Journal of Yeungnam Medical Science

Original article

Infectious Disease
Safety and efficacy of early oral switch in Enterobacterales bacteremia: a systematic review and meta-analysis: Rafael Levandowski, Tae Yoon Hwang, Sangwoon Bae, Kyeong-Soo Lee; J Yeungnam Med Sci. 2026;43:12. Published online January 7, 2026; DOI: https://doi.org/10.12701/jyms.2026.43.12

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Abstract PDF Supplementary Material: Background
Early oral switch (EOS) has been proposed as an alternative to prolonged intravenous (IV) therapy for Enterobacterales bacteremia; however, its safety and effectiveness have not been clearly established. This systematic review and meta-analysis evaluated whether EOS reduces treatment failure in uncomplicated Enterobacterales bacteremia and examined how the timing of switching affects outcomes.
Methods
We conducted a systematic review and random-effects meta-analysis of randomized controlled trials and observational studies that compared EOS with continued IV therapy in adults with uncomplicated Enterobacterales bacteremia. Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using random-effects models. The primary outcome was treatment failure by ≤90 days. Prespecified analyses evaluated the timing of the switch.
Results
Across 10 studies that met the inclusion criteria, EOS was associated with lower treatment failure than continued IV therapy (RR, 0.72; 95% CI, 0.58–0.89; I²=26%). Switching within 4 days reduced the failure (RR, 0.58; 95% CI, 0.44–0.76; I²=0%), whereas switching after 4 days showed no clear advantage (RR, 0.87; 95% CI, 0.71–1.06; I²=0%). No evidence of small study effects was observed.
Conclusion
EOS was associated with a lower risk of treatment failure than prolonged IV therapy, with the greatest benefit observed when the switch occurred within 4 days. These findings should be interpreted with clinical caution given that most of the evidence is observational.

Case reports

Microbiology
Unusual Serratia marcescens pleural infection in secondary spontaneous pneumothorax: a case report: Asem Ali Ashraf, Sayantani Nag, Vimal Kumar Karnaker; J Yeungnam Med Sci. 2025;42:35. Published online May 15, 2025; DOI: https://doi.org/10.12701/jyms.2025.42.35

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Abstract PDF: Serratia marcescens is an opportunistic gram-negative pathogen that causes pneumonia, bloodstream infections, and urinary tract infections, particularly in individuals who are immunocompromised. Although commonly associated with pulmonary infections, its involvement in pneumothorax-related infections is exceedingly rare. Secondary spontaneous pneumothorax (SSP) is a life-threatening condition that can complicate underlying lung diseases, such as chronic obstructive pulmonary disease (COPD). This case report describes a rare presentation of S. marcescens infection in a patient with SSP complicated by a bronchopleural fistula. A 64-year-old male with a history of COPD, chronic smoking, and alcohol use presented with progressive dyspnea, cough, and left-sided chest pain. Clinical evaluation revealed tachypnea, tracheal deviation, and reduced breath sounds in the left lung. Laboratory investigations revealed leukocytosis with marked neutrophilia and an elevated erythrocyte sedimentation rate. Chest imaging confirmed pneumothorax, necessitating intercostal drain (ICD) placement. Pleural fluid cultures identified multidrug-resistant S. marcescens, prompting antibiotic escalation to intravenous meropenem and oral faropenem. Despite prolonged antimicrobial therapy and ICD placement, persistent pneumothorax with a bronchopleural fistula was noted. Bronchoscopy with Fogarty balloon placement and cyanoacrylate closure was performed. However, owing to financial constraints, the patient declined follow-up cultures and high-resolution computed tomography imaging, and was discharged with an ICD in situ. This case underscores the need for heightened clinical awareness of S. marcescens in pneumothorax-associated infections. Early microbiological identification and targeted therapy are crucial for the management of rare yet challenging presentations, particularly in resource-limited settings.

Oncology and Cancer Research
Intraabdominal abscess mimicking gastric cancer recurrence: a case report: Yong-Eun Park; J Yeungnam Med Sci. 2023;40(4):426-429. Published online February 1, 2023; DOI: https://doi.org/10.12701/jyms.2022.00864

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Abstract PDF

Surgical site infection is a common healthcare-associated infection that rarely occurs several months after surgery. Herein, a case is described in which an abdominal mass lesion was found at a 6-month follow-up visit after gastrectomy was performed for early gastric cancer. Positron emission tomography-computed tomography revealed a 2.5 cm-sized mass with a high maximal standard uptake value (8.32), located above a previous anastomosis site. Locoregional recurrence of gastric cancer was diagnosed by multidisciplinary team discussion, and explorative laparotomy was performed. However, surgical and pathologic findings revealed that the mass was an intraabdominal abscess. In conclusion, differential diagnosis of delayed abscess formation should be considered if the possibility of tumor recurrence is low, especially after early gastric cancer surgery.

