Usefulness of Two-Step Algorithm with Earlier Growth Detection in Anaerobic Bottle and Time to Positivity to Predict Candida glabrata Fungemia

변정현,이동현,김선주 대한임상미생물학회 2018 Annals of clinical microbiology Vol.21 No.2

Background: Fast identification of Candida glabrata is important, because empirical antifungal therapy for fungemia with C. glabrata and non-C. glabrata varies. We proposed an algorithm for rapid presumptive diagnosis to identify fungemia with C. glabrata using earlier or only growth from anaerobic bottles and longer time to positivity (TTP) in blood cultures. Methods: Positivity and TTP using the BacT/Alert 3D system (bioMerieux Inc, USA) with resin bottles (FA Plus and FN Plus) were analyzed in 215 candidemia patients from June 2014 to June 2016 in a university-affiliated hospital in Korea. Results: A higher proportion of earlier or only growth from anaerobic bottles was observed in C. glabrata (38.8%, 7/18) than in C. albicans (7.6%, 8/105), C. parapsilosis (10.5%, 4/138), and C. tropicalis (9.2%, 5/54) (P=0.006). The mean (±standard deviation) TTP for C. glabrata was 41.7 h (±16.3 h) compared with 26.7 h (±15.9 h) for C. albicans, 33.4 h (±8.4 h) for C. parapsilosis, and 23.1 h (±17.3 h) for C. tropicalis (P<0.0001). We could predict fungemia with C. glabrata with a sensitivity of 94.4%, specificity of 63.9%, positive predictive value of 19.3%, and negative predictive value of 99.2% using a two-step algorithm: earlier or only growth from anaerobic bottles and TTP >31.4 h. Conclusion: This two-step algorithm in the BacT/Alert 3D system could be the basis for an initial empirical antifungal therapy for fungemia with C. glabrata prior to final identification. (Ann Clin Microbiol 2018;21:-27)

Antimicrobial Susceptibility Patterns of Anaerobic Bacterial Clinical Isolates From 2014 to 2016, Including Recently Named or Renamed Species

변정현,김명숙,이양순,이경원,정윤섭 대한진단검사의학회 2019 Annals of Laboratory Medicine Vol.39 No.2

Background: Anaerobic bacterial resistance trends may vary across regions or institutions. Regional susceptibility patterns are pivotal in the empirical treatment of anaerobic infections. We determined the antimicrobial resistance patterns of clinically important anaerobic bacteria, including recently named or renamed anaerobes. Methods: A total of 521 non-duplicated clinical isolates of anaerobic bacteria were collected from a tertiary-care hospital in Korea between 2014 and 2016. Anaerobes were isolated from blood, body fluids, and abscess specimens. Each isolate was identified by conventional methods and by Bruker biotyper mass spectrometry (Bruker Daltonics, Leipzig, Germany) or VITEK matrix-assisted laser desorption ionization time-of-flight mass spectrometry (bioMérieux, Marcy-l’Étoile, France). Antimicrobial susceptibility was tested using the agar dilution method according to the CLSI guidelines. The following antimicrobials were tested: piperacillin-tazobactam, cefoxitin, cefotetan, imipenem, meropenem, clindamycin, moxifloxacin, chloramphenicol, tetracycline, and metronidazole. Results: Most Bacteroides fragilis isolates were susceptible to piperacillin-tazobactam, imipenem, and meropenem. The non-fragilis Bacteroides group (including B. intestinalis, B. nordii, B. pyogenes, B. stercoris, B. salyersiae, and B. cellulosilyticus) was resistant to meropenem (14%) and cefotetan (71%), and Parabacteroides distasonis was resistant to imipenem (11%) and cefotetan (95%). Overall, the Prevotella and Fusobacterium isolates were more susceptible to antimicrobial agents than the B. fragilis group isolates. Anaerobic gram-positive cocci exhibited various resistance rates to tetracycline (6–86%). Clostridioides difficile was highly resistant to penicillin, cefoxitin, imipenem, clindamycin, and moxifloxacin. Conclusions: Piperacillin-tazobactam, cefoxitin, and carbapenems are highly active β-lactam agents against most anaerobes, including recently named or renamed species.

비장절제술을 받은 알코올 남용 환자의 말초혈액도말에서 보인 Pappenheimer 소체

변정현,고은하 대한진단검사의학회 2015 Laboratory Medicine Online Vol.5 No.4

제주도 읍・면지역 고등학교의 배치유형에 따른 외부공간 구성에 관한 연구

변정현,박철민 한국농촌건축학회 2019 농촌건축 : 한국농촌건축학회논문집 Vol.21 No.3

Dramatic increase of population migrating from suburban area to metropolitan area which started in 1990s resulted in the increase of aging population among this area. Centralized population also causes decreased number of students in suburban areas which in turn affects environmental facilities such as school and brings social issue. Additionally, compared to the alternative analysis and data regarding internal spatial arrangement of high school, there are not enough data or information on external spatial arrangement and how to construct such space. Therefore, the main purpose of this thesis is to provide fundamental data which can be used as a reference in improving educational environment of suburban high school by analyzing and investigating various factors including location, accessibility, facility status, and external spatial arrangement based on arrangement type of 8 normal high schools located across Jeju Island where the trend of decreasing number of students is prominent. Following is the result of such investigation. Despite the fact that high schools from suburban areas in Jeju Island possess diversity based on local characteristic, construction of external space is rather inconsistent as the plans regarding external space is not organized. Therefore, there is a need for preparing external spaces appropriate for each school based on the number of students and the characteristic of gymnasium.

