business.industry ,Medical record ,Retrospective cohort study ,Odds ratio ,Methicillin-resistant Staphylococcus aureus ,Confidence interval ,Anti-Bacterial Agents ,Infectious Diseases ,Logistic Models ,Female ,Erratum ,business ,medicine.drug - Abstract
Vancomycin is frequently inappropriately prescribed, especially as empirical treatment. The aim of this study was to evaluate (i) the amount of inappropriate continued empirical vancomycin use as a proportion of total vancomycin use and (ii) the risk factors associated with inappropriate continued empirical vancomycin use. We reviewed the medical records of adult patients who had been prescribed at least one dose of parenterally administered vancomycin between January and June 2012, in a single tertiary care hospital. When empirically prescribed vancomycin treatment was continued after 96 h without documentation of beta-lactam-resistant Gram-positive microorganisms in clinical specimens with significance, the continuation was considered inappropriate, and the amount used thereafter was considered inappropriately used. We identified risk factors associated with inappropriate continued empirical vancomycin use by multiple logistic regression. During the study period, the amount of parenterally administered vancomycin prescribed was 34.2 defined daily doses (DDDs)/1,000 patient-days (1,084 prescriptions for 971 patients). The amount of inappropriate continued empirical vancomycin use was 8.5 DDDs/1,000 patient-days, which represented 24.9% of the total parenterally administered vancomycin used (8.5/34.2 DDDs/1,000 patient-days). By multivariate analyses, inappropriate continued empirical vancomycin use was independently associated with the absence of any documented etiological organism (adjusted odds ratio [aOR], 1.60 [95% confidence interval {CI}, 1.06 to 2.41]) and suspected central nervous system (CNS) infections (aHR, 2.33 [95% CI, 1.20 to 4.50]). Higher Charlson's comorbidity index scores were inversely associated with inappropriate continued empirical vancomycin use (aHR, 0.90 [95% CI, 0.85 to 0.97]). Inappropriate continued empirical vancomycin use represented 24.9% of the total amount of vancomycin prescribed, which indicates room for improvement.
- Published
- 2014
40. Long-term Respiratory Complication in Patients with Middle East Respiratory Syndrome: 1-year Follow-up After the 2015 Outbreak in South Korea
- Author
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Gayeon Kim, Ji-Young Rhee, Yeonjae Kim, Jae-Phil Choi, Nam Joong Kim, Kang Il Jun, Myoung Don Oh, Ji Whan Bang, Pyeong Gyun Choe, Joon-Sung Joh, Shinhye Cheon, Hyoung Shik Shin, Yeon Sook Kim, Dong-Gyun Lim, Bum Sik Chin, J. Park, Sang Won Park, and Wan Beom Park
- Subjects
medicine.medical_specialty ,business.industry ,Atelectasis ,Poster Abstract ,medicine.disease ,respiratory tract diseases ,030218 nuclear medicine & medical imaging ,Pulmonary function testing ,Abstracts ,03 medical and health sciences ,Pneumonia ,FEV1/FVC ratio ,0302 clinical medicine ,Infectious Diseases ,Oncology ,DLCO ,030220 oncology & carcinogenesis ,Diffusing capacity ,Internal medicine ,Medicine ,Middle East respiratory syndrome ,Respiratory function ,business - Abstract
Background: There are few data about long-term respiratory complications following Middle East Respiratory Syndrome coronavirus (MERS-CoV) infection This study aimed to evaluate respiratory functions and radiologic sequelae according to the severity of infection one year after the patients experienced MERS-CoV infection Methods: A total of 73 patients undergoing MERS-CoV infection during the 2015 MERS outbreak in South Korea were enrolled in this prospective multicenter study Pulmonary function tests and 6-minute walking tests were performed 1 year after infection Radiologic sequelae was defined as fibrosis