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Original article

Anesthesiology and Pain Medicine
Infection prevention measures and outcomes for surgical patients during a COVID-19 outbreak in a tertiary hospital in Daegu, South Korea: a retrospective observational study: Kyung-Hwa Kwak, Jay Kyoung Kim, Ki Tae Kwon, Jinseok Yeo; J Yeungnam Med Sci. 2022;39(3):223-229. Published online November 5, 2021; DOI: https://doi.org/10.12701/yujm.2021.01431

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Abstract PDF: Background
The first large coronavirus disease 2019 (COVID-19) outbreak outside China occurred in Daegu. In response, we developed infection prevention measures for surgical patients during the outbreak at our hospital and retrospectively reviewed the outcomes of COVID-19–related surgical patients.
Methods
We reviewed the medical records of 118 COVID-19–related surgical patients and monitored their clinical outcomes until March 31, 2021. We also interviewed healthcare workers who participated in their perioperative care at Kyungpook National University Chilgok Hospital. The perioperative management guidelines for COVID-19–related patients were prepared through multidisciplinary discussions, including the infection control department, surgical departments, and anesthesiology department before and during the COVID-19 outbreak.
Results
One standard operating room was temporarily converted to a negative-pressure room by increasing the exhaust air volume, creating a relative pressure of −11.3 Pa. The healthcare workers were equipped with personal protective equipment according to the patient's classification of the risk of COVID-19 transmission. The 118 COVID-19–related patients underwent emergent surgery in the negative-pressure room, including three COVID-19–confirmed patients and five COVID-19–exposed patients.
Conclusion
All surgeries of the COVID-19–related patients were performed without specific adverse events or perioperative COVID-19 transmission. Our experience setting up a negative-pressure operating room and conservative perioperative protocol to prevent COVID-19 transmission will help plan and execute infection control measures in the future.

Case report

Infectious Disease
Coinfection of Sphingomonas paucimobilis meningitis and Listeria monocytogenes bacteremia in an immunocompetent patient: a case report: Sang Woon Bae, Jong Ho Lee; J Yeungnam Med Sci. 2022;39(1):67-71. Published online June 7, 2021; DOI: https://doi.org/10.12701/yujm.2021.01074

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Abstract PDF

This report describes a case of coinfection of Sphingomonas paucimobilis meningitis and Listeria monocytogenes bacteremia in a 66-year-old immunocompetent female patient. The patient had undergone traditional procedures, including acupuncture, which possibly caused the coinfection. During treatment with susceptible antibiotics for bacterial meningitis, she developed hydrocephalus on the third day. Consequently, the patient recovered with a mild neurological deficit of grade 4 motor assessment in both upper and lower extremities at discharge. S. paucimobilis and L. monocytogenes are rare pathogens in developed countries, occurring only during environmental outbreaks. S. paucimobilis meningitis is rarely reported. Hence, the various presentations of S. paucimobilis meningitis and the antibiotic regimen for its treatment are hereby reported, in addition to a review of other similar reported cases. This case is a possible traditional procedure-related infection. Appropriate oversight and training should be emphasized regarding preventive measures of this kind of infection. A team approach with neurologists and neurosurgeons is imperative in treating patients with hydrocephalus-complicated meningitis.

Citations

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Literature Review on Adverse Events (2020-2023) Associated with Acupuncture and Moxibustion
Yasufumi FUKUYO, Taro MIYAWAKI, Hisashi SHINBARA, Nobutatsu FURUSE, Hitoshi YAMASHITA
Zen Nihon Shinkyu Gakkai zasshi (Journal of the Japan Society of Acupuncture and Moxibustion).2025; 75(4): 442. CrossRef
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Aung Kyaw Kyaw, Ohnmar, Zin Nwe Win, Sai Kyaw Win, Zarni Myint Shwe, Kyaw Lwin Show, Nan Aye Thida Oo, Mya Thandar Win, Khin Zarchi Aung, Win Pa Pa Naing, Phyu Phyu Lay, Hlaing Myat Thu, Zaw Than Htun
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Original article

Urology
Significance of albumin to globulin ratio as a predictor of febrile urinary tract infection after ureteroscopic lithotripsy: Seung Yun Yi, Dong Jin Park, Kyungchan Min, Jae-Wook Chung, Yun-Sok Ha, Bum Soo Kim, Hyun Tae Kim, Tae-Hwan Kim, Eun Sang Yoo; Yeungnam Univ J Med. 2021;38(3):225-230. Published online April 20, 2021; DOI: https://doi.org/10.12701/yujm.2021.00955

