Quantitation of BK Virus DNA for Diagnosis of BK Virus-Associated Nephropathy in Renal Transplant Recipients

성흥섭,최병후,표연정,김미나,한덕종 대한의학회 2008 Journal of Korean medical science Vol.23 No.5

Quantitative measurement of BK virus DNA (Q-BKDNA) has been used for the early diagnosis and monitoring of BK virus-associated nephropathy (BKVAN). This study was designed to determine the BKDNA cutoff for the diagnosis of BKVAN. Between June 2005 and February 2007, 64 renal transplant recipients taken renal biopsies due to renal impairment submitted plasma and urine for Q-BKDNA. Eight BKVAN patients (12.5%) had median viral loads of 6.0 log10 copies/mL in plasma and 7.3 log10 copies/mL in urine. Among 56 non-BKVAN patients, 45 were negative for Q-BKDNA; 4 were positive in plasma with a median viral load of 4.8 log10 copies/ mL, and 10 were positive in urine with a median viral load of 4.8 log10 copies/mL. Receiver operating characteristic curve analysis showed that a cutoff of 4.5 log10 copies/mL in plasma and a cutoff of 5.9 log10 copies/mL in urine had a sensitivity of 100% and a specificity of 96.4%, respectively. A combined cutoffs of 4 log10 copies/ mL in plasma and 6 log10 copies/mL in urine had better performance with a sensitivity of 100% and a specificity of 98.2% than each cutoff of urine or plasma. QBKDNA with the combined cutoffs could reliably diagnose BKVAN in renal transplant recipients.

BACTEC 9240 시스템에서 4일 혈액배양의 평가

성흥섭,김미나,배직현 대한임상병리학회 2001 대한임상병리학회지 Vol.21 No.3

침습성 아스페르길루스증 진단을 위한 Platelia Aspergillus 항원 검사법의 평가

성흥섭,정희정,표연정,남궁승,김미나 대한임상미생물학회 2005 Annals of clinical microbiology Vol.8 No.2

Background: Because the mortality rate of invasive aspergillosis (IA) is more than 50%, an early diagnosis and appropriate management are important to achieve a favorable outcome. Aspergillus galactomannan (AG) antigen test has recently been introduced for diagnosis and monitoring of IA. This study was to evaluate the clinical utility of AG detection in diagnosis of IA. Methods:One hundred and seventy-five samples from 149 patients were tested for AG during the period from September 2004 to May 2005 and the results were evaluated retrospectively. IA was diagnosed into ‘proven’, ‘probable’and ‘possible’, groups based on patients’clinical laboratory findings as per European Organization for Research and Treatment of Cancer/Mycoses Study Group. AG was tested using a Platelia Aspergillus antigen ELISA (Bio-Rad, Hercules, CA, USA); the optical density (OD) of the test specimen was divided by the mean OD of two cut-off controls. The test was classified as positive when the OD ratio was ≥1.5; ratios 1-1.5 were classified as equivocal. Clinical Information was obtained from the electronic medical records of the patients. Results: Of the 175 samples tested, 19 were positive, 14 equivocal, and 142 negative for AG. A number of the ‘proven’, ‘probable’, and ‘possible’IA patients were 2, 15, and 28, respectively. At the OD ratio of 1.5, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 76.9%, 94.7%, 58.8%, and 97.7%, respectively, when 4 false-negative patients treated with amphotericin B before Aspergillusantigen test were excluded. Conclusion: The Platelia Aspergillus ELISA demonstrated an excellent sensitivity, specificity and NPV for the diagnosis of IA. A combined use of the antigen test with microbiological and clinical evaluation might facilitate the early diagnosis of IA and, consequently, improve its clinical outcome.

