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Prayitno SP, Natasha A, Lee S, Kim CM, Lee YM, Park K, Kim J, Kim SG, Park J, Rajoriya S, Palacios G, Oh Y, Song JW, Kim DM, Kim WK. Etiological agent and clinical characteristics of haemorrhagic fever with renal syndrome in the southern Republic of Korea: a genomic surveillance study. Clin Microbiol Infect 2024:S1198-743X(24)00089-2. [PMID: 38402954 DOI: 10.1016/j.cmi.2024.02.014] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 01/29/2024] [Accepted: 02/17/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVES High incidences of haemorrhagic fever with renal syndrome (HFRS) have been reported in the southern Republic of Korea (ROK). A distinct southern genotype of Orthohantavirus hantanense (HTNV) was identified in Apodemus agrarius chejuensis on Jeju Island. However, its association with HFRS cases in southern ROK remains elusive. We investigated the potential of the southern HTNV genotype as an etiological agent of HFRS. METHODS Samples from 22 patients with HFRS and 193 small mammals were collected in the southern ROK. The clinical characteristics of patients infected with the southern HTNV genotype were analysed. Amplicon-based MinION sequencing was employed for southern HTNV from patients and rodents, facilitating subsequent analyses involving phylogenetics and genetic reassortment. RESULTS High-throughput sequencing of HTNV exhibited higher coverage with a cycle of threshold value below 32, acquiring nearly whole-genome sequences from six patients with HFRS and seven A. agrarius samples. The phylogenetic pattern of patient-derived HTNV demonstrated genetic clustering with HTNV from Apodemus species on Jeju Island and the southern Korean peninsula, revealing genetic reassortment in a single clinical sample between the M and S segments. DISCUSSION These findings imply that the southern HTNV genotype has the potential to induce HFRS in humans. The phylogenetic inference demonstrates the diverse and dynamic characteristics of the southern HTNV tripartite genomes. Therefore, this study highlights the significance of active surveillance and amplicon sequencing for detecting orthohantavirus infections. It also raises awareness and caution for physicians regarding the emergence of a southern HTNV genotype as a cause of HFRS in the ROK.
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Affiliation(s)
- Sara P Prayitno
- Department of Microbiology, College of Medicine, Hallym University, Chuncheon, Republic of Korea
| | - Augustine Natasha
- Department of Microbiology, College of Medicine, Hallym University, Chuncheon, Republic of Korea
| | - Seonghyeon Lee
- Department of Microbiology, College of Medicine, Hallym University, Chuncheon, Republic of Korea
| | - Choon-Mee Kim
- Premedical Science, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - You Mi Lee
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Kyungmin Park
- Department of Microbiology, College of Medicine, Korea University, Seoul, Republic of Korea; BK21 Graduate Program, Biomedical Sciences, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jongwoo Kim
- Department of Microbiology, College of Medicine, Korea University, Seoul, Republic of Korea; BK21 Graduate Program, Biomedical Sciences, Korea University College of Medicine, Seoul, Republic of Korea
| | - Seong-Gyu Kim
- Department of Microbiology, College of Medicine, Korea University, Seoul, Republic of Korea; BK21 Graduate Program, Biomedical Sciences, Korea University College of Medicine, Seoul, Republic of Korea
| | - Jieun Park
- Department of Microbiology, College of Medicine, Hallym University, Chuncheon, Republic of Korea
| | - Shivani Rajoriya
- Department of Microbiology, College of Medicine, Hallym University, Chuncheon, Republic of Korea
| | - Gustavo Palacios
- Department of Microbiology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Yeonsu Oh
- College of Veterinary Medicine and Institute of Veterinary Science, Kangwon National University, Chuncheon, Republic of Korea
| | - Jin-Won Song
- Department of Microbiology, College of Medicine, Korea University, Seoul, Republic of Korea; BK21 Graduate Program, Biomedical Sciences, Korea University College of Medicine, Seoul, Republic of Korea
| | - Dong-Min Kim
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Won-Keun Kim
- Department of Microbiology, College of Medicine, Hallym University, Chuncheon, Republic of Korea; Institute of Medical Science, College of Medicine, Hallym University, Chuncheon, Republic of Korea.
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Kim CW, Kim DM, Kim CM, Yun NR, Chatterjee S. Coxiella burnetii infection in a patient with tick bite. J Infect Dev Ctries 2023; 17:1173-1178. [PMID: 37699086 DOI: 10.3855/jidc.16872] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 04/29/2023] [Indexed: 09/14/2023] Open
Abstract
INTRODUCTION We report the case of a 60-year-old male who was hospitalized with fever, headache, fatigue, nausea, and myalgia for six days. METHODOLOGY Polymerase chain reactions (PCR) were performed on patient blood samples, and four ticks were collected from the area the patient mowed. Indirect immunofluorescence assays (IFAs) were performed on serum samples to detect specific antibodies. RESULTS The collected ticks were identified as Haemaphysalis longicornis. Coxiella species-specific nested PCR (N-PCR) and sequencing confirmed the presence of Coxiella burnetii in the patient, and Coxiella-like bacteria were identified in three of the four ticks. IFA results showed ≥ 4-fold increases in both IgM and IgG antibody titers against Q fever. CONCLUSIONS Despite positive PCR results for Coxiella species in both the patient and the ticks, different bacterial species were isolated, suggesting that the patient was not infected with C. burnetii through tick bites. Further investigation is required to identify the carriers or transmitters of the infection.
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Affiliation(s)
- Chang-Woo Kim
- Department of Internal Medicine, Chosun University College of Medicine, Gwangju, Republic of Korea
| | - Dong-Min Kim
- Department of Internal Medicine, Chosun University College of Medicine, Gwangju, Republic of Korea
| | - Choon-Mee Kim
- Premedical Science, Chosun University College of Medicine, Gwangju, Republic of Korea
| | - Na-Ra Yun
- Department of Internal Medicine, Chosun University College of Medicine, Gwangju, Republic of Korea
| | - Shilpa Chatterjee
- Department of Biomedical Science, Chosun University College of Medicine, Gwangju, Republic of Korea
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Bang MS, Kim CM, Cho NH, Seo JW, Kim DY, Yun NR, Kim DM. Evaluation of humoral immune response in relation to COVID-19 severity over 1 year post-infection: critical cases higher humoral immune response than mild cases. Front Immunol 2023; 14:1203803. [PMID: 37545518 PMCID: PMC10401267 DOI: 10.3389/fimmu.2023.1203803] [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] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 07/03/2023] [Indexed: 08/08/2023] Open
Abstract
Introduction Coronavirus disease 2019 (COVID-19) is caused by SARS-CoV-2. We investigated the antibody response against SARS-CoV-2 until 1 year after symptom onset. Methods We collected 314 serum samples from 97 patients with COVID-19. Antibody responses were tested using an indirect immunofluorescence assay (IFA), enzyme-linked immunosorbent assay (ELISA), and plaque reduction neutralization test (PRNT) to detect specific neutralizing antibodies. Results The positivity rates for neutralizing antibodies at a 1:10 titer cutoff were 58.1% at 1 week, 97.8% at 4 weeks, and 78% at 1 year after symptom onset (53.8% in asymptomatic patients and 89.3% in symptomatic patients). The IFA and anti-S1 ELISA IgG results significantly correlated with neutralizing antibody titers. Critical/fatal cases showed significantly higher antibody titers than the asymptomatic or mild-to-moderate illness groups. Nonetheless, the median number of days to the seroconversion of neutralizing antibodies was 10 and 15 in asymptomatic and symptomatic patients, respectively. The asymptomatic group had a significantly higher neutralizing potency index than the mild-to-severe illness groups. Conclusions Neutralizing antibodies corresponded to earlier seroconversion but had a shorter presence in the asymptomatic group than in the symptomatic group and were still present 1 year after symptom onset in critical/fatal cases.
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Affiliation(s)
- Mi-Seon Bang
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Choon-Mee Kim
- Premedical Science, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Nam-Hyuk Cho
- Department of Microbiology and Immunology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jun-Won Seo
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Da Young Kim
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Na Ra Yun
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Dong-Min Kim
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
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Lawrence Panchali MJ, Kim CM, Seo JW, Kim DY, Yun NR, Kim DM. SARS-CoV-2 RNAemia and Disease Severity in COVID-19 Patients. Viruses 2023; 15:1560. [PMID: 37515246 PMCID: PMC10386401 DOI: 10.3390/v15071560] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 06/26/2023] [Revised: 07/12/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023] Open
Abstract
OBJECTIVE The clinical implications of SARS-CoV-2 RNA viremia in blood (RNAemia) remain uncertain despite gaining more prognostic implications for coronavirus disease 2019 (COVID-19). However, the clinical relevance of SARS-CoV-2 RNAemia has not been well documented. METHODS We conducted a cohort study on 95 confirmed COVID-19 patients and explored the prospects with evidence of SARS-CoV-2 RNAemia in association with various clinical characteristics. We performed reverse transcription-polymerase chain reaction and studied the risk factors of SARS-CoV-2 RNAemia using logistic regression analysis. RESULTS The presence of SARS-CoV-2 RNAemia in critical or fatal cases was the highest (66.7%), followed by severe (12.5%) and mild to moderate (1.7%) in admission samples. SARS-CoV-2 viral RNAemia was detected on admission and 1st week samples; however, RNAemia was not detected on the samples collected on the second week post-symptom onset. Multiple regression analysis showed that the severity of the disease was an independent predictor of RNAemia (p < 0.021), and the Kaplan-Meier survival curve estimated an increased mortality rate in SARS-CoV-2 RNAemia cases (p < 0.001). CONCLUSIONS Our study demonstrated that SARS-CoV-2 RNAemia is a predictive risk factor for clinical severity in COVID-19 patients. Hence, we showed that blood RNAemia might be a critical marker for disease severity and mortality.
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Affiliation(s)
| | - Choon-Mee Kim
- Premedical Science, College of Medicine, Chosun University, Gwangju 61452, Republic of Korea
| | - Jun-Won Seo
- Premedical Science, College of Medicine, Chosun University, Gwangju 61452, Republic of Korea
| | - Da-Young Kim
- Premedical Science, College of Medicine, Chosun University, Gwangju 61452, Republic of Korea
| | - Na-Ra Yun
- Premedical Science, College of Medicine, Chosun University, Gwangju 61452, Republic of Korea
| | - Dong-Min Kim
- Department of Internal Medicine, Chosun University College of Medicine, Gwangju 61452, Republic of Korea
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Park J, Seo JW, Yoon NR, Kim DM, Kim CM. Clinical utility of universal 16S rRNA PCR using sterile body fluids: lung abscess caused by Nocardia farcinica. J Infect Dev Ctries 2023; 17:716-718. [PMID: 37279417 DOI: 10.3855/jidc.15449] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 02/01/2022] [Indexed: 06/08/2023] Open
Abstract
Nocardiosis is an infectious disease caused by Gram-positive rod-shaped bacteria and presents as a suppurative granulomatous disease in patients with compromised immune systems. Few studies have investigated the clinical utility of the universal 16S rRNA polymerase chain reaction (PCR) method using sterile body fluids for diagnosing nocardiosis. A 64-year-old female patient was admitted to Chosun University Hospital with the complaint of fever. Computed tomography scans of her chest revealed the presence of empyema and an abscess in the right lung. Pus samples were collected using closed chest thoracostomy and were cultured. The results revealed the presence of Gram-positive bacilli, but the culture tests were unable to identify the causative microorganism. Despite antibiotic treatment, the patient died of the suspected empyema and abscess. Universal 16S PCR of her sterile body fluids in combination with sequencing was performed, which led to the diagnosis of Nocardia farcinica infection. Postmortem, the remainder of the pus samples cultured for 8 days confirmed the presence of N. farcinica. This study illustrates the importance of using routine universal 16S rRNA PCR with sterile body fluids to help diagnose atypical bacterial infections such as nocardiosis.
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Affiliation(s)
- Jungseo Park
- College of Medicine, Chosun University, Gwangju, South Korea
| | - Jun-Won Seo
- Graduate School of Chosun University, Gwangju, Republic of Korea
| | - Na Ra Yoon
- Departments of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Dong-Min Kim
- Departments of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Choon-Mee Kim
- Premedical Science, College of Medicine, Chosun University, Gwangju, Republic of Korea
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Kim CM, Kim DM, Bang MS, Seo JW, Kim DY, Yun NR, Lim SC, Lee JH, Sohn EJ, Kang H, Min K, Choi BH, Lee S. Efficacy of Plant-Made Human Recombinant ACE2 against COVID-19 in a Golden Syrian Hamster Model. Viruses 2023; 15:v15040964. [PMID: 37112944 PMCID: PMC10146983 DOI: 10.3390/v15040964] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 03/31/2023] [Accepted: 04/10/2023] [Indexed: 04/29/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is a novel infectious respiratory disease caused by SARS-CoV-2. We evaluated the efficacy of a plant-based human recombinant angiotensin-converting enzyme 2 (hrACE2) and hrACE2-foldon (hrACE2-Fd) protein against COVID-19. In addition, we analyzed the antiviral activity of hrACE2 and hrACE2-Fd against SARS-CoV-2 using real-time reverse-transcription PCR and plaque assays. The therapeutic efficacy was detected using the Golden Syrian hamster model infected with SARS-CoV-2. Both hrACE2 and hrACE2-Fd inhibited SARS-CoV-2 by 50% at concentrations below the maximum plasma concentration, with EC50 of 5.8 μg/mL and 6.2 μg/mL, respectively. The hrACE2 and hrACE2-Fd injection groups showed a tendency for decreased viral titers in nasal turbinate tissues on day 3 after virus inoculation; however, this decrease was not detectable in lung tissues. Histopathological examination on day 9 after virus inoculation showed continued inflammation in the SARS-CoV-2 infection group, whereas decreased inflammation was observed in both the hrACE2 and hrACE2-Fd injection groups. No significant changes were observed at other time points. In conclusion, the potential therapeutic efficacy of plant-based proteins, hrACE2 and hrACE2-Fd, against COVID-19 was confirmed in a SARS-CoV-2-inoculated Golden Syrian hamster model. Further preclinical studies on primates and humans are necessary to obtain additional evidence and determine the effectiveness of these therapies.
