The first case of abdominal mycotic aneurysm caused by K1 hypervirulent Klebsiella pneumoniae in a healthy adult

Incidence of hypervirulent Klebsiella pneumoniae (hvKp) infection has been steadily increasing in the Asia-Pacific rim. The characteristic of hvKp infection is its ability to cause multiple site infections and unpredictable metastatic spread in the community. We describe the first case of mycotic aneurysm caused by hvKp serotype K1 in a previously healthy man and review the literature. Of a total of 13 cases, including our case, three cases were related to hvKp. Among patients with hvKp, the level of mycotic aneurysm in most patients was the infrarenal aorta, and they underwent an aortic graft or coil embolization. All strains were susceptible to most antimicrobial agents, except ampicillin. Early detection of hvKp can help to prevent the metastatic spread of pathogens and be useful for optimal patient care and epidemiologic research

Environmental Forcing Shapes Regional House Mosquito Synchrony in a Warming Temperate Island

Seasonal changes in the abundance of exothermic organisms can be expected with climate change if warmer temperatures can induce changes in their phenology. Given the increased time for ectothermic organism development at lower temperatures, we asked whether population dynamics of the house mosquito, Culex pipiens s.l. (L.) (Diptera: Culicidae), in Jeju-do (South Korea), an island with a gradient of warming temperatures from north to south, showed differences in sensitivity to changes in temperature along the warming gradient. In addition, we asked whether synchrony, that is, the degree of concerted fluctuations in mosquito abundance across locations, was affected by the temperature gradient. We found the association of mosquito abundance with temperature to be delayed by 2 wk in the north when compared with the south. The abundance across all our sampling locations had a flat synchrony profile that could reflect impacts of rainfall and average temperature on the average of all our samples. Finally, our results showed that population synchrony across space can emerge even when abundance is differentially impacted by an exogenous factor across an environmental gradient

Proposed searches for candidate sources of gravitational waves in a nearby core-collapse supernova survey

Gravitational wave bursts in the formation of neutron stars and black holes in energetic core-collapse supernovae (CC-SNe) are of potential interest to LIGO-Virgo and KAGRA. Events nearby are readily discovered using moderately sized telescopes. CC-SNe are competitive with mergers of neutron stars and black holes, if the fraction producing an energetic output in gravitational waves exceeds about 1%. This opportunity motivates the design of a novel Sejong University Core-CollapsE Supernova Survey (SUCCESS), to provide triggers for follow-up searches for gravitational waves. It is based on the 76 cm Sejong university telescope (SUT) for weekly monitoring of nearby star-forming galaxies, i.e., M51, M81-M82 and blue dwarf galaxies from the unified nearby galaxy catalog with an expected yield of a few hundred per year. Optical light curves will be resolved for the true time-of-onset for probes of gravitational waves by broadband time-sliced matched filtering

The First Case of Catheter-related Bloodstream Infection Caused by Nocardia farcinica

Nocardia farcinica is an emerging pathogen in immunocompromised hosts. Even though several species of Nocardia have been reported as causative pathogens of catheter-related blood stream infections (CRBSI), CRBSI caused by N. farcinica has not been reported. A 70-yr-old man with a tunneled central venous catheter (CVC) for home parenteral nutrition was admitted with fever for two days. Norcardia species was isolated from the blood through CVC and peripheral bloods and identified to N. farcinica by 16S rRNA and rpoB gene sequence analyses. This report emphasizes the rapid and correct identification of causative agents in infectious diseases in the selection of antimicrobial agents and the consideration of catheter removal

Analysis of Methicillin Resistance among Staphylococcus aureus Blood Isolates in an Emergency Department

The increasing prevalence of methicillin-resistant Staphylococcus aureus (MRSA) has become of great concern in both hospital and community settings. To evaluate the prevalence and risk factors for methicillin resistance among Staphylococcus aureus, blood isolates in our Emergency Department (ED) were collected. All patients with S. aureus bacteremia (SAB) who presented to the ED from January 2000 to August 2005 were included, and a retrospective study was performed. A total of 231 patients with SAB were enrolled (median age, 59 yr; M:F, 125:106). Among these patients, methicillin-resistant strains accounted for 27.3% (63 patients). Catheter-related infection was the most frequent primary site of SAB (39.0%), followed by skin and soft tissue infection (16.5%). In multivariate analysis, recent surgery (OR, 3.41; 95% CI, 1.48-7.85), recent hospitalization (2.17; 1.06-4.62), and older age (≥61 yr) (2.39; 1.25-4.57) were independently associated with the acquisition of methicillin-resistant strains. When antimicrobial therapy is considered for the treatment of a patient with suspected SAB, clinicians should consider obtaining cultures and modifying empirical therapy to provide MRSA coverage for patients with risk factors: older age, recent hospitalization, and recent surgery

A Prediction Rule to Identify Severe Cases among Adult Patients Hospitalized with Pandemic Influenza A (H1N1) 2009

