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Park Y, Koo SH. Epidemiology, Molecular Characteristics, and Virulence Factors of Carbapenem-Resistant Pseudomonas aeruginosa Isolated from Patients with Urinary Tract Infections. Infect Drug Resist 2022; 15:141-151. [PMID: 35058697 PMCID: PMC8765443 DOI: 10.2147/idr.s346313] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 12/30/2021] [Indexed: 12/20/2022] Open
Abstract
Purpose Pseudomonas aeruginosa is an important pathogen that causes urinary tract infections. Carbapenems are the drugs of choice for the treatment of P. aeruginosa infections. However, the emergence and spread of carbapenem-resistant P. aeruginosa (CRPA) is a serious global health threat. In this study, we investigated the epidemiology, molecular characteristics, drug resistance, and virulence factors of CRPA isolated from urine samples. Methods A total of 124 P. aeruginosa isolates were obtained from urine samples collected between March 2020 and February 2021. Clonal relatedness was evaluated using multilocus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE). We performed antimicrobial susceptibility tests and investigated the presence of carbapenemase genes and virulence factors in CRPA isolates. Results The carbapenem resistance rate of the isolated P. aeruginosa was 46.7% (59/124). A total of 54 (91.5%) out of the 59 CRPA isolates were identified as multidrug-resistant. The majority of the CRPA isolates (81.4%, 48/59) harbored carbapenemase genes, such as blaIMP-6 or blaNDM-1. In an epidemiological analysis using MLST, 88.1% of CRPA isolates were confirmed to be ST773 (50.8%, 30/59) or ST235 (37.3%, 22/59). The CRPA isolates harboring blaIMP-6 and blaNDM-1 belonged to ST235 (PFGE pulsotypes E1-E18, F) and ST773 (PFGE pulsotypes H1-H2, I1-I16) subtypes, respectively. The studied CRPA isolates simultaneously harbored 10 to 14 virulence factors of the 16 virulence factors examined. Nine virulence factor genes (toxA, exoT, plcH, plcN, phzM, phzS, lasB, aprA, and algD) were identified in all CRPA isolates. Conclusion Our study shows that P. aeruginosa ST235 harboring blaIMP-6 and ST773 harboring blaNDM-1—known internationally as high-risk clones with multiple virulence factors—are widely spread in the study area. These findings suggest that continuous monitoring is necessary to prevent the further spread of carbapenemase-producing CRPA.
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Affiliation(s)
- Yumi Park
- Department of Laboratory Medicine, Konyang University College of Medicine and Myunggok Medical Research Center, Daejeon, Republic of Korea
- Department of Laboratory Medicine, Konyang University Hospital, Daejeon, Republic of Korea
| | - Sun Hoe Koo
- Department of Laboratory Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
- Correspondence: Sun Hoe Koo Department of Laboratory Medicine, Chungnam National University Hospital, 282 Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of KoreaTel +82-42-280-7798Fax +82-42-280-5365 Email
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Torumkuney D, Van PH, Thinh LQ, Koo SH, Tan SH, Lim PQ, Sivhour C, Lamleav L, Somary N, Sosorphea S, Lagamayo E, Morrissey I. Results from the Survey of Antibiotic Resistance (SOAR) 2016-18 in Vietnam, Cambodia, Singapore and the Philippines: data based on CLSI, EUCAST (dose-specific) and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints. J Antimicrob Chemother 2021; 75:i19-i42. [PMID: 32337597 DOI: 10.1093/jac/dkaa082] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES To determine antibiotic susceptibility of Streptococcus pneumoniae and Haemophilus influenzae isolates collected from community-acquired respiratory tract infections (CA-RTIs) in 2016-18 in four Asian countries. METHODS MICs were determined by CLSI broth microdilution and susceptibility was assessed using CLSI, EUCAST (dose-specific) and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints. RESULTS In total, 260 S. pneumoniae and 258 H. influenzae isolates were tested. Pneumococci from Vietnam (n = 161) were the least susceptible, with rates of susceptibility >90% for fluoroquinolones by CLSI breakpoints, ∼60% for amoxicillin, amoxicillin/clavulanic acid and ceftriaxone but <14% for most other agents. Pneumococcal isolates from Cambodia (n = 48) and Singapore (n = 34) showed susceptibilities ranging from ∼30% for trimethoprim/sulfamethoxazole and oral penicillin to 100% for fluoroquinolones. Among isolates of H. influenzae from Cambodia (n = 30), the Philippines (n = 59) and Singapore (n = 80), rates of susceptibility using CLSI breakpoints were >90% for amoxicillin/clavulanic acid, cephalosporins [except cefaclor in Singapore (77.5%)], macrolides and fluoroquinolones; for isolates from Vietnam (n = 89) the rates of susceptibility were >85% only for amoxicillin/clavulanic acid (95.5%), ceftriaxone (100%) and macrolides (87.6%-89.9%). Susceptibility to other antibiotics ranged from 7.9% (trimethoprim/sulfamethoxazole) to 57.3%-59.6% (fluoroquinolones) and 70.8% (cefixime). The application of different EUCAST breakpoints for low and higher doses for some of the antibiotics (amoxicillin, amoxicillin/clavulanic acid, ampicillin, penicillin, ceftriaxone, clarithromycin, erythromycin, levofloxacin and trimethoprim/sulfamethoxazole) allowed, for the first time in a SOAR study, the effect of raising the dosage on susceptibility to be quantified. A limitation of the study was the small sample sizes and only one or two sites participating per country; however, since susceptibility data are scarce in some of the participating countries any information concerning antibiotic susceptibility is of value. CONCLUSIONS Antibiotic susceptibility varied across countries and species, with isolates from Vietnam demonstrating the lowest susceptibility. Knowledge of resistance patterns can be helpful for clinicians when choosing empirical therapy options for CA-RTIs.
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Affiliation(s)
- D Torumkuney
- GlaxoSmithKline, 980 Great West Road, Brentford, Middlesex TW8 9GS, UK
| | - P H Van
- Nguyen Tri Phuong Hospital, Ho Chi Minh City, Vietnam
| | - L Q Thinh
- Children Hospital 1, Ho Chi Minh City, Vietnam
| | - S H Koo
- Clinical Trials & Research Unit, Changi General Hospital, 2 Simei Street 3, 529889 Singapore
| | - S H Tan
- Department of Laboratory Medicine, 2 Simei Street 3, 529889 Singapore
| | - P Q Lim
- Clinical Trials & Research Unit, Changi General Hospital, 2 Simei Street 3, 529889 Singapore
| | - C Sivhour
- Battambang Provincial Referral Hospital Prek Mohatep Village, Svaypor Commune, Battambang City and Battambang Province, Cambodia
| | - L Lamleav
- Siem Reap Provincial Referral Hospital Mondul 1 Village, Svay Dangum Commune, Siem Reap City, Siem Reap Province, Cambodia
| | - N Somary
- Kampong Cham Provincial Referral Hospital, Praketmealea Road, #7 Village, Kampong Cham Commune, Kampong Cham City, Kampong Cham Province, Cambodia
| | - S Sosorphea
- Takeo Provincial Referral Hospital, Phumi 3 Village, RokaKnong Commune, Daunkeo Town, Takeo Province, Cambodia
| | - E Lagamayo
- St. Luke's Medical Center Quezon City, Institute of Pathology, Microbiology Section, 279 E Rodriguez SR. BLVD Cathedral Heights, Quezon City, Philippines
| | - I Morrissey
- IHMA Europe Sàrl, Route de l'Ile-au-Bois 1A, 1870 Monthey/VS, Switzerland
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Lee JH, Kwon KC, Koo SH. Molecular Analysis of Pathogenic Molds Isolated from Clinical Specimen. Korean J Clin Lab Sci 2020. [DOI: 10.15324/kjcls.2020.52.3.229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Jang Ho Lee
- Department of Clinical Laboratory Science, Semyung University, Jecheon, Korea
| | - Kye Chul Kwon
- Department of Laboratory Medicine, College of Medicine, Chungnam National University, Daejeon, Korea
| | - Sun Hoe Koo
- Department of Laboratory Medicine, College of Medicine, Chungnam National University, Daejeon, Korea
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Park Y, Choi Q, Kwon GC, Koo SH. Molecular epidemiology and mechanisms of tigecycline resistance in carbapenem-resistant Klebsiella pneumoniae isolates. J Clin Lab Anal 2020; 34:e23506. [PMID: 32815626 PMCID: PMC7755817 DOI: 10.1002/jcla.23506] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 06/26/2020] [Accepted: 07/08/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND The emergence and transmission of tigecycline- and carbapenem-resistant Klebsiella pneumoniae (TCRKP) have become a major concern to public health globally. Here, we investigated the molecular epidemiology and mechanisms of tigecycline resistance in carbapenem-resistant K pneumoniae (CRKP) isolates. METHODS Forty-five non-duplicate CRKP isolates were collected from January 2017 to June 2019. We performed antimicrobial susceptibility tests, multilocus sequence typing (MLST), and pulsed-field gel electrophoresis (PFGE). PCR and DNA sequencing were performed for the detection and mutation analysis of acrR, oqxR, ramR, rpsJ, tet(A), and tet(X) genes, which are related to tigecycline resistance. The expression levels of efflux pump genes acrB and oqxB and their regulator genes rarA, ramA, soxS, and marA were assessed by quantitative real-time PCR. RESULTS The resistance rate to tigecycline in CRKP isolates was 37.8% (17/45). K pneumoniae ST307 was a predominant clone type (70.6%, 12/17) among the TCRKP isolates. The expression levels of acrB (P < .001) and marA (P = .009) were significantly higher in the tigecycline-resistant group than in the tigecycline-intermediate and tigecycline-susceptible groups. Increased expression of acrB was associated with marA expression (r = 0.59, P = .013). CONCLUSIONS We found that the activated MarA-induced overexpression of AcrAB efflux pump plays an important role in the emergence of tigecycline resistance in CRKP isolates.
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Affiliation(s)
- Yumi Park
- Department of Laboratory Medicine, Chungnam National University Hospital, Daejeon, South Korea.,Department of Laboratory Medicine, Konyang University College of Medicine, Daejeon, South Korea.,Department of Laboratory Medicine, Konyang University Hospital, Daejeon, South Korea
| | - Qute Choi
- Department of Laboratory Medicine, Chungnam National University Hospital, Daejeon, South Korea
| | - Gye Cheol Kwon
- Department of Laboratory Medicine, Chungnam National University Hospital, Daejeon, South Korea
| | - Sun Hoe Koo
- Department of Laboratory Medicine, Chungnam National University Hospital, Daejeon, South Korea
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5
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Park Y, Lim J, Kim SY, Kwon GC, Koo SH, Kim J. Changes of frequency and expression level of CD161 in CD8
+
T cells and natural killer T cells in peripheral blood of patients with systemic lupus erythematosus. Microbiol Immunol 2020; 64:532-539. [DOI: 10.1111/1348-0421.12798] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 03/30/2020] [Accepted: 04/25/2020] [Indexed: 01/06/2023]
Affiliation(s)
- Yumi Park
- Department of Laboratory MedicineKonyang University College of Medicine Daejeon Republic of Korea
- Department of Laboratory MedicineKonyang University Hospital Daejeon Republic of Korea
| | - Jinsook Lim
- Department of Laboratory MedicineChungnam National University Hospital Daejeon Republic of Korea
| | - Seon Young Kim
- Department of Laboratory MedicineChungnam National University Hospital Daejeon Republic of Korea
| | - Gye Cheol Kwon
- Department of Laboratory MedicineChungnam National University Hospital Daejeon Republic of Korea
| | - Sun Hoe Koo
- Department of Laboratory MedicineChungnam National University Hospital Daejeon Republic of Korea
| | - Jimyung Kim
- Department of Laboratory MedicineChungnam National University Hospital Daejeon Republic of Korea
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Kim HJ, Choi Q, Kwon GC, Koo SH. Molecular epidemiology and virulence factors of methicillin-resistant Staphylococcus aureus isolated from patients with bacteremia. J Clin Lab Anal 2020; 34:e23077. [PMID: 31721291 PMCID: PMC7083439 DOI: 10.1002/jcla.23077] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 09/15/2019] [Accepted: 09/27/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The various virulence factors of methicillin-resistant Staphylococcus aureus bacteremia (MRSAB) are associated with a high mortality rate worldwide. Further studies are warranted to confirm the significant relationship between the strains and virulence genes. Here, we prospectively investigated the molecular characteristics underlying the genotypes and virulence factors of MRSA isolated from patients with bacteremia. METHODS We collected 59 MRSA isolates from adult patients with bacteremia. Antimicrobial susceptibility results were obtained with the Vitek2 automated system. Genotypes were identified with multi-locus sequence typing (MLST) and pulse-field gel electrophoresis (PFGE), and 21 virulence genes were detected with polymerase chain reaction (PCR). RESULTS The 59 MRSA isolates mainly comprised ST5 (n = 31, 52.5%) and ST72 (n = 22, 37.2%). Most ST5 isolates and all ST72 isolates were clustered into one and two PFGE groups, respectively. The mean number of virulence genes was higher in ST5 than in ST72. Sel was more frequently detected in ST5 than in ST72, whereas sec and sed were found only in ST5. ST5 had significantly higher resistance against many antibiotics than ST72. CONCLUSION Most MRSA isolates causing bacteremia were ST5 (CC5) and ST72 (CC8), and those belonging to the same STs were divided into only a few PFGE groups. ST5 was associated with higher antibiotic resistance and staphylococcal superantigen toxin genes, than ST72, which may be related to its higher virulence.