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Affiliation(s)
- Choon-Mee Kim
- Premedical Science, Chosun University College of Medicine, Gwangju 61452, Republic of Korea
| | - Dong-Min Kim
- Department of Internal Medicine, Chosun University College of Medicine, Gwangju 61452, Republic of Korea
| | - Mi-Seon Bang
- Department of Internal Medicine, Chosun University College of Medicine, Gwangju 61452, Republic of Korea
| | - Jun-Won Seo
- Department of Internal Medicine, Chosun University College of Medicine, Gwangju 61452, Republic of Korea
| | - Da-Young Kim
- Department of Internal Medicine, Chosun University College of Medicine, Gwangju 61452, Republic of Korea
| | - Na-Ra Yun
- Department of Internal Medicine, Chosun University College of Medicine, Gwangju 61452, Republic of Korea
| | - Sung-Chul Lim
- Department of Pathology, Chosun University College of Medicine, Gwangju 61452, Republic of Korea
| | - Ju-Hyung Lee
- Department of Preventive Medicine, Jeonbuk National University Medical School, Jeonju 54907, Republic of Korea
| | - Eun-Ju Sohn
- BioApplications Inc., Pohang Techno Park Complex, 394 Jigok-ro Nam-gu, Pohang 37668, Republic of Korea
| | - Hyangju Kang
- BioApplications Inc., Pohang Techno Park Complex, 394 Jigok-ro Nam-gu, Pohang 37668, Republic of Korea
| | - Kyungmin Min
- BioApplications Inc., Pohang Techno Park Complex, 394 Jigok-ro Nam-gu, Pohang 37668, Republic of Korea
| | - Bo-Hwa Choi
- BioApplications Inc., Pohang Techno Park Complex, 394 Jigok-ro Nam-gu, Pohang 37668, Republic of Korea
| | - Sangmin Lee
- BioApplications Inc., Pohang Techno Park Complex, 394 Jigok-ro Nam-gu, Pohang 37668, Republic of Korea
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Lawrence Panchali MJ, Kim CM, Lee YM, Seo JW, Kim DY, Yun NR, Kim DM. Diagnostic Sensitivity of Saliva and Other Respiratory Tract Samples of SARS-CoV-2 Variants in Patients with COVID-19. Microbiol Spectr 2023; 11:e0307622. [PMID: 36976007 PMCID: PMC10100734 DOI: 10.1128/spectrum.03076-22] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 03/03/2023] [Indexed: 03/29/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants continue to emerge during the ongoing coronavirus disease 2019 (COVID-19) pandemic. Contrasting studies on the omicron variant have demonstrated higher viral loads in different clinical specimens, which is consistent with its high transmissibility. We investigated the viral load in clinical specimens that were infected with the SARS-CoV-2 wild-type, delta, and omicron variants, and we analyzed the diagnostic accuracy of upper and lower respiratory specimens for these variants. We performed nested reverse transcription (RT)-polymerase chain reaction (PCR), targeting the spike gene and sequencing for variant classification. RT-PCR was performed using upper and lower respiratory specimens, including saliva from 78 COVID-19 patients (wild-type, delta, and omicron variants). A comparison of the sensitivity and specificity, using the area under the receiver operating characteristic curve (AUC) values from the N gene, showed that the omicron variant saliva samples had a higher sensitivity (AUC = 1.000) than did the delta (AUC = 0.875) and the wild-type (AUC = 0.878) variant samples. The sensitivity of the omicron saliva samples was greater than that of the wild-type nasopharynx and sputum samples (P < 0.001). The viral loads of the saliva samples containing the wild-type, delta, and omicron variants were 8.18 × 105, 2.77 × 106, and 5.69 × 105, respectively, which did not differ significantly (P = 0.610). Statistically significant differences were not observed in the saliva viral loads between vaccinated and nonvaccinated patients who were infected with the omicron variant (P = 0.120). In conclusion, omicron saliva samples had higher sensitivity than did wild-type and delta samples, and the viral load did not significantly differ between vaccinated and nonvaccinated patients. Further research is necessary to elucidate the mechanisms underlying the sensitivity differences. IMPORTANCE Owing to the vast heterogeneity of the studies focused on the correlation between the SARS-CoV-2 omicron variant and COVID-19, accurate comparisons of the specificity and sensitivity of samples and associated outcomes are still inconclusive. Moreover, limited information is available on the leading causes of infection and the factors that are associated with the conditions that underlie the spread of infection. Although several studies have contributed important knowledge regarding infectious specimens, the impact of saliva samples remains unknown. This study showed that the sensitivity of the omicron variant saliva samples was higher than that of the wild-type nasopharyngeal and sputum samples. Moreover, neither vaccinated nor nonvaccinated patients who were infected with the omicron variant showed any significant differences in SARS-CoV-2 viral loads. Hence, this study is an important step toward understanding how saliva sample results are correlated with other specimen results, regardless of the vaccination status of patients who are infected with the SARS-CoV-2 omicron variant.
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Affiliation(s)
| | - Choon-Mee Kim
- Premedical Science, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Yu-Mi Lee
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Jun-Won Seo
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Da Young Kim
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Na Ra Yun
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Dong-Min Kim
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
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Kim CM, Han MA, Yun NR, Bang MS, Lee YM, Lee B, Kim DM. Seroprevalence of severe fever with thrombocytopenia syndrome using specimens from the Korea National Health & Nutrition Examination Survey. PLoS Negl Trop Dis 2023; 17:e0011097. [PMID: 36947741 PMCID: PMC10032665 DOI: 10.1371/journal.pntd.0011097] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 01/13/2023] [Indexed: 03/24/2023] Open
Abstract
BACKGROUND Severe fever with thrombocytopenia syndrome (SFTS) is an acute febrile disease caused by bites from ticks infected with the SFTS virus. In Korea, SFTS patients are observed nationwide, including Jeju Island, but there are currently no data regarding the national prevalence of SFTS, including that of residents of 16 cities and provinces. This study aimed to investigate the seroprevalence of SFTS in Korea. METHODOLOGY/PRINCIPAL FINDINGS A total of 1500 participants were selected through random sampling from the 2014-2015 Korea National Health and Nutrition Examination Survey (KNHANES). An indirect immunofluorescence antibody assay (IFA) was performed to assess immunoglobulin (Ig) G and IgM antibody titers against SFTS virus. RESULTS Of the 1500 participants, 55 (3.7%) tested positive for IgG and 1 (0.1%) tested positive for IgM, with antibody titer of ≥ 1:32. Approximately 3.9% and 2.5% of participants in urban and rural areas, respectively, had a positive titer of ≥ 1:32. There was a significant correlation between SFTS incidence per 100,000 population and seroprevalence using an IgG titer ≥ 1:64 as the cut-off value. CONCLUSION This is the first study to investigate national SFTS seroprevalence in all 16 cities and provinces representing Korea. Our study will also provide useful guidelines for the development of preventive measures against SFTS.
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Affiliation(s)
- Choon-Mee Kim
- Premedical Science, College of Medicine, Chosun University, Gwangju, South Korea
| | - Mi Ah Han
- Department of Preventive Medicine, College of Medicine, Chosun University, Gwangju, South Korea
| | - Na Ra Yun
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, South Korea
| | - Mi-Seon Bang
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, South Korea
| | - You Mi Lee
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, South Korea
| | - Beomgi Lee
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, South Korea
| | - Dong-Min Kim
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, South Korea
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Kim CM, Kim DM, Bang MS, Seo JW, Yun NR, Kim DY, Han MA, Hwang JH, Park SK. The Seroprevalence of Severe Fever with Thrombocytopenia Syndrome: An Epidemiological Study of Korean Veterinary Hospital Workers. Viruses 2023; 15:v15030609. [PMID: 36992318 PMCID: PMC10052674 DOI: 10.3390/v15030609] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 02/15/2023] [Accepted: 02/17/2023] [Indexed: 02/25/2023] Open
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is a zoonotic tick-borne infectious disease caused by the SFTS virus (SFTSV). Few studies have assessed SFTS seroprevalence among veterinary hospital staff and their awareness of SFTS. From January to May 2021, serum samples from 103 veterinary hospital staff were tested for SFTS using an enzyme-linked immunosorbent assay (ELISA), an immunofluorescence assay, and a 50% plaque reduction neutralization antibody test, which yielded positive results in four (3.9%), three (2.9%), and two (1.9%) participants, respectively. A questionnaire was used for an epidemiological investigation. ELISA positivity was higher among those who lacked awareness of possible animal-to-human SFTS transmission (p = 0.029). SFTS awareness was significantly lower among veterinary hospital staff than among the veterinarians (p < 0.001). Providing staff with training concerning standard precautions and the use of appropriate personal protective equipment is important.
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Affiliation(s)
- Choon-Mee Kim
- Premedical Science, College of Medicine, Chosun University, Gwangju 61452, Republic of Korea
| | - Dong-Min Kim
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju 61452, Republic of Korea
- Correspondence: ; Tel.: +82-62-220-3108; Fax: +82-62-234-9653
| | - Mi-Seon Bang
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju 61452, Republic of Korea
| | - Jun-Won Seo
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju 61452, Republic of Korea
| | - Na-Ra Yun
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju 61452, Republic of Korea
| | - Da-Young Kim
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju 61452, Republic of Korea
| | - Mi-Ah Han
- Department of Preventive Medicine, College of Medicine, Chosun University, Gwangju 61452, Republic of Korea
| | - Ji-Hye Hwang
- Division of Control for Zoonotic and Vector Borne Disease, Korea Disease Control and Prevention Agency, Cheongju-si 28159, Republic of Korea
| | - Sook-Kyung Park
- Division of Control for Zoonotic and Vector Borne Disease, Korea Disease Control and Prevention Agency, Cheongju-si 28159, Republic of Korea
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Kim CM, Lee JB, Shin SJ, Ahn JB, Lee M, Kim HS. The efficacy of immune checkpoint inhibitors in elderly patients: a meta-analysis and meta-regression. ESMO Open 2022; 7:100577. [PMID: 36156450 PMCID: PMC9588901 DOI: 10.1016/j.esmoop.2022.100577] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [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: 03/04/2022] [Revised: 07/03/2022] [Accepted: 08/02/2022] [Indexed: 12/15/2022] Open
Abstract
Background Immune checkpoint inhibitor (ICI) therapy has improved patient survival in advanced cancers; however, the efficacy of ICIs in elderly patients is still elusive. This study assessed the efficacy of ICIs in elderly patients with advanced cancer in terms of overall survival (OS) and progression-free survival (PFS). Materials and methods We carried out a systematic review and identified 30 head-to-head phase II/III randomized controlled trials that compared immunotherapy with the standard of care in advanced solid tumor patients. The data on patients younger or over 65 years of age were indexed from PubMed-Medline, Embase, and Scopus and obtained for meta-analysis. The subgroup analyses were stratified by primary tumor type, line of treatment, or type of immunotherapy, and a meta-regression analysis was carried out after adjusting for all other variables. Results The study included 17 476 patients, comprising 58% (10 119) younger (<65 years old) and 42% (7357) elderly (≥65 years old) patients. The hazard ratio (HR) for OS was 0.77 [95% confidence interval (CI) 0.70-0.85] and 0.77 (95% CI 0.70-0.85) in the younger and elderly groups, respectively, suggesting similar efficacies of ICIs in these two age groups. The subgroup analyses revealed no significant relationship between age and treatment outcomes, except for the PFS benefit in younger patients with melanoma than in elderly patients (HR 0.44 in younger patients versus 0.65 in elderly patients, P = 0.04). These results were further supported by meta-regression analysis, which showed no statistically significant difference in OS (P = 0.954) and PFS (P = 0.555) between the two age groups. Conclusions The findings suggest that age-associated impairments of the immune system did not affect the efficacy of ICIs in elderly patients compared to younger patients. Therefore, the choice of ICIs for elderly patients can be considered, regardless of chronological age. We evaluated the efficacy of ICI in 17 476 patients, comprising 58% younger and 42% elderly patients. Meta-analysis resulted in the comparable efficacy of ICI between younger and older age groups. Further, meta-regression analysis showed no significant difference in OS and PFS. Our study suggests that chronological age does not lead to immunosenescence in response to ICI in immune-oncology.
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Affiliation(s)
- C M Kim
- Yonsei University College of Medicine, Seoul
| | - J B Lee
- Lung Cancer Clinic, Yonsei Cancer Center, Severance Hospital, Seoul
| | - S J Shin
- Yonsei Cancer Center, Division of Medical Oncology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul
| | - J B Ahn
- Yonsei Cancer Center, Division of Medical Oncology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul
| | - M Lee
- Biostatistics Collaboration Unit, Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Seoul.
| | - H S Kim
- Yonsei Cancer Center, Division of Medical Oncology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul; Graduate School of Medical Science, Brain Korea 21 Project, Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea.
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Seo MH, Kim CM, Kim DM, Yun NR, Park JW, Chung JK. Emerging hantavirus infection in wild rodents captured in suburbs of Gwangju Metropolitan City, South Korea. PLoS Negl Trop Dis 2022; 16:e0010526. [PMID: 35737659 PMCID: PMC9223619 DOI: 10.1371/journal.pntd.0010526] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 05/20/2022] [Indexed: 11/23/2022] Open
Abstract
Background Hemorrhagic fever with renal syndrome (HFRS) caused by hantaviruses is a frequently reported acute hemorrhagic fever in South Korea. These viruses are transmitted by various rodent species such as Apodemus agrarius. Methodology/Principal findings To investigate hantavirus infection and seroprevalence in rodents, wild rodents were captured from two districts in the suburbs of Gwangju Metropolitan City from January 2016 to December 2018. Nested reverse-transcription polymerase chain reaction (RT-PCR) targeting the hantavirus-specific L segment and indirect immunofluorescence antibody (IFA) assay using Hantaan virus antigen slides were performed. A total of 585 wild rodents were captured—512 A. agrarius, 49 Crocidura lasiura, and 24 Myodes regulus. Nested RT-PCR was performed to examine the rate of hantavirus infection in wild rodents, and 1.88% (11/585) of all rodents, 1.17% (6/512) of A. agrarius, 6.12% (3/49) of C. lasiura, and 8.33% (2/24) of M. regulus tested positive. The nucleotide sequence analysis of the eleven PCR-positive products revealed that six PCR products showed over 85% sequence similarity with the Jeju virus, four showed over 99.7% similarity with the Hantaan virus, and one showed over 95.3% homology with the Imjin virus. Moreover, IgG antibodies against the Hantaan virus were detected in 6.15% (36/585) of all rodents, 6.8% (35/512) of A. agrarius, and 4.17% (1/24) of M. regulus. IgG antibodies were not detected in C. lasiura. Conclusions/Significance Hantaviruses were detected in all three wild rodent species of A. agrarius, C. lasiura, and M. regulus captured in the suburbs of Gwangju Metropolitan City, South Korea, and it was demonstrated that they were various strains of hantaviruses such as the Hantaan, Jeju, and Imjin viruses. Hantaviruses (family Hantaviridae, genus Hantavirus) are rodent viruses that can cause two fatal human diseases—hemorrhagic fever with renal syndrome and hantavirus pulmonary syndrome. These viruses are transmitted by various rodent species such as Apodemus agrarius. In the present study, wild rodents captured in the suburbs of Gwangju Metropolitan City were analyzed by nested reverse-transcription polymerase chain reaction targeting the hantavirus-specific L segment and indirect immunofluorescence antibody assay using Hantaan virus antigen slides. A total of 585 wild rodents were captured and 1.88% (11/585) of all rodents, 1.17% (6/512) of A. agrarius, 6.12% (3/49) of Crocidura lasiura, and 8.33% (2/24) of Myodes regulus were PCR-positive. Of the eleven PCR-positive wild rodents, six PCR products showed over 85% sequence similarity with the Jeju virus, four showed over 99.7% similarity with the Hantaan virus, and one showed over 95.3% homology with the Imjin virus. Moreover, IgG antibodies against the Hantaan virus were detected in 6.15% (36/585) of all rodents, 6.8% (35/512) of A. agrarius, and 4.17% (1/24) of M. regulus. IgG antibodies were not detected in C. lasiura. When we examined the detection rate of hantavirus genes in different seasons, hantaviruses were most commonly detected in fall (seven cases [5.69%]) and winter (four cases [2.76%]). No hantaviruses were detected in spring or summer. However, the seasonal prevalence of IgG antibodies was higher in spring and summer (12 [7.32%] and 11 [7.10%] cases, respectively) than in fall and winter (seven [5.69%] and six [4.14%] cases, respectively). This study was performed on a monthly basis throughout a three-year period, and thus, it provides reliable data that may provide insight into preventive measures against HFRS. Our results suggest that various types of hantaviruses, including Hantaan, Jeju, and Imjin viruses, are distributed throughout Gwangju Metropolitan City, South Korea. Data regarding the rate of Hantaan virus infection in rodents in Gwangju and knowledge of the hantavirus seroprevalence, species, and genotypes circulating in these domestic rodent species will provide useful information for developing vaccines and diagnostic testing using sequence data. These will help increase preparedness for the emergence of new species.