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Abstract PDF

Background
We aimed to analyze the effectiveness of albumin to globulin ratio (AGR) in predicting postoperative febrile urinary tract infection (fUTI) after ureteroscopic lithotripsy (URS) and retrograde intrarenal surgery (RIRS).
Methods
From January 2013 to May 2018, 332 patients underwent URS and RIRS. The rate of postoperative fUTI and risk factors for postoperative fUTI were analyzed using logistic regression. Patients were divided into postoperative fUTI and non-postoperative fUTI (non-fUTI) groups. AGR with other demographic and perioperative data were compared between the two groups to predict the development of fUTI after URS.
Results
Of the 332 patients, postoperative fUTI occurred in 41 (12.3%). Preoperative pyuria, microscopic hematuria, diabetes mellitus, hypoalbuminemia, and hyperglobulinemia were more prevalent in the fUTI group. Patients in the fUTI group had larger stone size, lower preoperative AGR, longer operation time, and longer preoperative antibiotic coverage period. In a multivariable logistic analysis, preoperative pyuria, AGR, and stone size were independently correlated with postoperative fUTI (p<0.001, p=0.008, and p=0.041, respectively). Receiver operating curve analysis showed that the cutoff value of AGR that could predict a high risk of fUTI after URS was 1.437 (sensitivity, 77.3%; specificity, 76.9%), while the cutoff value of stone size was 8.5 mm (sensitivity, 55.3%; specificity, 44.7%).
Conclusion
This study demonstrated that preoperative pyuria, AGR, and stone size can serve as prognostic factors for predicting fUTI after URS.

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Review article

Nuclear Medicine
F-18 fluorodeoxyglucose positron emission tomography/computed tomography in the infection of heart: Eunjung Kong; Yeungnam Univ J Med. 2021;38(2):95-106. Published online October 15, 2020; DOI: https://doi.org/10.12701/yujm.2020.00479

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Abstract PDF

Infections involving the heart are becoming increasingly common, and a timely diagnosis of utmost importance, despite its challenges. F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) is a recently introduced diagnostic tool in cardiology. This review focuses on the current evidence for the use of FDG PET/CT in the diagnosis of infective endocarditis, cardiac implantable device infection, left ventricular assist device infection, and secondary complications. The author discusses considerations when using FDG PET/CT in routine clinical practice, patient preparation for reducing physiologic myocardial uptake, acquisition of images, and interpretation of PET/CT findings. This review also functions to highlight the need for a standardized acquisition protocol.

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Focused Review article

Pulmonary and Respiratory Medicine
Novel respiratory infectious diseases in Korea: Hyun Jung Kim; Yeungnam Univ J Med. 2020;37(4):286-295. Published online September 23, 2020; DOI: https://doi.org/10.12701/yujm.2020.00633

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Abstract PDF

Respiratory infections are very common and highly contagious. Respiratory infectious diseases affect not only the person infected but also the family members and the society. As medical sciences advance, several diseases have been conquered; however, the impact of novel infectious diseases on the society is enormous. As the clinical presentation of respiratory infections is similar regardless of the pathogen, the causative agent is not distinguishable by symptoms alone. Moreover, it is difficult to develop a cure because of the various viral mutations. Various respiratory infectious diseases ranging from influenza, which threaten the health of mankind globally, to the coronavirus disease 2019, which resulted in a pandemic, exist. Contrary to human expectations that development in health care and improvement in hygiene will conquer infectious diseases, humankind’s health and social systems are threatened by novel infectious diseases. Owing to the development of transport and trading activity, the rate of spread of new infectious diseases is increasing. As respiratory infections can threaten the members of the global community at any time, investigations on preventing the transmission of these diseases as well as development of effective antivirals and vaccines are of utmost importance and require a worldwide effort.

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Original article

Plastic and Reconstructive surgery
Factors affecting complications after treatment of epidermal cyst: Man Ki Choi, Kyu Jin Chung; Yeungnam Univ J Med. 2019;36(2):136-140. Published online April 1, 2019; DOI: https://doi.org/10.12701/yujm.2019.00164

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Abstract PDF

Background
Epidermal cysts are the most common benign epithelial tumors in humans. The curative treatment of epidermal cyst is surgical excision. However, only few studies have investigated the cause and mechanism of postoperative complications of epidermal cysts. Therefore, this study aimed to evaluate the factors affecting complications of epidermal cyst after surgical treatment.
Methods
Patients with histologically diagnosed epidermal cysts were selected from among 98 consecutive patients with excised benign cystic tumors from March 2014 to August 2017. Sex, age, size, mobility, site of occurrence, history of infection, history of incision and drainage, complications, history of reoperation, and method of overcoming complications was obtained by analyzing medical records retrospectively.
Results
Five of the 98 patients had wound dehiscence due to surgical infection. Three of them underwent wound healing with conservative treatment without a second operation. The other two patients underwent a second operation and showed signs of preoperative infection. None of the factors showed statistical significance in relation to the occurrence of complications.
Conclusion
Postoperative complications occurred when the excision of the epidermal cyst was performed at preoperative infection sites or at sites with high tension, so attention should be paid to postoperative care.