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Affiliation(s)
- Hyun Jin Kim
- Department of Laboratory MedicineChungnam National University HospitalDaejeonKorea
| | - Qute Choi
- Department of Laboratory MedicineChungnam National University HospitalDaejeonKorea
| | - Gye Cheol Kwon
- Department of Laboratory MedicineChungnam National University HospitalDaejeonKorea
| | - Sun Hoe Koo
- Department of Laboratory MedicineChungnam National University HospitalDaejeonKorea
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Park Y, Choi Q, Kwon GC, Koo SH. Emergence and transmission of New Delhi metallo-beta-lactamase-5-producing Escherichia coli Sequence Type 361 in a Tertiary Hospital in South Korea. J Clin Lab Anal 2019; 34:e23041. [PMID: 31541503 PMCID: PMC7031584 DOI: 10.1002/jcla.23041] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Revised: 08/29/2019] [Accepted: 09/02/2019] [Indexed: 12/25/2022] Open
Abstract
Background The emergence of carbapenem‐resistant Escherichia coli (E coli) is a serious global health threat, but little is known about carbapenemase‐producing E coli in Daejeon, South Korea. The aim of this study was to investigate characteristics of thirteen carbapenem‐resistant E coli isolates in a tertiary hospital. Methods Thirteen non‐duplicate carbapenem‐resistant E coli strains were collected from October 2017 to January 2018. Antimicrobial susceptibility was determined with the E test or disk diffusion method. The carbapenem minimum inhibitory concentrations (MICs) were determined by the agar dilution method. The colistin and tigecycline MICs were determined by broth microdilution. The resistance genes, including carbapenemase genes, were evaluated by polymerase chain reaction, and DNA sequencing was performed to characterize the genes. Pulsed‐field gel electrophoresis and multilocus sequence typing (MLST) were performed to evaluate the clonal relatedness of isolates. The clinical data of patients were retrospectively reviewed. Results All the E coli isolates harbored blaNDM‐5 gene and were resistant to most of the antimicrobial agents, such as carbapenem, cephalosporins, ciprofloxacin, and chloramphenicol, excluding amikacin and colistin. Other resistant genes, such as blaTEM‐1, blaCTX‐M‐15, blaCMY‐2, aac(6')‐Ib‐cr, and qepA, were detected. The E coli isolates harboring blaNDM‐5 belonged to ST361 (n = 11), ST12 (n = 1), ST410 (n = 1), and PFGE types A (n = 11), B (n = 1), and C (n = 1). Conclusions This study reports on an outbreak of a predominant epidemic clone, the NDM‐5 producing, multidrug‐resistant E coli ST361 isolate. These findings suggest that we should pay attention to infection control measures to limit the spread of NDM‐5‐producing pathogens.
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Affiliation(s)
- Yumi Park
- Department of Laboratory MedicineChungnam National University HospitalDaejeonKorea
| | - Qute Choi
- Department of Laboratory MedicineChungnam National University HospitalDaejeonKorea
| | - Gye Cheol Kwon
- Department of Laboratory MedicineChungnam National University HospitalDaejeonKorea
| | - Sun Hoe Koo
- Department of Laboratory MedicineChungnam National University HospitalDaejeonKorea
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8
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Kim J, Choi Q, Kim JW, Kim SY, Kim HJ, Park Y, Kwon GC, Koo SH. Comparison of the Genedia MTB/NTM Detection Kit and Anyplex plus MTB/NTM Detection Kit for detection of Mycobacterium tuberculosis complex and nontuberculous mycobacteria in clinical specimens. J Clin Lab Anal 2019; 34:e23021. [PMID: 31523847 PMCID: PMC6977133 DOI: 10.1002/jcla.23021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 08/04/2019] [Accepted: 08/07/2019] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Real-time (RT) PCR is a rapid and accurate method that is widely used for the detection of Mycobacterium tuberculosis complex (MTB). The aim of this study was to evaluate and compare the performance of the Genedia MTB/NTM Detection Kit and the Anyplex plus MTB/NTM Detection kit in the detection of MTB and nontuberculous mycobacteria (NTM) in clinical specimens. METHODS From October 2017 to February 2018, 236 respiratory specimens and 137 non-respiratory specimens, from patients with suspected tuberculosis, were examined. AFB smear, culture, and RT-PCR using the Genedia MTB/NTM Detection kit (Green Cross Medical Science Corp.) and the Anyplex plus MTB/NTM Detection kit (Seegene) were applied. PCR performance in the detection of MTB and NTM was evaluated in relation to culture results and between the two assays. RESULTS Culture was positive for MTB in 30 (8.0%) of the 373 specimens and for NTM in 23 (6.2%). The sensitivity and specificity of MTB detection with the Genedia kit were 76.7% and 99.7%, respectively, whereas the Anyplex kit sensitivity and specificity for MTB detection were 86.7% and 97.5%, respectively. Both kits exhibited the same sensitivity (73.9%) for NTM detection, and the specificity was 100% and 99.4% for the Genedia and Anyplex kits, respectively. CONCLUSIONS The Genedia and Anyplex kits demonstrated high sensitivity and specificity for the detection of MTB and NTM. Both kits have a high concordance rate and can be used more widely in clinical laboratories for the early detection of tuberculosis.
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Affiliation(s)
- Jihoon Kim
- Department of Laboratory Medicine, Chungnam National University College of Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Qute Choi
- Department of Laboratory Medicine, Chungnam National University College of Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Jong Wan Kim
- Department of Laboratory Medicine, Dankook University College of Medicine, Dankook University Hospital, Cheonan, Korea
| | - Seon Young Kim
- Department of Laboratory Medicine, Chungnam National University College of Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Hyun Jin Kim
- Department of Laboratory Medicine, Chungnam National University College of Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Yumi Park
- Department of Laboratory Medicine, Chungnam National University College of Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Gye Cheol Kwon
- Department of Laboratory Medicine, Chungnam National University College of Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Sun Hoe Koo
- Department of Laboratory Medicine, Chungnam National University College of Medicine, Chungnam National University Hospital, Daejeon, Korea
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Koo SH, Kim J, Kim SY, Kwon GC. Clinical significance of anti-DFS70 antibody in antinuclear antibody-positive samples with a dense fine speckled pattern. J LAB MED 2019. [DOI: 10.1515/labmed-2019-0036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background
When the dense fine speckled (DFS) pattern-antinuclear antibodies (ANA) are detected in the indirect immunofluorescence (IIF) assay, the presence of anti-dense fine speckles 70 (DFS70) antibodies has been suggested to facilitate the exclusion of ANA-associated rheumatic diseases (AARD). We evaluated the potential use of anti-DFS70 antibodies for verifying AARD in patients with a positive ANA result of the DFS pattern.
Methods
A total of 5509 patients who were requested ANA testing were included. The DFS pattern was confirmed using two IIF assays. Semiquantitative DFS70 ELISA (Euroimmun, Germany) was examined in samples with the DFS pattern.
Results
Among 639 ANA-positive patients, 19.6% displayed the DFS pattern. And 17.6% of patients with the DFS pattern were diagnosed with AARD. The low titer of 1:80 was more prevalent in the non-AARD group than in the AARD group (64.1% vs. 4.5%, p < 0.0001). Anti-DFS70 antibodies were positive in 60.0% of patients with the DFS pattern. The frequency of anti-DFS70 positivity was higher in the non-rheumatic disease (NRD) group (74.2%) than in the other rheumatic disease group (43.2%, p = 0.003) and the AARD group (45.5%, p = 0.019).
Conclusions
The DFS pattern is present in both AARD and non-AARD cases. In the DFS pattern, a low titer of 1:80 and isolated anti-DFS70 antibodies without AARD-associated antibodies represent a low likelihood of AARD. The presence of anti-DFS70 antibodies cannot exclude AARD and should be analyzed in combination with AARD-associated antibodies in the diagnostic algorithm.
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Lim J, Kim J, Koo SH, Kwon GC. Comparison of triglyceride glucose index, and related parameters to predict insulin resistance in Korean adults: An analysis of the 2007-2010 Korean National Health and Nutrition Examination Survey. PLoS One 2019; 14:e0212963. [PMID: 30845237 PMCID: PMC6405083 DOI: 10.1371/journal.pone.0212963] [Citation(s) in RCA: 112] [Impact Index Per Article: 22.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Accepted: 02/12/2019] [Indexed: 01/20/2023] Open
Abstract
The triglyceride glucose (TyG) index, a product of triglyceride and fasting glucose, is a reliable marker for insulin resistance (IR). Obesity is also known to be closely related with IR. Recently, the efficiency of TyG-related markers that combine obesity markers with TyG index has been studied; however, earlier studies were limited in number and the results were inconsistent. Therefore, in this study, we investigated the efficiency of several combinations of TyG index and obesity indices, namely, body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR), in reflecting IR. Data were obtained from the Korean National Health and Nutrition Examination Survey from 2007-2010. A total of 11,149 subjects (4,777 men and 6,372 women) were included. IR was defined as the homeostasis model assessment for IR (HOMA-IR) of above the 75th percentile for each gender. Logistic regression analysis was performed after adjusting for confounding factors, to compare and identify the associations of the 4 parameters (TyG index, TyG-BMI, TyG-WC, and TyG-WHtR) with IR. For each parameter, odds ratios (OR) and 95% confidence intervals (CIs) of quartiles 2-4 were calculated and compared with quartile 1 as a reference. A receiver operating characteristic (ROC) curve analysis was conducted to evaluate the ability of each parameter to predict IR. The adjusted ORs of quartile 4 in comparison with quartile 1 (95% CIs) for IR were 7.60 (6.52-8.87) for TyG index, 12.82 (10.89-15.10) for TyG-BMI, 16.29 (13.70-19.38) for TyG-WC, and 14.86 (12.53-17.62) for TyG-WHtR. The areas under the ROC curve for each parameter were 0.690 for TyG index, 0.748 for TyG-BMI, 0.731 for TyG-WC, and 0.733 for TyG-WHtR. In conclusion, TyG-BMI was found to be superior to other parameters for IR prediction. We propose TyG-BMI as an alternative marker for assessing IR in clinical settings.