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Affiliation(s)
- Mi hee Seo
- Division of Infectious Disease Investigation, Health and Environment Research Institute of Gwangju City, Gwangju, Republic of Korea
| | - Choon-Mee Kim
- Premedical Science, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Dong-Min Kim
- Departments of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
- * E-mail:
| | - Na Ra Yun
- Departments of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Jung Wook Park
- Division of Infectious Disease Investigation, Health and Environment Research Institute of Gwangju City, Gwangju, Republic of Korea
| | - Jae Keun Chung
- Division of Infectious Disease Investigation, Health and Environment Research Institute of Gwangju City, Gwangju, Republic of Korea
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Bang MS, Kim CM, Kim DM, Yun NR. Effective Drugs Against Severe Fever With Thrombocytopenia Syndrome Virus in an in vitro Model. Front Med (Lausanne) 2022; 9:839215. [PMID: 35433715 PMCID: PMC9008449 DOI: 10.3389/fmed.2022.839215] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 12/23/2021] [Accepted: 02/22/2022] [Indexed: 11/13/2022] Open
Abstract
Background Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne infectious disease caused by the SFTS virus (SFTSV). This syndrome is endemic in China, South Korea, and Japan, with a fatality rate of approximately 20–30%. Although the World Health Organization has listed SFTS as a disease that requires urgent steps for the development of its treatment, no treatments are available. Methods We analyzed the antiviral activity of 41 drugs against the SFTSV to explore potential therapeutic candidates using real-time reverse transcription-polymerase chain reaction and plaque assay in vitro. Results Peramivir, nitazoxanide, and favipiravir were found to have inhibitory effects on the SFTSV at concentrations below the maximum plasma concentration (Cmax). The concentrations that inhibited the SFTSV by 50% were as follows: peramivir, half maximal effective concentration (EC50) 12.9 μg/mL; nitazoxanide, EC50 0.57 μg/mL; and favipiravir, EC50 4.14 μg/mL. Conclusion The effects of peramivir and nitazoxanide on the SFTSV were identified for the first time in this study. Future studies need to include animal models of SFTSV infection, clinical trials including dose-ranging trials, and evaluation of combination therapy with other potential antivirals.
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Affiliation(s)
- Mi-Seon Bang
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, South Korea
| | - Choon-Mee Kim
- Premedical Science, College of Medicine, Chosun University, Gwangju, South Korea
| | - Dong-Min Kim
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, South Korea
- *Correspondence: Dong-Min Kim,
| | - Na Ra Yun
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, South Korea
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Ko YJ, Lee OJ, Lee SB, Kim CM, Lee J, Kook JK, Park SN, Shin JH, Kim SH, Won EJ, Park G, Kang SH, Jang SJ. Accuracy of ASTA MicroIDSys, a New Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry System, for the Identification of Korean Reference and Clinical Bacterial and Yeast Strains. Diagn Microbiol Infect Dis 2022; 103:115658. [DOI: 10.1016/j.diagmicrobio.2022.115658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 01/17/2022] [Accepted: 01/22/2022] [Indexed: 11/03/2022]
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Kim DM, Seo JW, Kim Y, Park U, Ha NY, Park H, Yun NR, Kim DY, Yoon SH, Na YS, Moon DS, Lim SC, Kim CM, Kim YS, Cho NH. Eosinophil-mediated lung inflammation associated with elevated natural killer T cell response in COVID-19 patients. Korean J Intern Med 2022; 37:201-209. [PMID: 34565131 PMCID: PMC8747909 DOI: 10.3904/kjim.2021.093] [Citation(s) in RCA: 4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 07/16/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND/AIMS Coronavirus disease 2019 (COVID-19) is associated with acute respiratory syndrome. The mechanisms underlying the different degrees of pneumonia severity in patients with COVID-19 remain elusive. This study provides evidence that COVID-19 is associated with eosinophil-mediated inflammation. METHODS We performed a retrospective case series of three patients with laboratory and radiologically confirmed COVID-19 pneumonia admitted to Chosun University Hospital. Demographic and clinical data on inflammatory cell lung infiltration and cytokine levels in patients with COVID-19 were collected. RESULTS Cytological analysis of sputum, tracheal aspirates, and bronchoalveolar lavage fluid (BALF) samples from all three patients revealed massive infiltration of polymorphonuclear cells (PMNs), such as eosinophils and neutrophils. All sputum and BALF specimens contained high levels of eosinophil cationic proteins. The infiltration of PMNs into the lungs, together with elevated levels of natural killer T (NKT) cells in BALF and peripheral blood samples from patients with severe pneumonia in the acute phase was confirmed by flow cytometry. CONCLUSION These results suggest that the lungs of COVID-19 patients can exhibit eosinophil-mediated inflammation, together with an elevated NKT cell response, which is associated with COVID-19 pneumonia.
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Affiliation(s)
- Dong-Min Kim
- Department of Internal Medicine, Chosun University College of Medicine, Gwangju,
Korea
| | - Jun-Won Seo
- Department of Internal Medicine, Chosun University College of Medicine, Gwangju,
Korea
| | - Yuri Kim
- Department of Microbiology and Immunology, Seoul National University College of Medicine, Seoul,
Korea
| | - Uni Park
- Department of Microbiology and Immunology, Seoul National University College of Medicine, Seoul,
Korea
| | - Na-Young Ha
- Department of Microbiology and Immunology, Seoul National University College of Medicine, Seoul,
Korea
| | - Hyoree Park
- Department of Microbiology and Immunology, Seoul National University College of Medicine, Seoul,
Korea
| | - Na Ra Yun
- Department of Internal Medicine, Chosun University College of Medicine, Gwangju,
Korea
| | - Da Young Kim
- Department of Internal Medicine, Chosun University College of Medicine, Gwangju,
Korea
| | - Sung Ho Yoon
- Department of Internal Medicine, Chosun University College of Medicine, Gwangju,
Korea
| | - Yong Sub Na
- Department of Internal Medicine, Chosun University College of Medicine, Gwangju,
Korea
| | - Do Sik Moon
- Department of Internal Medicine, Chosun University College of Medicine, Gwangju,
Korea
| | - Sung-Chul Lim
- Department of Pathology, Chosun University College of Medicine, Gwangju,
Korea
| | - Choon-Mee Kim
- Department of Premedical Science, Chosun University College of Medicine, Gwangju,
Korea
| | - Yeon-Sook Kim
- Department of Internal Medicine, Chungnam National University College of Medicine, Daejeon,
Korea
| | - Nam-Hyuk Cho
- Department of Microbiology and Immunology, Seoul National University College of Medicine, Seoul,
Korea
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Tariq M, Hur J, Seo JW, Kim DY, Yun NR, Lee YM, Bang MS, Hwang SY, Kim CM, Lee JH, Song KH, Lee H, Jung J, Park JY, Kim HB, Kim ES, Lee S, Kim DM. Usefulness of ELISA Using Total Antibody against Plant-Expressed Recombinant Nucleocapsid Protein of SARS-CoV-2. Microbiol Spectr 2021; 9:e0067221. [PMID: 34817278 PMCID: PMC8612163 DOI: 10.1128/spectrum.00672-21] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 10/25/2021] [Indexed: 12/02/2022] Open
Abstract
Here, we aimed to investigate the diagnostic value of a serological assay using the nucleocapsid protein developed for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection and evaluated its performance using three commercial enzyme-linked immunosorbent assays (ELISAs), namely, Standard E 2019 novel coronavirus disease (COVID-19) total antibody (Ab) ELISA (SD Biosensor), and EDI novel coronavirus COVID-19 IgG and IgM ELISA. A recombinant nucleocapsid protein (rNP) was expressed from plants and Escherichia coli for the detection of serum total Ab. We prospectively collected 141 serum samples from 32 patients with reverse transcription-PCR (RT-PCR)-confirmed COVID-19 and determined the sensitivity and dynamics of their total Ab response. Specificity was evaluated using 158 prepandemic samples. To validate the assays, we evaluated the performance using two different cutoff values. The sensitivity and specificity for each assay were as follows: 92.91% and 94.30% (plant-rNP), 83.69% and 98.73% (SD Biosensor), 75.89% and 98.10% (E. coli-rNP), 76.47% and 100% (EDI-IgG), and 80.39% and 80% (EDI-IgM). The plant-based rNP showed the highest sensitivity and area under the receiver operating characteristic (ROC) curve (0.980) among all the assays (P < 0.05). The seroconversion rate for total Ab increased sequentially with disease progression, with a sensitivity of 100% after 10 to 12 days of post-symptom onset (PSO) for both rNP-plant-based and SD Biosensor ELISAs. After 2 weeks of PSO, the seroconversion rates were >80% and 100% for EDI-IgM and EDI-IgG ELISA, respectively. Seroconversion occurred earlier with rNP plant-based ELISA (5 days PSO) compared with E. coli-based (7 days PSO) and SD Biosensor (8 days PSO) ELISA. We determined that rNP produced in plants enables the robust detection of SARS-CoV-2 total Abs. The assay can be used for serosurvey and complementary diagnosis of COVID-19. IMPORTANCE At present, the principal diagnostic methods for COVID-19 comprise the identification of viral nucleic acid by genetic approaches, including PCR-based techniques or next-generation sequencing. However, there is an urgent need for validated serological assays which are crucial for the understanding of immune responses against SARS-CoV-2. In this study, a highly sensitive and specific serological antibody assay was developed for the detection of SARS-CoV-2 with an overall accuracy of 93.56% using a recombinant nucleoprotein expressed from plants.
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Affiliation(s)
- Misbah Tariq
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Jian Hur
- Department of Infectious Disease Internal Medicine, College of Medicine, Yeungnam University, Gyeongsan, Republic of Korea
| | - Jun-Won Seo
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Da Young Kim
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Na Ra Yun
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - You Mi Lee
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Mi-Seon Bang
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Seong Yeon Hwang
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Choon-Mee Kim
- Premedical Science, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Ju-Hyung Lee
- Department of Preventive Medicine, Jeonbuk National University Medical School, Jeonju, Republic of Korea
| | - Kyoung-Ho Song
- Department of Internal Medicine, Seoul National University Bundang Hospital, College of Medicine, Seongnam, Republic of Korea
| | - Hyunju Lee
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Jongtak Jung
- Department of Internal Medicine, Seoul National University Bundang Hospital, College of Medicine, Seongnam, Republic of Korea
| | - Ji Young Park
- Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Hong Bin Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, College of Medicine, Seongnam, Republic of Korea
| | - Eu Suk Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, College of Medicine, Seongnam, Republic of Korea
| | - Sangmin Lee
- BioApplications Inc., Pohang, Republic of Korea
| | - Dong-Min Kim
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
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Tariq M, Kim DM, Kim CM, Bang MS, Lee YM, Seo JW, Kim DY, Yun NR. Viable Severe Acute Respiratory Syndrome Coronavirus 2 Isolates Exhibit Higher Correlation With Rapid Antigen Assays Than Subgenomic RNA or Genomic RNA. Front Microbiol 2021; 12:718497. [PMID: 34867844 PMCID: PMC8633410 DOI: 10.3389/fmicb.2021.718497] [Citation(s) in RCA: 4] [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: 06/01/2021] [Accepted: 10/11/2021] [Indexed: 12/23/2022] Open
Abstract
Background: Rapid identification and effective isolation are crucial for curbing the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). To meet this requirement, antigen-detection rapid diagnostic tests (Ag-RDTs) are essential. Methods: Between February 2020 and August 2020 we performed a cohort study of patients with confirmed COVID-19. The clinical performance of Ag rapid fluorescence immunoassay (FIA) and Ag Gold was evaluated and compared in parallel with genomic and subgenomic real-time reverse transcription-polymerase chain reaction (rRT-PCR) and cell culture-based assays. Results: In total, 150 samples were tested. Of these, 63 serial samples were obtained from 11 patients with SARS-CoV-2 and 87 from negative controls. Serial respiratory samples were obtained 2 days prior to symptom onset (-2) up to 25 days post-symptom onset. Overall, for rRT-PCR-positive samples (n = 51), the detection sensitivity of Ag rapid FIA and Ag Gold was 74.5% and 53.49%, respectively, with a specificity of 100%; however, for samples with low cycle threshold (Ct) values, Ag rapid FIA and Ag Gold exhibited a sensitivity of 82.61% (Ct ≤ 30, 5.6 log10RNA copies/mL) and 80% (Ct ≤ 25, 6.9 log10RNA copies/mL), respectively. Despite low analytical sensitivity, both Ag-RDTs detected 100% infection in cell culture-positive samples (n = 15) and were highly effective in distinguishing viable samples from those with subgenomic RNA (66.66%). For both Ag-RDTs, all samples that yielded discordant results (rRT-PCR + ve/Ag-RDT -ve) were also negative by culture. Conclusion: The data suggest that Ag-RDTs reliably detect viable SARS-CoV-2; thus, they may serve as an important tool for rapid detection of potentially infectious individuals.
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Affiliation(s)
- Misbah Tariq
- Department of Internal Medicine, Chosun University College of Medicine, Gwangju, South Korea
| | - Dong-Min Kim
- Department of Internal Medicine, Chosun University College of Medicine, Gwangju, South Korea
| | - Choon-Mee Kim
- Premedical Science, Chosun University College of Medicine, Gwangju, South Korea
| | - Mi-Seon Bang
- Department of Internal Medicine, Chosun University College of Medicine, Gwangju, South Korea
| | - You Mi Lee
- Department of Internal Medicine, Chosun University College of Medicine, Gwangju, South Korea
| | - Jun-Won Seo
- Department of Internal Medicine, Chosun University College of Medicine, Gwangju, South Korea
| | - Da Young Kim
- Department of Internal Medicine, Chosun University College of Medicine, Gwangju, South Korea
| | - Na Ra Yun
- Department of Internal Medicine, Chosun University College of Medicine, Gwangju, South Korea
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Jalal S, Kim CM, Kim DM, Song HJ, Lee JC, Shin MY, Lim HC. Geographical clustering of Hantavirus isolates from Apodemus agrarius identified in the Republic of Korea indicate the emergence of a new Hantavirus genotype. J Clin Virol 2021; 146:105030. [PMID: 34839200 DOI: 10.1016/j.jcv.2021.105030] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 10/22/2021] [Accepted: 11/14/2021] [Indexed: 10/19/2022]
Abstract
AIM AND METHODOLOGY Several studies on hantavirus evolution have shown that genetic reassortment plays an important role in the evolution and epidemiology of this disease. To understand the genetic epidemiology of human hantaviruses, samples from rodent reservoirs were subjected to reverse-transcription nested polymerase chain reaction (RT-N-PCR) targeting the L- and S-segments of the hantavirus genome. RESULTS Positive isolates from Gwangju, Boseong-gun (Jeollanam-do Province), and Jeju Island were confirmed as Hantaan virus using DNA sequencing. Phylogenetic analysis showed that all isolates grouped together as Hantaan virus but with each region forming a distinct cluster. In addition, these three clusters were distinct from other Hantaan isolates reported in previous studies from Korea and its neighboring countries China and Russia. CONCLUSION This suggests Hantaan viruses exhibit a considerable degree of geographical clustering, and there may be a novel Hantaan genotype in southwestern ROK. This study helps expand our knowledge regarding the emergence of new hantavirus strains and their degree of geographical variation. IMPORTANCE Hantaan virus, a pathogenic prototype hantavirus carried by Apodemus agrarius, is found throughout China, Russia, and Korea. Here, we examined the genetic diversity of hantaviruses to expand our knowledge regarding the emergence of new hantavirus strains and their degree of geographical variation. We found that hantaan viruses show a considerable degree of geographical clustering, which may allude to the development of a new genotype variant in the southwestern region of the ROK.
