Sungmin Kim

Carriage of Antibiotic-Resistant Pneumococci among Asian Children: A Multinational Surveillance by the Asian Network for Surveillance of Resistant Pathogens (ANSORP)

To investigate the nasal carriage of antibiotic-resistant pneumococci by children, anterior nasal swabs were done for 4963 children <5 years old in 11 countries in Asia and the Middle East. In total, 1105 pneumococci isolates (carriage rate, 22.3%) were collected, 35.8% of which were found to be nonsusceptible to penicillin. Prevalence of penicillin nonsusceptibility was highest in Taiwan (91.3%), followed by Korea (85.8%), Sri Lanka (76.5%), and Vietnam (70.4%). Penicillin resistance was related to residence in urban areas, enrollment in day care, and a history of otitis media. The most common serogroups were 6 (21.5%), 23 (16.5%), and 19 (15.7%). The most common clone, as assessed by pulsed-field gel electrophoresis, was identical to the Spanish 23F clone and to strains of invasive isolates from adult patients. Data in this study documented the high rate of penicillin or multidrug resistance among isolates of pneumococci carried nasally in children in Asia and the Middle East and showed that this is due to the spread of a few predominant clones in the region.

Detection of parenchymal abnormalities in acute pyelonephritis by pulse inversion harmonic imaging with or without microbubble ultrasonographic contrast agent: correlation with computed tomography.

The purpose of this study was to evaluate the ability of pulse inversion harmonic imaging with or without microbubble ultrasonographic contrast agent in depicting renal parenchymal changes in acute pyelonephritis. The study population included 30 patients with acute pyelonephritis and 10 healthy volunteers. Pulse inversion harmonic imaging with or without contrast agent was compared with conventional ultrasonography and tissue harmonic imaging in terms of detection and conspicuity of renal abnormalities. The detection and conspicuity of renal parenchymal abnormalities in acute pyelonephritis on tissue harmonic imaging, pulse inversion harmonic imaging, and contrast‐enhanced pulse inversion harmonic imaging were significantly better than those on conventional ultrasonography. In 2 of 10 healthy volunteers all 4 techniques yielded false‐positive diagnoses of parenchymal abnormalities. In conclusion, tissue harmonic imaging and pulse inversion harmonic imaging are sensitive techniques for depicting renal parenchymal lesions in acute pyelonephritis. Despite relatively lower specificities and negative predictive values, these techniques are thought to be useful for the depiction of subtle parenchymal changes in acute pyelonephritis.

Antimicrobials as Potential Adjunctive Agents in the Treatment of Biofilm Infection with Staphylococcus epidermidis

Background: This study was performed to evaluate the interaction of erythromycin or rifampin with vancomycin against Staphylococcus epidermidis biofilms. Methods: Biofilm-forming S. epidermidis strains (ATCC 35983, 35984) and polyurethane (PU) sheets were incubated for the formation of bacterial biofilms. Biofilms on PU sheets were treated with various antibiotic regimens. The number of viable bacteria on the sheets was counted. Results: While erythromycin or vancomycin alone did not significantly reduce the biofilm bacterial concentration, the combination of vancomycin and erythromycin resulted in a clear reduction in bacterial concentration compared with the single agents. Rifampin was the most active single agent against biofilm-forming S. epidermidis, while the combination of rifampin and vancomycin showed further reduction in bacterial concentration. Conclusions: These data suggest that the combination of erythromycin or rifampin and vancomycin is more effective than vancomycin alone in the treatment of biofilm infections caused by biofilm-forming S. epidermidis.

Clinical usefulness of human cytomegalovirus antigenemia assay after kidney transplantation.

Background. Human (H) cytomegalovirus (CMV) infections are a major cause of morbidity and mortality among kidney transplants. We performed a prospective study to evaluate the clinical usefulness of HCMV antigenemia assay for preemptive treatment after kidney transplantation. Methods. A total of 100 patients were followed up by HCMV antigenemia assay at posttransplantation weeks 1, 3, 5, 7, 9, 13, 17, and 21. Asymptomatic patients with positive antigenemia were observed without specific antiviral therapy. Results. Most patients had been given cyclosporine A- and prednisolone-based immunosuppressive therapy (99.0%) and were HCMV seropositive before transplantation (99.0%). A positive antigenemia assay was detected in 41 patients among 97 eligible patients. Symptomatic CMV diseases were observed in 10 of 41 patients. HCMV infections were related to history of acute rejection and use of antithymocyte globulin. HCMV-related symptoms and signs were clearly correlated with the level of antigenemia. All patients who had an HCMV antigenemia titer of higher than 50 per 400,000 leukocytes developed HCMV-related symptoms and signs during the follow-up period. This criterion showed the highest positive predictive value and specificity in the development of symptomatic HCMV infection. Conclusions. Data suggest that HCMV antigenemia titer can be used as a useful guide to preemptive treatment of HCMV infection after kidney transplantation in HCMV-positive donor and recipient.