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Affiliation(s)
- Jinsook Lim
- Department of Laboratory Medicine, Chungnam National University Hospital, Daejeon, South Korea
| | - Jimyung Kim
- Department of Laboratory Medicine, Chungnam National University Hospital, Daejeon, South Korea
| | - Sun Hoe Koo
- Department of Laboratory Medicine, Chungnam National University Hospital, Daejeon, South Korea
| | - Gye Cheol Kwon
- Department of Laboratory Medicine, Chungnam National University Hospital, Daejeon, South Korea
- * E-mail:
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Kim SY, Park JS, Hong YJ, Kim TS, Hong K, Song KH, Lee H, Kim ES, Kim HB, Park KU, Song J, Koo SH, Kim EC. Microarray-Based Nucleic Acid Assay and MALDI-TOF MS Analysis for the Detection of Gram-Negative Bacteria in Direct Blood Cultures. Am J Clin Pathol 2019; 151:143-153. [PMID: 30383194 DOI: 10.1093/ajcp/aqy118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Objectives To compare a microarray-based identification and resistance determination system (blood culture gram-negative [BC-GN]; Nanosphere, Northbrook, IL) with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) for direct blood cultures (BCs). Methods BC-GN and MALDI-TOF MS assay results from direct BCs were compared with conventional test results after pure culture. Results Among 124 BCs, 130 gram-negative rods (GNRs), including six cultures with mixed GNRs (117 bacteria were covered by the BC-GN panel), were detected. The BC-GN test presented 116/117 (99.1%) concordance for the identification of targeted GNRs. Among the six polymicrobial BCs, 10 targeted GNRs were correctly identified. Among the 100 BCs tested by MALDI-TOF MS, 88/106 (86.7%) GNRs were correctly identified, and 18 GNRs were not identified. Among the six polymicrobial samples, seven of 12 GNRs (58.3%) were correctly identified. Conclusions The BC-GN assay exhibited superior performance compared with MALDI-TOF MS for the identification of targeted GNRs in direct BCs, particularly in polymicrobial samples.
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Affiliation(s)
- Seon Young Kim
- Department of Laboratory Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Jeong Su Park
- Department of Laboratory Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Yun Ji Hong
- Department of Laboratory Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Taek Soo Kim
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Kiho Hong
- Department of Laboratory Medicine, Seoul Medical Center, Seoul, Republic of Korea
| | - Kyoung-Ho Song
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Hyunju Lee
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Eu Suk Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Hong Bin Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Kyoung Un Park
- Department of Laboratory Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Junghan Song
- Department of Laboratory Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sun Hoe Koo
- Department of Laboratory Medicine, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Eui-Chong Kim
- Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
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Park Y, Kim SY, Kwon GC, Koo SH, Kang ES, Kim J. Automated Versus Conventional Microscopic Interpretation of Antinuclear Antibody Indirect Immunofluorescence Test. Ann Clin Lab Sci 2019; 49:127-133. [PMID: 30814088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND The detection of antinuclear antibodies (ANAs) is crucial for the diagnosis of systemic autoimmune rheumatic diseases. Here, we evaluated the performance of an automated ANA image analyzer, EUROPattern Suite. METHODS We compared the automated and manually revised interpretations of EUROPattern Suite with conventional microscopic interpretations of indirect immunofluorescence (IIF) by calculating the analytical sensitivity and specificity for ANA detection and evaluating the concordance between these approaches for ANA detection, pattern recognition, and titer determination. RESULTS The analytical sensitivity and specificity of EUROPattern Suite for ANA detection were 97.7% and 88.2%, respectively, relative to those of conventional IIF, with a concordance of 94.4% 3κ=0.874). After manual revision, the analytical sensitivity, specificity, and concordance improved to 98.5%, 94.1%, and 97.0% (κ=0.932), respectively. The concordance rates for pattern recognition with simple and mixed patterns were 72.1% and 56.0%, respectively, and varied depending on the type of pattern. After manual revision, the concordance rates with simple and mixed patterns increased to 97.1% and 84.0%, respectively. The concordance rate for titer determination with a simple pattern was 84.6%. CONCLUSION Although automated pattern recognition has some limitations, EUROPattern Suite facilitates automated ANA detection with a high sensitivity and concordance with conventional IIF.
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Affiliation(s)
- Yumi Park
- Department of Laboratory Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Seon Young Kim
- Department of Laboratory Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Gye Cheol Kwon
- Department of Laboratory Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Sun Hoe Koo
- Department of Laboratory Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Eun-Suk Kang
- Departments of Laboratory Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Jimyung Kim
- Department of Laboratory Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
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Oh Y, Song IC, Kim J, Kwon GC, Koo SH, Kim SY. Pyrosequencing-based quantitative measurement of CALR mutation allele burdens and their clinical implications in patients with myeloproliferative neoplasms. Clin Chim Acta 2018; 483:183-191. [DOI: 10.1016/j.cca.2018.05.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 04/17/2018] [Accepted: 05/01/2018] [Indexed: 12/26/2022]
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Sung JY, Kim S, Kwon G, Koo SH. Molecular Characterization of Salmonella Genomic Island 1 in Proteus mirabilis Isolates from Chungcheong Province, Korea. J Microbiol Biotechnol 2018; 27:2052-2059. [PMID: 29032652 DOI: 10.4014/jmb.1708.08040] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
The emergence and dissemination of Salmonella genomic island 1 (SGI1) are strongly associated with the occurrence of multidrug-resistant (MDR) enterobacteria in humans and animals. Diverse SGI1s have been reported among Salmonella enterica and Proteus mirabilis in several countries. We aimed to characterize SGI1 in P. mirabilis isolates from humans and chickens in Chungcheong Province, Korea. A total of 44 P. mirabilis isolates were recovered from humans (n = 20) and chickens (n = 24). Antimicrobial susceptibility was determined by disk diffusion assay. To detect and characterize SGI1s, PCR amplification and PCR mapping experiments were performed. Repetitive extragenic palindromic-PCR (REP-PCR) was performed to assess the clonality of the isolates. The four P. mirabilis strains (16.7%) from chicken harbored a SGI1, whereas none of the isolates from clinical specimens contained SGI1. The SGI1s detected in our study were all confirmed as SGI1-PmABB harboring aminoglycoside-resistant genes (aacCA5 and aadA7). In P. mirabilis isolates, the presence of SGI1-PmABB was significantly correlated with high resistance rates of the isolates to antimicrobial agents, such as gentamicin, streptomycin, and spectinomycin. Moreover, the four SGI1-bearing isolates showed the same REP-PCR patterns and that suggested both horizontal and clonal spread of the isolates. This study is the first attempt to determine SGI1s in P. mirabilis isolates in Korea. We confirmed that P. mirabilis isolates carrying SGI1-PmABB were distributed at poultry farms in Korea. The present study emphasizes the need for continuous monitoring of SGI1s to prevent spreading of the MDR genomic islands among P. mirabilis isolates from humans and animals.
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Affiliation(s)
- Ji Youn Sung
- Department of Biomedical Laboratory Science, Far East University, Eumseong 27601, Republic of Korea
| | - Semi Kim
- Department of Laboratory Medicine, College of Medicine, Chungnam National University, Daejeon 35015, Republic of Korea
| | - GyeCheol Kwon
- Department of Laboratory Medicine, College of Medicine, Chungnam National University, Daejeon 35015, Republic of Korea
| | - Sun Hoe Koo
- Department of Laboratory Medicine, College of Medicine, Chungnam National University, Daejeon 35015, Republic of Korea
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Cho HH, Kwon KC, Kim S, Park Y, Koo SH. Association between Biofilm Formation and Antimicrobial Resistance in Carbapenem-Resistant Pseudomonas Aeruginosa. Ann Clin Lab Sci 2018; 48:363-368. [PMID: 29970441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Recently, carbapenem resistance in P. aeruginosa is an increasingly important problem globally. Biofilm formation is a well-known pathogenic mechanism of P. aeruginosa, and the gene, pslA, plays an important role in its primary stages. We studied the association between biofilm formation and pslA in carbapenem-resistant P. aeruginosa isolates, along with antimicrobial resistance and the prevalence of metallo-β-lactamase (MBL) genes, based on the presence of pslA 82 carbapenem-resistant P. aeruginosa isolates were collected from a tertiary hospital in Daejeon, Korea, between March 2008 and June 2014. Minimum inhibitory concentrations (MICs) of nine antimicrobial agents were determined using the agar dilution method. Biofilm formation was measured by microtiter plate assay. PCR and sequencing were used to identify pslA and the MBL gene. 76 (92.7%) carbapenem-resistant isolates were biofilm producers. These biofilm producers showed higher levels of amikacin, ceftazidime, and cefepime resistance than non-producers. pslA was detected in 71 (93.4%) biofilm-producing isolates and these results were statically significant (p<0.01). 11 isolates carrying pslA and blaIMP-6 were extremely resistant to all antimicrobials tested. In this study, biofilm formation was significantly associated with pslA Furthermore, the coexistence of pslA and the MBL gene in carbapenem-resistant isolates likely contributed to the increase in antimicrobial resistance.
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Affiliation(s)
- Hye Hyun Cho
- Departments of Biomedical Laboratory Science, Daejeon Institute of Science and Technology, Daejeon, Republic of Korea
| | - Kye Chul Kwon
- Department of Laboratory Medicine, College of Medicine, Chungnam National University, Daejeon, Republic of Korea
| | - Semi Kim
- Department of Laboratory Medicine, College of Medicine, Chungnam National University, Daejeon, Republic of Korea
| | - Yumi Park
- Department of Laboratory Medicine, College of Medicine, Chungnam National University, Daejeon, Republic of Korea
| | - Sun Hoe Koo
- Department of Laboratory Medicine, College of Medicine, Chungnam National University, Daejeon, Republic of Korea
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Kim SY, Park Y, Kim H, Kim J, Kwon GC, Koo SH. Discriminating myelodysplastic syndrome and other myeloid malignancies from non-clonal disorders by multiparametric analysis of automated cell data. Clin Chim Acta 2018; 480:56-64. [PMID: 29378171 DOI: 10.1016/j.cca.2018.01.029] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 12/19/2017] [Accepted: 01/18/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND We investigated the usefulness of novel complete blood count (CBC) data for discriminating myeloid malignancies from non-clonal CBC abnormalities. METHODS Data were obtained during routine CBC tests of 119 samples from 37 myelodysplastic syndrome (MDS) patients, 92 samples from 45 myeloproliferative neoplasm (MPN) patients, and 15 samples from 11 chronic myelogenous leukemia (CML) patients using a DxH800 (Beckman Coulter). Data obtained from patients with hypocellular bone marrow and from those with other non-clonal diseases with CBC abnormalities were included in the comparisons. RESULTS For cell population data of neutrophils, the means of median, upper median, lower median, and low angle light scatters were significantly lower in MDS patients than in patients without hematological malignancies. Low hemoglobin density (LHD) did not significantly differ between the MDS and non-clonal cytopenia patients, but it was significantly higher in the MPN and CML patients. We selected 13 parameters and scored the MDS diagnosis using cut-off values obtained from receiver operating characteristic (ROC) curve analysis. Using a score > 9, MDS was distinguished from non-clonal cytopenia with a sensitivity of 92.4% and a specificity of 85.4%. CONCLUSIONS Multiparametric analyses of new automated parameters are useful for discriminating MDS from non-clonal cytopenia.
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Affiliation(s)
- Seon Young Kim
- Department of Laboratory Medicine, Chungnam National University School of Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea; Cancer Research Institute, Chungnam National University School of Medicine, Daejeon, Republic of Korea.
| | - Yumi Park
- Department of Laboratory Medicine, Chungnam National University School of Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Hyunjin Kim
- Department of Laboratory Medicine, Chungnam National University School of Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Jimyung Kim
- Department of Laboratory Medicine, Chungnam National University School of Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Gye Cheol Kwon
- Department of Laboratory Medicine, Chungnam National University School of Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Sun Hoe Koo
- Department of Laboratory Medicine, Chungnam National University School of Medicine, Chungnam National University Hospital, Daejeon, Republic of Korea
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Choi Q, Kim HJ, Kim JW, Kwon GC, Koo SH. Manual versus automated streaking system in clinical microbiology laboratory: Performance evaluation of Previ Isola for blood culture and body fluid samples. J Clin Lab Anal 2018; 32:e22373. [PMID: 29314254 DOI: 10.1002/jcla.22373] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Accepted: 11/27/2017] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The process of plate streaking has been automated to improve routine workflow of clinical microbiology laboratories. Although there were many evaluation reports about the inoculation of various body fluid samples, few evaluations have been reported for blood. In this study, we evaluated the performance of automated inoculating system, Previ Isola for various routine clinical samples including blood. METHODS Blood culture, body fluid, and urine samples were collected. All samples were inoculated on both sheep blood agar plate (BAP) and MacConkey agar plate (MCK) using Previ Isola and manual method. We compared two methods in aspect of quality and quantity of cultures, and sample processing time. To ensure objective colony counting, an enumeration reading reference was made through a preliminary experiment. RESULTS A total of 377 nonduplicate samples (102 blood culture, 203 urine, 72 body fluid) were collected and inoculated. The concordance rate of quality was 100%, 97.0%, and 98.6% in blood, urine, and other body fluids, respectively. In quantitative aspect, it was 98.0%, 97.0%, and 95.8%, respectively. The Previ Isola took a little longer to inoculate the specimen than manual method, but the hands-on time decreased dramatically. The shortened hands-on time using Previ Isola was about 6 minutes per 10 samples. CONCLUSION We demonstrated that the Previ Isola showed high concordance with the manual method in the inoculation of various body fluids, especially in blood culture sample. The use of Previ Isola in clinical microbiology laboratories is expected to save considerable time and human resources.