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Subramaniam Guru Naidu, Nazan Can Guru Naidu, Pia Borgas, Dinesh Balasubramaniam
Cureus.2026;[Epub] CrossRef
Development and Validation of a Clinical Predictive Model for the Risk of Pathological Infection in Epidermoid Cysts: A Real‐World Large‐Sample Retrospective Cohort Study
Jiaxin Li, Hua Zhang, Chong Wu, Chengxin Li, Rui Wang, Suraiya Saleem
Dermatologic Therapy.2026;[Epub] CrossRef
Epidermal Inclusion Cysts of the Head and Neck: A One-Year Tertiary Care Experience With Emphasis on the Periauricular Region and Review of Literature
Tejaswi Mishra, Swaha Panda, Madhu Chaudhary, Gulistan Bano, Dheeraj Kumar, Suji PS, Bhartendu Bharti, KSBS Krishna Sasanka, Anila Sinha, Pradosh Kumar Sarangi
Cureus.2025;[Epub] CrossRef
Intraoral Epidermoid Cyst: Case Report and Literature Review
Ana Andabak Rogulj, Danica Vidović Juras, Božana Lončar Brzak, Ivana Škrinjar, Bruno Špiljak, Sven Seiwerth
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Case Reports

Obstetrics, Gynecology, and Reproductive Medicine
Puerperal septic shock and necrotizing fasciitis caused by Staphylococcus caprae and Escherichia coli: Yu-Jin Koo; Yeungnam Univ J Med. 2018;35(2):248-252. Published online December 31, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.2.248

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Abstract PDF

Puerperal sepsis is one of the leading causes of maternal morbidity and mortality worldwide. Postpartum pelvic infections can cause various complications, including wound infections and necrotizing fasciitis. Several microorganisms are known to cause such infections; however, no study has reported on Staphylococcus caprae, a coagulase-negative staphylococcus that is isolated frequently from animals and infrequently from human specimens, as a causative agent. Here, we report a rare case of septic shock complicated by necrotizing fasciitis after a cesarean section. This is the first report of a human isolate of S. caprae in association with puerperal sepsis and necrotizing fasciitis.

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Infectious Disease
A successful management after preterm delivery in a patient with severe sepsis during third-trimester pregnancy: Moni Ra, Myungkyu Kim, Mincheol Kim, Sangwoo Shim, Seong Yeon Hong; Yeungnam Univ J Med. 2018;35(1):84-88. Published online June 30, 2018; DOI: https://doi.org/10.12701/yujm.2018.35.1.84

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Abstract PDF: A 33-year-old woman visited the emergency department presenting with fever and dyspnea. She was pregnant with gestational age of 31 weeks and 6 days. She had dysuria for 7 days, and fever and dyspnea for 1 day. The vital signs were as follows: blood pressure 110/70 mmHg, heart rate 118 beats/minute, respiratory rate 28/minute, body temperature 38.7℃, and oxygen saturation by pulse oximetry 84% during inhalation of 5 liters of oxygen by nasal prongs. Crackles were heard over both lung fields. There were no signs of uterine contractions. Chest X-ray and chest computed tomography scan showed multiple consolidations and air bronchograms in both lungs. According to urinalysis, there was pyuria and microscopic hematuria. She was diagnosed with community-acquired pneumonia and urinary tract infection (UTI) that progressed to severe sepsis and acute respiratory failure. We found extended-spectrum beta-lactamase producing Escherichia coli in the blood culture and methicillin-resistant Staphylococcus aureus in the sputum culture. The patient was transferred to the intensive care unit with administration of antibiotics and supplementation of high-flow oxygen. On hospital day 2, hypoxemia was aggravated. She underwent endotracheal intubation and mechanical ventilation. After 3 hours, fetal distress was suspected. Under 100% fraction of inspired oxygen, her oxygen partial pressure was 87 mmHg in the arterial blood. She developed acute kidney injury and thrombocytopenia. We diagnosed her with multi-organ failure due to severe sepsis. After an emergent cesarean section, pneumonia, UTI, and other organ failures gradually recovered. The patient and baby were discharged soon thereafter.

Original Articles

Pediatrics, Perinatology, and Child Health
Clinical characteristics of acute lower respiratory tract infections according to respiratory viruses in hospitalized children without underlying disease during the last 3 years: Min Hae Seo, Hyung Young Kim, Tae Min Um, Hye Young Kim, Hee Ju Park; Yeungnam Univ J Med. 2017;34(2):182-190. Published online December 31, 2017; DOI: https://doi.org/10.12701/yujm.2017.34.2.182

