Mycobacteriological characteristics and treatment outcomes in extrapulmonary Mycobacterium abscessus complex infections

Jeong, S.H.,Kim, S.Y.,Huh, H.J.,Ki, C.S.,Lee, N.Y.,Kang, C.I.,Chung, D.R.,Peck, K.R.,Shin, S.J.,Koh, W.J. Decker 2017 INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES Vol.60 No.-

<P>Conclusions: Precise species and subspecies identification and the determination of macrolide susceptibility are recommended for the optimal treatment of extrapulmonary MABC infections. (C) 2017 The Author(s). Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license</P>

Prevalence of type-specific oncogenic human papillomavirus infection assessed by HPV E6/E7 mRNA among women with high-grade cervical lesions

Wang, H.y.,Park, S.,Lee, D.,Kim, S.,Kim, G.,Park, K.H.,Lee, H. Decker 2015 INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES Vol.37 No.-

Objectives: Human papillomavirus (HPV) infection is a major cause of premalignant dysplasia and cervical cancer. There are no data on the prevalence of genotype-specific HPV infection assessed by HPV E6/E7 mRNA in women representative of the Korean population across a broad age range. Methods: A total of 630 women aged 17-90 years were enrolled in this study. ThinPrep liquid-based cytology samples were evaluated using the CervicGen HPV RT-qDx assay, which detects 16 high-risk (HR) HPV genotypes (set 1: HPV 16, 31, 33, 35, 52, and 58; set 2: HPV 18, 39, 45, 51, 59, and 68; and set 3: HPV 53, 56, 66, and 69). Results: The overall prevalence of HPV infection was 33.2% (n=209), and oncogenic high-risk HPV was detected in 75.9% (n=107) of 141 women with high-grade cervical lesions. HPV 16 was the most common HPV genotype among women with high-grade cervical lesions and histologically confirmed cervical intraepithelial neoplasia grade 2 and above (CIN2+) in the Republic of Korea (41.6%). Among women aged over 30 years, 182/329 (55%) had invasive cervical cancer and 135 (74%) of these were infected with oncogenic HR-HPV types (in particular 25% with HPV 16). Among patients diagnosed with CIN2+, the positivity rate of HR-HPV was the highest in women aged 40-49 years. Conclusions: These results suggest that the determination of specific HPV genotypes is very important for evaluating the potential impact of preventive measures, including the use of prophylactic vaccines, on reducing the burden of cervical cancer.

Clinical outcome and predictive factors of recurrence among patients with Kikuchi's disease

Song, J.Y.,Lee, J.,Park, D.W.,Sohn, J.W.,Suh, S.I.,Kim, I.S.,Kim, W.J.,Kim, M.J.,Cheong, H.J. Decker 2009 INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES Vol.13 No.3

Objectives: To evaluate the clinical outcome and predictive factors of recurrence among patients with Kikuchi's disease. Methods: Between January 2001 and December 2006, all patients with Kikuchi's disease were included in the study. Data were collected on co-morbidities, clinical manifestations, and ultrasound/laboratory findings, and the differences were compared between recurrent disease and non-recurrent disease groups. Results: The study included 102 patients with a mean age of 26.7 years. Among these patients, three developed systemic lupus erythematosus during the follow-up period, while two cases were later associated with tuberculosis. Eight patients (7.8%) experienced early relapse and 13 (12.7%) showed late recurrence. Patients with recurrent episodes were more likely to have fever and fatigue with extranodal involvement. Compared to the non-recurrent cases, recurrent cases remained symptomatic for a rather longer duration. The positive rate of the fluorescence anti-nuclear antibody (FANA) test was significantly higher in the recurrent disease group compared to the non-recurrent disease group. Conclusions: Kikuchi's disease took a self-limiting clinical course in most cases, but the recurrence rate found in the present study was higher than that of previous reports. Kikuchi's disease might be a phenotype of diverse disease entities. The prognosis is different according to the underlying cause. The FANA test would be useful in predicting recurrence.

