The efficacy was similar to a previous Phase III trial and a safety profile of sunitinib was manageable in Korean patients with advanced renal cell carcinoma, although the incidence of dose reduction and Grade 3 or 4 adverse events were higher than those of western reports. Future studies should investigate the ethnic differences in toxicity profiles of sunitinib.

Of 522 patients with Propionibacterium acnes bacteremia (PAB), 18 (3.5%) had clinically significant PAB. Of these 18 patients, 10 (55.6%) had hospital-acquired bacteremia and 6 (33.3%) had undergone invasive procedures before development of PAB. One patient with a ventricular septal defect presented with infective endocarditis. After the exclusion of 1 patient whose outcome was not available, the overall mortality rate was 5.9% (1/17).Propionibacterium acnes is a microaerophilic, anaerobic, Gram-positive bacillus, and one end product of bacterial fermentation is propionic acid. The organism is a member of the normal flora of the oral cavity, large intestine, conjunctiva, and skin in humans (4). In some patients, however, P. acnes can cause severe infections, including endocarditis, intravascular infections (6, 7), central nervous system infections (11), endophthalmitis (13), and, rarely, arthritis (12, 16).Identification of P. acnes as a pathogen is difficult because anaerobic conditions and a long incubation time are required for its culture. Moreover, P. acnes is usually considered a contaminant of blood cultures (5). The exact frequency and characteristics of clinically significant P. acnes bacteremia (PAB) have not been well known. We therefore evaluated the clinical significance and characteristics of P. acnes recovered from blood cultures in a tertiary care hospital.The medical records of all patients, including 151 pediatric patients (less than 16 years old), who gave blood samples of which one or more were positive for P. acnes on culture, between January 1997 and August 2009, at the Asan Medical Center (a 2,700-bed tertiary affiliated hospital in Seoul, Republic of Korea) were reviewed. Recommendations for blood culture practices during the study period were as follows: (i) 3 sets of blood cultures, (ii) sampling from separate venipuncture sites (if a patient had a central venous catheter, 1 set from the central venous catheter), and (iii) 20 ml of blood sampled for each culture set with 10 ml inoculated into 1 aerobic bottle and 10 ml inoculated into 1 anaerobic bottle. One percent chlorhexidine in 70% isopropyl alcohol or 10% povadine (povidone-iodine) was used for skin disinfection, as 2% chlorhexidine is not yet available in Korea. The overall blood culture contamination rate of our hospital has been sustained at less than 1% (unpublished data). All blood cultures were processed by the hospital microbiology laboratory using a standard blood culture system (Bactec 730 or Bactec 9240; Becton Dickinson, Sparks, MD). Clinical isolates were identified using MicroScan (Dade Behring, West Sacramento, CA) or Vitek 2 (bioMérieux, Marcy l'Etoile, France). Antibiotic susceptibility tests were not routinely performed. Antibiotic susceptibilities were assessed only when a physician requested the antibiotic susceptibility information.P. acnes blood isolates were considered significant if two or more separate blood culture sets were positive on the same day and if systemic inflammatory response syndrome (SIRS) was...