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Abstract PDF: BACKGROUND
Respiratory viruses play a significant role in the etiology of acute respiratory infections and exacerbation of chronic respiratory illnesses. This study was conducted to identify the epidemiological and clinical characteristics of children with acute viral lower respiratory infections. METHODS: This study investigated 1,168 children diagnosed with acute viral lower respiratory tract infections (RTIs) between January 2012 and December 2014. Specimens of respiratory viruses were collected using a nasopharyngeal swab and analyzed by reverse transcriptase polymerase chain reaction. We retrospectively reviewed the medical records and analyzed the clinical features of children hospitalized for acute lower respiratory infections. RESULTS: Respiratory syncytial virus (RSV), the main cause of infection in children aged <5 years, was the most commonly detected pathogen in children with bronchiolitis and pneumonia, and resulted in high proportions of children requiring oxygen treatment and intensive care unit admission. Rhinovirus was preceded by RSV as the second most common cause of bronchiolitis and pneumonia, and was detected most frequently in the children aged ≥6 years. In addition, asthma was predominantly caused by rhinovirus in children aged ≥6 years, whereas croup was mostly caused by parainfluenza virus in those aged <5 years. Rhinovirus infection (p < 0.001) and history of asthma (p=0.049) were identified as significant risk factors for readmission within a month. CONCLUSION: We identified the epidemiological and clinical characteristics of respiratory viruses in children with acute lower respiratory infections during the last 3 years. Our findings may provide useful clinical insight to comprehend the acute viral lower RTIs in children.

Pediatrics, Perinatology, and Child Health
Epidemiology and Clinical Features of Respiratory Viruses in Pediatric Inpatients in a Single Medical Center in Daegu from 2010 to 2012.: Eun Kyung Lee, Yun Young Lee, Kwang Hae Choi; Yeungnam Univ J Med. 2013;30(2):95-100. Published online December 31, 2013; DOI: https://doi.org/10.12701/yujm.2013.30.2.95

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Abstract PDF

BACKGROUND
This study was performed to investigate the epidemiologic and clinical features of acute respiratory viral infection in hospitalized children. METHODS: From 2010 to 2012, we tested nasopharyngeal swab specimen in 1,584 hospitalized children with multiple real-time polymerase chain reactions to identify 10 kinds of respiratory viruses (including influenza virus A, B (FluA, FluB), respiratory syncytial virus (RSV), human metapneumovirus (MPV), adenovirus (AdV), human coronavirus (CoronaV), human enterovirus (HEV), human bocavirus (HBoV), parainfluenza virus (PIV), and human rhinovirus (Rhinovirus)). We analyzed the positive rate, annual and seasonal variations, and clinical features (respiratory tract and non-respiratory tract) according to the retrospective review of medical records. RESULTS: Respiratory viruses were detected from 678 (42.8%) of 1,584 patients. The most common detected virus was RSV (35.0%), and then AdV (19.0%), HEV (18.1%). The critical period of the respiratory viral infection was during the first 12 months of a child's life. PIV increased by 8.4%, 12.1%, and 21.1% annually. Bronchiolitis was most frequently caused by RSV, and croup was frequently caused by PIV. The most common cause of meningitis was HEV. Hepatitis-associated respiratory virus was developed 111 in 678 cases. CONCLUSION: Although this study was confined to a single medical center for three years, we identified the epidemiology and clinical feature of respiratory viruses in Daegu from 2010 to 2012. Future surveillance will be necessary for annual and seasonal variations.

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Eun Woo Choi, Jun Young Do, A. Young Kim, Seok Hui Kang
BMC Nephrology.2021;[Epub] CrossRef
Correlation between Infection with Multiple Respiratory Viruses and Length of Hospital Stay in Patients from Cheonan, Korea
Jae-Sik Jeon, Jin-Wan Park, Jae Kyung Kim
The Korean Journal of Clinical Laboratory Science.2017; 49(1): 22. CrossRef
Infection Frequency and Mixed infection on Eight Viruses from Patients with Acute Respiratory Syndromes in Seoul
Heejin Ham, Jungim Jang, Sukju Jo, Younghee Oh, Sonil Pak
Journal of Bacteriology and Virology.2014; 44(3): 274. CrossRef

Hematology
Comparative Study on the Infection Rates of Protected Environment versus Non-Protected Environment in Acute Myeloid Leukemia during Remission Induction Chemotherapy.: Se Hoon Sohn, Ha young Lee, Dong Geun Kim, Sung Woo Park, Myung Jin Kim, Myung Jin Oh, Hye Deok Woo, Hun Mo Ryoo, Sung Hwa Bae, Kyung Hee Lee, Min Kyoung Kim, Myung Soo Hyun; Yeungnam Univ J Med. 2010;27(2):113-121. Published online December 31, 2010; DOI: https://doi.org/10.12701/yujm.2010.27.2.113

