Shift from Streptococcus pneumoniae to Klebsiella pneumoniae: a 15-year nationwide study of bacterial meningitis in Korea Min Seo Kang, Seung Hoo Lee, Sook-In Jung, Ahrang Lee, Jeong Rae Yoo, Sang Taek Heo, Chisook Moon, Shin-Woo Kim, Bomi Kim, A Reum Kim, Jongtak Jung, Cheon Hoo Jun, Ji Yeon Lee, Misuk Lee, Ki Tae Kwon, Seung Ji Kang, Soo-youn Moon, So Yeon Park, Seung Soon Lee, Jungok Kim, Doo Ryeon Chung International Journal of Infectious Diseases, 2025 BACKGROUND: Bacterial meningitis is a medical emergency with high mortality and neurologic sequelae. Its epidemiology is changing with vaccination and evolving pathogens. We investigated current etiologic patterns of adult community-acquired bacterial meningitis in Korea and outcome determinants. METHODS: In this 15-year (2009-2023) retrospective study of 17 hospitals, 247 cases were analyzed for causative organisms, and 224 for 30-day outcomes. Risk factors for mortality and neurologic sequelae were determined. RESULTS: Streptococcus pneumoniae declined from 36.4% in 2009-2013 to 19.4% in 2019-2023 (P = 0.060). Meanwhile, Klebsiella pneumoniae increased significantly (6.8% to 29.2%; P = 0.001), becoming the most common cause. K. pneumoniae meningitis showed a tendency toward higher attributable mortality (35.7%) at 30 days compared to S. pneumoniae (19.7%). Independent predictors of 30-day mortality were older age, seizure at presentation, and septic shock, whereas hypertension was associated with a lower mortality risk. Neurologic sequelae occurred in 29% and were associated with pre-existing cerebrovascular disease, headache, and stuporous consciousness. CONCLUSIONS: Over 15 years in Korea, the declining incidence of S. pneumoniae meningitis coincided with widespread pneumococcal vaccination, while K. pneumoniae has become the leading cause. Given its association with poor outcomes, K. pneumoniae meningitis requires increased awareness.
The role of infectious disease consultations in the management of patients with fever in a long-term care facility Soo-youn Moon, Kyoung Ree Lim, Jun Seong Son Plos One, 2023 Background Infectious disease (ID) clinicians can provide essential services for febrile patients in tertiary hospitals. The aim of this study was to evaluate the role of ID consultations (IDC) in managing hospitalized patients with infections in an oriental medical hospital (OMH), which serves as a long-term care facility. To our knowledge, this is the first study on the role of IDCs in managing patients in an OMH. Methods This retrospective study was conducted in an OMH in Seoul, Korea, from June 2006 to June 2013. Results Among the 465 cases of hospital-acquired fever, 141 (30.3%) were referred for ID. The most common cause of fever was infection in both groups. The peak body temperature of the patient was higher in IDC group (38.8±0.6°C vs. 38.6±0.5°C, p<0.001). Crude mortality at 30 days (14.6% vs. 7.8%, p = 0.043) and infection-attributable mortality (15.3% vs. 6.7%, p = 0.039) were higher in the No-IDC group. Multivariable analysis showed that infection as the focus of fever (adjusted Odd ratio [aOR] 3.49, 95% confidence interval (CI) 1.64–7.44), underlying cancer (aOR 10.32, 95% CI 4.34–24.51,), and multiorgan dysfunction syndrome (aOR 15.68, 95% CI 2.06–119.08) were associated with increased 30-day mortality. Multivariate analysis showed that in patients with infectious fever, appropriate antibiotic therapy (aOR 0.19, 95% CI 0.05–0.76) was the only factor associated with decreased infection-attributable mortality while underlying cancer (aOR 7.80, 95% CI 2.555–23.807) and severe sepsis or septic shock at the onset of fever (aOR 10.15, 95% CI 1.00–102.85) were associated with increased infection-attributable mortality. Conclusion Infection was the most common cause of fever in patients hospitalized for OMH. Infection as the focus of fever, underlying cancer, and MODS was associated with increased 30-day mortality in patients with nosocomial fever. Appropriate antibiotic therapy was associated with decreased infection-attributable mortality in patients with infectious fever.