전기차 충전 솔루션 전문기업 에바

변정현 전력전자학회 2023 전력전자학회지 Vol.28 No.5

초등학생의 정보리터러시 활동과비판적 사고력의 관계 연구

변정현 한국교육사회학회 2009 교육사회학연구 Vol.19 No.4

Tremendous amount of information is being produced and is disappearing everyday in today's information society, and for learners there is great difficulty in organizing and reproducing the necessary information relying solely on the existing information-acquiring learning method that is taught unilaterally in schools. There is a greater demand for learners, including elementary school students, to be able to select the necessary information out of the numerous information available in their surroundings, and be able to analyze and reorganize them in order to produce new information suitable to their own needs. Information literacy, or the ability to utilize new information after acquiring, synthesizing, and analyzing existing information is increasingly becoming crucial - as much as the ability to read - for learners in information society, and as one's proficiency in it increases, the opportunity to come in contact with various data that information-orientated society can provide and the ability to optimally select and apply the right information correspondingly increase. There are various modes of thinking learners need to possess today, but among these, critical thinking emphasizes reliability of evidence and validity of arguments as a rational and reflective method of thinking used to determine what to believe and how to act. An increase in critical thinking ability is possible by developing related elements and utilizing various programs on scenes of learning, and this research examines the influence activities based on Irving's info-literacy model has on critical thinking power (areas of function and tendency), and the change in information literacy they bring to high, intermediate, and low group of critical thinking ability. 현재의 정보화 사회에서는 엄청난 양의 정보가 매일 생산 및 소멸되고 있으며 이러한 사회 속에서 일방적으로 제공 되어지는 기존의 정보습득형의 학습방식으로는 학습자에 필요한 정보를 조직하고 재생산하여 학습의 장에 적용하는데 있어 많은 어려움이 있다. 초등학생을 비롯한 학습자들의 경우, 주변에 산재해 있는 많은 정보들 중에 자신에게 필요한 것을 선택하고, 그것을 분석/재조직하여 자신의 필요에 적합한 새로운 정보를 생산해 내는 능력을 갖추도록 요구가 점점 더 강조되어지고 있다. 따라서 필요한 정보를 인식한 후 습득-종합-분석의 과정을 거쳐 최종적으로 정보를 활용하기까지의 정보리터러시 능력이 정보화시대에 살고 있는 학생들을 비롯한 우리들 모두에게 문자를 해독할 수 있는 능력만큼이나 중요하다고 볼 수 있고, 정보리터러시의 수준이 높을수록 정보화 사회가 제공하는 다양한 자료를 접할 수 있는 기회와 그 기회에 따른 최적의 선택과 활용에 대한 기회의 가능성이 그 만큼 증가한다고도 볼 수 있다. 학습자들이 생활 및 학습에 필요한 사고력으로는 몇 가지가 있는데, 이중 비판적 사고력은 무엇을 믿고 해야 될 것인가에 대하여 판단을 내릴 때 작용하는 합리적이고 반성적인 사고로서 증거의 신뢰성, 논증의 타당성에 강조를 두고 있다. 비판적 사고력의 향상은 관련 요소들의 개발 및 다양한 프로그램 개발을 통해 학습의 장에 투입함으로써 가능해지는데, 본 연구에서는 Irving의 정보리터러시 모형에 기초한 정보리터러시 활동이 비판적 사고력(기능영역, 성향영역)에 있어 어떠한 영향을 미치는지 분석해보고, 비판적 사고력의 상, 중, 하 그룹에 따른 정보리터러시 활동의 변화를 살펴보고자 한다.