vanA 유전자와 vanC1 유전자를 동시에 가진 Enterococcus gallinarum 1예

성흥섭,윤경아,김미나,배직현 대한진단검사의학회 2002 Annals of Laboratory Medicine Vol.22 No.1

저자들은 중환자실 감시배양을 통해 3년간 치료받던 환자에서vanA 와 vanC1 유전자를 동시에 가진 E. gallinarum을 분리하였다. E. gallinarum, SI04는 반코마이신에 고도내성(MIC of ≥256 g/mL) 이었으며, teicoplanin에도 고도내성(MIC of ≥256g/mL)이었다. vanA, vanB, vanC1, vanC2/3 내성형 결정을위하여 multiplex PCR을 시행한 결과 SI04에서 vanA 와 vanC1두 가지 유전자가 동시에 관찰되었다. 본 증례는 국내에서 처음으로 VanC형의 반코마이신 내성 장구균에서vanA 유전자가 존재함을 보여 주어, 반코마이신 내성 장구균의 임상적 의의를 판단하는데 내성 유전자의 검출이 필요하다는 것을 시사하였다.

염기서열분석을 이용한 미생물 동정의 신뢰도

성흥섭,김미나 대한감염학회 2008 Infection and Chemotherapy Vol.40 No.6

Sezary 증후군 1예

성흥섭,서을주,박찬정,지현숙,허주령,이규형 大韓血液學會 2000 大韓血液學會誌 Vol.35 No.3

T 림프구 아형 측정에서 총 T 림프구 측정의 재현성 및 CD3+CD4-CD8- 세포군의 특성

성흥섭,권수진,박찬정,지현숙 대한진단검사의학회 2002 Annals of Laboratory Medicine Vol.22 No.2

배경 : T 림프구 아형 측정시, 총 T 림프구를 CD3-fluores-cein isothiocyanate (FITC)/CD4-phycoerythrin (PE) 측정시험관과 CD3-FITC/CD8-PE 측정 시험관의 결과에서 각각 구할 수 있으므로, 두 시험관의 측정치 차이를 구하여, 총 T 림프구 측정의 재현성을 평가할 수 있다. 일부 검체에서는 T 수용체에 대한 단클론항체를 이용하여 T 림프구를 측정하여이를 CD3+CD4-CD8- T 림프구와 비교하였다. 방법 : 21개 검체에 대하여 T 림프구 아형 검사를 시행하였다. Simultest IMK-Lymphocyte kit (Becton-Dickinson, SanJose, CA, USA)를사용하여 2색상 직접면역형광염색 후 유세포분석법을 시행하였다. 두 시험관에서 얻은 총 T 림프구 백분율의차가 3% 이상인 경우 검사의 전과정을 검색하고 재분석하였다.71개 검체는 T 림프구도 동시에 측정하였다. 결과 : 두 시험관에서 얻은 총 T 림프구 백분율의 차는 정상대조군, 만성 간질환자, 암환자, 기타 질환자, 소아에서 각각3.0%, 3.6%, 3.0%, 3.4%, 2.4%이었다. 전체 221검체 중 69검체(31.2%)에서 총 T 림프구 백분율의 차가 3% 이상이었다. T 림프구는 정상 대조군, 간질환자, 암환자, 기타 질환자에서 각각 0.81%, 2.46%, 2.50% and 0.85%이었으며, CD3+CD4-CD8-T 림프구와의 상관성은 없었다.

디스크확산법에 의한 Helicobacter pylori의 Clarithromycin과 Amoxicillin 항균제감수성 검사

성흥섭,강정옥,이미애,이종욱,이혜경,이미경,임지훈,김미나,Helicobacter 연구회 대한임상미생물학회 2009 Annals of clinical microbiology Vol.12 No.1