Efficacy of inducible protein 10 as a biomarker for the diagnosis of tuberculosis

Hong, J.Y.,Jung, G.S.,Kim, H.,Kim, Y.M.,Lee, H.J.,Cho, S.N.,Kim, S.K.,Chang, J.,Kang, Y.A. Decker 2012 INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES Vol.16 No.12

Objective: This study evaluated inducible protein 10 (IP-10) as a diagnostic biomarker for specific tuberculosis (TB) infection and evaluated the ability of IP-10 to distinguish between active TB and latent TB infection (LTBI). Methods: Forty-six patients with active pulmonary TB, 22 participants with LTBI, and 32 non-TB controls were enrolled separately. We measured IP-10 in serum and in supernatants from whole blood stimulated with TB-specific antigens. Results: TB antigen-dependent IP-10 secretion was significantly increased in the active TB patients and LTBI subjects compared with controls, but did not differ significantly between the active TB patients and LTBI subjects. Serum IP-10 levels were higher in active TB than in LTBI (174.9 vs. 102.7pg/ml, p=0.002). The respective rates of positive responders of TB antigen-dependent IP-10 were 97.8%, 90.9%, and 12.5% in active TB, LTBI, and non-TB controls, respectively. For serum IP-10, 87.5%, 45.5%, and 9.5% of responders were positive in the respective groups. Conclusions: The IP-10 response to TB antigen may constitute a specific biomarker for TB infection, but does not by itself distinguish between active TB and LTBI. Serum IP-10 may enhance the diagnostic performance when used in combination with another marker.

Secondary structure conservation of the stem-loop IV sub-domain of internal ribosomal entry sites in human rhinovirus clinical isolates

Kim, H.,Kim, K.,Kwon, T.,Kim, D.W.,Kim, S.S.,Kim, Y.J. Decker 2015 INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES Vol.41 No.-

Objectives: The aim of this study was to investigate the genetic diversity in the stem-loop (SL) IV sub-domain of the human rhinovirus (HRV) internal ribosomal entry site (IRES), which plays key roles in the initiation of viral translation by host protein interaction. Methods: The primary SL-IV sequences of 194 HRVs, consisting of 97 reference strains and 97 clinical isolates, including the IRES sub-domains SL-IVa, SL-IVb, SL-IVc, and SL-IVd, were analyzed using Lasergene, MEGA 4, and WebLogo. Additionally, secondary structures of SL-IV were predicted and classified by RNAfold and CentroidHomfold-LAST. Results: The predicted secondary structures of SL-IV showed variations in the position of bulbs, size of the loop, and length of stems. SL-IVc had the most highly conserved nucleotide sequence, with structures classified into two groups by the location of the poly(C) loop. Of the SL-IV sequences analyzed, 74 (79.56%) were classified in the major group and 19 (20.44%) in the minor group. Thirteen compensatory substitution pairs of SL-IVc contributed to maintaining the stem structure. Conclusions: This study showed that the IRES secondary structures of a large number of reference and clinical HRVs were highly conserved, with several compensatory substitutions. It is expected that these results will facilitate investigations into HRV function based on IRES secondary structures.

Incidence of and risk factors for infectious complications in patients with cardiac device implantation

Ann, H.W.,Ahn, J.Y.,Jeon, Y.D.,Jung, I.Y.,Jeong, S.J.,Joung, B.,Lee, M.,Ku, N.S.,Han, S.H.,Kim, J.M.,Choi, J.Y. Decker 2015 INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES Vol.36 No.-