The First Case of Infectious Spondylitis Caused by Gemella bergeri Kyoung Ree Lim, Jun Seong Son, Soo-youn Moon Medicina Lithuania, 2023 Gemella bergeri, a member of the genus Gemella, is a facultatively anaerobic, Gram-positive cocci. G. bergeri is a component of normal oral flora; however, it can become pathogenic and cause infections in patients with poor oral hygiene. A 78-year-old man was admitted to a hospital with a complaint of increasing posterior neck pain and lower back pain for 2 weeks. MRI was suggestive of infectious spondylitis at the C3-C4 level with prevertebral abscess formation, anterior epidural abscess formation. We identified Gemella bergeri in closed pus obtained during the surgery. Herein, we describe the first case of infective spondylitis caused by G. bergeri.
Case report of infectious spondylitis caused by kytococcus sedentarius Kyoung Ree Lim, Jun Seong Son, Soo-youn Moon Medicina Lithuania, 2021 Background: Kytococcus species has not been considered a pathogen, but infections caused by this species are increasing. There are several cases of infections caused by Kytococcus sedentarius, but no case of infectious spondylitis has been reported yet. Case presentation: A 79-year-old female patient was hospitalized because of back pain for several months. She was diagnosed with infectious spondylitis, and K. sedentarius was cultured from the pus and specimen obtained during the surgical procedure. The patient recovered completely without recurrence after 6 months of treatment with ciprofloxacin alone for 8 weeks. Conclusion: This is the first case report of infectious spondylitis caused by K. sedentarius.
Understanding viral infection mechanisms and patient symptoms for the development of covid-19 therapeutics Hyung Muk Choi, Soo Youn Moon, Hyung In Yang, Kyoung Soo Kim International Journal of Molecular Sciences, 2021 Coronavirus disease 2019 (COVID-19), caused by the SARS-CoV-2 virus, has become a worldwide pandemic. Symptoms range from mild fever to cough, fatigue, severe pneumonia, acute respiratory distress syndrome (ARDS), and organ failure, with a mortality rate of 2.2%. However, there are no licensed drugs or definitive treatment strategies for patients with severe COVID-19. Only antiviral or anti-inflammatory drugs are used as symptomatic treatments based on clinician experience. Basic medical researchers are also trying to develop COVID-19 therapeutics. However, there is limited systematic information about the pathogenesis of COVID-19 symptoms that cause tissue damage or death and the mechanisms by which the virus infects and replicates in cells. Here, we introduce recent knowledge of time course changes in viral titers, delayed virus clearance, and persistent systemic inflammation in patients with severe COVID-19. Based on the concept of drug reposition, we review which antiviral or anti-inflammatory drugs can effectively treat COVID-19 patients based on progressive symptoms and the mechanisms inhibiting virus infection and replication.
Clinical effectiveness of carbapenems versus alternative antibiotics for treating ESBL-producing Enterobacteriaceae bacteraemia: A systematic review and meta-analysis Soo Kyung Son, Na Rae Lee, Jae-Hoon Ko, Jae Ki Choi, Soo-Youn Moon, Eun Jeong Joo, Kyong Ran Peck, Dong Ah Park Journal of Antimicrobial Chemotherapy, 2018 Objectives The widespread administration of carbapenems to patients with ESBL-producing Enterobacteriaceae bacteraemia (ESBL-B) has accelerated the emergence of carbapenem-resistant Enterobacteriaceae. This study aimed to systematically review recently published data to evaluate the clinical effectiveness of carbapenems, compared with other antibiotics, in the treatment of ESBL-B. Methods We searched the Ovid-Medline, Ovid-Embase, Cochrane Library and five Korean local databases until January 2016. We selected studies that reported overall mortality in patients with ESBL-B who had been treated with carbapenems and alternatives. Overall mortality was assessed as the primary outcome and sepsis-related mortality and adverse events were analysed as secondary outcomes. Results Thirty-five publications fulfilled the inclusion criteria. Regarding empirical therapy, there were no significant differences between the groups that received carbapenems and those that received non-carbapenems in relation to overall mortality. Regarding definitive therapy, overall mortality was lower for patients administered carbapenems compared with those administered non-carbapenems [risk ratio (RR) 0.78, 95% CI 0.61-0.98], non-β-lactam/β-lactamase inhibitor combinations (non-BL/BLI) (RR 0.71, 95% CI 0.56-0.90) and cephalosporins (RR 0.56, 95% CI 0.42-0.74). There were no differences between the carbapenems and the other antibiotics, namely BL/BLIs, quinolones and aminoglycosides. Conclusions This meta-analysis showed that BL/BLIs may be promising alternative antibiotics for definitive therapy in patients with ESBL-B. However, the lack of robust data derived from randomized controlled trials limits the conclusions and inferences from the pooled data.