or atelectasis on chest computer tomography and severe pneumonia was defined as that requiring oxygen therapy Multivariate linear regression tests were used to evaluate the effect of infection severity on respiratory function Results: At the time of MERS-CoV infection, 18 patients had no pneumonia, 35 experienced mild pneumonia, and 20 did severe pneumonia The median age was not different between groups (P = 0 942) Forced vital capacity (FVC) was 102 6%, 94 9%, and 88 7% in the no, mild, and severe pneumonia group, respectively (P = 0 010) and forced expiratory volume in 1 second was 105 3%, 95 7%, and 91 7% (P = 0 057) Diffusing capacity (DLCO) was significantly lower in the severe pneumonia group than in the no or mild pneumonia group (78 3% vs 89 4% or 88 6%, P = 0 035) In multivariate analyses, FVC and DLCO were significantly correlated with infection severity after adjustment with age, sex, underlying lung disease, and smoking There was no difference in the walking distance of 6 minute tests between groups Radiologic sequelae were shown in 18 8%, 65 6%, and 100% in the no, mild, and severe pneumonia group, respectively (P < 0 001) Conclusion: The patients with more severe pneumonia by MERS-CoV had more impaired respiratory function in one year follow-up, which was compatible with radiologic sequelae Disclosures: All authors: No reported disclosures FAU - Il Jun, Kang
- Published
- 2017
41. Ocular infection associated with Delftia lacustris: first report
- Author
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Sun Hoe Koo, Jin-Yang Baek, Yeon Sook Kim, Shinhye Cheon, and Kyung Mok Sohn
- Subjects
Microbiology (medical) ,Medicine(all) ,Infectious Diseases ,biology ,lcsh:QR1-502 ,lcsh:RC109-216 ,Delftia lacustris ,biology.organism_classification ,lcsh:Microbiology ,lcsh:Infectious and parasitic diseases ,Microbiology - Published
- 2015
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42. Erratum for Kim et al., Inappropriate Continued Empirical Vancomycin Use in a Hospital with a High Prevalence of Methicillin-Resistant Staphylococcus aureus
- Author
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Nak Hyun Kim, Kyoung Ho Song, Myoung Don Oh, Shinhye Cheon, Eui Chong Kim, Ji Hwan Bang, Sang Won Park, Wan Beom Park, Eu Suk Kim, Myung Jin Lee, Moonsuk Kim, Hei Lim Koo, Hong Bin Kim, Younghee Jung, Pyoeng Gyun Choe, and Nam Joong Kim
- Subjects
Pharmacology ,medicine.medical_specialty ,business.industry ,virus diseases ,medicine.disease_cause ,University hospital ,Methicillin-resistant Staphylococcus aureus ,humanities ,eye diseases ,Infectious Diseases ,Family medicine ,Medicine ,Vancomycin ,Pharmacology (medical) ,business ,medicine.drug - Abstract
Nak-Hyun Kim, Hei Lim Koo, Pyoeng Gyun Choe, Shinhye Cheon, Moonsuk Kim, Myung Jin Lee, Younghee Jung, Wan Beom Park, Kyoung-Ho Song, Eu Suk Kim, Ji Hwan Bang, Hong Bin Kim, Sang Won Park, Nam Joong Kim, Myoung-don Oh, Eui Chong Kim Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Infection Control Service, Seoul National University Hospital, Seoul, Republic of Korea; Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
- Published
- 2015
43. Benign Lymphoepithelial Cyst of the Parotid Gland as an Initial Manifestation of Human Immunodeficiency Virus Infection
- Author
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Shinhye Cheon, Younghee Jung, Nam Joong Kim, Myoung J. Lee, Eun-young Nam, Moonsuk Kim, and Sun Hee Na
- Subjects
Pathology ,medicine.medical_specialty ,medicine.anatomical_structure ,business.industry ,medicine ,Human immunodeficiency virus (HIV) ,Cyst ,Lymphoepithelial cyst ,medicine.disease_cause ,business ,medicine.disease ,Virology ,Parotid gland - Published
- 2015
44. Outbreaks of Middle East Respiratory Syndrome in Two Hospitals Initiated by a Single Patient in Daejeon, South Korea.