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Affiliation(s)
- Qute Choi
- Department of Laboratory Medicine, Dankook University College of Medicine, Cheonan, Korea
| | - Hyun Jin Kim
- Department of Laboratory Medicine, Chungnam National University College of Medicine, Daejeon, Korea
| | - Jong Wan Kim
- Department of Laboratory Medicine, Dankook University College of Medicine, Cheonan, Korea
| | - Gye Cheol Kwon
- Department of Laboratory Medicine, Chungnam National University College of Medicine, Daejeon, Korea
| | - Sun Hoe Koo
- Department of Laboratory Medicine, Chungnam National University College of Medicine, Daejeon, Korea
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Kim SY, Kim H, Park Y, Lim J, Kim J, Koo SH, Kwon GC. Evaluation of an Automated Reader and Color Interpretation-Based Immunoassays for Multiplexed Drug-of-Abuse Testing in Urine. J Anal Toxicol 2017; 41:412-420. [PMID: 28201761 DOI: 10.1093/jat/bkx014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Indexed: 11/14/2022] Open
Abstract
On-site drugs of abuse testing devices have undergone continuous improvement. We evaluated three devices with different designs: an automated reader, the Multi-Drug Screen Test Device with DxLINK (DxLINK; Innovacon, Alere, San Diego, USA) and two colorimetric immunoassays, the One Step Multi-Line Screen Panel with Integrated E-Z Split Key Cup II (E-Z Cup; Innovacon, Alere) and the One Step Multi-Drug Screen Panel card (Multi4 card; Alere, Abon Biopharm, Hangzhou, China). Eleven drugs [amphetamine, secobarbital, oxazepam, buprenorphine, benzoylecgonine, methylenedioxymethamphetamine (MDMA), 11-nor-9-carboxy-Δ9-tetrahydrocannabinol (THC), methamphetamine, methadone, morphine and nortriptyline] were tested using the DxLINK and E-Z Cup. Four drugs (benzoylecgonine, THC, methamphetamine and morphine) were tested using the Multi4 card using control materials (Detectabuse Stat-Skreen; Biochemical Diagnostics, Edgewood, NY, USA). The concentrations (-50%, -25%, +25%, +50% and 3× cut-off values) of the control materials were confirmed by mass spectrometry. Concordance rates were calculated around cut-offs. All devices showed high overall agreement rates of >90% with a few exceptions: the DxLINK exhibited lower sensitivity for benzoylecgonine, methadone and nortriptyline (60% and 30%, 92% and 40%, and 96% and 60% sensitivity at +50% and +25% cut-off levels, respectively). The E-Z Cup exhibited lower sensitivity for oxazepam and nortriptyline (97% and 50%, and 97% and 40% sensitivity at +50% and +25% cut-off levels, respectively). We additionally evaluated test-band color by visual inspection using a standard color-scale card. When detailed color criteria for determination of positivity were applied for the E-Z Cup, using slightly less stringent criteria, oxazepam, buprenorphine, MDMA and nortriptyline showed increases in sensitivity from 70-80% to 90-100%, all with a specificity above 98%. Overall, all devices exhibited satisfactory performance at ±50% cut-off levels for commonly used drugs, with the exception of lower sensitivity for cocaine testing for DxLINK. Careful evaluation of devices and elaborate calibration of visual interpretation for determining positivity may help improve the performance of these devices.
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Affiliation(s)
- Seon Young Kim
- Department of Laboratory Medicine, Chungnam National University School of Medicine, 282, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Hyunjin Kim
- Department of Laboratory Medicine, Chungnam National University School of Medicine, 282, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Yeongchun Park
- Department of Laboratory Medicine, Chungnam National University School of Medicine, 282, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Jinsook Lim
- Department of Laboratory Medicine, Chungnam National University School of Medicine, 282, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Jimyung Kim
- Department of Laboratory Medicine, Chungnam National University School of Medicine, 282, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Sun Hoe Koo
- Department of Laboratory Medicine, Chungnam National University School of Medicine, 282, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
| | - Gye Cheol Kwon
- Department of Laboratory Medicine, Chungnam National University School of Medicine, 282, Munhwa-ro, Jung-gu, Daejeon, 35015, Republic of Korea
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Lim HH, Kil HR, Koo SH. Incidence, puberty, and fertility in 45,X/47,XXX mosaicism: Report of a patient and a literature review. Am J Med Genet A 2017; 173:1961-1964. [PMID: 28485514 DOI: 10.1002/ajmg.a.38276] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Accepted: 04/06/2017] [Indexed: 01/15/2023]
Abstract
Turner syndrome (TS), characterized by short stature and premature ovarian failure, is caused by chromosomal aberrations with total or partial loss of one of the two X chromosomes. Spontaneous puberty, menarche, and pregnancy occur in some patients depending on the abnormality of the X. Moreover, spontaneous pregnancy is uncommon (<0.5%) for TS with 45,X monosomy. Among TS patients, 45,X/47,XXX karyotype is extremely rare. Previous reports have demonstrated that TS with 45,X/47,XXX is less severe than common TS due to higher occurrence of puberty (83%), menarche (57-67%), and fertility (14%) and lower occurrence of congenital anomalies (<5%). However, TS mosaicism may not reduce the frequency of short stature. We diagnosed a 10-year-girl with TS with 45,X/47,XXX mosaicism who presented with short stature. She showed mild TS phenotype including short stature but had spontaneous puberty. Based on our case and previous reports, we expect that girls with 45,X/47,XXX mosaicism may progress through puberty normally, without estrogen therapy. Therefore, it is necessary to consider specific guidelines for clinical decisions surrounding pubertal development and fertility in TS with 45,X/47,XXX karyotype.
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Affiliation(s)
- Han Hyuk Lim
- Department of Pediatrics, Chungnam National University School of Medicine, Daejeon, South Korea
| | - Hong Ryang Kil
- Department of Pediatrics, Chungnam National University School of Medicine, Daejeon, South Korea
| | - Sun Hoe Koo
- Department of Laboratory Medicine, Chungnam National University School of Medicine, Daejeon, South Korea
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Lee JK, Louzada S, An Y, Kim SY, Kim S, Youk J, Park S, Koo SH, Keam B, Jeon YK, Ku JL, Yang F, Kim TM, Ju YS. Complex chromosomal rearrangements by single catastrophic pathogenesis in NUT midline carcinoma. Ann Oncol 2017; 28:890-897. [PMID: 28203693 PMCID: PMC5378225 DOI: 10.1093/annonc/mdw686] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Accepted: 12/15/2016] [Indexed: 01/12/2023] Open
Abstract
Background Nuclear protein in testis (NUT) midline carcinoma (NMC) is a rare aggressive malignancy often occurring in the tissues of midline anatomical structures. Except for the pathognomonic BRD3/4–NUT rearrangement, the comprehensive landscape of genomic alterations in NMCs has been unexplored. Patients and methods We investigated three NMC cases, including two newly diagnosed NMC patients in Seoul National University Hospital, and a previously reported cell line (Ty-82). Whole-genome and transcriptome sequencing were carried out for these cases, and findings were validated by multiplex fluorescence in situ hybridization and using individual fluorescence probes. Results Here, we present the first integrative analysis of whole-genome sequencing, transcriptome sequencing and cytogenetic characterization of NUT midline carcinomas. By whole-genome sequencing, we identified a remarkably similar pattern of highly complex genomic rearrangements (previously denominated as chromoplexy) involving the BRD3/4–NUT oncogenic rearrangements in two newly diagnosed NMC cases. Transcriptome sequencing revealed that these complex rearrangements were transcribed as very simple BRD3/4–NUT fusion transcripts. In Ty-82 cells, we also identified a complex genomic rearrangement involving the BRD4–NUT rearrangement underlying the simple t(15;19) karyotype. Careful inspections of rearrangement breakpoints indicated that these rearrangements were likely attributable to single catastrophic events. Although the NMC genomes had >3000 somatic point mutations, canonical oncogenes or tumor suppressor genes were rarely affected, indicating that they were largely passenger events. Mutational signature analysis showed predominant molecular clock-like signatures in all three cases (accounting for 54%−75% of all base substitutions), suggesting that NMCs may arise from actively proliferating normal cells. Conclusion Taken together, our findings suggest that a single catastrophic event in proliferating normal cells could be sufficient for neoplastic transformation into NMCs.
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Affiliation(s)
- J-K Lee
- Korea Advanced Institute of Science and Technology, Graduate School of Medical Science and Engineering, Daejeon, South Korea
| | - S Louzada
- Molecular Cytogenetics Core Facility, Wellcome Trust Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge, UK
| | - Y An
- Biomedical Science and Engineering Interdisciplinary Program, Korea Advanced Institute of Science and Technology, Daejeon, South Korea
| | - S Y Kim
- Department of Laboratory Medicine, Chungnam National University School of Medicine, Daejeon, South Korea
| | - S Kim
- Seoul National University Cancer Research Institute, Seoul, South Korea
| | - J Youk
- Korea Advanced Institute of Science and Technology, Graduate School of Medical Science and Engineering, Daejeon, South Korea
| | - S Park
- Korea Advanced Institute of Science and Technology, Graduate School of Medical Science and Engineering, Daejeon, South Korea
| | - S H Koo
- Department of Laboratory Medicine, Chungnam National University School of Medicine, Daejeon, South Korea
| | - B Keam
- Department of Internal Medicine Seoul National University Hospital, Seoul, South Korea
| | - Y K Jeon
- Pathology, Seoul National University Hospital, Seoul, South Korea
| | - J-L Ku
- Seoul National University Cancer Research Institute, Seoul, South Korea
| | - F Yang
- Molecular Cytogenetics Core Facility, Wellcome Trust Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge, UK
| | - T M Kim
- Seoul National University Cancer Research Institute, Seoul, South Korea.,Department of Internal Medicine Seoul National University Hospital, Seoul, South Korea
| | - Y S Ju
- Korea Advanced Institute of Science and Technology, Graduate School of Medical Science and Engineering, Daejeon, South Korea.,Biomedical Science and Engineering Interdisciplinary Program, Korea Advanced Institute of Science and Technology, Daejeon, South Korea
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Lim J, Kim H, Koo SH, Kwon GC. Evaluation of the LABGEO PT10 Point-Of-Care Testing Device: Comparison of Analyte Measurements in Capillary Whole Blood and Lithium Heparin Whole Blood Samples With Those in Central Laboratory. J Clin Lab Anal 2017; 31:e22050. [PMID: 27638131 PMCID: PMC6817124 DOI: 10.1002/jcla.22050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 07/23/2016] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Point-of-care (POC) testing device has been widely used because of its rapid availability of results making diagnosis and management as early as possible. Capillary blood can reduce the difficulty of obtaining samples compared to venous blood and allows the prompt testing results. In this study, we evaluated the usefulness of capillary blood in Samsung LABGEO PT10. METHODS Fifty-one patients and 18 healthy adults aged between 20 and 65 were enrolled and their capillary and venous blood samples were collected. Venous blood samples were split into lithium heparin (LiHep) tube and serum-separating tube. Measurements using capillary blood and LiHep whole blood were performed in LABGEO PT10. Serum was used for measurement by Toshiba 2000FR NEO in central laboratory. RESULTS In comparison between measurements in LABGEO PT10 using capillary and LiHep whole blood, the slope ranged between 0.9289 and 1.0471, correlation coefficients (R2 ) were over 0.95 except albumin, high-density lipoprotein, and total protein. Comparison of measurements in capillary and LiHep whole blood using LABGEO PT10 with those in the central laboratory revealed that the slope ranged between 0.6433 and 1.1364 for capillary whole blood and 0.6255 and 1.1602 for LiHep whole blood except alkaline phosphatase. For most of analytes, R2 were over 0.95. CONCLUSION Measurements in LABGEO PT10 using capillary blood was well correlated with those in LABGEO PT10 using LiHep whole blood and also with in the central laboratory. In conclusion, capillary blood provides reliable measurements and can be trustfully used in LABGEO PT10.