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Abstract PDF: BACKGROUND
AND PURPOSE: Patients with acute leukemia experience prolonged periods of neutropenia due to their disease or its treatment. For this reason, they often develop serious infectious complications. Although antibiotic therapy has improved in recent years, the fatality rate from infection remains high. For the control of infection, protected environment was developed. But because of economic issue, most of chemotherapy with acute myeloid leukemia have conducted in non-protected environment. So this study compared the rate of complete remission, days with neutropenia, rate of fever, rate of positive culture, rate of overt infection and use of antibacterial and antifungal agents with patients within non-protected environment and protected environment, retrospectively. Patients with acute myeloid leukemia during first remission induction chemotherapy were eligible for this study. METHODS: Retrospective analysis was conducted between patients in non-protected (25 patients) and protected environment (14 patients) with acute myeloid leukemia during remission induction chemotherapy. RESULTS: Rate of overt infection, rate of fever, rate of positive culture and rate of use of antibiotics were significantly high in patients within non-protected environment compared with patients within protected environment. There were no differences in rate of complete remission and days of neutropenia. CONCLUSIONS: This study suggests protected environment for patients with acute myeloid leukemia during remission induction chemotherapy could reduce rate of overt infection, and rate of use of antibiotics.

Case Report

Nephrology
A Case of Exit-Site Infection and Abscess by Mycobacterium Abscessus in a CAPD Patient.: Sun Young Jung, Ji Hoon Na, Kyu Hyang Cho, Jong Won Park, Jun Young Do, Kyeung Woo Yun, In Wook Song, Jeong Hwan Cho, Chang Woo Son; Yeungnam Univ J Med. 2009;26(2):137-143. Published online December 31, 2009; DOI: https://doi.org/10.12701/yujm.2009.26.2.137

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Abstract PDF

Nontuberculous mycobacterial infections are a rare, but clinically important cause of infections in continuous ambulatory peritoneal dialysis (CAPD) patients. This is typically suspected when a patient does not respond to treatment with the usual antibiotics. We describe here a case of Mycobacterium abscessus exit site infection with abdominal wall abscess formation that was associated with CAPD, which required peritoneal catheter removal, surgical debridement of the abscess and long term antibiotic therapy.

Citations

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A Case Report ofMycobacterium abscessusPeritonitis in a Patient on Continuous Ambulatory Peritoneal Dialysis
Seon Joo Kang, Heungsoo Kim, Kyoung Un Park, Young Ae Lim, Wee Gyo Lee
Annals of Clinical Microbiology.2013; 16(2): 101. CrossRef
A Case of Continuous Ambulatory Peritonitis Dialysis Peritonitis Due toStenotrophomonas maltophiliaUsing Antibiotic Combination
Hee Sung Ko, Ah Ran Choi, Tae Hoon Kim, Chan Hee Kyung, Jang Ho Cho, Yong Hoon Kim, Jung Eun Lee
Yeungnam University Journal of Medicine.2013; 30(2): 109. CrossRef

Original Articles

Nephrology
The Effects of Catheter Revision and Mupirocin on Exit Site Infection/Peritonitis in CAPD Patients.: Jun Beom Park, Jung Mee Kim, Jun Hyuk Choi, Kyu Hyang Jo, Hang Jae Jung, Yeung Jin Kim, Jun Yeung Do, Kyung Woo Yoon; Yeungnam Univ J Med. 1999;16(2):347-356. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.347

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Abstract PDF: BACKGROUND
Exit site/tunnel infection causes cosiderable morbidity and technique failure in CAPD patients. We presently use a unique revision method for the treatment of refractory ESI/TI in CAPD patients and mupirocin prophylaxis for high risk patients. MATERIALS AND METHODS: We reviewed 139 CAPD patients about the ESI/TI from October 1993 to February 1999 at Yeungnam University Hospital. At the beginning of the ESI, we usually started medications with rifampicin and ciprofloxacin and then changed the antibiotics according to the sensitivity test. If the ESI had persisted and there were T1 symptoms(purulent discharge, abscess lesion around exit site), we performed catheter revision(external cuff shaving, disinfection around tunnel and new exit site on opposit direction) with a combination of proper antibiotics. We applied local mupirocin ointment at the exit site three times per week to the 34 patients who had the risk of ESI starting from October 1998. RESULTS: The total follow-up was 2401 patient months(pt. mon). ESI occurred on 105 occasions in 36 out of 139 patients, and peritonitis occurred on 112 occasions in 67 out of 139 patients. The total number of incidences of ESI and peritonitis was 1 per 23.0 pt.mon and 0 per 21.6 pt.mon. The most common organism responsible for ESI was Staphylococcus aureus(26 of 54 isolated cases, 48%), followed by the Methicillin resistant S. auresu(MRSA) (13 cases, 24%). Seven patients(5: MRSA, 2: Pseudomonas) had to be treated with a revision to control infection. Three patients experienced ESI relapse after revision. One of them improved with antibiotics, while another needed a second revision and the remaining required catheter removal due to persistent MRSA infection with re-insertion at the same time. But, there was no more ESI in these 3 patients who were received management to relapse (The mean duration: 14.0 months). The rates of ESI were significantly reduced after using mupirocin than before(1 per 12.7 vs 34.0 pt.mon, p<0.01). CONCLUSION: In summary, revision technique can be regarded as an effective method for refractory ESI/T1 before catheter removal. Also local mupirocin ointment can play a significant role in the prevention of ESI.