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Affiliation(s)
- Sehrish Jalal
- Department of Bio-Medical Science, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Choon-Mee Kim
- Premedical Science, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Dong-Min Kim
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea.
| | - Hyeon Je Song
- Department of Clinical Laboratory Science, Gwangju Health University, Gwangju 62287, Korea
| | - Jeong-Chi Lee
- Department of Clinical Laboratory Science, Gwangju Health University, Gwangju 62287, Korea
| | - Mi Yeong Shin
- Jeollanam-do Institute of Health and Environment, Korea
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Kim DY, Bae EK, Seo JW, Yun NR, Kim CM, Kim DM. Viral Kinetics of Severe Acute Respiratory Syndrome Coronavirus 2 in Patients with Coronavirus Disease 2019. Microbiol Spectr 2021; 9:e0079321. [PMID: 34704783 PMCID: PMC8549742 DOI: 10.1128/spectrum.00793-21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 07/08/2021] [Accepted: 10/07/2021] [Indexed: 01/12/2023] Open
Abstract
To determine the relationship between viral kinetics and severity of disease in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, we investigated the viral kinetics and compared the viral loads of patients with coronavirus disease 2019 (COVID-19; the disease caused by SARS-CoV-2), stratified by symptoms and severity. We determined the viral kinetics of 100 patients diagnosed with COVID-19 at Chosun University Hospital between February 2020 and May 2021 and analyzed the differences between asymptomatic, symptomatic, and nonsurvivor patients and between patients who died and those who survived. Clinical samples, comprising respiratory specimens (sputum samples and nasopharynx and oropharynx swab samples), were obtained at different time points of hospitalization, at 1, 3 to 5, 7, 10, 14, and 30 days. SARS-CoV-2 was detected using real-time reverse transcription-PCR (RT-PCR). All three groups, asymptomatic, symptomatic, and deceased patients, had higher numbers of viral copies at symptom onset, and the asymptomatic group had lower numbers of viral copies than the symptomatic or nonsurvivor group. Viral RNA release was detected until 30 days after symptom onset. The virus cleared up earlier in asymptomatic patients than in symptomatic and nonsurvivor patients, and it cleared up earlier in mildly affected patients than in severely affected patients. The cycle threshold values tended to be significantly lower in the group receiving steroids than in the nonsteroid group, even in the low-risk group with a pneumonia severity index of less than 90. The viral loads in patients with COVID-19 were significantly different according to disease severity and steroid use. IMPORTANCE In our study, we analyzed the viral kinetics of COVID-19 patients. Our study reveals differences in viral shedding according to the severity of disease in COVID-19 patients. Viral shedding had a longer duration in severely affected patients, and the cyclic threshold values were lower in the group receiving steroids. This study is expected to be helpful in analyzing the trend of the disease course according to steroid use and severity of SARS-CoV-2 disease.
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Affiliation(s)
- Da Young Kim
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Eun Kyung Bae
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Jun-Won Seo
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Na Ra Yun
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Choon-Mee Kim
- Department of Premedical Science, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Dong-Min Kim
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
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Chatterjee S, Kim CM, Kim DM. Potential efficacy of existing drug molecules against severe fever with thrombocytopenia syndrome virus: an in silico study. Sci Rep 2021; 11:20857. [PMID: 34675254 PMCID: PMC8531283 DOI: 10.1038/s41598-021-00294-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 09/23/2021] [Indexed: 11/09/2022] Open
Abstract
Severe fever with thrombocytopenia syndrome (SFTS) is a zoonotic disease caused by the SFTS virus (SFTSV). SFTS can be considered a life-threatening notifiable infectious disease. The unavailability of specific therapeutics encourages the investigation of potential efficacy of existing drugs against this infection. Drug repurposing was done by performing virtual screening of already established drug molecules followed by 100 ns molecular dynamics simulations and molecular mechanics Poisson-Boltzmann surface area-based binding-energy calculation by targeting the SFTS L protein. On the basis of binding energy and protein-ligand interactions, top 10 promising hits were identified, showing stable binding with SFTS L protein. Further 100 ns atomistic MD simulation refined the hits from top 10 to top 4 with docking-based binding energy lesser than -8.0 kcal/mol toward the SFTS L protein and engaged in π-π interactions with pivotal amino acid residues. Various parameters and binding affinity of top 4 ligands towards L protein was computed. Ligand zaltoprofen exhibited best binding energy -220.095 kJ/mol. The present work is the first in silico study to assess bromfenac, cinchophen, elliptinium, and zaltoprofen; four promising hits against SFTS. Nonetheless, further proper biological evaluation is necessary to determine their efficacy against SFTS.
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Affiliation(s)
- Shilpa Chatterjee
- Department of Biomedical Science, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Choon-Mee Kim
- Premedical Science, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Dong-Min Kim
- Department of Internal Medicine, College of Medicine, Chosun University, 588 Seosuk-dong, Dong-gu, Gwangju, 501-717, Republic of Korea.
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Kim DM, Kim Y, Seo JW, Lee J, Park U, Ha NY, Koh J, Park H, Lee JW, Ro HJ, Yun NR, Kim DY, Yoon SH, Na YS, Moon DS, Lim SC, Kim CM, Jeon K, Kang JG, Jang NY, Jeong H, Kim J, Cheon S, Sohn KM, Moon JY, Kym S, Han SR, Lee MS, Kim HJ, Park WY, Choi JY, Shin HW, Kim HY, Cho CH, Jeon YK, Kim YS, Cho NH. Enhanced eosinophil-mediated inflammation associated with antibody and complement-dependent pneumonic insults in critical COVID-19. Cell Rep 2021; 37:109798. [PMID: 34587481 PMCID: PMC8450316 DOI: 10.1016/j.celrep.2021.109798] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [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: 11/04/2020] [Revised: 01/25/2021] [Accepted: 09/14/2021] [Indexed: 02/07/2023] Open
Abstract
Despite the worldwide effect of the coronavirus disease 2019 (COVID-19) pandemic, the underlying mechanisms of fatal viral pneumonia remain elusive. Here, we show that critical COVID-19 is associated with enhanced eosinophil-mediated inflammation when compared to non-critical cases. In addition, we confirm increased T helper (Th)2-biased adaptive immune responses, accompanying overt complement activation, in the critical group. Moreover, enhanced antibody responses and complement activation are associated with disease pathogenesis as evidenced by formation of immune complexes and membrane attack complexes in airways and vasculature of lung biopsies from six fatal cases, as well as by enhanced hallmark gene set signatures of Fcγ receptor (FcγR) signaling and complement activation in myeloid cells of respiratory specimens from critical COVID-19 patients. These results suggest that SARS-CoV-2 infection may drive specific innate immune responses, including eosinophil-mediated inflammation, and subsequent pulmonary pathogenesis via enhanced Th2-biased immune responses, which might be crucial drivers of critical disease in COVID-19 patients.
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Affiliation(s)
- Dong-Min Kim
- Department of Internal Medicine, Chosun University College of Medicine, Gwangju 61452, Republic of Korea
| | - Yuri Kim
- Department of Microbiology and Immunology, Seoul National University College of Medicine, Seoul 03080, Republic of Korea; Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul 03080, Republic of Korea; Institute of Endemic Disease, Seoul National University Medical Research Center, Seoul 03080, Republic of Korea
| | - Jun-Won Seo
- Department of Internal Medicine, Chosun University College of Medicine, Gwangju 61452, Republic of Korea
| | - Jooyeon Lee
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon 35015, Republic of Korea
| | - Uni Park
- Department of Microbiology and Immunology, Seoul National University College of Medicine, Seoul 03080, Republic of Korea; Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Na-Young Ha
- Department of Microbiology and Immunology, Seoul National University College of Medicine, Seoul 03080, Republic of Korea; Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul 03080, Republic of Korea; Institute of Endemic Disease, Seoul National University Medical Research Center, Seoul 03080, Republic of Korea
| | - Jaemoon Koh
- Department of Pathology, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Hyoree Park
- Department of Microbiology and Immunology, Seoul National University College of Medicine, Seoul 03080, Republic of Korea; Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Jae-Won Lee
- Department of Microbiology and Immunology, Seoul National University College of Medicine, Seoul 03080, Republic of Korea; Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Hyo-Jin Ro
- Department of Microbiology and Immunology, Seoul National University College of Medicine, Seoul 03080, Republic of Korea; Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Na Ra Yun
- Department of Internal Medicine, Chosun University College of Medicine, Gwangju 61452, Republic of Korea
| | - Da Young Kim
- Department of Internal Medicine, Chosun University College of Medicine, Gwangju 61452, Republic of Korea
| | - Sung Ho Yoon
- Department of Internal Medicine, Chosun University College of Medicine, Gwangju 61452, Republic of Korea
| | - Yong Sub Na
- Department of Internal Medicine, Chosun University College of Medicine, Gwangju 61452, Republic of Korea
| | - Do Sik Moon
- Department of Internal Medicine, Chosun University College of Medicine, Gwangju 61452, Republic of Korea
| | - Sung-Chul Lim
- Department of Pathology, Chosun University College of Medicine, Gwangju 61452, Republic of Korea
| | - Choon-Mee Kim
- Premedical Science, Chosun University College of Medicine, Gwangju 61452, Republic of Korea
| | - Kyeongseok Jeon
- Department of Microbiology and Immunology, Seoul National University College of Medicine, Seoul 03080, Republic of Korea; Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Jun-Gu Kang
- Korea Zoonosis Research Institute, Jeonbuk National University, Iksan 54531, Republic of Korea
| | - Na-Yoon Jang
- Department of Microbiology and Immunology, Seoul National University College of Medicine, Seoul 03080, Republic of Korea; Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Hyeongseok Jeong
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon 35015, Republic of Korea
| | - Jungok Kim
- Department of Internal Medicine, Chungnam National University Sejong Hospital, Sejong 30099, Republic of Korea
| | - Shinhyea Cheon
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon 35015, Republic of Korea
| | - Kyung Mok Sohn
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon 35015, Republic of Korea
| | - Jae Youg Moon
- Department of Internal Medicine, Chungnam National University Sejong Hospital, Sejong 30099, Republic of Korea
| | - Sungmin Kym
- Department of Internal Medicine, Chungnam National University Sejong Hospital, Sejong 30099, Republic of Korea
| | - Seung Ro Han
- Department of Microbiology and Immunology, Eulji University School of Medicine, Daejeon 34824, Republic of Korea
| | - Myung-Shin Lee
- Department of Microbiology and Immunology, Eulji University School of Medicine, Daejeon 34824, Republic of Korea
| | - Hyun-Je Kim
- Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul 06351, Republic of Korea
| | - Woong-Yang Park
- Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences & Technology, Sungkyunkwan University, Seoul 06351, Republic of Korea; Geninus Inc., Seoul 05836, Republic of Korea
| | - Ji-Yeob Choi
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Hyun-Woo Shin
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Hye-Young Kim
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Chung-Hyun Cho
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Yoon Kyung Jeon
- Department of Pathology, Seoul National University College of Medicine, Seoul 03080, Republic of Korea
| | - Yeon-Sook Kim
- Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon 35015, Republic of Korea.
| | - Nam-Hyuk Cho
- Department of Microbiology and Immunology, Seoul National University College of Medicine, Seoul 03080, Republic of Korea; Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul 03080, Republic of Korea; Institute of Endemic Disease, Seoul National University Medical Research Center, Seoul 03080, Republic of Korea; Seoul National University Bundang Hospital, Seongnam-si, Gyeonggi-do 13620, Republic of Korea.
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21
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Chatterjee S, Kim CM, Yun NR, Kim DM, Song HJ, Chung KA. Correction to: Molecular detection and identification of Culex flavivirus in mosquito species from Jeju, Republic of Korea. Virol J 2021; 18:172. [PMID: 34416904 PMCID: PMC8377816 DOI: 10.1186/s12985-021-01639-4] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Shilpa Chatterjee
- Department of Internal Medicine, College of Medicine, Chosun University, 588 Seosuk‑dong, Dong‑gu,, Gwangju, 61453, Republic of Korea
| | - Choon-Mee Kim
- Department of Premedical Science, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Na Ra Yun
- Department of Internal Medicine, College of Medicine, Chosun University, 588 Seosuk‑dong, Dong‑gu,, Gwangju, 61453, Republic of Korea
| | - Dong-Min Kim
- Department of Internal Medicine, College of Medicine, Chosun University, 588 Seosuk‑dong, Dong‑gu,, Gwangju, 61453, Republic of Korea.
| | - Hyeon Je Song
- Department of Clinical Laboratory Science, Gwangju Health University, Gwangju, Republic of Korea
| | - Kyeoung A Chung
- Department of Clinical Laboratory Science, Gwangju Health University, Gwangju, Republic of Korea
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22
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Jalal S, Hwang SY, Kim CM, Kim DM, Yun NR, Seo JW, Young Kim D, Jung SI, Kim UJ, Kim SE, Kim HA, Kim ES, Hur J, Kim YK, Jeong HW, Heo JY, Jung DS, Kim J, Park SH, Kwak YG, Lee S, Lim S, Lee SH. Comparison of RT-PCR, RT-nested PCRs, and real-time PCR for diagnosis of severe fever with thrombocytopenia syndrome: a prospective study. Sci Rep 2021; 11:16764. [PMID: 34408188 PMCID: PMC8373928 DOI: 10.1038/s41598-021-96066-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Accepted: 08/02/2021] [Indexed: 12/01/2022] Open
Abstract
We designed a highly sensitive reverse transcription nested polymerase chain reaction targeting the M-segment (NPCR-M) of severe fever with thrombocytopenia syndrome (SFTS) virus. NPCR-M was performed in parallel with three other referenced PCR assays QPCR-S, PCR-M, and NPCR-S to assess their clinical usefulness as routine diagnostic techniques for SFTS. In this multi-centered prospective study, 122 blood samples from 38 laboratory-confirmed SFTS patients and 85 control samples were used. The results demonstrated that QPCR-S and NPCR-S had better sensitivity rate up to 21 days after symptom onset however, the PCR-M showed poor sensitivity after 7 days of symptom onset. Our designed NPCR-M had a higher detection rate up to 40 days from symptom onset and revealed the persistence of SFTSV RNA in the early convalescent phase. No false-positive results were seen for the control samples. Additionally, NPCR-M showed positive results for a sample that initially showed negative results from other PCRs and for many other samples collected in the convalescent phase of SFTS. Our designed nested PCR is suitable for SFTSV detection in patients’ blood collected in the acute and early convalescent phase of SFTS, and shows better sensitivity and high specificity even up to 40 days after symptom onset.