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Affiliation(s)
- Jinsook Lim
- Department of Laboratory MedicineChungnam National University HospitalDaejeonKorea
| | - Hyunjin Kim
- Department of Laboratory MedicineChungnam National University HospitalDaejeonKorea
| | - Sun Hoe Koo
- Department of Laboratory MedicineChungnam National University HospitalDaejeonKorea
| | - Gye Cheol Kwon
- Department of Laboratory MedicineChungnam National University HospitalDaejeonKorea
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Sung JY, Koo SH, Kim S, Kwon GC. Persistence of Multidrug-Resistant Acinetobacter baumannii Isolates Harboring blaOXA-23 and bap for 5 Years. J Microbiol Biotechnol 2017; 26:1481-9. [PMID: 27221112 DOI: 10.4014/jmb.1604.04049] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
The emergence and dissemination of carbapenemase-producing Acinetobacter baumannii isolates have been reported worldwide, and A. baumannii isolates harboring blaOXA-23 are often resistant to various antimicrobial agents. Antimicrobial resistance can be particularly strong for biofilm-forming A. baumannii isolates. We investigated the genetic basis for carbapenem resistance and biofilm-forming ability of multidrug-resistant (MDR) clinical isolates. Ninety-two MDR A. baumannii isolates were collected from one university hospital located in the Chungcheong area of Korea over a 5-year period. Multiplex PCR and DNA sequencing were performed to characterize carbapenemase and bap genes. Clonal characteristics were analyzed using REP-PCR. In addition, imaging and quantification of biofilms were performed using a crystal violet assay. All 92 MDR A. baumannii isolates involved in our study contained the blaOXA-23 and bap genes. The average absorbance of biomass in Bap-producing strains was much greater than that in non-Bap-producing strains. In our study, only three REP-PCR types were found, and the isolates showing type A or type B were found more than 60 times among unique patients during the 5 years of surveillance. These results suggest that the isolates have persisted and colonized for 5 years, and biofilm formation ability has been responsible for their persistence and colonization.
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Affiliation(s)
- Ji Youn Sung
- Department of Biomedical Laboratory Science, Far East University, Eumseong 27601, Republic of Korea
| | - Sun Hoe Koo
- Department of Laboratory Medicine, College of Medicine, Chungnam National University, Daejeon 34134, Republic of Korea
| | - Semi Kim
- Department of Laboratory Medicine, College of Medicine, Chungnam National University, Daejeon 34134, Republic of Korea
| | - Gye Cheol Kwon
- Department of Laboratory Medicine, College of Medicine, Chungnam National University, Daejeon 34134, Republic of Korea
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Heo MS, Shin JH, Choi MJ, Park YJ, Lee HS, Koo SH, Lee WG, Kim SH, Shin MG, Suh SP, Ryang DW. Molecular identification and amphotericin B susceptibility testing of clinical isolates of Aspergillus from 11 hospitals in Korea. Ann Lab Med 2016; 35:602-10. [PMID: 26354348 PMCID: PMC4579104 DOI: 10.3343/alm.2015.35.6.602] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2014] [Revised: 04/12/2015] [Accepted: 07/06/2015] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND We investigated the species distribution and amphotericin B (AMB) susceptibility of Korean clinical Aspergillus isolates by using two Etests and the CLSI broth microdilution method. METHODS A total of 136 Aspergillus isolates obtained from 11 university hospitals were identified by sequencing the internal transcribed spacer (ITS) and β-tubulin genomic regions. Minimal inhibitory concentrations (MICs) of AMB were determined in Etests using Mueller-Hinton agar (Etest-MH) and RPMI agar (Etest-RPG), and categorical agreement with the CLSI method was assessed by using epidemiological cutoff values. RESULTS ITS sequencing identified the following six Aspergillus species complexes: Aspergillus fumigatus (42.6% of the isolates), A. niger (23.5%), A. flavus (17.6%), A. terreus (11.0%), A. versicolor (4.4%), and A. ustus (0.7%). Cryptic species identifiable by β-tubulin sequencing accounted for 25.7% (35/136) of the isolates. Of all 136 isolates, 36 (26.5%) had AMB MICs of ≥2 μg/mL by the CLSI method. The categorical agreement of Etest-RPG with the CLSI method was 98% for the A. fumigatus, A. niger, and A. versicolor complexes, 87% for the A. terreus complex, and 37.5% for the A. flavus complex. That of Etest-MH was ≤75% for the A. niger, A. flavus, A. terreus, and A. versicolor complexes but was higher for the A. fumigatus complex (98.3%). CONCLUSIONS Aspergillus species other than A. fumigatus constitute about 60% of clinical Aspergillus isolates, and reduced AMB susceptibility is common among clinical isolates of Aspergillus in Korea. Molecular identification and AMB susceptibility testing by Etest-RPG may be useful for characterizing Aspergillus isolates of clinical relevance.
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Affiliation(s)
- Min Seok Heo
- Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Jong Hee Shin
- Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Korea.
| | - Min Ji Choi
- Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Yeon Joon Park
- Department of Laboratory Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Hye Soo Lee
- Department of Laboratory Medicine, Chonbuk National University Medical School and Chonbuk National University Hospital Branch of National Culture Collection for Pathogens, Jeonju, Korea
| | - Sun Hoe Koo
- Department of Laboratory Medicine, College of Medicine, Chungnam National University, Gwangju, Korea
| | - Won Gil Lee
- Department of Laboratory Medicine, Kyungpook National University School of Medicine, Daegu, Korea
| | - Soo Hyun Kim
- Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Myung Geun Shin
- Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Soon Pal Suh
- Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Dong Wook Ryang
- Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Korea
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Abstract
Carbapenemase production has been reported worldwide in gram-negative bacteria, including Acinetobacter species. We detected carbapenemase-producing Acinetobacter pittii in clinical isolates in Daejeon, Korea. Twenty-one ertapenem-resistant A. pittii isolates screened with a disk diffusion method were characterized by using the Epsilon test, four multiplex PCR assays, and a multilocus sequence typing (MLST) scheme. A total of 21 A. pittii isolates harbored the metallo-β-lactamase (MBL) gene bla(IMP-1) or bla(NDM-1). Nineteen isolates containing bla(IMP-1) were resistant to imipenem and meropenem, but two isolates harboring bla(NDM-1) were susceptible to them. The sequence types (STs) of the two New Delhi MBL (NDM-1)-producing A. pittii isolates were ST70 and ST207, which differed from the STs (ST63, ST119, ST396, and a novel ST) of the IMP-1-producing A. pittii. This is the first report on NDM-1-producing A. pittii isolates in Korea. Our results emphasize that the study of NDM-1-producing gram-negative bacteria should involve carbapenem-susceptible as well as carbapenem-resistant isolates.
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Affiliation(s)
- Ji Youn Sung
- Department of Biomedical Laboratory Science, Far East University, Eumseong-gun, Chungcheongbuk-do, Korea
| | - Sun Hoe Koo
- Department of Laboratory Medicine, College of Medicine, Chungnam National University, Daejeon, Korea.
| | - Semi Kim
- Department of Laboratory Medicine, College of Medicine, Chungnam National University, Daejeon, Korea
| | - Gye Cheol Kwon
- Department of Laboratory Medicine, College of Medicine, Chungnam National University, Daejeon, Korea
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Kim S, Sung JY, Cho HH, Kwon KC, Koo SH. Characteristics of the Molecular Epidemiology of CTX-M-Producing Escherichia coli Isolated from a Tertiary Hospital in Daejeon, Korea. J Microbiol Biotechnol 2016; 26:1643-9. [DOI: 10.4014/jmb.1603.03063] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Lim J, Song KE, Song SH, Choi HJ, Koo SH, Kwon GC. Traceability Assessment and Performance Evaluation of Results for Measurement of Abbott Clinical Chemistry Assays on 4 Chemistry Analyzers. Arch Pathol Lab Med 2016; 140:467-72. [DOI: 10.5858/arpa.2015-0088-oa] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Context.—The traceability of clinical results to internationally recognized and accepted reference materials and reference measurement procedures has become increasingly important. Therefore, the establishment of traceability has become a mandatory requirement for all in vitro diagnostics devices.
Objectives.—To evaluate the traceability of the Abbott Architect c8000 system (Abbott Laboratories, Abbott Park, Illinois), consisting of calibrators and reagents, across 4 different chemistry analyzers, and to evaluate its general performance on the Toshiba 2000FR NEO (Toshiba Medical Systems Corporation, Otawara-shi, Tochigi-ken, Japan).
Design.—For assessment of traceability, secondary reference materials were evaluated 5 times, and then bias was calculated. Precision, linearity, and carryover were determined according to the guidelines of the Clinical and Laboratory Standards Institute (Wayne, Pennsylvania).
Results.—The biases from 4 different analyzers ranged from −2.33% to 2.70% on the Toshiba 2000FR NEO, −2.33% to 5.12% on the Roche Hitachi 7600 (Roche Diagnostics International, Basel, Switzerland), −0.93% to 2.87% on the Roche Modular, and −2.16% to 2.86% on the Abbott Architect c16000. The total coefficients of variance of all analytes were less than 5%. The coefficients of determination (R2) were more than 0.9900. The carryover rate ranged from −0.54% to 0.17%.
Conclusions.—Abbott clinical chemistry assays met the performance criteria based on desirable biological variation for precision, bias, and total error. They also showed excellent linearity and carryover. Therefore, these clinical chemistry assays were found to be accurate and reliable and are readily applicable on the various platforms used in this study.
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Affiliation(s)
| | | | | | | | | | - Gye Choel Kwon
- From the Department of Laboratory Medicine, Chungnam National University Hospital, Daejeon, South Korea (Drs Lim, Koo, and Kwon); the Department of Laboratory Medicine, Kyungpook National University Hospital, Daegu, South Korea (Dr K.E. Song); the Department of Laboratory Medicine, Seoul National University Hospital and College of Medicine, Seoul, South Korea (Dr S.H. Song); the Department of Lab
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Jung SI, Shin JH, Kim SH, Kim J, Kim JH, Choi MJ, Chung EK, Lee K, Koo SH, Chang HH, Bougnoux ME, d’Enfert C. Comparison of E,E-Farnesol Secretion and the Clinical Characteristics of Candida albicans Bloodstream Isolates from Different Multilocus Sequence Typing Clades. PLoS One 2016; 11:e0148400. [PMID: 26848577 PMCID: PMC4743943 DOI: 10.1371/journal.pone.0148400] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2015] [Accepted: 01/18/2016] [Indexed: 11/18/2022] Open
Abstract
Using multilocus sequence typing (MLST), Candida albicans can be subdivided into 18 different clades. Farnesol, a quorum-sensing molecule secreted by C. albicans, is thought to play an important role in the development of C. albicans biofilms and is also a virulence factor. This study evaluated whether C. albicans bloodstream infection (BSI) strains belonging to different MLST clades secrete different levels of E,E-farnesol (FOH) and whether they have different clinical characteristics. In total, 149 C. albicans BSI isolates from ten Korean hospitals belonging to clades 18 (n = 28), 4 (n = 23), 1 (n = 22), 12 (n = 17), and other clades (n = 59) were assessed. For each isolate, the FOH level in 24-hour biofilms was determined in filtered (0.45 μm) culture supernatant using high-performance liquid chromatography. Marked differences in FOH secretion from biofilms (0.10–6.99 μM) were observed among the 149 BSI isolates. Clade 18 isolates secreted significantly more FOH than did non-clade 18 isolates (mean ± SEM; 2.66 ± 0.22 vs. 1.69 ± 0.10 μM; P < 0.001). Patients with isolates belonging to clade 18 had a lower mean severity of illness than other patients, as measured using the “acute physiology and chronic health evaluation” (APACHE) III score (14.4 ± 1.1 vs. 18.0 ± 0.7; P < 0.05). This study provides evidence that C. albicans BSI isolates belonging to the most prevalent MLST clade (clade 18) in Korea are characterized by increased levels of FOH secretion and less severe illness.