Hospital-acquired fever in oriental medical hospitals Soo-youn Moon, Ki-Ho Park, Mi Suk Lee, Jun Seong Son BMC Health Services Research, 2018 Traditional Oriental medicine is used in many Asian countries and involves herbal medicines, acupuncture, moxibustion, and cupping. We investigated the incidence and causes of hospital-acquired fever (HAF) and the characteristics of febrile inpatients in Oriental medical hospitals (OMHs). Patients hospitalized in two OMHs of a university medical institute in Seoul, Korea, were retrospectively reviewed from 2006 to 2013. Adult patients with HAF were enrolled. There were 560 cases of HAF (5.0%). Infection, non-infection, and unknown cause were noted in 331 cases (59.1%), 109 cases (19.5%), and 120 cases (21.4%) of HAF, respectively. Respiratory tract infection was the most common cause (51.2%) of infectious fever, followed by urinary tract infection. Drug fever due to herbal medicine was the most common cause of non-infectious fever (53.1%), followed by procedure-related fever caused by oriental medical procedures. The infection group had higher white blood cell count (WBC) (10,400/mm3 vs. 7000/mm3, p < 0.001) and more frequent history of antibiotic therapy (29.6% vs. 15.1%, p < 0.001). Multivariate analysis showed that older age (odds ratio (OR) 1.67, 95% confidence interval (C.I.) 1.08–2.56, p = 0.020), history of antibiotic therapy (OR 3.17, C.I. 1.85–5.41, p < 0.001), and WBC > 10,000/mm3 (OR 2.22, C.I. 1.85–3.32, p < 0.001) were associated with infection. Compared to previous studies on HAF in Western medicine, the incidence of HAF in OMHs was not high. However, Oriental medical treatment does play some role in HAF. Fever in patients with history of antibiotic therapy, or high WBC was more likely of infectious origin.
Anti-anaerobic coverage is not necessary for klebsiella pneumoniae liver abscess: A propensity score-matched cohort study Hyun Ah Kim, Doo Ryeon Chung, Joon-Sup Yeom, Hyun Kyun Ki, Hae Suk Cheong, Jun Seong Son, Jin Seo Lee, Soo-youn Moon, Seung Soon Lee, Jeong-A Lee, Kyung-Hwa Park, Seung-Ji Kang, Sook-In Jung, Shin-Woo Kim, Hyun Ha Chang, Seong Yeol Ryu, Ki Tae Kwon, Chisook Moon, Yu Mi Wi, Sang Taek Heo, Mi Kyong Joung, Cheol-In Kang, Kyong Ran Peck, Jae-Hoon Song Diagnostic Microbiology and Infectious Disease, 2015
Nasal deformity due to tuberculous chondritis Soo-youn Moon, Jeong-a Lee, Mi Kyong Joung, Doo Ryeon Chung, Jae-Hoon Song, Kyong Ran Peck Clinical and Experimental Otorhinolaryngology, 2014
Changing etiology of community-acquired bacterial meningitis in adults: A nationwide multicenter study in Korea S.-Y. Moon, D. R. Chung, S.-W. Kim, H. H. Chang, H. Lee, D. S. Jung, Y.-S. Kim, S. I. Jung, S. Y. Ryu, S. T. Heo, C. Moon, H. K. Ki, J. S. Son, K. T. Kwon, S. Y. Shin, J. S. Lee, S. S. Lee, J.-Y. Rhee, J.-A. Lee, M. K. Joung, H. S. Cheong, K. R. Peck, J.-H. Song European Journal of Clinical Microbiology and Infectious Diseases, 2010
Adenocarcinoma surrounding emphysema mimicking cavitary pneumonia Soo-Young Moon, Jee-Hong Yoo, Kyung-Yup Kim, Hye Sook Choi, Cheon Woong Choi, Myung Jae Park, Hong Mo Kang, Young Tae Kwak, Dae Hyun Kim, Gou Young Kim Tuberculosis and Respiratory Diseases, 2007