Objectives: The use of cardiac implantable electronic device (CIED; pacemakers, implantable cardioverter-defibrillators [ICD], cardiac re-synchronized therapy [CRT]) implantation, one essential treatment for cardiac arrhythmias, is increasing. Infectious complications related to implants are the main reason for device removal and patient morbidity. We sought to identify the incidence of infectious complications among patients with cardiac device implantation and analyze the risk factors for infectious complications. Methods: A retrospective analysis was conducted of 1307 patients (61.5+/-14.2 years-old, 49.6% male) with cardiac device implantation from January 1990 to April 2013. We analyzed the incidence of infectious complications during the follow-up period. To investigate risk factors associated with infectious complications, we conducted a 1:2 matched case-control study of patients with infectious complications and controls without infectious complications who had the same implantation period and physician. Results: Among 1307 patients, 12 had a confirmed device-related infection: 7 with a pocket infection and 5 with infective endocarditis. Over a total of 9091.9 device-years, the incidence of infectious complications was 1.3/1000 device-years, based on the 12 patients with an infection. ICD (5.1/1000 device-year) had a higher incidence of infectious complications than other cardiac devices, and no infectious complications were observed among patients with CRT implantation. Mean duration from the time of implantation to infection was 2.02+/-1.65 years. In a multivariate analysis, the number of prior procedures including wound revision or scar revision was an independent risk factor for infectious complications (OR=10.88, 95% CI 1.11→999, p=0.040). Conclusions: Infection was a rare complication of cardiac device implantation, but repeated procedures were associated with infectious complications.

Safety and immunogenicity of a single dose of a quadrivalent meningococcal conjugate vaccine (MenACYW-D): a multicenter, blind-observer, randomized, phase III clinical trial in the Republic of Korea

Kim, D.S.,Kim, M.J.,Cha, S.H.,Kim, H.M.,Kim, J.H.,Kim, K.N.,Lee, J.S.,Choi, J.Y.,Castells, V.B.,Kim, H.S.,Bang, J.,Oster, P. Decker 2016 INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES Vol.45 No.-

<P>Objectives: To assess the safety and immunogenicity of a meningococcal polysaccharide diphtheria toxoid conjugate vaccine (MenACYW-D) in a Korean population. Methods: This was a phase III, blind-observer, controlled study in which participants aged 11-55 years were randomized (2: 1 ratio) to a single dose of MenACYW-D or tetanus/diphtheria/acellular pertussis (Tdap) vaccine. Outcomes included rates of seroconversion against all serogroups (>= 4-fold increase in antibody titer from pre-vaccination), geometric mean titers (GMTs) at days 0 and 28 based on a serum bactericidal assay using baby rabbit complement, rates of seroprotection (titer >= 1: 128) at day 28, and safety. Results: A total of 300 participants were enrolled in the study (200 MenACYW-D and 100 Tdap). Seroconversion rates for serogroups A, C, Y, and W-135 were 77.8%, 88.3%, 74.6%, and 92.4%, respectively, for the MenACYW-D group and 9.3%, 8.1%, 12.2%, and 8.2%, respectively, for the Tdap group. The proportions of participants with pre-vaccination titers >= 1: 128 were 57.3%, 12.6%, 51.5%, and 22.2% for serogroups A, C, Y, and W-135, respectively; post-vaccination rates were 98.5%, 89.4%, 96.0%, and 95.0% for the MenACYW-D group. A lower proportion of participants reported solicited reactions with MenACYW-D (46.2%) compared with Tdap (76.8%). Conclusion: A single dose of MenACYW-D was well tolerated and elicited a robust immune response in Korean adolescents and adults. (C) 2016 The Authors. Published by Elsevier Ltd on behalf of International Society for Infectious Diseases. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).</P>

Incidence and pattern of implant fractures: A long-term follow-up multicenter study

Lee, Jae-Hong,Kim, Yeon-Tae,Jeong, Seong-Nyum,Kim, Na-Hong,Lee, Dong-Woon Decker 2018 CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH Vol.20 No.4

<P>ConclusionPeri-implantitis-induced marginal and vertical bone loss and manufacturing-induced defects were considered to be major factors in IF. Therefore, using clinically verified implant systems and striving to minimize bone loss by preventing and actively treating peri-implantitis is essential to reduce IFs.</P>

