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Chong, Yong Pil,Park, Ki-Ho,Kim, Eun Sil,Kim, Mi-Na,Kim, Sung-Han,Lee, Sang-Oh,Choi, Sang-Ho,Jeong, Jin-Yong,Woo, Jun Hee,Kim, Yang Soo American Society for Microbiology 2015 Antimicrobial Agents and Chemotherapy Vol.59 No.6
<P>The prevalence of the heterogeneous vancomycin-intermediate <I>Staphylococcus aureus</I> (hVISA) phenotype among methicillin-resistant <I>S. aureus</I> (MRSA) blood isolates can reach 38%. hVISA bacteremia is known to be associated with vancomycin treatment failure, including persistent bacteremia. We conducted this study to evaluate risk factors for 12-week mortality in patients with hVISA bacteremia through a detailed clinical and microbiological analysis of a prospective cohort of patients with <I>S. aureus</I> bacteremia. All isolates were collected on the first day of bacteremia and subjected to population analysis profiling for hVISA detection, genotyping, and PCR analysis for 39 virulence factors. Of 382 patient with MRSA bacteremia, 121 (32%) had hVISA bacteremia. Deceased patients were more likely to have hematologic malignancy (<I>P</I> = 0.033), ultimately or rapidly fatal disease (<I>P</I> = 0.007), and a higher Pitt bacteremia score (<I>P</I> = 0.010) than surviving patients. The sequence type 239 (ST239) clonal type and definitive linezolid treatment were associated with a trend toward reduced mortality (<I>P</I> = 0.061 and 0.072, respectively), but a high vancomycin MIC (≥2 mg/liter) was not associated with increased mortality (<I>P</I> = 0.368). In a multivariate analysis, ultimately or rapidly fatal disease (adjusted odds ratio [aOR], 2.80; 95% confidence interval [CI], 1.14 to 6.85) and a high Pitt bacteremia score (aOR, 1.26; 95% CI, 1.07 to 1.48) were independent risk factors for mortality. Hematologic malignancy was associated with a trend toward increased mortality (<I>P</I> = 0.094), and ST239 was associated with a trend toward reduced mortality (<I>P</I> = 0.095). Our study suggests that ST239 hVISA is a possible predictor of survival in hVISA bacteremia.</P>
Chong, Yong Pil,Lee, Sang-Oh,Song, Eun Hee,Lee, Eun Jung,Jang, Eun-Young,Kim, Sung-Han,Choi, Sang-Ho,Kim, Mi-Na,Jeong, Jin-Yong,Woo, Jun Hee,Kim, Yang Soo Scandinavian University Press [etc.] 2010 Scandinavian journal of infectious diseases Vol.42 No.6
<P>Quinupristin-dalfopristin and linezolid are widely used for the treatment of vancomycin-resistant Enterococcus faecium (VREF) infections. Increasing resistance of VREF to quinupristin-dalfopristin and linezolid is a cause for concern. To determine the efficacy of and the rate of development of resistance to quinupristin-dalfopristin and linezolid, we analyzed all episodes of clinically significant VREF bacteraemia at a tertiary-care hospital from January 2003 to June 2007. The main outcomes were rates of 30-day mortality, microbiological response, and development of resistance. Fifty-two patients were treated with quinupristin-dalfopristin and 61 were treated with linezolid. Baseline demographic and clinical characteristics were similar between the 2 groups. There were no significant between-group differences in 30-day mortality (48% in the quinupristin-dalfopristin group vs 41% in the linezolid group; p = 0.45) or microbiological response (60% vs 66%; p = 0.51). However, prolonged bacteraemia (18% of 45 evaluable cases vs 4% of 55 evaluable cases; p = 0.04) and development of resistance in blood isolates (11% vs 0%; p = 0.02) were more frequently observed in the quinupristin-dalfopristin group than in the linezolid group. There was no significant difference between the efficacy of quinupristin-dalfopristin and linezolid. However, prolonged bacteraemia and the development of resistance were more common in quinupristin-dalfopristin-treated patients.</P>
Yong Shik Kwon,Byoung Soo Kwon,Ock-hwa Kim,Yea Eun Park,Tae Sun Shim,Yong Pil Chong,조경욱 대한의학회 2020 Journal of Korean medical science Vol.35 No.9