RECENT SCHOLAR PUBLICATIONS
Shift from Streptococcus pneumoniae to Klebsiella pneumoniae: a 15-year nationwide study of bacterial meningitis in Korea MS Kang, SH Lee, SI Jung, A Lee, JR Yoo, ST Heo, C Moon, SW Kim, ... International Journal of Infectious Diseases, 108114 , 2025 2025 Citations: 1
Clinical characteristics of native vertebral osteomyelitis in patients with history of acupuncture KR Lim, S Moon, JS Son Journal of Infection and Chemotherapy 29 (12), 1114-1118 , 2023 2023 Citations: 1
The role of infectious disease consultations in the management of patients with fever in a long-term care facility S Moon, KR Lim, JS Son PLoS One 18 (9), e0291421 , 2023 2023 Citations: 1
The First Case of Infectious Spondylitis Caused by Gemella bergeri KR Lim, JS Son, S Moon Medicina 59 (1), 145 , 2023 2023 Citations: 3
Clinical Characteristics and Epidemiology of Native Vertebral Osteomyelitis Patients With or Without Acupuncture History. KR Lim, S Moon, JS Son Infection & Chemotherapy 54 , 2022 2022
A case of Slackia exigua bacteremia associated with pyometra in a patient with poor dentition KR Lim, JS Son, S Moon Anaerobe 73, 102477 , 2022 2022 Citations: 5
Case Report of Infectious Spondylitis Caused by Kytococcus sedentarius KR Lim, JS Son, S Moon Medicina 57 (8), 797 , 2021 2021 Citations: 4
Understanding viral infection mechanisms and patient symptoms for the development of COVID-19 therapeutics HM Choi, SY Moon, HI Yang, KS Kim International Journal of Molecular Sciences 22 (4), 1737 , 2021 2021 Citations: 38
한방치료의 안전성: 한약에 의한 약열과 시술관련 발열 문수연, 임경리, 손준성 The Journal of Internal Korean Medicine 42 (6), 1237-1244 , 2021 2021
Eggerthella Lenta Bacteremia after Appendectomy in a Healthy Patient S Jeong, HY Park, IT Hong, JB Kang, SY Moon, KH Park, MS Lee, JS Son The Korean Journal of Medicine 94 (6), 530-532 , 2019 2019
Clinical effectiveness of carbapenems versus alternative antibiotics for treating ESBL-producing Enterobacteriaceae bacteraemia: a systematic review and meta-analysis SK Son, NR Lee, JH Ko, JK Choi, SY Moon, EJ Joo, KR Peck, DA Park Journal of Antimicrobial Chemotherapy 73 (10), 2631-2642 , 2018 2018 Citations: 73
Hospital-acquired fever in oriental medical hospitals S Moon, KH Park, MS Lee, JS Son BMC health services research 18 (1), 88 , 2018 2018 Citations: 9
Appropriate non-carbapenems are not inferior to carbapenems as initial empirical therapy for bacteremia caused by extended-spectrum beta-lactamase-producing Enterobacteriaceae … JH Ko, NR Lee, EJ Joo, SY Moon, JK Choi, DA Park, KR Peck European journal of clinical microbiology & infectious diseases 37 (2), 305-311 , 2018 2018 Citations: 40
Impact of appropriateness of empiric therapy on outcomes in community-onset bacteremia by extended-spectrum-β-lactamase producing Escherichia coli and Klebisella pneumoniae … EJ Joo, DA Park, NR Lee, S Moon, JK Choi, JH Ko, KR Peck European Journal of Clinical Microbiology & Infectious Diseases 36 (11 … , 2017 2017 Citations: 20
Otomastoiditis caused by Candida auris : Case report and literature review HI Choi, J An, JJ Hwang, S Moon, JS Son Mycoses 60 (8), 488-492 , 2017 2017 Citations: 62