Infectious Disease
The Clinical Effects of Cefpirome for the Treatment of Acute Lower Respiratory Infection.: Kyeong Cheol Shin, Young Hoon Hong, Eun Young Lee, Ki Do Park, Sung Dong Kim, Jin Hong Chung, Choong Ki Lee, Kwan Ho Lee, Cha Kyung Sung, Hyun Woo Lee; Yeungnam Univ J Med. 1999;16(2):219-227. Published online December 31, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.2.219

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Abstract PDF: BACKGROUND
In contrast to a healthy person, patients who have acute lower pespiratory tract infection with underlying pulmonary diseases have various pathogens, a rapidly progressie downhill course, and a poor response to prior antimicrobial therapy. Broad spectrum antivacterial therapy is needed for full evaluation. MATERIALS AND METHODS: To evaluate the efficacy and safety of cefpirome, we administered 1gm cefpirome, twice a day to 30 patients who had signs and symptoms of acute lower repiratory infection regardless of their underlying disease, except to those who had an allergic history to antibiotics or severe systemic diseases. RESULTS: The results were as follows : 1) Among 30 cases, 21 cases(70.0%) showed excellent improvement, and 7 cases(23.3%) showed good improvement in their symptoms and signs of acute lower respiratory infection. 2) In 14 cases with isolated pathogens, we observed bacteriologic eradication in 11 cases(78.6%). 3) Significant side effects were not found CONCLUSION: Above results suggest that cefpirome was effective as a monotherapy in patients with acute lower respriatory infection, especially on those with as underlying chronic obstructive pulmonary disease(COPD).

Pediatrics, Perinatology, and Child Health
Causative organisms of neonatal sepsis.: Kyung Ah Kim, Son Moon Shin, Han Gu Moon, Young Hoon Park; Yeungnam Univ J Med. 1999;16(1):60-68. Published online June 30, 1999; DOI: https://doi.org/10.12701/yujm.1999.16.1.60

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Abstract PDF

A nationwide survey was conducted to investigate the annual occurrence rate of neonatal sepsis, maternal risk factor in neonatal sepsis, localized infection in neonate, causative organism in nosocomial infection and the most common causative organism in neonatal sepsis in Korea. Clinical and bacteriological data were collected from thirty seven neonatal units through retrospective review of the medical records of the newborn infants who were confirmed as neonatal sepsis by isolating organisms from blood culture during one year study period from January to December in 1997. 78,463 neonates were born at 37 hospital in 1997 and 20,869 neonates were admitted to the neonatal units. During this period, 772 episodes of neonatal sepsis were recorded in 517 neonates. The occurrence rate of neonatal sepsis was 0.73%(0~2.95%). Male to female ratio was 1.15:1 and 303 cases(42.1%) were born prematurely. The main pathogens of early onset sepsis were S. aureus(20%), S. epidermidis(14.4%) and coagulase negative Staphylococcus( 14.4%). Gram negative bacilli including Enterobacter spp (7.2%), E.coli(5.1%), Klepsiella(4.5%), Pseudomonas(3.7%) Enterobacter faecium(3.6%) constitute 24.1%. Only two cases of group B beta-hemolytic Streptococcus were isolated. Common obstetric factors were PROM(21.1%), difficulty delivery(18.7%), fetal tachycardia(5.3%), chorioamnionitis(4.9%), maternal fever(4.7%). The main pathogens of late-onset sepsis were S. aureus(22.3%), S. epidermidis(20.4%) and CONS(9.9%). There were 6 cases (1.0%) of Candida sepsis. Frequent focal infections accompanying sepsis were pneumonia(26.1%), urinary tract infection(10.5%), meningitis(8.2%), and arthritis(3.6%). S. epidermidis(22.0%) and S. aureus(21.7%) were also the most common pathogens in 373 nosocomial infection.

Citations

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Characteristics of Microorganisms Isolated from Blood Cultures at a University Hospital Located in an Island Region During 2003~2007
Sung Ha Kang, Young Ree Kim
Korean Journal of Clinical Microbiology.2008; 11(1): 11. CrossRef
Microorganisms Isolated from Blood Cultures and Their Antimicrobial Susceptibility Patterns At a University Hospital During 1994-2003
Eun-Mi Koh, Sang-Guk Lee, Chang Ki Kim, Myungsook Kim, Dongeun Yong, Kyungwon Lee, June Myung Kim, Dong Soo Kim, Yunsop Chong
Annals of Laboratory Medicine.2007; 27(4): 265. CrossRef

Pulmonary and Respiratory Medicine
The Clinical Effect of Sparfloxacin for the Treatment of Acute Respiratory Infection.: Hak Jun Lee, Hye Jung Park, Chang Jin Shin, Kyeong Cheol Shin, Jin Hong Chung, Kwan Ho Lee, Hyun Woo Lee; Yeungnam Univ J Med. 1998;15(2):246-253. Published online December 31, 1998; DOI: https://doi.org/10.12701/yujm.1998.15.2.246