Subcutaneously administered interferon-gamma for the treatment of multidrug-resistant pulmonary tuberculosis

Park, S.K.,Cho, S.,Lee, I.H.,Jeon, D.S.,Hong, S.H.,Smego, R.A.,Cho, S.N. Decker 2007 INTERNATIONAL JOURNAL OF INFECTIOUS DISEASES Vol.11 No.5

Objective: We evaluated the clinical and laboratory effects of subcutaneously administered interferon-gamma (IFN-γ) in the treatment of chronic and advanced multidrug-resistant tuberculosis (MDR-TB). Design: Eight patients with sputum smear and culture persistently positive MDR-TB were subcutaneously administered 2 million international units of recombinant human IFN-γ three times a week for 24 weeks (72 doses total) between December 2002 and May 2003. Subjects also received a customized drug regimen containing second- and third-line antituberculosis agents based upon drug susceptibility testing and previous treatment history. Results: Body weight remained stable or slightly decreased in all subjects during the study period, and none displayed radiographic improvement on serial chest computed tomography scanning. Sputum smears and cultures remained positive for all patients, and there was no increase in the mean time to yield a positive culture (from 16.5+/-6.4 to 11.8+/-4.9 days). There was no enhancement of cell-mediated immune responses in terms of production of IFN-γ or IL-10, or of composition of lymphocytes among peripheral blood mononuclear cells. In four patients, therapy was discontinued because of adverse reactions. Conclusion: In patients with chronic and advanced MDR-TB, subcutaneous IFN-γ treatment did not result in improvement in clinical, radiologic, microbiologic, or immunologic parameters.

Evaluation of the Quantamatrix Multiplexed Assay Platform system for simultaneous detection of Mycobacterium tuberculosis and the rifampicin resistance gene using cultured mycobacteria

Wang, H.y.,Uh, Y.,Kim, S.,Shim, T.s.,Lee, H. Decker 2017 International journal of infectious diseases Vol.61 No.-

Background: The differentiation of Mycobacterium tuberculosis complex (MTBC) from non-tuberculous mycobacteria (NTM) is of primary importance for infection control and the selection of anti-tuberculosis drugs. Up to date data on rifampicin (RIF)-resistant tuberculosis (TB) is essential for the early management of multidrug-resistant TB. The aim of this study was to evaluate the usefulness of a newly developed multiplexed, bead-based bioassay (Quantamatrix Multiplexed Assay Platform, QMAP) for the rapid differentiation of 23 Mycobacterium species including MTBC and RIF-resistant strains. Methods: A total of 314 clinical Mycobacterium isolates cultured from respiratory specimens were used in this study. Results: The sensitivity and specificity of the QMAP system for Mycobacterium species were 100% (95% CI 99.15-100%, p<0.0001) and 97.8% (95% CI 91.86-99.87%, p<0.0001), respectively. The results of conventional drug susceptibility testing and the QMAP Dual-ID assay were completely concordant for all clinical isolates (100%, 95% CI 98.56-100%). Out of 223 M. tuberculosis (MTB) isolates, 196 were pan-susceptible and 27 were resistant to RIF according to QMAP results. All of the mutations in the RIF resistance-determining region detected by the QMAP system were confirmed by rpoB sequence analysis and a REBA MTB-Rifa reverse blot hybridization assay. The majority of the mutations (n=26, 96.3%), including those missing wild-type probe signals, were located in three codons (529-534, 524-529, and 514-520), and 17 (65.4%) of these mutations were detected by three mutation probes (531TTG, 526TAC, and 516GTC). Conclusions: The entire QMAP system assay takes about 3h to complete, while results from the culture-based conventional method can take up to 48-72h. Although improvements to the QMAP system are needed for direct respiratory specimens, it may be useful for rapid screening, not only to identify and accurately discriminate MTBC from NTM, but also to identify RIF-resistant MTB strains in positive culture samples.