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Affiliation(s)
- Sehrish Jalal
- Department of Bio-Medical Science, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Seong Yeon Hwang
- Department of Internal Medicine, School of Medicine, Chosun University, 588 Seosuk-dong, Dong-gu, Gwangju, 61453, Republic of Korea
| | - Choon-Mee Kim
- Premedical Science, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Dong-Min Kim
- Department of Internal Medicine, School of Medicine, Chosun University, 588 Seosuk-dong, Dong-gu, Gwangju, 61453, Republic of Korea.
| | - Na Ra Yun
- Department of Internal Medicine, School of Medicine, Chosun University, 588 Seosuk-dong, Dong-gu, Gwangju, 61453, Republic of Korea
| | - Jun-Won Seo
- Department of Internal Medicine, School of Medicine, Chosun University, 588 Seosuk-dong, Dong-gu, Gwangju, 61453, Republic of Korea
| | - Da Young Kim
- Department of Internal Medicine, School of Medicine, Chosun University, 588 Seosuk-dong, Dong-gu, Gwangju, 61453, Republic of Korea
| | - Sook In Jung
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Uh Jin Kim
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Seong Eun Kim
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Hyun Ah Kim
- Division of Infectious Diseases, Keimyung University Dongsan Medical Center, Daegu, Republic of Korea
| | - Eu Suk Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Jian Hur
- Department of Internal Medicine, Yeungnam University Medical Center, Daegu, Republic of Korea
| | - Young Keun Kim
- Department of Internal Medicine, College of Medicine, Yonsei University Wonju, Wonju, Republic of Korea
| | - Hye Won Jeong
- Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju, Republic of Korea
| | - Jung Yeon Heo
- Department of Infectious Diseases, School of Medicine, Ajou University, Suwon, Republic of Korea
| | - Dong Sik Jung
- Department of Internal Medicine, College of Medicine, Dong-A University, Busan, Republic of Korea
| | - Jieun Kim
- Department of Internal Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Sun Hee Park
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Daejeon, Republic of Korea
| | - Yee Gyung Kwak
- Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea
| | - Sujin Lee
- Department of Internal Medicine, College of Medicine, Pusan National University, Yangsan, Republic of Korea
| | - Seungjin Lim
- Department of Internal Medicine, College of Medicine, Pusan National University, Yangsan, Republic of Korea
| | - Sun Hee Lee
- Department of Internal Medicine, School of Medicine, Pusan National University, Pusan, Republic of Korea
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23
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Seo JW, Kim DY, Kim CM, Yun NR, Lee YM, Lawrence Panchali MJ, Kim DM. Utility of Nested Reverse-Transcriptase Polymerase Chain Reaction of Clinical Specimens for Early Diagnosis of Hemorrhagic Fever with Renal Syndrome. Am J Trop Med Hyg 2021; 105:1285-1289. [PMID: 34370707 DOI: 10.4269/ajtmh.21-0185] [Citation(s) in RCA: 1] [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: 02/16/2021] [Accepted: 06/09/2021] [Indexed: 11/07/2022] Open
Abstract
Hemorrhagic fever with renal syndrome (HFRS) is confirmed by the isolation of hantavirus from serum, detection of virus-specific IgM, or a four-fold change in IgG titers during the acute and convalescent periods measured using an immunofluorescence assay (IFA). However, these tests are inefficient for early diagnosis. Therefore, this study investigated the usefulness of reverse-transcriptase nested polymerase chain reaction (RT-nPCR) for early diagnosis of HFRS using clinical samples such as urine and serum. Electronic medical records of eight patients with confirmed HFRS using IFA and RT-nPCR between May 2016 and May 2020 at Chosun University Hospital were reviewed. The virus was detected in all patients using RT-nPCR targeting the large (L) segment of hantavirus during the early phase in urine and serum. Importantly, the virus was identified in urine at a time when it was not identified in serum. Additionally, the virus was detected in urine and serum for up to 1 month after initial presentation with illness, but not in saliva, using RT-nPCR. We report eight HFRS cases diagnosed using urine and serum, but not using saliva, with RT-nPCR targeting the L-segment. Hantavirus RNA detection by RT-nPCR in urine and serum may aid the rapid diagnosis of HFRS during the early phase of the disease. In particular, HFRS should not be ruled out based on negative RT-PCR results in serum, and RT-PCR should be performed using urine as well as serum during the early phase of symptoms.
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Affiliation(s)
- Jun-Won Seo
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Da Young Kim
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Choon-Mee Kim
- Department of Premedical Science, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Na-Ra Yun
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Yu-Mi Lee
- Biomedical Sciences, Graduate School of Chosun University, Gwangju, Republic of Korea
| | | | - Dong-Min Kim
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
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Chatterjee S, Kim CM, Yun NR, Kim DM, Song HJ, Chung KA. Molecular detection and identification of Culex flavivirus in mosquito species from Jeju, Republic of Korea. Virol J 2021; 18:150. [PMID: 34281569 PMCID: PMC8287664 DOI: 10.1186/s12985-021-01618-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 12/22/2020] [Accepted: 07/12/2021] [Indexed: 11/10/2022] Open
Abstract
Background Mosquito-borne flaviviruses are prime pathogens and have been a major hazard to humans and animals. They comprise several arthropod-borne viruses, including dengue virus, yellow fever virus, Japanese encephalitis virus, and West Nile virus. Culex flavivirus (CxFV) is a member of the insect-specific flavivirus (ISF) group belonging to the genus Flavivirus, which is widely distributed in a variety of mosquito populations.
Methods Viral nucleic acid was extracted from adult mosquito pools and subjected to reverse transcriptase nested polymerase chain reaction (PCR) using target-specific primers for detecting CxFV nonstructural protein 5 (NS5). The PCR-positive samples were then sequenced, and a phylogenetic tree was constructed, including reference sequences obtained from GenBank. Results 21 pools, belonging to Culex pipiens pallens (Cx. p. pallens) were found to be positive for the CxFV RNA sequence, with a minimum infection rate of 14.5/1000 mosquitoes. The phylogenetic analysis of the NS5 protein sequences indicated that the detected sequences were closely related to strains identified in China, with 95–98% sequence similarities. Conclusion Our findings highlight the presence of CxFV in Cx. p. pallens mosquito species in Jeju province, Republic of Korea. This is the first study reporting the prevalence of CxFV in Culex Pipiens (Cx. pipiens) host in the Jeju province, which can create possible interaction with other flaviviruses causing human and animal diseases. Although, mosquito-borne disease causing viruses were not identified properly, more detailed surveillance and investigation of both the host and viruses are essential to understand the prevalence, evolutionary relationship and genetic characteristic with other species.
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Affiliation(s)
- Shilpa Chatterjee
- Department of Internal Medicine, College of Medicine, Chosun University, 588 Seosuk-dong, Dong-gu, Gwangju, 61453, Republic of Korea
| | - Choon-Mee Kim
- Department of Premedical Science, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Na Ra Yun
- Department of Internal Medicine, College of Medicine, Chosun University, 588 Seosuk-dong, Dong-gu, Gwangju, 61453, Republic of Korea
| | - Dong-Min Kim
- Department of Internal Medicine, College of Medicine, Chosun University, 588 Seosuk-dong, Dong-gu, Gwangju, 61453, Republic of Korea.
| | - Hyeon Je Song
- Department of Clinical Laboratory Science, Gwangju Health University, Gwangju, Republic of Korea
| | - Kyeoung A Chung
- Department of Clinical Laboratory Science, Gwangju Health University, Gwangju, Republic of Korea
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Lim SC, Lee YM, Kim CM, Yun NR, Kim DM. Acute Appendicitis Associated with Hantaan Virus Infection. Am J Trop Med Hyg 2021. [PMID: 34228635 DOI: 10.4269/ajtmh.20-1468.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Hantaviruses are Bunyaviridae viruses that cause hemorrhagic fever with renal syndrome. Appendicitis caused by Hantaan virus has not been reported previously. An 81-year-old man who underwent laparoscopic appendectomy for suspected appendicitis based on abdominal pain, fever, hypotension, and computed tomography findings. Based on a suspicion of hemorrhagic fever with renal syndrome, the patient's plasma was simultaneously analyzed using an indirect immunofluorescent antibody assay and nested reverse transcription-polymerase chain reaction (RT-PCR). The appendix tissue was also analyzed using nested RT-PCR and immunohistochemical (IHC) staining to identify the presence of Hantaan virus. Nested RT-PCR detected the presence of Hantaan virus, and indirect immunofluorescent antibody assay results revealed the presence of elevated antibody levels. Furthermore, IHC staining of the appendix tissue confirmed Hantaan virus antigens in the peripheral nerve bundle. Based on these findings, we confirmed the nerve tropism of the Hantaan virus. Hantaan virus in plasma and appendix tissue samples was confirmed using PCR and phylogenetic tree analysis. Moreover, we detected hypertrophy of the submucosa and periappendiceal adipose tissue nerve bundle along with Hantaan virus antigens in peripheral nerve bundles using IHC staining. Hence, we report that Hantaan virus infection may be accompanied by appendicitis.
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Affiliation(s)
- Sung-Chul Lim
- 1Department of Pathology, Chosun University College of Medicine, Dong-gu, Gwangju, South Korea
| | - Young Min Lee
- 2Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Choon-Mee Kim
- 3Premedical Science, College of Medicine, Chosun University, Gwangju, South Korea
| | - Na Ra Yun
- 2Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Dong-Min Kim
- 2Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
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26
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Lim SC, Lee YM, Kim CM, Yun NR, Kim DM. Acute Appendicitis Associated with Hantaan Virus Infection. Am J Trop Med Hyg 2021; 105:801-806. [PMID: 34228635 DOI: 10.4269/ajtmh.20-1468] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 04/22/2021] [Indexed: 02/05/2023] Open
Abstract
Hantaviruses are Bunyaviridae viruses that cause hemorrhagic fever with renal syndrome. Appendicitis caused by Hantaan virus has not been reported previously. An 81-year-old man who underwent laparoscopic appendectomy for suspected appendicitis based on abdominal pain, fever, hypotension, and computed tomography findings. Based on a suspicion of hemorrhagic fever with renal syndrome, the patient's plasma was simultaneously analyzed using an indirect immunofluorescent antibody assay and nested reverse transcription-polymerase chain reaction (RT-PCR). The appendix tissue was also analyzed using nested RT-PCR and immunohistochemical (IHC) staining to identify the presence of Hantaan virus. Nested RT-PCR detected the presence of Hantaan virus, and indirect immunofluorescent antibody assay results revealed the presence of elevated antibody levels. Furthermore, IHC staining of the appendix tissue confirmed Hantaan virus antigens in the peripheral nerve bundle. Based on these findings, we confirmed the nerve tropism of the Hantaan virus. Hantaan virus in plasma and appendix tissue samples was confirmed using PCR and phylogenetic tree analysis. Moreover, we detected hypertrophy of the submucosa and periappendiceal adipose tissue nerve bundle along with Hantaan virus antigens in peripheral nerve bundles using IHC staining. Hence, we report that Hantaan virus infection may be accompanied by appendicitis.
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Affiliation(s)
- Sung-Chul Lim
- 1Department of Pathology, Chosun University College of Medicine, Dong-gu, Gwangju, South Korea
| | - Young Min Lee
- 2Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Choon-Mee Kim
- 3Premedical Science, College of Medicine, Chosun University, Gwangju, South Korea
| | - Na Ra Yun
- 2Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Dong-Min Kim
- 2Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
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27
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Bang MS, Kim CM, Pyun SH, Kim DM, Yun NR. Molecular investigation of tick-borne pathogens in ticks removed from tick-bitten humans in the southwestern region of the Republic of Korea. PLoS One 2021; 16:e0252992. [PMID: 34129613 PMCID: PMC8205137 DOI: 10.1371/journal.pone.0252992] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 11/04/2020] [Accepted: 05/26/2021] [Indexed: 11/19/2022] Open
Abstract
In this study, we investigated the presence of tick-borne pathogens in ticks removed from tick-bitten humans in the southwestern provinces of the Republic of Korea (ROK). We identified 33 ticks from three tick species, namely Amblyomma testudinarium (60.6%), Haemaphysalis longicornis (27.3%), and Ixodes nipponensis (12.1%) in order of occurrence via morphology and 16S rDNA-targeting polymerase chain reaction (PCR). Tick-borne pathogens were detected in 16 ticks using pathogen-specific PCR. From the results, 12 ticks (36.4%) tested positive for spotted fever group (SFG) Rickettsia: Rickettsia monacensis (1/12), R. tamurae (8/12), and Candidatus Rickettsia jingxinensis (3/12). Three ticks (9.1%) were positive for Anaplasma phagocytophilum. In addition, three ticks (9.1%) tested positive for Babesia gibsoni (1/3) and B. microti (2/3). In conclusion, we identified three tick species; the most common species was A. testudinarium, followed by H. longicornis and I. nipponensis. SFG Rickettsia, A. phagocytophilum, and Babesia spp. were the most frequently detected pathogens in ticks removed from tick-bitten humans. To our knowledge, this is the first report of R. tamurae and Ca. R. jingxinensis detection in Korea. The present results will contribute to the understanding of tick-borne infections in animals and humans in the ROK.
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Affiliation(s)
- Mi Seon Bang
- Department of Medical Science, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Choon-Mee Kim
- Premedical Science, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Sang-Hyun Pyun
- Graduate School of Chosun University, Gwangju, Republic of Korea
| | - Dong-Min Kim
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
- * E-mail:
| | - Na Ra Yun
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
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Tariq M, Seo JW, Kim DY, Panchali MJL, Yun NR, Lee YM, Kim CM, Kim DM. First report of the molecular detection of human pathogen Rickettsia raoultii in ticks from the Republic of Korea. Parasit Vectors 2021; 14:191. [PMID: 33827669 PMCID: PMC8025568 DOI: 10.1186/s13071-021-04695-5] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 03/20/2021] [Indexed: 12/02/2022] Open
Abstract
Background Rickettsial diseases associated with the spotted fever group constitute a growing number of newly identified Rickettsia pathogens and their tick vectors in various parts of the world. At least 15 distinct tick species belonging to six genera have shown the presence of Rickettsia raoultii. Herein, we report the detection of R. raoultii in ticks from the Republic of Korea (ROK). Methods Thirty-five ticks were collected from 29 patients with tick bites in Gwangju Metropolitan City, Jeollanam Province, ROK. The ticks were identified using molecular, morphological, and taxonomic characteristics. All samples were screened for presence of Rickettsia species using nested polymerase chain reactions of their outer membrane protein (ompA) and citrate synthase (gltA) genes. The amplified products were sequenced for subsequent phylogenetic analyses. Results Sequencing data showed the DNA sequences of R. raoultii in three Haemaphysalis longicornis ticks. All three tick samples were 99.4–100% similar to previously reported partial sequences of ompA of R. raoultii strains CP019435 and MF002523, which formed a single clade with the reference strains. Conclusions We provide the first description and molecular identification of R. raoultii detected in H. longicornis ticks in the ROK. This observation extends the geographical distribution of R. raoultii. Screening of human samples for this pathogen will provide information about the prevalence of rickettsial infections in this region. ![]()
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Affiliation(s)
- Misbah Tariq
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Jun-Won Seo
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Da Young Kim
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | | | - Na Ra Yun
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - You Mi Lee
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Choon-Mee Kim
- Department of Premedical Science, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Dong-Min Kim
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea.