Infectivity of an asymptomatic patient with Middle East respiratory syndrome coronavirus infection S Moon, JS Son Clinical Infectious Diseases 64 (10), 1457-1458 , 2017 2017 Citations: 37
Predictive risk factors for Listeria monocytogenes meningitis compared to pneumococcal meningitis: a multicenter case–control study S Lim, DR Chung, YS Kim, KM Sohn, SJ Kang, SI Jung, SW Kim, ... Infection 45 (1), 67-74 , 2017 2017 Citations: 41
Middle East respiratory syndrome coronavirus transmission in dialysis unit and infection control interventions in Korea S Moon, JS Son, YH Lee, YT Kwak, HY Chung, HL Lee, WI Lee, SH Lee, ... Infection Control & Hospital Epidemiology 37 (12), 1514-1516 , 2016 2016 Citations: 8
Septicemia caused by Neisseria meningitidis with decreased ciprofloxacin susceptibility: the first case report in Korea JY Ahn, JK Min, MH Kim, S Moon, KH Park, MS Lee, JS Son Annals of Laboratory Medicine 36 (3), 275 , 2016 2016 Citations: 4
Comparison of the microbiological characteristics and virulence factors of ST131 and non-ST131 clones among extended-spectrum β-lactamase–producing Escherichia coli causing … MK Cha, CI Kang, SH Kim, SY Cho, YE Ha, YM Wi, DR Chung, KR Peck, ... Diagnostic Microbiology and Infectious Disease 84 (2), 102-104 , 2016 2016 Citations: 25
MOST CITED SCHOLAR PUBLICATIONS
Clinical significance and outcome of nosocomial acquisition of spontaneous bacterial peritonitis in patients with liver cirrhosis KR Peck, HS Cheong, CI Kang, JA Lee, SY Moon, MK Joung, DR Chung, ... Clinical Infectious Diseases 48 (9), 1230-1236 , 2009 2009 Citations: 254
Impact of de-escalation therapy on clinical outcomes for intensive care unit-acquired pneumonia KM Joung, J Lee, S Moon, HS Cheong, EJ Joo, YE Ha, KM Sohn, ... Critical Care 15 (2), R79 , 2011 2011 Citations: 142
Risk factors for treatment failure in patients with prosthetic joint infections J Lee, CI Kang, JH Lee, M Joung, S Moon, YM Wi, DR Chung, CW Ha, ... Journal of Hospital Infection 75 (4), 273-276 , 2010 2010 Citations: 100
Clinical effectiveness of carbapenems versus alternative antibiotics for treating ESBL-producing Enterobacteriaceae bacteraemia: a systematic review and meta-analysis SK Son, NR Lee, JH Ko, JK Choi, SY Moon, EJ Joo, KR Peck, DA Park Journal of Antimicrobial Chemotherapy 73 (10), 2631-2642 , 2018 2018 Citations: 73
Clinical features and treatment outcomes of infections caused by Sphingomonas paucimobilis HS Cheong, YM Wi, SY Moon, CI Kang, JS Son, KS Ko, DR Chung, ... Infection Control & Hospital Epidemiology 29 (10), 990-992 , 2008 2008 Citations: 71
Changing etiology of community-acquired bacterial meningitis in adults: a nationwide multicenter study in Korea SY Moon, DR Chung, SW Kim, HH Chang, H Lee, DS Jung, YS Kim, ... European journal of clinical microbiology & infectious diseases 29 (7), 793-800 , 2010 2010 Citations: 65
Impact of inappropriate antimicrobial therapy on outcome in patients with hospital-acquired pneumonia caused by Acinetobacter baumannii MK Joung, KT Kwon, CI Kang, HS Cheong, J Rhee, DS Jung, SM Chung, ... Journal of Infection 61 (3), 212-218 , 2010 2010 Citations: 63