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Affiliation(s)
- Sook-In Jung
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - Jong Hee Shin
- Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, South Korea
- * E-mail:
| | - Soo Hyun Kim
- Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - Jin Kim
- Biomedical Research Institute, Chonnam National University Hospital, Gwangju, Korea
| | - Joo Hee Kim
- Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - Min Ji Choi
- Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - Eun-Kyung Chung
- Department of Medical Education, Chonnam National University Medical School, Gwangju, South Korea
| | - Kyungwon Lee
- Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, Korea
| | - Sun Hoe Koo
- Department of Laboratory Medicine, Chungnam National University College of Medicine, Daejeon, South Korea
| | - Hyun Ha Chang
- Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, South Korea
| | - Marie-Elisabeth Bougnoux
- Institut Pasteur, Unité Biologie et Pathogenicité Fongiques, F-75015 Paris, France
- INRA, USC2019, F-75015 Paris, France
- Laboratoire de Parasitologie-Mycologie, Service de Microbiologie, Hôpital Necker-Enfants Malades, Université Paris Descartes, Faculté de Médicine, F-75015 Paris, France
| | - Christophe d’Enfert
- Institut Pasteur, Unité Biologie et Pathogenicité Fongiques, F-75015 Paris, France
- INRA, USC2019, F-75015 Paris, France
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Lee JH, Subhadra B, Son YJ, Kim DH, Park HS, Kim JM, Koo SH, Oh MH, Kim HJ, Choi CH. Phylogenetic group distributions, virulence factors and antimicrobial resistance properties of uropathogenic Escherichia coli strains isolated from patients with urinary tract infections in South Korea. Lett Appl Microbiol 2015; 62:84-90. [PMID: 26518617 DOI: 10.1111/lam.12517] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 10/07/2015] [Accepted: 10/25/2015] [Indexed: 12/21/2022]
Abstract
UNLABELLED Urinary tract infections (UTIs) are one of the most common diseases by which humans seek medical help and are caused mainly by uropathogenic Escherichia coli (UPEC). Studying the virulence and antibiotic resistance of UPEC with respect to various phylogenetic groups is of utmost importance in developing new therapeutic agents. Thus, in this study, we analysed the virulence factors, antibiotic resistance and phylogenetic groups among various UPEC isolates from children with UTIs. The phylogenetic analysis revealed that majority of the strains responsible for UTIs belonged to the phylogenetic groups B2 and D. Of the 58 E. coli isolates, 79·31% belonged to group B2, 15·51% to group D, 3·44% to group A and 1·72% to B1. Simultaneously, the number of virulence factors and antibiotic resistance exhibited were also significantly high in groups B2 and D compared to other groups. Among the isolates, 44·8% were multidrug resistant and of that 73% belonged to the phylogenetic group B2, indicating the compatibility of antibiotic resistance and certain strains carrying virulence factor genes. The antibiotic resistance profiling of UPEC strains elucidates that the antimicrobial agents such as chloramphenicol, cefoxitin, cefepime, ceftazidime might still be used in the therapy for treating UTIs. SIGNIFICANCE AND IMPACT OF THE STUDY As the antibiotic resistance pattern of uropathogenic Escherichia coli varies depending on different geographical regions, the antibiotic resistance pattern from this study will help the physicians to effectively administer antibiotic therapy for urinary tract infections. In addition, the frequency of virulence factors and antibiotic resistance genes among various phylogenic groups could be effectively used to draw new targets for uropathogenic Escherichia coli antibiotic-independent therapies. The study emphasizes need of public awareness on multidrug resistance and for more prudent use of antimicrobials.
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Affiliation(s)
- J H Lee
- Department of Pediatrics, Chungnam National University Hospital, Daejeon, Korea
| | - B Subhadra
- Department of Microbiology, College of Medicine, Chungnam National University, Daejeon, Korea
| | - Y-J Son
- Department of Microbiology, College of Medicine, Chungnam National University, Daejeon, Korea
| | - D H Kim
- Department of Microbiology, College of Medicine, Chungnam National University, Daejeon, Korea
| | - H S Park
- Department of Microbiology, College of Medicine, Chungnam National University, Daejeon, Korea
| | - J M Kim
- Department of Pediatrics, Chungnam National University Hospital, Daejeon, Korea
| | - S H Koo
- Department of Laboratory Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - M H Oh
- Department of Nanobiomedical Science, Dankook University, Cheonan, Korea
| | - H-J Kim
- Department of Microbiology, College of Medicine, Chungnam National University, Daejeon, Korea
| | - C H Choi
- Department of Microbiology, College of Medicine, Chungnam National University, Daejeon, Korea
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Cho HH, Kwon GC, Kim S, Koo SH. Distribution of Pseudomonas-Derived Cephalosporinase and Metallo-��-Lactamases in Carbapenem-Resistant Pseudomonas aeruginosa Isolates from Korea. J Microbiol Biotechnol 2015; 25:1154-62. [DOI: 10.4014/jmb.1503.03065] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Affiliation(s)
- Sun Hoe Koo
- Department of Laboratory Medicine, Chungnam National University Hospital, Daejeon, Korea
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Sohn KM, Baek JY, Cheon S, Kim YS, Koo SH. Ocular infection associated with Delftia lacustris: first report. Braz J Infect Dis 2015; 19:449-50. [PMID: 26095905 PMCID: PMC9427517 DOI: 10.1016/j.bjid.2015.05.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2015] [Accepted: 05/06/2015] [Indexed: 11/24/2022] Open
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Park Y, Lim J, Ko YH, Kim J, Kwon GC, Koo SH. A case of pentasomy 21 with two isochromosome 21s in acute megakaryoblastic leukemia associated with Down syndrome. Ann Lab Med 2015; 35:373-5. [PMID: 25932450 PMCID: PMC4390710 DOI: 10.3343/alm.2015.35.3.373] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2014] [Revised: 11/07/2014] [Accepted: 02/07/2015] [Indexed: 01/08/2023] Open
Affiliation(s)
- Yeongchun Park
- Department of Laboratory Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Jinsook Lim
- Department of Laboratory Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Yong Hyun Ko
- Department of Laboratory Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Jimyung Kim
- Department of Laboratory Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Gye Cheol Kwon
- Department of Laboratory Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Sun Hoe Koo
- Department of Laboratory Medicine, Chungnam National University Hospital, Daejeon, Korea
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Lim J, Kim J, Kim JW, Ihm C, Sohn YH, Cho HJ, Kim J, Koo SH. Multicenter evaluation of Seegene Anyplex TB PCR for the detection of Mycobacterium tuberculosis in respiratory specimens. J Microbiol Biotechnol 2015; 24:1004-7. [PMID: 24786527 DOI: 10.4014/jmb.1403.03071] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Culture is the gold standard for diagnosis of tuberculosis, but it takes 6 to 8 weeks to confirm the result. This issue is complemented by the detection method using polymerase chain reaction, which is now widely used in a routine microbiology laboratory. In this study, we evaluated the performance of the Seegene Anyplex TB PCR to assess its diagnostic sensitivity and specificity, and compared its results with the Roche Cobas TaqMan MTB PCR, one of the most widely used assays in the world. Five university hospitals located in the Chungcheong area in South Korea participated in the study. A total of 1,167 respiratory specimens ordered for acid-fast bacilli staining and culture were collected for four months, analyzed via the Seegene Anyplex TB PCR, and its results were compared with the Roche Cobas TaqMan MTB PCR. For detection of Mycobacterium tuberculosis, the diagnostic sensitivity and specificity of the Anyplex TB PCR were 87.5% and 98.2% respectively, whereas those of the Cobas TaqMan were 92.0% and 98.0% respectively (p value > 0.05). For smear-positive specimens, the sensitivity of the Anyplex TB PCR was 95.2%, which was exactly the same as that of the Cobas TaqMan. For smear-negative specimens, the sensitivity of the Anyplex TB PCR was 69.2%, whereas that of the Cobas TaqMan TB PCR was 84.6%. For detection of MTB, the Seegene Anyplex TB PCR showed excellent diagnostic performance, and high sensitivity and specificity, which were comparable to the Roche Cobas TaqMan MTB PCR. In conclusion, the Anyplex TB PCR can be a useful diagnostic tool for the early detection of tuberculosis in clinical laboratories.
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Affiliation(s)
- Jinsook Lim
- Department of Laboratory Medicine, Chungnam National University Hospital, Daejeon, 301-721, South Korea
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Shin HW, Lim J, Kim S, Kim J, Kwon GC, Koo SH. Characterization of Trimethoprim-Sulfamethoxazole Resistance Genes and Their Relatedness to Class 1 Integron and Insertion Sequence Common Region in Gram-Negative Bacilli. J Microbiol Biotechnol 2015; 25:137-42. [DOI: 10.4014/jmb.1409.09041] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Kim S, Sung JY, Cho HH, Kwon KC, Koo SH. Characterization of CTX-M-14- and CTX-M-15-Producing Escherichia coli and Klebsiella pneumoniae Isolates from Urine Specimens in a Tertiary-Care Hospital. J Microbiol Biotechnol 2014; 24:765-70. [DOI: 10.4014/jmb.1306.06036] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Sung JY, Koo SH, Kim S, Kwon KC. Epidemiological characterizations of class 1 integrons from multidrug-resistant acinetobacter isolates in Daejeon, Korea. Ann Lab Med 2014; 34:293-9. [PMID: 24982834 PMCID: PMC4071186 DOI: 10.3343/alm.2014.34.4.293] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Revised: 10/09/2013] [Accepted: 05/01/2014] [Indexed: 01/19/2023] Open
Abstract
Background Multidrug-resistant (MDR) Acinetobacter spp. acquire antimicrobial agent-resistance genes via class 1 integrons. In this study, integrons were characterized to investigate the antimicrobial resistance mechanisms of MDR Acinetobacter isolates. In addition, the relationship between the integron type and integron-harboring bacterial species was analyzed by using epidemiological typing methods. Methods Fifty-six MDR Acinetobacter spp.-A. baumannii (N=30), A. bereziniae (N=4), A. nosocomialis (N=5), and A. pittii (N=17)-were isolated. The minimum inhibitory concentrations (MICs) were determined on the basis of the results of the Epsilometer test (Etest). PCR and DNA sequencing was performed to characterize the gene cassette arrays of class 1 integrons. Multilocus sequence typing (MLST) and repetitive extragenic palindromic sequence (REP)-PCR were performed for epidemiological typing. Results Class 1 integrons were detected in 50 (89.3%) of the 56 isolates, but no class 2 or 3 integron was found within the cohorts. The class 1 integrons were classified into 4 types: 2.3-kb type A (aacA4-catB8-aadA1), 3.0-kb type B (aacA4-blaIMP-1-blaOXA-2), 3.0-kb type C (blaVIM-2-aacA7-aadA1), and 1.8-kb type D (aac3-1-blaOXA-2-orfD). Type A was most prevalent and was detected only in A. baumannii isolates, except for one A. bereziniae isolate; however, type B was amplified in all Acinetobacter isolates except for A. baumannii isolates, regardless of clone and separation time of the bacteria. Conclusions Although class 1 integron can be transferred horizontally between unrelated isolates belonging to different species, certain types of class 1 integrons tend to transfer horizontally and vertically among A. baumannii or non-baumannii Acinetobacter isolates.