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Kim SW, Kim CM, Kim DM, Yun NR, Neupane GP, Pyun SH, Yu BJ. Orientia tsutsugamushi DNA load and genotypes in blood as a marker of severity. Acta Trop 2021; 215:105786. [PMID: 33309595 DOI: 10.1016/j.actatropica.2020.105786] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 10/26/2020] [Accepted: 11/30/2020] [Indexed: 12/20/2022]
Abstract
Scrub typhus is an acute febrile illness caused by Orientia tsutsugamushi and is endemic to many parts of the Asia-Pacific region. We investigated whether the genotype of O. tsutsugamushi or the DNA load would be a useful marker of disease severity in scrub typhus patients. We evaluated the clinical features, genotypes and bacterial DNA load in the blood of 118 patients, including 114 surviving and 4 non-surviving patients, admitted at Chosun University Hospital. Four patients infected with the Pajoo, Yonchon, Youngworl and Boryong genotypes died. In the 114 survivors, 100 Boryong and 2 Taguchi genotypes were identified. The genotypes involved showed significant differences between the surviving and non-surviving patients (p<0.001). The median number of O. tsutsugamushi DNA copies was 78 copies /μL (range 3,960) in surviving patients, whereas 83,800 copies/μL (range 244,600) in the non-surviving patients. We found that the genotype and DNA load in the patient's blood are useful markers of disease severity in scrub typhus.
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Kim CM, Park G, Ko YJ, Kang SH, Jang SJ. Relationships between relative expression of RND efflux pump genes, H33342 efflux activity, biofilm-forming activity, and antimicrobial resistance in Acinetobacter baumannii clinical isolates. Jpn J Infect Dis 2021; 74:499-506. [PMID: 33642430 DOI: 10.7883/yoken.jjid.2020.765] [Citation(s) in RCA: 2] [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: 11/17/2022]
Abstract
Various mechanisms underlying antimicrobial resistance in Acinetobacter baumannii have been reported. There exists controversy regarding the relationships between efflux pump activity, biofilm formation, and antimicrobial resistance in A. baumannii. In this study, we investigated the relative expression of RND efflux pump genes, H33342 efflux activity, and biofilm-forming activity in 120 A. baumannii clinical isolates, examined their potential relationships with one another, and then statistically analyzed their effects on antibiotic resistance. High adeB expression and high H33342 efflux activity were correlated with low biofilm-forming activity. High adeB expression was significantly correlated with resistance to tigecycline and cefotaxime, but not with the multidrug resistance (MDR) phenotype. Importantly, only high adeJ expression was significantly correlated with the MDR phenotype, and was observed to be correlated with resistance to various antibiotics. However, we found no significant correlation between adeJ expression and biofilm-forming activity. Further, adeG expression was found to not be correlated with antibiotic resistance and biofilm-forming activity. The results of multivariate analysis showed that adeB overexpression and high H33342 efflux activity are related to biofilm-forming activity, and only adeJ overexpression is significantly associated with the MDR phenotype, highlighting the importance of adeJ overexpression.
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Affiliation(s)
- Choon-Mee Kim
- Premedical Science, College of Medicine, Chosun University, Republic of Korea
| | - Geon Park
- Department of Laboratory Medicine, School of Medicine, Chosun University, Republic of Korea
| | - Young Jin Ko
- Department of Laboratory Medicine, School of Medicine, Chosun University, Republic of Korea
| | - Seong-Ho Kang
- Department of Laboratory Medicine, School of Medicine, Chosun University, Republic of Korea
| | - Sook Jin Jang
- Department of Laboratory Medicine, School of Medicine, Chosun University, Republic of Korea
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Jung SI, Kim YE, Yun NR, Kim CM, Kim DM, Han MA, Kim UJ, Kim SE, Kim J, Ryu SY, Kim HA, Hur J, Kim YK, Jeong HW, Heo JY, Jung DS, Lee H, Huh K, Kwak YG, Lee S, Lim S, Lee SH, Park SH, Yeom JS, Kim SW, Bae IG, Lee J, Kim ES, Seo JW. Effects of steroid therapy in patients with severe fever with Thrombocytopenia syndrome: A multicenter clinical cohort study. PLoS Negl Trop Dis 2021; 15:e0009128. [PMID: 33606699 PMCID: PMC7928499 DOI: 10.1371/journal.pntd.0009128] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 03/03/2021] [Accepted: 01/12/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Severe fever with thrombocytopenia syndrome (SFTS) is an acute, febrile, and potentially fatal tick-borne disease caused by the SFTS Phlebovirus. Here, we evaluated the effects of steroid therapy in Korean patients with SFTS. METHODS A retrospective study was performed in a multicenter SFTS clinical cohort from 13 Korean university hospitals between 2013 and 2017. We performed survival analysis using propensity score matching of 142 patients with SFTS diagnosed by genetic or antibody tests. RESULTS Overall fatality rate was 23.2%, with 39.7% among 58 patients who underwent steroid therapy. Complications were observed in 37/58 (63.8%) and 25/83 (30.1%) patients in the steroid and non-steroid groups, respectively (P < .001). Survival analysis after propensity score matching showed a significant difference in mean 30-day survival time between the non-steroid and steroid groups in patients with a mild condition [Acute Physiology and Chronic Health Evaluation II (APACHE II) score <14; 29.2 (95% CI 27.70-30.73] vs. 24.9 (95% CI 21.21-28.53], P = .022]. Survival times for the early steroid (≤5 days from the start of therapy after symptom onset), late steroid (>5 days), and non-steroid groups, were 18.4, 22.4, and 27.3 days, respectively (P = .005). CONCLUSIONS After steroid therapy, an increase in complications was observed among patients with SFTS. Steroid therapy should be used with caution, considering the possible negative effects of steroid therapy within 5 days of symptom onset or in patients with mild disease (APACHE II score <14).
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Affiliation(s)
- Sook In Jung
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Ye Eun Kim
- Department of Nursing, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Na Ra Yun
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Choon-Mee Kim
- Department of Preventive Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Dong-Min Kim
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
- * E-mail:
| | - Mi Ah Han
- Department of Preventive Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Uh Jin Kim
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Seong Eun Kim
- Department of Internal Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Jieun Kim
- Department of Internal Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Seong Yeol Ryu
- Division of Infectious Diseases, Keimyung University Dongsan Medical Center, Daegu, Republic of Korea
| | - Hyun ah Kim
- Division of Infectious Diseases, Keimyung University Dongsan Medical Center, Daegu, Republic of Korea
| | - Jian Hur
- Department of Internal Medicine, Yeungnam University Medical Center, Daegu, Republic of Korea
| | - Young Keun Kim
- Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea
| | - Hye Won Jeong
- Department of Internal Medicine, College of Medicine, Chungbuk National University, Cheongju, Republic of Korea
| | - Jung Yeon Heo
- Department of Infectious Diseases, School of Medicine, Ajou University, Suwon, Republic of Korea
| | - Dong Sik Jung
- Department of Internal Medicine, College of Medicine, Dong-A University, Busan, Republic of Korea
| | - Hyungdon Lee
- Department of Internal Medicine, College of Medicine, Hallym University, Chuncheon, Republic of Korea
| | - Kyungmin Huh
- Division of Infectious Diseases, Department of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Yee Gyung Kwak
- Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea
| | - Sujin Lee
- Department of Internal Medicine, College of Medicine, Pusan National University, Yangsan, Republic of Korea
| | - Seungjin Lim
- Department of Internal Medicine, College of Medicine, Pusan National University, Yangsan, Republic of Korea
| | - Sun Hee Lee
- Department of Internal Medicine, Pusan National University School of Medicine, Pusan National University Hospital, Busan, Republic of Korea
| | - Sun Hee Park
- Division of Infectious Diseases, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Daejeon, Republic of Korea
| | - Joon-Sup Yeom
- Department of Internal Medicine, College of Medicine, Yonsei University, Seoul, Republic of Korea
| | - Shin-Woo Kim
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - In-Gyu Bae
- Department of Internal Medicine, College of Medicine, Gyeongsang National University, Jinju, Republic of Korea
| | - Juhyung Lee
- Department of Preventive Medicine, Jeonbuk National University Medical School, Jeonju, Republic of Korea
| | - Eu Suk Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Jun-Won Seo
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
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Kim CM, Kim DM, Yun NR. Follow-up investigation of antibody titers and diagnostic antibody cutoff values in patients with scrub typhus in South Korea. BMC Infect Dis 2021; 21:69. [PMID: 33441087 PMCID: PMC7807423 DOI: 10.1186/s12879-020-05735-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 09/01/2020] [Accepted: 12/22/2020] [Indexed: 11/19/2022] Open
Abstract
Background Scrub typhus is a mite-borne infectious disease caused by Orientia tsutsugamushi. Few follow-up studies have assessed antibody titers using serologic tests from various commercial laboratories and the Korea Centers for Disease Control and Prevention (KCDC). Methods A prospective study to assess the antibody titers in patients with scrub typhus and seroprevalence in individuals undergoing health checkups was conducted using results of immunofluorescence antibody assays (IFAs) and serologic tests, used by the KCDC and commercial laboratories, respectively. The following tests were performed simultaneously: (i) indirect IFA used by the KCDC to detect immunoglobulin (Ig) M and IgG, (ii) IFA used by a commercial laboratory to detect total Ig, and (iii) antibody tests using two commercially available kits. Results When the IgM and IgG cutoff values (≥1:16 and ≥1:256, respectively) used in the IFA and the total IgG cutoff values (≥1:40) were used in prospective follow-up investigations, the antibody positivity rates of 102 patients with scrub typhus were 44.1, 35.3, and 57.6%, respectively, within 5 days of symptom onset. Among 91 individuals who recovered from scrub typhus, the follow-up IgM, IgG, and total Ig positivity rates for 13 years were 37.4% (34/91), 22.0% (20/91), and 76.9% (70/91), respectively. Among 216 individuals undergoing health checkups, the seroprevalence of IgM was 4.2% (9/216); no seroprevalence of IgG was observed. Conclusions IFAs used by the KCDC and the commercial laboratory and rapid commercial kits could not distinguish between patients who had recovered from scrub typhus and those who are currently infected with O. tsutsugamushi. In South Korea and other countries, where low antibody cutoff values are used, upward adjustments of cutoff values may be necessary. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-020-05735-8.
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Affiliation(s)
- Choon-Mee Kim
- Premedical Science, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Dong-Min Kim
- Departments of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea.
| | - Na Ra Yun
- Departments of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
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Kim DY, Lee JH, Oh HJ, Seo JW, Yun NR, Kim CM, Kim DM. 513. Viral kinetics of SARS-CoV-2 in patients with COVID-19. Open Forum Infect Dis 2020. [PMCID: PMC7776487 DOI: 10.1093/ofid/ofaa439.707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background As only few studies have analyzed viral kinetics between the incubation and symptomatic periods of COVID-19 patients, we investigated the viral kinetics and compared viral loads between patients with mild and severe COVID-19. Methods We determined the viral kinetics of 10 patients diagnosed with COVID-19 at Chosun University Hospital. Six patients were classified into the “mild” group and 4 into the “severe” group according to supplemental oxygen use during admission. Samples were collected via nasopharyngeal swabs and sputum specimens. SARS-CoV-2 was detected using real-time reverse transcription-polymerase chain reaction (RT-PCR). Chest radiograph scores during hospitalization were obtained Results Ct values of the upper respiratory tract specimens were low during the early stages after symptom onset but gradually increased over time in both groups. The severe group had lower Ct values than the mild group. The Ct values of the RdRP and E genes on day 6 after symptom onset were significantly lower in the severe group than in the mild group (p < 0.05). Three of 6 patients had positive results on RT-PCR even before symptom onset; 2 of them had the lowest Ct values. The chest radiograph scores were higher in the severe group than in the mild group, and the score in the severe group was the highest at approximately 3 weeks after symptom onset. Ct values when the RdRP gene and E gene were targeted to detect SARS-CoV-2 on the basis of the days after symptom onset in all the patients ![]()
Conclusion Viral load and chest radiograph scores were significantly different between the severe and mild groups of COVID-19 patients. Disclosures All Authors: No reported disclosures
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Affiliation(s)
- Da Young Kim
- Chosun university Hospital, Gwangju, Cholla-namdo, Republic of Korea
| | - Ju-Hyung Lee
- Department of Preventive Medicine, Jeonbuk National University Medical School, Jeonju, Republic of Korea, Jeonju, Cholla-bukto, Republic of Korea
| | - Hyeon Jeong Oh
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea, Gwangju, Cholla-namdo, Republic of Korea
| | - Jun-won Seo
- Chosun university Hospital, Gwangju, Cholla-namdo, Republic of Korea
| | - Na Ra Yun
- Chosun University Hospital, Gwang ju, Kwangju-jikhalsi, Republic of Korea
| | - Choon-Mee Kim
- Chosun University, Gwang ju, Kwangju-jikhalsi, Republic of Korea
| | - Dong-Min Kim
- Chosun University Hospital, Gwang ju, Kwangju-jikhalsi, Republic of Korea
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Lee SH, Shin NR, Kim CM, Park S, Yun NR, Kim DM, Jung DS. First identification of Anaplasma phagocytophilum in both a biting tick Ixodes nipponensis and a patient in Korea: a case report. BMC Infect Dis 2020; 20:826. [PMID: 33176719 PMCID: PMC7656494 DOI: 10.1186/s12879-020-05522-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 10/16/2020] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Human granulocytic anaplasmosis (HGA) is a tick-borne infectious disease caused by Anaplasma phagocytophilum. To date, there have been no reported cases of A. phagocytophilum infection found in both the biting tick and the patient following a tick bite. CASE PRESENTATION An 81-year-old woman presented with fever following a tick bite, with the tick still intact on her body. The patient was diagnosed with HGA. The tick was identified as Ixodes nipponensis by morphological and molecular biological detection methods targeting the 16S rRNA gene. The patient's blood was cultured after inoculation into the human promyelocytic leukemia cell line HL-60. A. phagocytophilum growth was confirmed via culture and isolation. A. phagocytophilum was identified in both the tick and the patient's blood by Anaplasma-specific groEL- and ankA-based nested polymerase chain reaction followed by sequencing. Moreover, a four-fold elevation in antibodies was observed in the patient's blood. CONCLUSION We report a case of a patient diagnosed with HGA following admission for fever due to a tick bite. A. phagocytophilum was identified in both the tick and the patient, and A. phagocytophilum was successfully cultured. The present study suggests the need to investigate the possible incrimination of I. nipponensis as a vector for HGA in Korea.