Otomastoiditis caused by Candida auris : Case report and literature review HI Choi, J An, JJ Hwang, S Moon, JS Son Mycoses 60 (8), 488-492 , 2017 2017 Citations: 62
Catheter-related candidemia caused by Candida haemulonii in a patient in long-term hospital care S Kim, KS Ko, SY Moon, MS Lee, MY Lee, JS Son Journal of Korean Medical Science 26 (2), 297-300 , 2011 2011 Citations: 53
Septic Shock due to Vibrio alginolyticus in a Cirrhotic Patient: The First Case in Korea DY Lee, SY Moon, SO Lee, HY Yang, HJ Lee, MS Lee Yonsei medical journal 49 (2), 329-332 , 2008 2008 Citations: 48
Clinical and economic consequences of failure of initial antibiotic therapy for patients with community-onset complicated intra-abdominal infections YP Chong, IG Bae, SR Lee, JW Chung, JB Jun, EJ Choo, S Moon, ... PloS one 10 (4), e0119956 , 2015 2015 Citations: 47
Continuous increase of the antimicrobial resistance among gram-negative pathogens causing bacteremia: a nationwide surveillance study by the Korean Network for Study on … K Huh, J Kim, SY Cho, YE Ha, EJ Joo, CI Kang, DR Chung, NY Lee, ... Diagnostic Microbiology and Infectious Disease 76 (4), 477-482 , 2013 2013 Citations: 47
Predictive risk factors for Listeria monocytogenes meningitis compared to pneumococcal meningitis: a multicenter case–control study S Lim, DR Chung, YS Kim, KM Sohn, SJ Kang, SI Jung, SW Kim, ... Infection 45 (1), 67-74 , 2017 2017 Citations: 41
Appropriate non-carbapenems are not inferior to carbapenems as initial empirical therapy for bacteremia caused by extended-spectrum beta-lactamase-producing Enterobacteriaceae … JH Ko, NR Lee, EJ Joo, SY Moon, JK Choi, DA Park, KR Peck European journal of clinical microbiology & infectious diseases 37 (2), 305-311 , 2018 2018 Citations: 40
Understanding viral infection mechanisms and patient symptoms for the development of COVID-19 therapeutics HM Choi, SY Moon, HI Yang, KS Kim International Journal of Molecular Sciences 22 (4), 1737 , 2021 2021 Citations: 38
Infectivity of an asymptomatic patient with Middle East respiratory syndrome coronavirus infection S Moon, JS Son Clinical Infectious Diseases 64 (10), 1457-1458 , 2017 2017 Citations: 37
Disseminated gonococcal infection presenting as bacteremia and liver abscesses in a healthy adult MH Lee, J Byun, M Jung, JJ Yang, KH Park, S Moon, HJ Lee, MS Lee Infection & Chemotherapy 47 (1), 60-63 , 2015 2015 Citations: 37
Clinical Experience of Tigecycline Treatment in Infections Caused by Extensively Drug-Resistant Acinetobacter spp. SY Moon, KR Peck, HH Chang, SW Kim, ST Heo, JS Son, SY Ryu, ... Microbial Drug Resistance 18 (6), 562-566 , 2012 2012 Citations: 32
Comparison of the microbiological characteristics and virulence factors of ST131 and non-ST131 clones among extended-spectrum β-lactamase–producing Escherichia coli causing … MK Cha, CI Kang, SH Kim, SY Cho, YE Ha, YM Wi, DR Chung, KR Peck, ... Diagnostic Microbiology and Infectious Disease 84 (2), 102-104 , 2016 2016 Citations: 25
Fatal necrotizing fasciitis due to Streptococcus pneumoniae: a case report SY Park, SY Park, S Moon, JS Son, MS Lee J Korean Med Sci 26 (1), 131-134 , 2011 2011 Citations: 22