혈액배양에서 BacT/Alert 3D FA Plus와 FN Plus 레진배지 성능분석

변정현,김승욱,고은하,김선주,김성춘 대한진단검사의학회 2016 Laboratory Medicine Online Vol.6 No.3

Background: We prospectively evaluated the performance of blood culture resin media, FA Plus and FN Plus, of the BacT/Alert 3D System (bioMérieux Inc., USA) in a tertiary university-affiliated hospital. Methods: We obtained 2,994 blood culture sets. The positivity and time to detection (TTD) were compared between FA Plus and FN Plus for clinically significant microorganisms. We then categorized patients into two groups based on antibiotic treatment before blood culture to observe the difference of positivity between two groups. Results: Among 2,994 sets received, 371 (12.4%) yielded 385 clinically significant pathogens. Comparing FA Plus to FN Plus media, lactose non-fermenters (18 vs. 1; P<0.001) and yeasts (15 vs. 0; P<0.001) were recovered at a significantly higher rate using FA Plus, whereas gram-positive cocci (10 vs. 26; P=0.011) and gram-negative anaerobes (0 vs. 10 P=0.002) were isolated at a higher rate using FN Plus. In terms of detection time in FA Plus compared to that in FN Plus, Staphylococcus aureus (13.8 hr vs. 18.1 hr) and gram-positive cocci (14.1 hr vs. 20.3 hr) were detected significantly earlier in FA Plus (each, P<0.001). There was no statistically significant difference in positivity based on prior antibiotic use (13.1%, 65/498) compared to antibiotic naïve patients (12.3%, 306/2,496) (P>0.05). Conclusions: Complementary detection of microorganisms was observed between FA Plus and FN Plus. Gram-positive cocci including S. aureus grew faster in FA Plus. In addition, the rate of positivity was not affected by prior antibiotic therapy in BacT/Alert 3D resin media. 배경: 저자들은 한 대학병원에서 BacT/Alert 3D System (bioMérieux Inc., USA)의 혈액배양 레진 배지인 FA Plus와 FN Plus의 성능을 전향적으로 평가하였다. 방법: 총 2,994세트에 대해서 임상적으로 의의가 있는 세균의 양성률과 균 검출시간을 두 배지 간에 비교하였다. 또한 항균제 사용 유무에 따라 환자를 분류하고 두 군 간에 양성률을 비교하였다. 결과: 총 371세트(12.4%)에서 385개의 병원균이 배양되었다. 유당 비발효균과 효모균은 FA Plus에서 유의하게 높게 배양된 반면, 그람양성 알균과 그람음성 무산소성 간균은 FN Plus에서 유의하게 높게 배양되었다(P<0.001). 황색포도알균과 그람양성 알균은 FA Plus에서 유의하게 빠르게 배양되었다. 이미 항균제가 투여된 경우와 투여되지 않은 경우 양성률은 통계적으로 유의한 차이가 없었없었다(13.1%와 12.3%, P>0.05). 결론: 호기병인 FA Plus와 혐기병인 FN Plus는 상호 보완적으로 균이 검출되었다. FA Plus에서는 황색포도알균을 포함한 그람양성 알균이 신속하게 배양되었다. 레진 배지를 사용할 경우 BacT/Alert 3D System에서는 항균제 사용 유무에 의해 양성률은 차이가 없었다.

Performance of Microflex LT Biotyper and VITEK MS for Routine Identification of Yeasts

변정현,유아름,김명숙,이경원 대한진단검사의학회 2018 Annals of Laboratory Medicine Vol.38 No.5

Dear Editor, The epidemiology of yeast infections is rapidly evolving, leading to the emergence of uncommon yeasts [1]. Rapid identification, followed by appropriate antimicrobial therapy, is associated with lower mortality [2]. Conventional phenotypic methods cannot differentiate certain yeast species accurately [3]. Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) has been introduced in clinical microbiology to facilitate rapid yeast identification [3]. MALDI-TOF MS for yeast identification requires special preparation, similar to that for Mycobacterium species and gram-positive bacteria [4]. We compared the yeast identification capabilities of two MALDI-TOF systems—the Microflex LT Biotyper (Bruker Daltonics, Leipzig, Germany) and the VITEK MS (bioMerieux, Marcy-l’Étoile, France)—with respect to different sample preparation methods.

청년취업역량 강화 프로그램 현황과 발전방안

변정현,진서현,이만기 한국취업진로학회 2015 한국취업진로학회 학술대회 Vol.2015 No.05

알코올 상담 센터 환자를 대상으로 한 알코올 의존의 생물학적 표지자 비교 연구

변정현,이병철,함병주,정찬승,허미나,이정준,최인근,Byun, Jung-Hyun,Lee, Boung-Chul,Ham, Byung-Joo,Chung, Chan Seung,Hur, Mina,Lee, Jung-Joon,Choi, Ihn-Geun 대한생물정신의학회 2006 생물정신의학 Vol.13 No.4

Objectives : Biochemical markers can provide an objective evidence of heavy alcohol drinking. The purpose of this study was to compare and evaluate the usefulness of biological markers detecting alcohol dependence, such as mean corpuscular volume(MCV), gamma-glutamyl transferase(GGT), and carbohydrate-deficient transferrin(CDT) in the patients of an alcohol counseling center. Methods : This study was done with 64 patients with alcohol dependence and 36 healthy subjects. Relative values(%) of CDT were determined in their sera with turbidimetric immunoassay(Bio-Rad %CDT assay, Axis-Shield ASA, Oslo, Norway), and were compared with conventional markers of alcohol consumption, GGT and MCV. Results : Among the patients with alcohol dependence, 78.1% showed abnormal %CDT levels compared with GGT(61.9%) and MCV(20.7%). The areas under the receiver operating characteristic(ROC) curves(95% confidence interval) for %CDT, GGT, and MCV were 0.934(0.866-0.973), 0.871(0.789-0.930), and 0.575 (0.472-0.673), respectively. Conclusion : %CDT seems to be the most reliable biological marker for the detection and monitoring of alcohol consumption in the patients with alcohol dependence of the alcohol counseling center.