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Affiliation(s)
- Seung Hun Lee
- Division of Bacterial Disease Research, Center for Infectious Disease Research, Korea National Institute of Health, Osong, Cheongju-si, 28159, Chungcheongbuk-do, Republic of Korea
| | - Na-Ri Shin
- Division of Bacterial Disease Research, Center for Infectious Disease Research, Korea National Institute of Health, Osong, Cheongju-si, 28159, Chungcheongbuk-do, Republic of Korea
| | - Choon-Mee Kim
- Premedical Science, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Sungdo Park
- Division of Bacterial Disease Research, Center for Infectious Disease Research, Korea National Institute of Health, Osong, Cheongju-si, 28159, Chungcheongbuk-do, Republic of Korea.
| | - Na Ra Yun
- Department of Internal Medicine, College of Medicine, Chosun University, 588 Seosuk-dong, Dong-gu, Gwangju, 61453, Republic of Korea
| | - Dong-Min Kim
- Department of Internal Medicine, College of Medicine, Chosun University, 588 Seosuk-dong, Dong-gu, Gwangju, 61453, Republic of Korea.
| | - Dong Sik Jung
- Department of Internal Medicine, College of Medicine, Dong-A University, Busan, Republic of Korea
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Yoo J, Chung JH, Kim CM, Yun NR, Kim DM. Asymptomatic-anaplasmosis confirmation using genetic and serological tests and possible coinfection with spotted fever group Rickettsia: a case report. BMC Infect Dis 2020; 20:458. [PMID: 32605544 PMCID: PMC7325360 DOI: 10.1186/s12879-020-05170-9] [Citation(s) in RCA: 2] [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: 01/07/2020] [Accepted: 06/17/2020] [Indexed: 11/11/2022] Open
Abstract
Background Anaplasmosis is an emerging acute febrile disease that is caused by a bite of an Anaplasma phagocytophilum–infected hard tick. As for healthy patients, reports on asymptomatic anaplasmosis resulting from such tick bites are rare. Case presentation A 55-year-old female patient visited the hospital with a tick bite in the right infraclavicular region. The tick was suspected to have been on the patient for more than 10 days. PCR and an indirect immunofluorescence assay (IFA) were performed to identify tick-borne infectious diseases. The blood sample collected at admission yielded a positive result in nested PCR targeting Ehrlichia- or Anaplasma-specific genes groEL and ankA. Subsequent sequencing confirmed the presence of A. phagocytophilum, and seroconversion was confirmed by the IFA involving an A. phagocytophilum antigen slide. PCR detected no Rickettsia-specific genes [outer membrane protein A (ompA) or surface cell antigen 1 (sca1)], but seroconversion of spotted fever group (SFG) rickettsiosis was confirmed by an IFA. Conclusions This study genetically and serologically confirmed an asymptomatic A. phagocytophilum infection. Although SFG rickettsiosis was not detected genetically, it was detected serologically. These findings indicate the possibility of an asymptomatic coinfection: anaplasmosis plus SFG rickettsiosis. It is, therefore, crucial for clinicians to be aware of potential asymptomatic anaplasmosis following a tick bite.
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Affiliation(s)
- Jiyeon Yoo
- College of Medicine, Chosun University, Gwangju, South Korea
| | - Jong-Hoon Chung
- Departments of Internal Medicine, College of Medicine, Chosun University, 588 Seosuk-dong, Dong-gu, Gwangju, 61453, Republic of Korea
| | - Choon-Mee Kim
- Premedical Science, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Na Ra Yun
- Departments of Internal Medicine, College of Medicine, Chosun University, 588 Seosuk-dong, Dong-gu, Gwangju, 61453, Republic of Korea
| | - Dong-Min Kim
- Departments of Internal Medicine, College of Medicine, Chosun University, 588 Seosuk-dong, Dong-gu, Gwangju, 61453, Republic of Korea.
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Seo JW, Kim CM, Yun NR, Kim DM, Kim SS, Choi S, Chu H. Scalp eschar and neck lymphadenopathy after tick bite (SENLAT) caused by Bartonella henselae in Korea: a case report. BMC Infect Dis 2020; 20:216. [PMID: 32164559 PMCID: PMC7066777 DOI: 10.1186/s12879-020-4940-0] [Citation(s) in RCA: 5] [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: 10/04/2019] [Accepted: 03/01/2020] [Indexed: 11/20/2022] Open
Abstract
Background Tick-borne lymphadenopathy (TIBOLA) is an infectious disease, mainly caused by species from the spotted fever group rickettsiae and is characterized by enlarged lymph nodes following a tick bite. Among cases of TIBOLA, a case of scalp eschar and neck lymphadenopathy after tick bite (SENLAT) is diagnosed when an eschar is present on the scalp, accompanied by peripheral lymphadenopathy (LAP). Only a few cases of SENLAT caused by Bartonella henselae have been reported. Case presentation A 58-year-old male sought medical advice while suffering from high fever and diarrhea. Three weeks before the visit, he had been hunting a water deer, and upon bringing the deer home discovered a tick on his scalp area. Symptoms occurred one week after hunting, and a lump was palpated on the right neck area 6 days after the onset of symptoms. Physical examination upon presentation confirmed an eschar-like lesion on the right scalp area, and cervical palpation revealed that the lymph nodes on the right side were non-painful and enlarged at 2.5 × 1.5 cm. Fine needle aspiration of the enlarged lymph nodes was performed, and results of nested PCR for the Bartonella internal transcribed spacer (ITS) confirmed B. henselae as the causative agent. Conclusion With an isolated case of SENLAT and a confirmation of B. henselae in Korea, it is pertinent to raise awareness to physicians in other Asian countries that B. henselae could be a causative agent for SENLAT.
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Affiliation(s)
- Jun-Won Seo
- Department of Internal Medicine, College of Medicine, Chosun University, 588 Seosuk-dong, Dong-gu, Gwangju, 61453, Republic of Korea
| | - Choon-Mee Kim
- Premedical Science, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Na Ra Yun
- Department of Internal Medicine, College of Medicine, Chosun University, 588 Seosuk-dong, Dong-gu, Gwangju, 61453, Republic of Korea
| | - Dong-Min Kim
- Department of Internal Medicine, College of Medicine, Chosun University, 588 Seosuk-dong, Dong-gu, Gwangju, 61453, Republic of Korea.
| | - Sung Soon Kim
- Division of Bacterial Disease Research, Center for Infectious Disease Research, Korea National Institute of Health, Chungcheongbuk-do, Korea
| | - Sangho Choi
- Division of Bacterial Disease Research, Center for Infectious Disease Research, Korea National Institute of Health, Chungcheongbuk-do, Korea
| | - Hyuk Chu
- Division of Bacterial Disease Research, Center for Infectious Disease Research, Korea National Institute of Health, Chungcheongbuk-do, Korea
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Abstract
Rickettsia monacensis and Orientia tsutsugamushi are bacteria of the family Rickettsiaceae, which causes fever, rash, and eschar formation; outdoor activities are a risk factor for Rickettsiaceae infection. A 75-year-old woman presented with fever, rash, and eschar and was confirmed as being scrub typhus based on a nested-polymerase chain reaction (N-PCR) test for a 56-kDa gene of O. tsutsugamushi; the genome was identified as the Boryong genotype. In addition, a pan-Rickettsia real-time PCR test was positive and a N-PCR test using a Rickettsia-specific partial outer membrane protein A (rOmpA) confirmed R. monacensis. This is the first case wherein a patient suspected of having scrub typhus owing to the presence of rash and eschar was also found to be coinfected with O. tsutsugamushi and R. monacensis based on molecular testing.
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Affiliation(s)
- Seok Won Kim
- Department of Neurosurgery, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Choon-Mee Kim
- Premedical Science, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Dong-Min Kim
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Na Ra Yun
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
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Jeong HJ, Choi S, Lee J, Gill B, Lee KM, Lee YS, Kim CM, Yun NR, Kim DM. Case Report: Scrub Typhus and Q Fever Coinfection. Am J Trop Med Hyg 2020; 100:1130-1133. [PMID: 30915946 DOI: 10.4269/ajtmh.18-0092] [Citation(s) in RCA: 1] [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: 11/07/2022] Open
Abstract
A 56-year-old female goat herder had scrub typhus that persisted after receiving doxycycline for 5 days. Her symptoms continued, prompting us to perform further examinations that revealed coinfection of Q fever and scrub typhus via molecular and serological testing. We also isolated Orientia tsutsugamushi using BALB/c mice and L929 cells.
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Affiliation(s)
- Hang Jin Jeong
- Division of Bacterial Disease Research, Center for Infectious Diseases Research, National Institute of Health, Korea Centers for Disease Control and Prevention, Cheongju-si, South Korea
| | - Sangho Choi
- Division of Bacterial Disease Research, Center for Infectious Diseases Research, National Institute of Health, Korea Centers for Disease Control and Prevention, Cheongju-si, South Korea
| | - Jeongmin Lee
- Division of Bacterial Disease Research, Center for Infectious Diseases Research, National Institute of Health, Korea Centers for Disease Control and Prevention, Cheongju-si, South Korea
| | - Byoungchul Gill
- Division of Bacterial Disease Research, Center for Infectious Diseases Research, National Institute of Health, Korea Centers for Disease Control and Prevention, Cheongju-si, South Korea
| | - Kang Mo Lee
- Division of Bacterial Disease Research, Center for Infectious Diseases Research, National Institute of Health, Korea Centers for Disease Control and Prevention, Cheongju-si, South Korea
| | - Yeong Seon Lee
- Division of Bacterial Disease Research, Center for Infectious Diseases Research, National Institute of Health, Korea Centers for Disease Control and Prevention, Cheongju-si, South Korea
| | - Choon-Mee Kim
- Department of Premedical Science, College of Medicine, Chosun University, Gwangju, South Korea
| | - Na-Ra Yun
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, South Korea
| | - Dong-Min Kim
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, South Korea
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Abstract
Hemorrhagic fever with renal syndrome (HFRS) is a febrile disorder caused in Korea by the Hantaan and Seoul viruses. Its characteristic clinical manifestations include fever, hemorrhage, and renal failure, but a primary presentation with acute infectious diarrhea is rare. Owing to decreased urine output and renal function, a 54-year-old patient was transferred to our hospital from a local clinic, where he had been receiving treatment for diarrhea occurring more than 10 times a day. The patient was treated in the Gastroenterology Department at our hospital for acute renal failure secondary to inflammatory diarrhea based on the findings of stool leukocytes. An immunofluorescent antibody assay showed a 4-fold increase in the acute-phase antibody titer to Hantavirus during recovery. A nested reverse transcription polymerase chain reaction (RT-nPCR) assay of plasma yielded negative results, but Hantaan virus positivity was confirmed on an RT-nPCR assay of the buffy coat. Another 60-year-old patient with watery diarrhea was treated conservatively for suspected infectious diarrhea. However, an immunofluorescent antibody assay showed a 4-fold increase in the acute-phase HFRS antibody titer. RT-nPCR using plasma yielded negative results, but Seoul virus was detected on an RT-nPCR buffy coat assay, confirming the diagnosis of HFRS. Hemorrhagic fever with renal syndrome can present with gastrointestinal symptoms such as acute diarrhea alone. This report highlights the importance of considering HFRS in the differential diagnosis of patients with acute diarrhea and the need for additional research on the usefulness of the buffy coat in the PCR diagnosis of HFRS.
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Affiliation(s)
- Hyun Kuk Kim
- Department of Pulmonary and Critical Care Medicine, Haeundae Paik Hospital, Inje University College of Medicine, Busan, Korea
| | - Jong-Hoon Chung
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Dong-Min Kim
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Na-Ra Yun
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Choon-Mee Kim
- Premedical Science, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Sehrish Jalal
- Department of Bio-Medical Sciences, College of Medicine, Chosun University, Gwangju, Republic of Korea
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Kim UJ, Kim CM, Jang SJ, Lee SB, Cho SS, Jeong SH, Ko YJ, Kang SH, Park G, Kim DM, Yoon NR, Ahn YJ, Lim DH, Kook JK. Evaluation of Synergistic Effect of Combined Treatment with Linalool and Colistin on Multidrug-Resistant Acinetobacter baumannii to Expand Candidate for Therapeutic Option. Ann Clin Microbiol 2020. [DOI: 10.5145/acm.2020.23.1.11] [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)
- Ung-Jun Kim
- Department of Laboratory Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Choon-Mee Kim
- Premedical Science, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Sook-Jin Jang
- Department of Laboratory Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Seul-Bi Lee
- Department of Laboratory Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Seong-Sik Cho
- Department of Laboratory Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Seok-Hoon Jeong
- Department of Laboratory Medicine and Research Institute of Antimicrobial Resistance, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Young-Jin Ko
- Department of Laboratory Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Seong-Ho Kang
- Department of Laboratory Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Geon Park
- Department of Laboratory Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Dong-Min Kim
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Na-Ra Yoon
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Young-Joon Ahn
- Department of Medical Education, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Dong-hoon Lim
- Department of Urology, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Joong-Ki Kook
- Korean Collection for Oral Microbiology and Department of Oral Biochemistry, College of Dentistry, Chosun University, Gwang-Ju, Republic of Korea
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Choi JA, Kim CM, Jang SJ, Cho SS, Jang CH, Ko YJ, Kang SH, Park G. Role of Efflux Pump Gene adeIJKto Multidrug Resistance in Acinetobacter baumanniiClinical Isolates. Ann Clin Microbiol 2020. [DOI: 10.5145/acm.2020.23.1.45] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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 Ae Choi
- Division of Antimicrobial Resistance, Center for Infectious Diseases Research, Korea National Institute of Health, KCDC, Cheongju, Republic of Korea
| | - Choon-Mee Kim
- Premedical Science, College of Medicine, Chosun University Hospital, Gwangju, Republic of Korea
| | - Sook-Jin Jang
- Department of Laboratory Medicine, College of Medicine, Chosun University Hospital, Gwangju, Republic of Korea
| | - Seong-Sik Cho
- Department of Laboratory Medicine, Chosun University Hospital, Gwangju, Republic of Korea
| | - Chul Ho Jang
- Department of Otolaryngology, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Young-Jin Ko
- Department of Laboratory Medicine, College of Medicine, Chosun University Hospital, Gwangju, Republic of Korea
| | - Seong-Ho Kang
- Department of Laboratory Medicine, College of Medicine, Chosun University Hospital, Gwangju, Republic of Korea
| | - Geon Park
- Department of Laboratory Medicine, College of Medicine, Chosun University Hospital, Gwangju, Republic of Korea
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Lee W, Seong H, Kim JH, Choi H, Kim JH, Ahn JY, Jeong SJ, Ku NS, Choi JY, Kim CM, Kim DM, Yeom JS. A Case of African Tick-Bite Fever in a Returning Traveler from Southern Africa. Infect Chemother 2020; 54:202-207. [PMID: 32757495 PMCID: PMC8987174 DOI: 10.3947/ic.2019.0073] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Accepted: 12/30/2019] [Indexed: 11/24/2022] Open
Abstract
African tick-bite fever (ATBF), caused by Rickettsia africae, is the second most frequent cause of fever after malaria in travelers returning from Southern Africa. As the Korean outbound travelers are increasing every year, tick-borne rickettsial diseases as a cause of febrile illness are likely to increase. We describe a febrile Korean returning traveler who showed two eschars after visiting the rural field in Manzini, Swaziland. We performed nested polymerase chain reaction using the eschar and diagnosed the patient with ATBF. He was treated with oral doxycycline for 7 days, and recovered without any complications. We believe that the present case is the first ATBF case diagnosed in a Korean traveler.