Background: Long-term administration of ethambutol (EMB) for Mycobacterium avium complex lung disease (MAC-LD) sometimes leads to permanent discontinuation of EMB due to various adverse events. This study aimed to investigate treatment outcomes after discontinuation of EMB. Methods: Among patients diagnosed with MAC-LD between January 2001 and December 2014, 508 patients whose treatment was initiated with standard regimen until May 2018 were enrolled at a tertiary referral center in Korea. Of these 508 patients, 60 (11.8%) discontinued EMB due to various adverse effects. Among these 60 patients, treatment outcomes were analyzed for 44 patients by comparing their outcomes with those of matched subjects who received the standard treatment regimen without EMB discontinuation. Results: The mean age of the 60 patients who discontinued EMB was 64.4 years. Ocular toxicity was the most common cause of discontinuation of EMB (75.0%, 45/60). The mean duration of EMB administration before its discontinuation was 7.0 ± 4.6 months. The treatment failure rate of the 44 patients with EMB discontinuation analyzed for treatment outcome was 29.6%, which was higher than that of the matched patients who received the standard regimen (18.3%), although the difference was not significant (P = 0.095). Of these 44 patients, EMB was substituted with later-generation fluoroquinolone in 23 patients, and the treatment failure rate of these 23 patients was significantly higher than that of the matched patients who received the standard regimen (39.1% vs. 19.3%, P = 0.045). Conclusion: These findings suggest that treatment outcomes are unsatisfactory in patients with MAC-LD who discontinue EMB owing to adverse events. Notably, there was a statistically significant high failure rate in patients who were prescribed fluoroquinolone to replace EMB.
Kim, Deok Soo,Chung, Yong Chae,Seo, Sang Won,Kim, Sang Pil,Kim, Chong Min Trans Tech Publications, Ltd. 2006 Key Engineering Materials Vol.317 No.-
<P>The structural configurations of atom constituting materials are one of the fundamental factors in the study of physical properties of materials. Presented in this paper is a mathematical and computational methodology to efficiently classify a given atomic structure of an arbitrary material into groups of atoms in BCC, FCC, and HCP crystal structures. The approach is based on the angle distributions among neighboring atoms efficiently identified by a computational geometry technique called Voronoi diagram. In this paper, the presented mathematical theory was applied to analyze a multi-layer atomic structure in a geometric perspective so that a best condition for thin film growth can be found.</P>
Lee, Ju Young,Chong, Yong Pil,Kim, Tark,Hong, Hyo-Lim,Park, Su-Jin,Lee, Eun-Sook,Kim, Mi-Na,Kim, Sung-Han,Lee, Sang-Oh,Choi, Sang-Ho,Woo, Jun Hee,Kim, Yang Soo Oxford University Press 2014 The Journal of antimicrobial chemotherapy Vol.69 No.7
<P><B>Background</B></P><P>A new clone of community-acquired methicillin-resistant <I>Staphylococcus aureus</I> (CA-MRSA), sequence type (ST) 72-staphylococcal chromosomal cassette <I>mec</I> (SCC<I>mec</I>) type IV/IVA without the Panton–Valentine leucocidin (PVL) genes, has been the major clonal type in Korea since 2007. However, there have been no evaluations of the clinical features, risk factors and outcomes associated with CA-MRSA bacteraemia in Korea.</P><P><B>Methods</B></P><P>Adult patients with community-acquired <I>S. aureus</I> bacteraemia (SAB) were enrolled between 1 January 2004 and 31 September 2012. We compared the clinical features and outcomes of CA-MRSA bacteraemia with those of community-acquired methicillin-susceptible <I>S. aureus</I> (CA-MSSA) bacteraemia and evaluated the risk factors for CA-MRSA infection. A microbiological study of the CA-MRSA isolates was also conducted.</P><P><B>Results</B></P><P>In total, 169 patients were included, i.e. 31 (18%) patients with CA-MRSA bacteraemia and 138 (82%) patients with CA-MSSA bacteraemia. Bone and joint infection [45.2% (14/31) versus 22.5% (31/138); adjusted OR, 2.61; 95% CI, 1.09–6.21] was an independent predictor of CA-MRSA bacteraemia. There were no significant differences in relapse of bacteraemia and mortality within 12 weeks after SAB between the two groups. ST72-SCC<I>mec</I> type IV/IVA without the PVL genes was the most common genotype, especially among bone and joint infections (64%, 9/14) as well as among the CA-MRSA isolates (71%, 22/31).</P><P><B>Conclusions</B></P><P>CA-MRSA accounted for 18% of community-acquired SAB and was significantly associated with bone and joint infection. Our study suggests that CA-MRSA should be considered in patients with bone and joint infection and that empirical therapy against MRSA should be included.</P>