Background: CLSI provides a guideline only for a agar dilution method of testing clarithromycin susceptibility for Helicobacter pylori. This study was to evaluate a disk diffusion method for clarithromycin and amoxicillin. Methods: One hundred and forty clinical isolates of H. pylori isolated from May 2005 to May 2007 were tested by the CLSI agar dilution method and a disk diffusion method using 2μg (2CLR) and 15μg (15CLR) clarithromycin disks and 2μg (2AMX) and 10μg (10AMX) amoxicillin disks. The interpretation criteria used for the disk diffusion method were established by linear regression and error rate-bounded method for disk diffusion zone of inhibition (DDZ) compared to MIC. Results: Resistance and intermediate rates to clarithromycin were 21.4% and 1.4%, respectively. A number of isolates with MIC 0.5, 1, and 2 (μg/mL) to amoxicillin were 7, 2, and 1, respectively. For 2CLR and 15CLR, the coefficients of determination (R2) between MIC and DDZ were 0.931 and 0.923 (P< 0.001), respectively, and the criteria for resistance/ susceptibility were 12/28 mm for 2CLR and 23/39 mm for 15CLR. For 2AMX and 10AMX, the R2 between MIC and DDZ were 0.478 and 0.421 (P< 0.001), respectively, and the criteria for resistance with breakpoint of 2μg/mL were 21 mm for 2AMX and 32 mm for 10AMX. All isolates had DDZ<60 mm with 2CLR and 2AMX, but 61.4% and 75.7% of the isolates had DDZ<60 mm with 15CLR and 10AMX, respectively. Conclusion: Excellent correlation and agreement between MIC and DDZ were found for clarithromycin and amoxicillin. With 2μg disks, the susceptibility breakpoints were 28 mm or less; thus, two disks could be tested in one plate.

LG HBsAg Confirm 시약의 성능 평가

성흥섭,유수진,오흥범,황병갑,손미진 大韓輸血學會 2001 大韓輸血學會誌 Vol.12 No.2

Rhinovirus, Human Metapneumovirus, Coronavirus 검출을 위한SeeplexTM RV Detection 키트의 평가

성흥섭,박숙자,우영대,최병후,김미나 대한진단검사의학회 2008 Annals of Laboratory Medicine Vol.28 No.2

Background : Direct antigen test (DAT) and culture are primary tests to diagnose infections by respiratory viruses, but are mainly available for the traditional viral pathogens such as respiratory syncytial virus (RSV), influenza virus, parainfluenza virus (PIV), and adenovirus in clinical laboratories. The objective of this study was to evaluate a multiplex reverse transcriptase-PCR method using SeeplexTM RV Detection kit (Seegene, Korea) for the detection of rhinovirus, coronavirus, and human metapneumovirus (hMPV). Methods : From January to May 2007, nasopharyngeal aspirates (NPAs) from pediatric patients negative for culture and DAT of traditional viral pathogens were tested with SeeplexTM. All the amplicons were directly sequenced and homology of the sequences was searched in the National Center for Biotechnology Information (NCBI) database. Patients’ medical records were reviewed for clinical and demographic features. Results : Forty-seven (26.4%) of 178 NPAs were positive: 18 rhinovirus, 15 hMPV, 4 RSV A, 3 coronavirus OC43, 3 influenza virus A, 2 adenovirus, 1 coronavirus NL63, and 1 RSV B. Based on maximum identity, each of the sequences indicating rhinovirus, hMPV, and coronavirus OC43 matched to the corresponding viruses with homology of 94-98%, 96-99%, and 98-100%, respectively. SeeplexTMpositive patients were 0-11 yr old with a male:female ratio of 1.5:1. Clinical diagnoses included 9 pneumonia, 6 bronchiolitis, 2 cold, 1 asthma exacerbation for rhinovirus; 10 pneumonia, 4 bronchiolitis, and 1 clinical sepsis for hPMV; and 1 pneumonia, 2 croup, and 1 cold for coronavirus. Conclusions : Multiplex reverse transcriptase-PCR method using SeeplexTM RV Detection kit is a reliable test to detect rhinovirus, hMPV, and coronavirus. It may improve the diagnostic sensitivity for RSV, influenza virus, PIV, and adenovirus. (Korean J Lab Med 2008;28:109-17)