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Affiliation(s)
- Woonji Lee
- Division of Infectious Disease, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Hye Seong
- Division of Infectious Disease, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jung Ho Kim
- Division of Infectious Disease, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Heun Choi
- Division of Infectious Disease, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jun Hyoung Kim
- Division of Infectious Disease, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jin Young Ahn
- Division of Infectious Disease, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Su Jin Jeong
- Division of Infectious Disease, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Nam Su Ku
- Division of Infectious Disease, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Jun Yong Choi
- Division of Infectious Disease, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Choon-Mee Kim
- Premedical Science, Chosun University College of Medicine, Gwangju, Korea
| | - Dong-Min Kim
- Division of Infectious Disease, Department of Internal Medicine, Chosun University College of Medicine, Gwangju, Korea
| | - Joon-sup Yeom
- Division of Infectious Disease, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
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Park HR, Kim DM, Yun NR, Kim CM. Identifying the mechanism underlying treatment failure for Salmonella Paratyphi A infection using next-generation sequencing – a case report. BMC Infect Dis 2019; 19:191. [PMID: 30808284 PMCID: PMC6390365 DOI: 10.1186/s12879-019-3821-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 02/15/2019] [Indexed: 11/10/2022] Open
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Kim YS, Kim DM, Yoon NR, Jang MS, Kim CM. Effects of Rifampin and Doxycycline Treatments in Patients With Uncomplicated Scrub Typhus: An Open-Label, Randomized, Controlled Trial. Clin Infect Dis 2019; 67:600-605. [PMID: 29462266 DOI: 10.1093/cid/ciy130] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Accepted: 02/14/2018] [Indexed: 11/14/2022] Open
Abstract
Background Doxycycline is currently the most frequently used treatment in patients with scrub typhus. However, doxycycline-resistant strains have been found, necessitating the development of a new treatment. Rifampin is known to be effective even for such strains. Our aim in this study was to compare the effects of rifampin and doxycycline treatment in patients with scrub typhus in areas in which resistance to doxycycline has not been reported. Methods Patients admitted to Chosun University Hospital and regional network hospitals between 2007 and 2009 with a body temperature ≥37.5°C and suspected to have scrub typhus were randomly assigned to 1 of 2 treatment groups: a group administered doxycycline 100 mg twice daily for 5 days and a group administered rifampin 600 mg once daily for 5 days. For treatment outcomes, fever, headache, muscle ache, and rash clearance times were compared between the groups. Results The rifampin and doxycycline groups showed equivalence in all treatment outcomes evaluated. The proportions of patients with fever clearance within 48 hours were similar between groups. Furthermore, there was no significant difference in the occurrence of side effects following drug administration between groups. Conclusions On the basis of the finding that equivalent treatment effects and safety were found in patient groups that received 600 mg of rifampin and 200 mg of doxycycline, respectively, for 5 days to treat scrub typhus, rifampin may be considered an alternative treatment to doxycycline. Clinical Trials Registration NCT00568711.
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Affiliation(s)
- Yun Sung Kim
- Department of Internal Medicine, Chosun University, Gwangju, Republic of Korea
| | - Dong-Min Kim
- Department of Internal Medicine, Chosun University, Gwangju, Republic of Korea
| | - Na-Ra Yoon
- Department of Internal Medicine, Chosun University, Gwangju, Republic of Korea
| | - Mi-Sun Jang
- Department of Internal Medicine, Chosun University, Gwangju, Republic of Korea
| | - Choon-Mee Kim
- Premedical Science, College of Medicine, Chosun University, Gwangju, Republic of Korea
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Kim DM, Kim CM, Ra Yun N. 2138. Follow-up Investigation of Antibody Titers and Diagnostic Antibody Cut-Off Values in Scrub Typhus Patients in Korea. Open Forum Infect Dis 2019. [PMCID: PMC6810008 DOI: 10.1093/ofid/ofz360.1818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background Scrub typhus is a mite-borne infectious disease caused by Orientia tsutsugamushi. There have been few follow-up studies assessing antibody titers using serologic tests from various commercial labs. Methods A prospective investigation to assess antibody titers of scrub typhus patients and seroprevalence for health checkup individuals were evaluated. The antibody titers of former patients diagnosed with scrub typhus at least 1 year and a maximum of 13 years were also investigated. The following tests were performed simultaneously: (i) immunofluorescence antibody assays (IFAs) that detect immunoglobulin(Ig) M and IgG, (ii) IFA that detects total Ig by a commercial lab, (iii) antibody tests using two commercially available kits. Results In prospective analyses with cutoff values set to ≥1:16 for IgM, ≥1:256 for IgG based on the KCDC’s criteria, and ≥1:40 for total Ig. The antibody positive rates of 102 confirmed scrub typhus patients were 44%, 35.3%, and 57.6%, respectively, in the first week after symptom onset. Among 91 former patients recovered, the follow-up IgM, IgG, and total Ig positivity rates were 38.5% (35/91), 22% (20/91), and 76.9% (70/91), respectively. In overall cohort of 216 health checkup subjects, 4.2% (9/216) IgM and 0% (0/216) IgG seroprevalence was observed. Conclusion The IFA from KCDC and commercial lab, and rapid commercial kits cannot differentiate between former patients recovered from scrub typhus and current scrub typhus. In Korea and other countries where low antibody cut-off titer values have been used as criteria for diagnosing and reporting scrub typhus, upward adjustments of cut-off values may be necessary. ![]()
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Disclosures All authors: No reported disclosures.
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Affiliation(s)
- Dong-Min Kim
- Chosun University Hospital, Gwang ju, Kwangju-jikhalsi, Republic of Korea
| | - Choon-Mee Kim
- Chosun University, Gwang ju, Kwangju-jikhalsi, Republic of Korea
| | - Na Ra Yun
- Chosun University Hospital, Gwanjugwangyeoksi, Kwangju-jikhalsi, Republic of Korea
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Kim DM, Seon Bang M, Kim CM, Ra Yun N, Seo JW. 1648. Prevalence of Orientia tsutsugamushi, Anaplasma phagocytophilum, and Leptospira interrogans in Striped Field Mice in Gwangju, Republic of Korea. Open Forum Infect Dis 2019. [PMCID: PMC6808657 DOI: 10.1093/ofid/ofz360.1512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background Methods Results Conclusion Disclosures
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Affiliation(s)
- Dong-Min Kim
- Chosun University Hospital, Gwang ju, Kwangju-jikhalsi, Republic of Korea
| | - Mi Seon Bang
- Chosun University, Gwang ju, Kwangju-jikhalsi, Republic of Korea
| | - Choon-Mee Kim
- Chosun University, Gwang ju, Kwangju-jikhalsi, Republic of Korea
| | - Na Ra Yun
- Chosun university hospital, Gwanjugwangyeoksi, Kwangju-jikhalsi, Republic of Korea
| | - Jun-won Seo
- Chosun university Hospital, Gwangju, Kwangju-jikhalsi, Republic of Korea
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Bang MS, Kim CM, Park JW, Chung JK, Kim DM, Yun NR. Prevalence of Orientia tsutsugamushi, Anaplasma phagocytophilum and Leptospira interrogans in striped field mice in Gwangju, Republic of Korea. PLoS One 2019; 14:e0215526. [PMID: 31419222 PMCID: PMC6697328 DOI: 10.1371/journal.pone.0215526] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Accepted: 04/03/2019] [Indexed: 11/18/2022] Open
Abstract
This study investigated the prevalence of Orientia tsutsugamushi, Anaplasma phagocytophilum, and Leptospira interrogans in wild rodents through molecular detection using organ samples and through serological assay using blood samples of mice collected from two distinct sites in Gwangju Metropolitan City, Republic of Korea (ROK). A total of 47 wild rodents, identified as Apodemus agrarius (A. agrarius), were captured from June to August 2016. The seroprevalence of antibodies against bacterial pathogens in A. agrarius sera was analyzed; 17.4% (8/46) were identified as O. tsutsugamushi through indirect immunofluorescence assay and 2.2% (1/46) were identified as Leptospira species through passive hemagglutination assay. Using polymerase chain reaction, the spleen, kidney and blood samples were investigated for the presence of O. tsutsugamushi, A. phagocytophilum, and L. interrogans. Out of the 47 A. agrarius, 19.1% (9/47) were positive for A. phagocytophilum and 6.4% (3/47) were positive for L. interrogans, while none were positive for O. tsutsugamushi. Four out of 46 (8.7%) blood samples, six out of 45 (13.3%) spleen samples, and one out of 47 (2.1%) kidney samples were positive for A. phagocytophilum. Three out of 47 (6.4%) kidney samples were positive for L. interrogans. The sequencing results of PCR positive samples demonstrated > 99% similarity with A. phagocytophilum and L. interrogans sequences. A. phagocytophilum was mostly detected in the spleen, whereas L. interrogans was mostly detected in the kidneys. Notably, A. phagocytophilum and L. interrogans were detected in A. agrarius living in close proximity to humans in the metropolitan suburban areas. The results of this study indicate that rodent-borne bacteria may be present in wild rodents in the metropolitan suburban areas of ROK.
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Affiliation(s)
- Mi-Seon Bang
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Choon-Mee Kim
- Premedical Science, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Jung Wook Park
- Division of Infectious Disease Investigation, Health and Environment Research Institute of Gwangju City, Gwangju, Republic of Korea
| | - Jae Keun Chung
- Division of Infectious Disease Investigation, Health and Environment Research Institute of Gwangju City, Gwangju, Republic of Korea
| | - Dong-Min Kim
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Na Ra Yun
- Department of Internal Medicine, College of Medicine, Chosun University, Gwangju, Republic of Korea
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Kim HL, Park HR, Kim CM, Cha YJ, Yun NR, Kim DM. Indicators of severe prognosis of scrub typhus: prognostic factors of scrub typhus severity. BMC Infect Dis 2019; 19:283. [PMID: 30909868 PMCID: PMC6434784 DOI: 10.1186/s12879-019-3903-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 07/07/2018] [Accepted: 03/13/2019] [Indexed: 12/29/2022] Open
Abstract
Background Scrub typhus is an acute disease, characterized by symptoms of fever, which occurs due to infection by Orientia tsutsugamushi. In most cases, patients recover from the disease with appropriate treatment, but serious and fatal complications may occur. The present study examined laboratory findings and tumor necrosis factor-alpha (TNF-α) levels of scrub typhus patients to identify the prognostic predictors of disease severity. Method Patients whose scrub typhus diagnosis was confirmed by elevated indirect fluorescent antibody (IFA) levels and positive polymerase chain reaction (PCR) results were classified according to disease severity into one of three groups; i.e., deceased (n = 7), severe (n = 15), and mild (n = 15) retrospectively registered. Additionally, the usefulness of modified Acute Physiology and Chronic Health Evaluation II (APACHE II) score, C-reactive protein (CRP) level, white blood cell (WBC) count, and TNF-α level as prognostic predictors were examined. Result The mean TNF-α levels of the deceased, severe, and mild groups were 53.5 (range: 7.8–147.8), 26.0 (1.7–64.4), and 8.8 pg/mL (4.6–16.0), respectively. The results of Kruskal-Wallis tests showed statistically significant differences between the deceased and severe groups versus the mild group (p = 0.005). CRP level and Modified APACHE II score also differed significantly among the groups (p = 0.046 and 0.007, respectively); however, WBC count did not (p = 0.196). Conclusion An elevated serum TNF-α level in patients with scrub typhus could predict a severe condition or death and may be useful in predicting patient prognosis.
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Affiliation(s)
- Hyun Lee Kim
- Department of Internal Medicine, Chosun University College of Medicine, 588 Seosuk-dong, Dong-gu, Gwangju, 501-717, Republic of Korea
| | - Hye Rim Park
- Department of Internal Medicine, Chosun University College of Medicine, 588 Seosuk-dong, Dong-gu, Gwangju, 501-717, Republic of Korea
| | - Choon-Mee Kim
- Premedical sciences, College of Medicine, Chosun University, Gwang-ju, South Korea
| | - Youn Jung Cha
- Department of Internal Medicine, Chosun University College of Medicine, 588 Seosuk-dong, Dong-gu, Gwangju, 501-717, Republic of Korea
| | - Na Ra Yun
- Department of Internal Medicine, Chosun University College of Medicine, 588 Seosuk-dong, Dong-gu, Gwangju, 501-717, Republic of Korea
| | - Dong-Min Kim
- Department of Internal Medicine, Chosun University College of Medicine, 588 Seosuk-dong, Dong-gu, Gwangju, 501-717, Republic of Korea.
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Han MA, Kim CM, Kim DM, Yun NR, Park SW, Han MG, Lee WJ. Seroprevalence of Severe Fever with Thrombocytopenia Syndrome Virus Antibodies in Rural Areas, South Korea. Emerg Infect Dis 2019; 24. [PMID: 29664384 PMCID: PMC5938763 DOI: 10.3201/eid2405.152104] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We investigated 1,228 residents of 3 rural areas in South Korea and determined that 50 (4.1%) were positive for severe fever with thrombocytopenia syndrome virus antibodies. Fever and gastrointestinal symptoms in the previous 3 years and career duration were associated with virus seropositivity.
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50
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Abstract
This study compared the frequency of abnormal electrocardiogram (ECG) types between scrub typhus patient group and age- and gender-matched health checkup group and their associations with disease severity in scrub typhus patient. Demographic characteristics and ECG and laboratory findings of patients with scrub typhus admitted to Chosun University Hospital, and normal subjects visiting the hospital for health checkup from January 2008 to December 2012 were retrospectively studied. Electrocardiogram abnormalities at admission were observed in 72 of 165 (43.6%) scrub typhus confirmed patients. The following ECG abnormalities were observed: arrhythmic group (31 cases, 18.8%), ischemic change group (25 cases, 15.1%), prolonged QT group (32 cases, 19.4%).Compared with the age and gender-matched health checkup group, ECG abnormalities were more commonly observed in scrub typhus patient group (13.9% versus 43.6%, P < 0.001). In addition, when compared with the normal ECG group, scrub typhus in the abnormal ECG group showed greater disease severity and this phenomenon was particularly prominent in the prolonged QT group. Based on our study prolonged QT observed in approximately 20% of patients with scrub typhus, clinicians should pay additional attention to drugs that affect QT interval.
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Affiliation(s)
- Seo-Won Choi
- Department of Internal Medicine, School of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Na Ra Yun
- Department of Internal Medicine, School of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Dong-Hyun Choi
- Department of Internal Medicine, School of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Young-Jae Ki
- Department of Internal Medicine, School of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Seok Won Kim
- Department of Neurosurgery, School of Medicine, Chosun University, Gwangju, Republic of Korea
| | - Choon-Mee Kim
- The Division of Natural Medical Sciences, College of Health Science, Chosun University, Gwangju, Republic of Korea
| | - Dong-Min Kim
- Department of Internal Medicine, School of Medicine, Chosun University, Gwangju, Republic of Korea
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