- Author
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Sun Hee Park, Yeon-Sook Kim, Younghee Jung, Soo young Choi, Nam-Hyuk Cho, Hye Won Jeong, Jung Yeon Heo, Ji Hyun Yoon, Jacob Lee, Shinhye Cheon, and Kyung Mok Sohn
- Subjects
MIDDLE East respiratory syndrome transmission ,MERS coronavirus ,DISEASE outbreaks ,PNEUMONIA ,DISEASE progression - Abstract
Background: A Middle East Respiratory Syndrome coronavirus (MERS-CoV) outbreak in South Korea in 2015 started by a single imported case and was amplified by intra- and inter-hospital transmission. We describe two hospital outbreaks of MERS-CoV infection in Daejeon caused by a single patient who was infected by the first Korean case of MERS. Materials and Methods: Demographic and clinical information involving MERS cases in the Daejeon cluster were retrospectively collected and potential contacts and exposures were assessed. The incubation periods and serial intervals were estimated. Viral RNAs were extracted from respiratory tract samples obtained from the index case, four secondary cases and one tertiary case from each hospital. The partial S2 domain of the MERS-CoV spike was sequenced. Results: In Daejeon, a MERS patient (the index case) was hospitalized at Hospital A in the first week of illness and was transferred to Hospital B because of pneumonia progression in the second week of illness, where he received a bronchoscopic examination and nebulizer therapy. A total of 23 secondary cases (10 in Hospital A and 13 in Hospital B) were detected among patients and caregivers who stayed on the same ward with the index case. There were no secondary cases among healthcare workers. Among close hospital contacts, the secondary attack rate was 15.8% (12/76) in Hospital A and 14.3% (10/70) in Hospital B. However, considering the exposure duration, the incidence rate was higher in Hospital B (7.7/100 exposure-days) than Hospital A (3.4/100 exposure-days). In Hospital B, the median incubation period was shorter (4.6 days vs. 10.8 days), the median time to pneumonia development was faster (3 days vs. 6 days) and mortality was higher (70% vs. 30.8%) than in Hospital A. MERS-CoV isolates from 11 cases formed a single monophyletic clade, with the closest similarity to strains from Riyadh. Conclusion: Exposure to the MERS case in the late stage (2nd week) of diseases appeared to increase the risk of transmission and was associated with shorter incubation periods and rapid disease progression among those infected. Early detection and isolation of cases is critical in preventing the spread of MERS in the hospital and decreasing the disease severity among those infected. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
45. Pseudomonas aeruginosa bacteremia in patients with liver cirrhosis: a comparison with bacteremia caused by Enterobacteriaceae
- Author
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Ji Hwan Bang, Myoung Don Oh, Shinhye Cheon, Kyung Ho Song, Pyeong Gyun Choe, Eu Suk Kim, Wan Beom Park, Sang Won Park, Hyo-Suk Lee, Nam Joong Kim, Chung Jong Kim, Hong Bin Kim, and Younghee Jung
- Subjects
Adult ,Liver Cirrhosis ,Male ,medicine.medical_specialty ,Cirrhosis ,medicine.drug_class ,Antibiotics ,Bacteremia ,Biology ,medicine.disease_cause ,Gastroenterology ,Biliary disease ,Enterobacteriaceae ,Risk Factors ,Internal medicine ,medicine ,Odds Ratio ,Humans ,Pseudomonas Infections ,Aged ,Pseudomonas aeruginosa ,Case-control study ,Enterobacteriaceae Infections ,Odds ratio ,Middle Aged ,medicine.disease ,Confidence interval ,Anti-Bacterial Agents ,Infectious Diseases ,Treatment Outcome ,Case-Control Studies ,Immunology ,Multivariate Analysis ,Female ,Research Article - Abstract
Background This study was performed to detect risk factors for Pseudomonas aeruginosa bacteremia in patients with liver cirrhosis. Methods A retrospective case–control study was designed to identify risk factors for P. aeruginosa bacteremia in cirrhotic patients. The cases were cirrhotic patients with P. aeruginosa bacteremia and the controls were cirrhotic patients with Enterobacteriaceae bacteremia. Results Sixty-one cases and the same number of controls were enrolled. In a multivariate analysis, younger age {adjusted odds ratio (aOR) per one year: 0.96, 95% confidence interval: 0.93 - 0.99}, nosocomial acquisition (aOR 3.87, 95% confidence interval: 1.50 - 9.94), preexisting biliary disease (aOR 4.79, 95% confidence interval: 1.92 - 10.47), and recent exposure to immunosuppressive agent (aOR 3.10, 95% confidence interval: 1.23 - 7.82) were associated with P. aeruginosa bacteremia. In the case group the frequency of appropriate initial antibiotic regimens was considerably lower than in the control group: 29.5% vs. 65.6% (P Conclusions Nosocomial acquisition, preexisting biliary disease, and recent use of immunosuppressive agents are strong predictive factors for P. aeruginosa bacteremia in cirrhotic patients.