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Abstract PDF: Sparfloxacin is a new synthetic quinolone antimicrobial developed at the Research Laboratories of Dainippon Pharmaceutical Co, Ltd. To evaluate the efficacy and safty of sparfloxacin in acute pulmonary infection, we administered sparfloxacina(100mg) twice in a day to 30 patients who had sign and symptoms of acute pulmonary infectious diseases regardless of their underlying lung disease for 7 days. The results were : 1) A total 30 patients were enrolled in the trial. Among them 24 cases(80%) had underlying lung problems such as chronic obstructive pulmonary disease(36.4%), bronchiectasis(36.4%), bronchial asthma(3.3%), lung cancer(3.3%). 2) In 26 cases(86.6%), we observed effective improvement, and 4 cases(13.4%) show mildly effective improvement of symptoms and signs of respiratory infection. 3) In 23 cases(73.4%), we observed bacteriological eradication in culture or decreased the number of bacteria in Gram stain which found dominantly in previous Gram stain. 4) The significant side effect was not noted. The above results suggest that sparfloxacin was effective as a first line therapy in patients with acute respiratory infection.

Case Report

Hematology
Acute Pulmonary Mycetoma Due to Candida albicans in AML patient.: Jae Kyo Lee, Mi Soo Hwang, Mi Jin Kim; Yeungnam Univ J Med. 1995;12(1):135-140. Published online June 30, 1995; DOI: https://doi.org/10.12701/yujm.1995.12.1.135

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Abstract PDF: Acute cavitating pulmonary infection with a mycetoma is sometimes occur in immunocompromised patient. Most mycetoma lesions are due to Aspergillus species, and lesion caused by Candida species is rare. So we report an experienced case that pulmonary and rib infection caused by Candida species-'in -AML patient and complete remission with previous reports.

Original Articles

Gastroenterology and Hepatology
Intrafamilial transmission of HCV: comparison with HBV.: Heon Ju Lee; Yeungnam Univ J Med. 1992;9(2):407-415. Published online December 31, 1992; DOI: https://doi.org/10.12701/yujm.1992.9.2.407

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Abstract PDF: Among 85 patients with anti-HCV positive chronic liver disease, only 21.2% have past history of blood transfusion and over half the cases, they do not have any suspicious risk factors for HCV infection. 3 of 85 families show anti-HCV positive family members. On the other hand, 40 of 60 patients with HBsAg positive chronic liver disease show HBsAg positive family members. In Korea, HBV is transmitted mainly through vertical and intrafamilial infection but HCV disease might be rather horizontal and sporadic than vertical. To define the evident source of infection in sporadic hepatitis C, first of all, simple test with high sensitivity and specificity for diagnosis of HCV infection would be needed.

Pediatrics, Perinatology, and Child Health
Urinary tract infections in pediatric oncology patients with febrile neutropenia.: Kyoo Hyun Suh, Sun Young Park, Sae Yoon Kim, Jae Min Lee; Yeungnam Univ J Med. 2016;33(2):105-111.; DOI: https://doi.org/10.12701/yujm.2016.33.2.105

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Abstract PDF: BACKGROUND
Neutropenic fever is one of the most common and potentially severe complications of chemotherapy in pediatric oncology patients, while urinary tract infection (UTI) is one of the most prevalent bacterial infections in these patients. Therefore, this study was conducted to investigate features of UTI with neutropenic fever in pediatric oncology patients. METHODS: We retrospectively reviewed and analyzed the medical records, laboratory results and image findings of cases of neutropenic fever in the Department of Pediatrics of Yeungnam University Medical Center, South Korea between November 2013 and May 2015. Episodes were divided into two groups, UTI vs. non-UTI group according to the results of urine culture. The results were then compared between groups. The analysis was performed using IBM SPSS 23.0. A p-value <0.05 was considered to indicate a significant difference between groups. RESULTS: Overall, 112 episodes of neutropenic fever were analyzed, among which 22 episodes (19.6%) showed organisms on urine culture and were classified as UTI. The remaining 90 episodes were classified as non-UTI. Only four episodes (18.2%) of the UTI group showed pyuria on urine analysis. In the UTI group, 76.5% were sensitive to the first line antibiotics and showed higher clinical response than the non-UTI group. Among hematologic malignancy patients, the UTI group revealed higher serum β 2-microglobulin levels than the non-UTI group (1.56±0.43 mg/L vs. 1.2±0.43 mg/L, p<0.028). CONCLUSION: UTI in pediatric neutropenic fever responds well to antibiotics. Hematologic malignancy cases with UTI reveal increased serum β2-microglobulin level. These results will be helpful to early phase diagnosis of UTI.

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