Therapeutic efficacy of meropenem for treatment of experimental penicillin-resistant pneumococcal meningitis.

With the widespread emergence of antimicrobial resistance, combination regimens of ceftriaxone and vancomycin (C+V) or ceftriaxone and rifampin (C+R) are recommended for empirical treatment of pneumococcal meningitis. To evaluate the therapeutic efficacy of meropenem (M), we compared various treatment regimens in arabbit model of meningitis caused by penicillin-resistant Streptococcus pneumoniae (PRSP). Therapeutic efficacy was also evaluated by the final bacterial concentration in the cerebrospinal fluid (CSF) at 24 hr. Each group consisted of six rabbits. C+V cleared the CSF at 10 hr, but regrowth was noted in 3 rabbits at 24 hr. Meropenem monotherapy resulted in sterilization at 10 hr, but regrowth was observed in all 6 rabbits at 24 hr. M+V also resulted in sterilization at 10 hr, but regrowth was observed in 2 rabbits at 24 hr. M+V was superior to the meropenem monotherapy at 24 hr (reduction of 4.8 vs. 1.8 log10 cfu/mL, respectively; p=0.003). The therapeutic efficacy of M+V was comparable to that of C+V (reduction of 4.8 vs. 4.0 log10 cfu/mL, respectively; p=0.054). The meropenem monotherapy may not be a suitable choice for PRSP meningitis, while combination of meropenem and vancomycin could be a possible alternative in the treatment of PRSP meningitis.

T91. Factors predicting the successful generation of baseline motor evoked potentials in patients undergoing spine surgery

Introduction The purpose of this study was to search for clinical factors predicting the successful generation of baseline muscle motor evoked potentials (mMEPs) in patients undergoing spine surgery and to determine the relationship with postoperative functional outcome. Methods From July 2014 to June 2015, a total of 345 patients underwent spine surgery with intraoperative mMEPs monitoring and were consecutively included in this study. Their demographic features, clinical parameters, and mMEPs recording results were reviewed retrospectively. Results Two hundred and fifty-three (73%) patients showed the successful generation of baseline mMEPs at all recording muscles, and 92 (27%) patients failed to record baseline mMEPs at one or more limb muscles. When we compared the preoperative clinical parameters of the two groups, the latter group (“Failure group”) significantly had a higher male ratio, lower MRC grades, higher Nurick grades, more often cervical/cervicothoracic segment involvement, higher proportion of the presence of spine surgery history, motor deficits, sensory symptoms, bladder/bowel dysfunction, T2-weighted high signal intensity (HSI) of cord at spine MRI compared to the former group (“Success group”) and were older. Among these factors, male sex, cervical/cervicothoracic lesion location the presence of T2-weighted HSI of cord, preoperative Nurick grade, and MRC grade showed a significant contribution for predicting the successful generation of mMEPs. When analyzing predictors for postoperative poor functional outcomes, the success rate of mMEPs recording and lesion etiology were significantly related factors for the aggravation of the Nurick grades before and after surgery. Conclusion Various clinical parameters including lesion location, abnormal cord signal on MRI, preoperative motor power, and functional status were revealed to have a significant relationship with the successful generation of baseline mMEPs. Additionally, the successful generation of mMEPs was one of the indicators for predicting the long-term functional outcome.

Correction: Accuracy of the Fluorescence-Activated Cell Sorting Assay for the Aquaporin-4 Antibody (AQP4-Ab): Comparison with the Commercial AQP4-Ab Assay Kit

[This corrects the article DOI: 10.1371/journal.pone.0162900.].

Synthesis of thiazolo[4,5-e][1,2,4]triazolo[1,5-c]pyrimidine derivatives

Abstract Synthesis of a series of 8-phenylthiazolo[4,5-e][1,2,4]triazolo[1,5-c]pyrimidin-5(4H)-one and 5-piperazino-8-phenylthiazolo[4,5-e][1,2,4]triazolo[1,5-c]pyrmidine compounds with promising biological activity is described.