- Published
- 2013
46. A Case of Vertebral Osteomyelitis Caused bySerratia grimesiiin a Patient without Predisposing Factors
- Author
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Sun Hoe Koo, Shinhye Cheon, Yeon Sook Kim, Seung Won Choi, Kyung Mok Sohn, Hyuk Soo Eun, and Hyeon Jung
- Subjects
medicine.medical_specialty ,Serratia grimesii ,business.industry ,Medicine ,Vertebral osteomyelitis ,business ,medicine.disease ,Surgery - Abstract
Serratia에 의한 감염은 대부분 병원 시술이나 수술 혹은 면역 저하와 관련되어 있다. 인간 감염을 일으키는 것으로 S. marcescens가 가장 흔하고 S. liquefaciens도 종종 문제가 된다. 그러나 S. gimesii에 의한 감염 혹은 지역사회 획득 Serratia 척추염은 보고된 적이 없다. 저자들은 고혈압 외에는 건강하게 지내던 환자에서 발생한 경막외 고름을 동반한 S. grimesii에 의한 척추 골수염을 경험하였다. 고름 제거 후 항생제 치료로 호전되어 문헌고찰과 함께 보고하는 바이다.
- Published
- 2012
47. Community-Onset Extended-Spectrum Beta-Lactamase-ProducingEscherichia coliOsteomyelitis of the Pubic Symphysis
- Author
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Deuk-Soo Hwang, Hyeon Jung, Sun Hoe Koo, Yeon Sook Kim, Kyung Mok Sohn, and Shinhye Cheon
- Subjects
business.industry ,medicine.drug_class ,Osteomyelitis ,medicine.medical_treatment ,Antibiotics ,Pubic symphysis ,Drug resistance ,medicine.disease_cause ,medicine.disease ,Microbiology ,medicine.anatomical_structure ,medicine ,Beta-lactamase ,business ,Escherichia coli ,Beta lactam antibiotics ,Community onset - Published
- 2011
48. 관절 내 주사 치료 후 발생한 Staphylococcus lugdunensis에 의한 화농성 슬관절염.
- Author
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Chang Hun Song, Kyung Mok Sohn, Yong Bum Joo, Min Seong Kim, Shinhye Cheon, Yeon-Sook Kim, and Sun Hoe Koo
- Abstract
Staphylococcus lugdunensis is a coagulase-negative staphylococcus. However, it causes various clinically important human infections and behaves similar to Staphylococcus aureus. S. lugdunensis reportedly causes infective endocarditis, skin and soft tissue infection, bone and joint infection, septicemia, endarteritis, urinary tract infection, ocular infection, and peritonitis. There are no reports of septic arthritis by this organism in Korea. We presented a case of septic arthritis due to S. lugdunensis in an elderly patient with diabetes mellitus after an intra-articular injection. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
49. Vertebral Osteomyelitis caused by Burkholderia cepacia in an Immunocompetent Elderly Patient After Acupuncture.
- Author
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Ki Dae Kim, Kyung Mok Sohn, Yeon-Sook Kim, Shinhye Cheon, Chang Hun Song, Jin-Young Youm, and Sun Hoe Koo
- Abstract
Burkholderia cepacia is an important nosocomial pathogen in hospitalized patients, particularly those with prior antimicrobial therapy. B. cepacia causes various clinically significant infections such as bacteremia, pneumonia, and urinary tract and surgical site infections. However, osteomyelitis caused by B. cepacia is very rare. We present a case of B. cepacia vertebral osteomyelitis with review of the literature. [ABSTRACT FROM AUTHOR]
- Published
- 2014
- Full Text
- View/download PDF
50. Ocular infection associated with Delftia lacustris: first report.
- Author
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Kyung Mok Sohn, Jin-Yang Baek, Shinhye Cheon, Yeon-Sook Kim, and Sun Hoe Koo
- Published
- 2015
- Full Text
- View/download PDF
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