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Affiliation(s)
- Ji Youn Sung
- Department of Biomedical Laboratory Science, Far East University, Eumseong, Korea
| | - Sun Hoe Koo
- Department of Laboratory Medicine, College of Medicine, Chungnam National University, Daejeon, Korea
| | - Semi Kim
- Department of Laboratory Medicine, College of Medicine, Chungnam National University, Daejeon, Korea
| | - Kye Chul Kwon
- Department of Laboratory Medicine, College of Medicine, Chungnam National University, Daejeon, Korea
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Cho HH, Kwon KC, Kim S, Koo SH. Correlation between virulence genotype and fluoroquinolone resistance in carbapenem-resistant Pseudomonas aeruginosa. Ann Lab Med 2014; 34:286-92. [PMID: 24982833 PMCID: PMC4071185 DOI: 10.3343/alm.2014.34.4.286] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Revised: 01/22/2014] [Accepted: 05/07/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Pseudomonas aeruginosa is a clinically important pathogen that causes opportunistic infections and nosocomial outbreaks. Recently, the type III secretion system (TTSS) has been shown to play an important role in the virulence of P. aeruginosa. ExoU, in particular, has the greatest impact on disease severity. We examined the relationship among the TTSS effector genotype (exoS and exoU), fluoroquinolone resistance, and target site mutations in 66 carbapenem-resistant P. aeruginosa strains. METHODS Sixty-six carbapenem-resistant P. aeruginosa strains were collected from patients in a university hospital in Daejeon, Korea, from January 2008 to May 2012. Minimum inhibitory concentrations (MICs) of fluoroquinolones (ciprofloxacin and levofloxacin) were determined by using the agar dilution method. We used PCR and sequencing to determine the TTSS effector genotype and quinolone resistance-determining regions (QRDRs) of the respective target genes gyrA, gyrB, parC, and parE. RESULTS A higher proportion of exoU+ strains were fluoroquinolone-resistant than exoS+ strains (93.2%, 41/44 vs. 45.0%, 9/20; P≤0.0001). Additionally, exoU+ strains were more likely to carry combined mutations than exoS+ strains (97.6%, 40/41 vs. 70%, 7/10; P=0.021), and MIC increased as the number of active mutations increased. CONCLUSIONS The recent overuse of fluoroquinolone has led to both increased resistance and enhanced virulence of carbapenem-resistant P. aeruginosa. These data indicate a specific relationship among exoU genotype, fluoroquinolone resistance, and resistance-conferring mutations.
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Affiliation(s)
- Hye Hyun Cho
- Department of Biomedical Laboratory Science, Jeonju Kijeon College, Jeonju, Korea
| | - Kye Chul Kwon
- Department of Laboratory Medicine, College of Medicine, Chungnam National University, Daejeon, Korea
| | - Semi Kim
- Department of Laboratory Medicine, College of Medicine, Chungnam National University, Daejeon, Korea
| | - Sun Hoe Koo
- Department of Laboratory Medicine, College of Medicine, Chungnam National University, Daejeon, Korea
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Lim J, Kwon GC, Koo SH, Song IC, Kim J. A case of acute promyelocytic leukemia concomitant with plasma cell myeloma. Ann Lab Med 2014; 34:152-4. [PMID: 24624353 PMCID: PMC3948830 DOI: 10.3343/alm.2014.34.2.152] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Revised: 07/29/2013] [Accepted: 09/02/2013] [Indexed: 11/19/2022] Open
Affiliation(s)
- Jinsook Lim
- Department of Laboratory Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Gye Cheol Kwon
- Department of Laboratory Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Sun Hoe Koo
- Department of Laboratory Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Ik Chan Song
- Department of Internal Medicine, Chungnam National University Hospital, Daejeon, Korea
| | - Jimyung Kim
- Department of Laboratory Medicine, Chungnam National University Hospital, Daejeon, Korea
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Sung JY, Koo SH, Cho HH, Kwon KC. Nosocomial infection by sequence type 357 multidrug-resistant Acinetobacter baumannii isolates in a neonatal intensive care unit in Daejeon, Korea. Ann Lab Med 2013; 33:279-82. [PMID: 23826565 PMCID: PMC3698307 DOI: 10.3343/alm.2013.33.4.279] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2013] [Revised: 02/18/2013] [Accepted: 05/21/2013] [Indexed: 11/19/2022] Open
Abstract
Acinetobacter baumannii is an important microorganism responsible for a number of nosocomial outbreaks, in particular, in intensive care units (ICUs). We investigated a nosocomial infection caused by multidrug-resistant (MDR) A. baumannii in a neonatal intensive care unit (NICU) in Korea. A. baumannii isolates were characterized using Etest (AB Biodisk, Sweden), two multiplex PCR assays, and multilocus sequence typing (MLST) scheme. PCR and PCR mapping experiments were performed for detecting and characterizing the determinants of antimicrobial resistance. Eight strains isolated from an NICU belonged to European (EU) clone II and revealed only one sequence type (ST), namely, ST357. All the isolates were susceptible to imipenem but were resistant to amikacin, gentamicin, ceftazidime, cefepime, and ciprofloxacin. To the best of our knowledge, this is the first report of a nosocomial infection in an NICU in Korea caused by ST357 MDR/carbapenem-susceptible A. baumannii strains. This result demonstrates that nosocomial outbreaks of MDR/carbapenem-susceptible strains as well as MDR/carbapenem-resistant isolates may occur in NICUs.
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Affiliation(s)
- Ji Youn Sung
- Department of Biomedical Laboratory Science, Far East University, Eumseong, Korea
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Cho HH, Kwon KC, Sung JY, Koo SH. Spread and genetic characterization of ST137 and ST138 multidrug-resistant Acinetobacter baumannii isolated from a tertiary hospital in Korea. Ann Clin Lab Sci 2013; 43:145-150. [PMID: 23694788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Acinetobacter baumannii is an increasingly important global nosocomial pathogen. Clonal complex 92 (CC92) has become the most prevalent clonal complex in many regions. We investigated the molecular epidemiology and resistance profile of 52 imipenem-nonsusceptible A. baumannii isolates obtained from a university hospital in Daejeon, Korea, from 2007 to 2011. The minimum inhibitory concentrations of 7 antimicrobials were determined. PCR and DNA sequencing were used to identify genes contributing to resistance phenotypes. Multilocus sequence typing was performed to determine epidemiological relationships, and European clonal lineages were identified by multiplex PCR. The A. baumannii isolates were of 6 sequence types (STs; ST92, ST75, ST137, ST138, ST358, and ST69) and 1 allelic profile. All 6 STs were clustered into CC92 and the European clone II. ST138 was the most commonly observed ST, followed by ST137. We identified several genetic characteristics in carbapenem-, aminoglycoside-, and fluoroquinolone-resistance genes between ST137 and ST138. Imipenem-nonsusceptible A. baumannii has emerged in Daejeon, Korea, over a 5-year period, and is associated with the global spread of CC92 and European clone II. Epidemiological surveillance may be required to track the spread of epidemic strains and to guide adequate containment measures.
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Affiliation(s)
- Hye Hyun Cho
- Department of Laboratory Medicine, College of Medicine, Chungnam National University, Daejeon, Republic of Korea
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Sung JY, Koo SH, Cho HH, Kwon KC. Dissemination of an AbaR-type Resistance Island in Multidrug-resistantAcinetobacter baumanniiGlobal Clone 2 in Daejeon of Korea. Ann Clin Microbiol 2013. [DOI: 10.5145/acm.2013.16.2.75] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Ji Youn Sung
- Department of Biomedical Laboratory Science, Far East University, Eumseong, Korea
| | - Sun Hoe Koo
- Department of Laboratory Medicine, College of Medicine, Chungnam National University, Daejeon, Korea
| | - Hye Hyun Cho
- Department of Biomedical Laboratory Science, Jeonju Kijeon College, Jeonju, Korea
| | - Kye Chul Kwon
- Department of Laboratory Medicine, College of Medicine, Chungnam National University, Daejeon, Korea
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Cho HH, Kwon KC, Sung JY, Koo SH. Prevalence and genetic analysis of multidrug-resistant Pseudomonas aeruginosa ST235 isolated from a hospital in Korea, 2008-2012. Ann Clin Lab Sci 2013; 43:414-419. [PMID: 24247798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Pseudomonas aeruginosa is one of the primary opportunistic pathogens responsible for nosocomial infections. Recently, sequence type 235 (ST235) has been found internationally in a multidrug-resistant clone and is involved in the dissemination of genes encoding IMP-6 and VIM-2. This study aimed to describe the prevalence of metallo-β-lactamase (MBL), epidemiological relationship, and genetic characterization to aminoglycoside resistance in carbapenem-resistant P. aeruginosa isolates obtained from a tertiary hospital in Daejeon, Korea, from 2008 to 2012. Minimum inhibitory concentrations (MICs) of six antimicrobial agents were determined using the agar dilution method. PCR and DNA sequencing were used to identify MBL genes, class 1 integrons, and genes contributing to the aminoglycoside resistance phenotype. In addition, an epidemiological relationship was investigated by multilocus sequence typing (MLST). Eleven (16.2%) carbapenem-resistant isolates were MBL-producers; the major MBL type was IMP-6 (10 isolates). IMP-6-producing isolates were multidrug-resistant and belonged to ST235. All IMP-6-producing isolates had class 1 integrons (5.5 Kb; blaIMP-6-qac-aacA4-blaOXA-1-addA1). We identified genetic characteristics in aminoglycoside genes between ST235 and non-ST235. All ST235 isolates contained aminoglycoside-modifying enzyme (AME) genes, whereas 23.5% of non-ST235 isolates contained AME genes. Development and spread of the aminoglycoside resistance gene in P. aeruginosa non-ST235 could result in multidrug resistance in the future.
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Affiliation(s)
- Hye Hyun Cho
- Department of Laboratory Medicine, College of Medicine, Chungnam National University, 640, Daesa-dong, Jung-ku, Daejeon 301-721, Korea; phone: +82 42 280 7798, fax: +82 42 257 5365; e mail:
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Won EJ, Shin JH, Lee WK, Koo SH, Kim SY, Park YJ, Lee WG, Kim SH, Uh Y, Lee MK, Kim MN, Lee HS, Lee K. Distribution of Yeast and Mold Species Isolated from Clinical Specimens at 12 Hospitals in Korea during 2011. Ann Clin Microbiol 2013. [DOI: 10.5145/acm.2013.16.2.92] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Eun Jeong Won
- Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Jong Hee Shin
- Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Won-Kil Lee
- Department of Laboratory Medicine, Kyungpook National University of Medicine, Daegu, Korea
| | - Sun Hoe Koo
- Department of Laboratory Medicine, Chungnam National University of Medicine, Daejeon, Korea
| | - Shine Young Kim
- Department of Laboratory Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea
| | - Yeon-Joon Park
- Department of Laboratory Medicine, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Wee Gyo Lee
- Department of Laboratory Medicine, Ajou University School of Medicine, Suwon, Korea
| | - Soo-Hyun Kim
- Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Young Uh
- Department of Laboratory Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Mi-Kyung Lee
- Department of Laboratory Medicine, Chung-Ang University College of Medicine, Seoul, Korea
| | - Mi-Na Kim
- Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Hye-Soo Lee
- Department of Laboratory Medicine, Chonbuk National University Medical School, Jeonju, Korea
| | - Kyungwon Lee
- Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Korea
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Sung JY, Koo SH, Cho HH, Kwon KC. AbaR7, a genomic resistance island found in multidrug-resistant Acinetobacter baumannii isolates in Daejeon, Korea. Ann Lab Med 2012; 32:324-30. [PMID: 22950067 PMCID: PMC3427819 DOI: 10.3343/alm.2012.32.5.324] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2012] [Revised: 05/22/2012] [Accepted: 07/19/2012] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Acinetobacter baumannii resistance islands (AbaRs) have been recently recognized as mobile genetic elements that harbor multiple resistance determinants and are associated with multidrug resistance (MDR). In the present study, we aimed to determine the AbaRs conferring multiple antimicrobial resistance and their clonal relatedness to MDR A. baumannii clinical isolates obtained from a university hospital in Daejeon, Korea. METHODS This study included 29 MDR A. baumannii strains isolated in Daejeon, Korea. The minimal inhibitory concentrations (MICs) were determined by Etest. A. baumannii isolates were characterized using the 2 multiplex PCR assays and multilocus sequence typing (MLST) scheme. To detect and characterize AbaRs, PCR and PCR mapping experiments were performed. RESULTS Twenty-seven of the 29 isolates belonged to the European (EU) clone II lineage and contained 5 sequence types (STs) (75, 92, 137, 138, and 357). In this study, ST357 was confirmed for the first time in Korea. Only 2 of the 29 isolates belonged to the EU clone I lineage, and were confirmed as ST109. These 2 isolates harbored the 22-kb AbaR7 aacC1-orfP-orfQ-aadA1 gene cassette array. In contrast, AbaR was not found in EU clone II isolates. CONCLUSIONS This is the first study that attempted to determine the AbaRs in MDR A. baumannii isolates in Korea. We found 2 EU clone I isolates (ST109) that harbored AbaR7.