The purpose of this study was to establish a prediction rule for severe illness in adult patients hospitalized with pandemic influenza A (H1N1) 2009. At the time of initial presentation, the baseline characteristics of those with severe illness (i.e., admission to intensive care unit, mechanical ventilation, or death) were compared to those of patients with non-severe illnesses. A total of 709 adults hospitalized with pandemic influenza A (H1N1) 2009 were included: 75 severe and 634 non-severe cases. The multivariate analysis demonstrated that altered mental status, hypoxia (PaO2/FiO2 ≤ 250), bilateral lung infiltration, and old age (≥ 65 yr) were independent risk factors for severe cases (all P < 0.001). The area under the ROC curve (0.834 [95% CI, 0.778-0.890]) of the number of risk factors were not significantly different with that of APACHE II score (0.840 [95% CI, 0.790-0.891]) (P = 0.496). The presence of ≥ 2 risk factors had a higher sensitivity, specificity, positive predictive value and negative predictive value than an APACHE II score of ≥ 13. As a prediction rule, the presence of ≥ 2 these risk factors is a powerful and easy-to-use predictor of the severity in adult patients hospitalized with pandemic influenza A (H1N1) 2009

New prognostic scoring system for mortality in idiopathic pulmonary fibrosis by modifying the gender, age, and physiology model with desaturation during the six-minute walk test

BackgroundIdiopathic pulmonary fibrosis (IPF) is a progressive fibrosing interstitial lung disease (ILD) with variable and heterogeneous clinical course. The GAP (gender, age, and physiology) model had been used to predict mortality in patients with IPF, but does not contain exercise capacity. Therefore, our aim in this study was to develop new prognostic scoring system in the Korea IPF Cohort (KICO) registry.Materials and methodsThis is a retrospective study of Korean patients with IPF in KICO registry from June 2016 to August 2021. We developed new scoring system (the GAP6) based on the GAP model adding nadir saturation of percutaneous oxygen (SpO2) during six-minute walk test (6MWT) in the KICO registry and compared the efficacy of the GAP and the GAP6 model.ResultsAmong 2,412 patients in KICO registry, 966 patients were enrolled. The GAP6 model showed significant prognostic value for mortality between each stage [HR Stage II vs. Stage I = 2.89 (95% CI = 2.38–3.51), HR Stage III vs. Stage II = 2.68 (95% CI = 1.60–4.51)]. In comparison the model performance with area under curve (AUC) using receiver operating characteristic (ROC) curve analysis, the GAP6 model showed a significant improvement for predicting mortality than the GAP model (AUC the GAP vs. the GAP6, 0.646 vs. 0.671, p &lt; 0.0019). Also, the C-index values slightly improved from 0.674 to 0.691 for mortality.ConclusionThe GAP6 model adding nadir SpO2 during 6WMT for an indicator of functional capacity improves prediction ability with C-index and AUC. Additional multinational study is needed to confirm these finding and validate the applicability and accuracy of this risk assessment system

Severe Fever with Thrombocytopenia Syndrome

Severe fever with thrombocytopenia syndrome (SFTS) is a newly emerging infectious disease, caused by a novel species of &amp;lt;i&amp;gt;Phlebovirus&amp;lt;/i&amp;gt; of &amp;lt;i&amp;gt;Bunyaviridae&amp;lt;/i&amp;gt; family, in China, South Korea, and Japan. SFTS is primarily known as a tick-borne disease, and human-to-human transmission is also possible in contact with infectious blood. Common clinical manifestations include fever, thrombocytopenia, and leukopenia as initial symptoms, and multiple organ dysfunction and failure manifest with disease progression. Whereas disease mortality is reported to be 12% to 30% in China, a recent report of cumulative SFTS cases indicated 47% in Korea. Risk factors associated with SFTS were age, presence of neurologic disturbance, serum enzyme levels, and elevated concentrations of certain cytokines. Diagnosis of SFTS is based on viral isolation, viral identification by polymerase chain reaction, and serologic identification of specific immunoglobulin G. Therapeutic guideline has not been formulated, but conservative management is the mainstream of treatment to prevent disease progression and fatal complications

Environmental Forcing Shapes Regional House Mosquito Synchrony in a Warming Temperate Island

Seasonal changes in the abundance of exothermic organisms can be expected with climate change if warmer temperatures can induce changes in their phenology. Given the increased time for ectothermic organism development at lower temperatures, we asked whether population dynamics of the house mosquito, Culex pipiens s.l. (L.) (Diptera: Culicidae), in Jeju-do (South Korea), an island with a gradient of warming temperatures from north to south, showed differences in sensitivity to changes in temperature along the warming gradient. In addition, we asked whether synchrony, that is, the degree of concerted fluctuations in mosquito abundance across locations, was affected by the temperature gradient. We found the association of mosquito abundance with temperature to be delayed by 2 wk in the north when compared with the south. The abundance across all our sampling locations had a flat synchrony profile that could reflect impacts of rainfall and average temperature on the average of all our samples. Finally, our results showed that population synchrony across space can emerge even when abundance is differentially impacted by an exogenous factor across an environmental gradient