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Affiliation(s)
- Ji Youn Sung
- Department of Biomedical Laboratory Science, Far East University, Eumseong, Korea
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Kang JU, Koo SH. Evolving applications of microarray technology in postnatal diagnosis (review). Int J Mol Med 2012; 30:223-8. [PMID: 22580383 DOI: 10.3892/ijmm.2012.988] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2012] [Accepted: 04/16/2012] [Indexed: 11/06/2022] Open
Abstract
Microarray-based cytogenetics is revealing the tremendous fluidity and complexity of the human genome, and is starting to illustrate the implications of genomic variability with respect to human health and disease. In the last few years, the robustness of array-based technologies has provided accurate diagnosis and appropriate clinical management in a timely and efficient manner for identifying genomic defects of congenital and developmental abnormalities including developmental delay (DD), intellectual disability (ID), autism spectrum disorders (ASD) and/or multiple congenital anomalies (MCA). The implementation of this technology in these categories of disorders has been thoroughly evaluated and is now recommended as a first-line diagnostic approach for clinically suspected genetic disorders. However, clinical application of array-CGH in postnatal evaluation raises the debate of whether array-CGH will replace traditional cytogenetics in the near future and whether there is still a role for karyotyping and FISH. In this article, we therefore review the current status of array-based technology use for postnatal diagnosis and predict that it will replace standard cytogenetics as a first-line test for clinical evaluation in these population groups.
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Affiliation(s)
- Ji Un Kang
- Department of Biomedical Laboratory Science, Korea Nazarene University, Cheonan, Republic of Korea
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Cho HH, Sung JY, Kwon KC, Koo SH. Expression of Sme efflux pumps and multilocus sequence typing in clinical isolates of Stenotrophomonas maltophilia. Ann Lab Med 2011; 32:38-43. [PMID: 22259777 PMCID: PMC3255492 DOI: 10.3343/alm.2012.32.1.38] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2011] [Revised: 08/11/2011] [Accepted: 09/20/2011] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Stenotrophomonas maltophilia has emerged as an important opportunistic pathogen, which causes infections that are often difficult to manage because of the inherent resistance of the pathogen to a variety of antimicrobial agents. In this study, we analyzed the expressions of smeABC and smeDEF and their correlation with antimicrobial susceptibility. We also evaluated the genetic relatedness and epidemiological links among 33 isolates of S. maltophilia. METHODS In total, 33 S. maltophilia strains were isolated from patients in a tertiary hospital in Daejeon. Minimum inhibitory concentrations (MICs) of 11 antimicrobial agents were determined by using agar dilution method and E-test (BioMérieux, France). Real-time PCR analysis was performed to evaluate the expression of the Sme efflux systems in the S. maltophilia isolates. Additionally, an epidemiological investigation was performed using multilocus sequence typing (MLST) assays. RESULTS The findings of susceptibility testing showed that the majority of the S. maltophilia isolates were resistant to β-lactams and aminoglycosides. Twenty-one clinical isolates overexpressed smeABC and showed high resistance to ciprofloxacin. Moreover, a high degree of genetic diversity was observed among the S. maltophilia isolates; 3 sequence types (STs) and 23 allelic profiles were observed. CONCLUSIONS The smeABC efflux pump was associated with multidrug resistance in clinical isolates of S. maltophilia. In particular, smeABC efflux pumps appear to perform an important role in ciprofloxacin resistance of S. maltophilia. The MLST scheme for S. maltophilia represents a discriminatory typing method with stable markers and is appropriate for studying population structures.
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Affiliation(s)
- Hye Hyun Cho
- Department of Laboratory Medicine, College of Medicine, Chungnam National University, Daejeon, Korea
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Shin SY, Kwon KC, Park JW, Kim JM, Shin SY, Koo SH. Evaluation of the Seeplex® Meningitis ACE Detection kit for the detection of 12 common bacterial and viral pathogens of acute meningitis. Ann Lab Med 2011; 32:44-9. [PMID: 22259778 PMCID: PMC3255489 DOI: 10.3343/alm.2012.32.1.44] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2011] [Revised: 09/14/2011] [Accepted: 11/01/2011] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Bacterial meningitis is an infectious disease with high rates of mortality and high frequency of severe sequelae. Early identification of causative bacterial and viral pathogens is important for prompt and proper treatment of meningitis and for prevention of life-threatening clinical outcomes. In the present study, we evaluated the value of the Seeplex Meningitis ACE Detection kit (Seegene Inc., Korea), a newly developed multiplex PCR kit employing dual priming oligonucleotide methods, for diagnosing acute meningitis. METHODS Analytical sensitivity of the kit was studied using reference strains for each pathogen targeted by the kit, while it's analytical specificity was studied using the human genome DNA and 58 clinically well-identified reference strains. For clinical validation experiment, we used 27 control cerebrospinal fluid (CSF) samples and 78 clinical CSF samples collected from patients at the time of diagnosis of acute meningitis. RESULTS The lower detection limits ranged from 10(1) copies/µL to 5×10(1) copies/µL for the 12 viral and bacterial pathogens targeted. No cross-reaction was observed. In the validation study, high detection rate of 56.4% was obtained. None of the control samples tested positive, i.e., false-positive results were absent. CONCLUSIONS The Seeplex Meningitis ACE Detection kit showed high sensitivity, specificity, and detection rate for the identification of pathogens in clinical CSF samples. This kit may be useful for rapid identification of important acute meningitis-causing pathogens.
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Affiliation(s)
- So Youn Shin
- Department of Laboratory Medicine, College of Medicine, Chungnam National University, Daejeon, Korea
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Kang JU, Koo SH. ORAOV1 is a probable target within the 11q13.3 amplicon in lymph node metastases from gastric adenocarcinoma. Int J Mol Med 2011; 29:81-7. [PMID: 21993861 DOI: 10.3892/ijmm.2011.811] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2011] [Accepted: 09/21/2011] [Indexed: 11/06/2022] Open
Abstract
The lymph node metastatic (LNM) spread of tumor cells is a frequent event in the initial process of cancer dissemination and is a powerful independent prognostic indicator in gastric adenocarcinoma (GAC). High density genomic arrays were conducted to identify molecular markers associated with lymph node metastasis in GAC. In the genome-wide profile, large copy number gains involving chromosomes 1p, 3q, 8q, 9q, 11q, 16p, 19p, and 20q (log2 ratio >0.25) (>40% of patients) were more prevalent than copy number losses. The most notable finding was copy number gains at the long arm of chromosome 11, which occurred in 75.0% of lymphatic metastasis GAC cases, and the delineated minimal common region was 11q24.2-q12.1. More specifically, 2 amplified (>1 log2 ratio) loci on the 11q13.3 region were detected in 12.5% of the cases. The first locus, covers a region of ~7.7 Mbp, and comprises the representative oncogene of cyclin D1 (CCNDI). This finding occurred in 12.5% of the cases. Additionally, an oral cancer overexpressed 1 (ORAOV1) gene was identified as a probable target within the 11q13 amplicon, which previously was not assumed to play a pathogenic role in GACs (12.5%). A second locus spanning 7.8 Mbp on 11q13.3 without associated genes also showed high-level amplifications in 12.5% of the GACs. This study indicates that the long arm of chromosome 11 harbors protooncogenes that are associated with lymphatic metastasis formation and the ORAOV1 gene at the 11q13.3 region could be a potential target and serve as an indicator for the presence of occult metastases in GAC.
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Affiliation(s)
- Ji Un Kang
- Department of Biomedical Laboratory Science, Korea Nazarene University, Cheonan, Republic of Korea
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Sung JY, Kwon KC, Cho HH, Koo SH. Antimicrobial resistance determinants in imipenem-nonsusceptible Acinetobacter calcoaceticus-baumannii complex isolated in Daejeon, Korea. Korean J Lab Med 2011; 31:265-70. [PMID: 22016680 PMCID: PMC3190005 DOI: 10.3343/kjlm.2011.31.4.265] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2011] [Revised: 06/27/2011] [Accepted: 07/19/2011] [Indexed: 01/29/2023] Open
Abstract
Background Members of the Acinetobacter calcoaceticus-baumannii (Acb) complex are important opportunistic bacterial pathogens and present significant therapeutic challenges in the treatment of nosocomial infections. In the present study, we investigated the integrons and various genes involved in resistance to carbapenems, aminoglycosides, and fluoroquinolones in 56 imipenem-nonsusceptible Acb complex isolates. Methods This study included 44 imipenem-nonsusceptible A. baumannii, 10 Acinetobacter genomic species 3, and 2 Acinetobacter genomic species 13TU strains isolated in Daejeon, Korea. The minimum inhibitory concentrations (MICs) were determined by Etest. PCR and DNA sequencing were used to identify the genes that potentially contribute to each resistance phenotype. Results All A. baumannii isolates harbored the blaOXA-51-like gene, and 21 isolates (47.7%) co-produced OXA-23. However, isolates of Acinetobacter genomic species 3 and 13TU only contained blaIMP-1 or blaVIM-2. Most Acb complex isolates (94.6%) harbored class 1 integrons, armA, and/or aminoglycoside-modifying enzymes (AMEs). Of particular note was the fact that armA and aph(3')-Ia were only detected in A. baumannii isolates, which were highly resistant to amikacin (MIC50≥256) and gentamicin (MIC50≥1,024). In all 44 A. baumannii isolates, resistance to fluoroquinolones was conferred by sense mutations in the gyrA and parC. However, sense mutations in parC were not found in Acinetobacter genomic species 3 or 13TU isolates. Conclusions Several differences in carbapenem, aminoglycoside, and fluoroquinolone resistance gene content were detected among Acb complex isolates. However, most Acb complex isolates (87.5%) possessed integrons, carbapenemases, AMEs, and mutations in gyrA. The co-occurrence of several resistance determinants may present a significant threat.
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Affiliation(s)
- Ji Youn Sung
- Department of Biomedical Laboratory Science, Far East University, Eumseong, Korea
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Kang JU, Koo SH. Assessment of the beneficial loci and prognostic implications of microsatellite instability in gastric carcinoma. Mol Med Rep 2011; 4:1175-81. [PMID: 21805035 DOI: 10.3892/mmr.2011.541] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2011] [Accepted: 07/18/2011] [Indexed: 11/06/2022] Open
Abstract
Microsatellite instability (MSI) is a hyper-mutable phenotype caused by the loss of DNA mismatch repair activity, and plays a crucial role in gastric carcinogenesis. To clarify the role of genetic instability in relation to clinicopathological variables, and to identify predictive MSI markers that facilitate the early detection and improve the classification of gastric carcinomas (GCs), 13 microsatellite (MS) loci, including the National Cancer Institute (NCI) panel of MS markers (D2S123, D5S346, D17S250, BAT25 and BAT26) and 8 dinucleotide repeats (D3S1260, D5S107, D5S409, D17S261, D17S520, D17S855, D18S34 and D18S61) were studied in GC patients. MSI was found in 88.2% (30/34) of GC cases and the number of high-frequency MSI (MSI-H, 23.5%, 8/34), low-frequency MSI (64.7%, 22/34), and stable MSI (11.8%, 4/34), was calculated. Among the MS loci analyzed, D18S34 and D17S261 (15/34, 44.1%) exhibited the highest frequency of MSI, followed by D2S123 (14/34, 41.2%), D5S107, D5S346, D5S409 and D18S61 (12/34, 35.3%) (MSI>35%). MSI-H was particularly prevalent in older patients and was mainly found in the antrum and poorly differentiated tumors. Furthermore, MSI-H was significantly associated with lymph node involvement cases in females. One notable finding in this analysis was that the markers, D17S250 and D17S520, exhibited a significantly higher percentage of MSI in advanced gastric carcinomas than in early gastric carcinomas (P=0.046 and 0.046, respectively), and the D17S520 and BAT26 loci represented significant different correlations between the tumor stages (P=0.038 and 0.042, respectively). This study indicates that the novel markers, D18S34 and D17S261, perform more favorably than the NCI panel for the detection of MSI, and the D17S520 locus presents a potential target for predicting the clinical impact of GC. These novel MS loci may prove to be beneficial and independent tools for the construction of a comprehensive genetic classification for GC cases.
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Affiliation(s)
- Ji Un Kang
- Department of Biomedical Laboratory Science, Korea Nazarene University, Cheonan 331-718, Republic of Korea
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