• Journal of Yeungnam Medical Science
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• 제33권1호
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• pp.59-63
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• 2016

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a rare and severe drug-induced hypersensitivity syndrome characterized by hematological abnormalities and multiorgan involvement. Liver involvement is the most common visceral manifestation. However, renal failure has been rarely described. The common culprit drugs are anticonvulsants and allopurinol. We experienced a patient with DRESS syndrome with acute interstitial nephritis caused by concomitant administration of quinolone and non-steroidal anti-inflammatory drugs (NSAIDs). A 41-year-old man presented with a diffuse erythematous rash and fever which developed after administration of quinolone and NSAIDs for a month due to prostatitis. He was diagnosed with DRESS syndrome. Skin rash, fever, eosinophilia, and elevations of liver enzymes improved with conservative treatment and discontinuation of the causative drugs. However, deterioration of his renal function occurred on day 8 of admission. The levels of blood urea nitrogen and serum creatinine increased and oliguria, proteinuria and urinary eosinophils were observed. Ultrasonography showed diffuse renal enlargement. The clinical features were compatible with acute interstitial nephritis. Despite intravenous rehydration and diuretics, renal function did not improve. After hemodialysis, his renal function recovered completely within 2 weeks without administration of systemic corticosteroid.

• 한국수산과학회지
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• 제47권3호
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• pp.247-254
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• 2014

To investigate the acquisition of quinolone resistance, we examined mutations in the quinolone resistance-determining region (QRDR) of type II topoisomerase genes in ciprofloxacin (CIP)-resistant clinical isolates and in vitro mutants of Streptococcus parauberis. The CIP-resistant clinical isolates had one base change responsible for a Ser-79${\rightarrow}$Thr in the QRDR of parC. However, the CIP-resistant in vitro mutants had an altered QRDR of parC (Ser-79${\rightarrow}$Ile) that differed from that of the isolates. None of the CIP-resistant S. parauberis clinical isolates or in vitro mutants exhibited amino acid changes in gyrA or gyrB. However, even though involvement in the increased resistance was not clear, an Arg-449${\rightarrow}$Ser mutation outside of the QRDR of parE was detected in CIP-resistant mutant 2P1. These results suggest that the topoisomerase IV gene, parC (and possibly parE, as well), is the primary ciprofloxacin target in S. parauberis. Additionally we established a high-resolution melting (HRM) assay capable of detecting the dominant mutation in four type II topoisomerase genes conferring ciprofloxacin resistance. These rapid and reliable assays may provide a convenient method of surveillance for genetic mutations conferring antibiotic resistance.

• 대한화학회지
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• 제35권5호
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• pp.580-585
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• 1991

본 연구는 퀴놀론 중간체 합성을 위한 모델 연구로서 3,4-디클로로아세토페논의 C-, O-아실화의 경쟁반응에 대해 조사하였다. 3,4-디클로로아세토페논의 C-, O-아실화 비율에 대한 염기, 용매, 아실화물의 이탈기 효과에 대해 논하였으며, 이 때 아실화물로는 클로로포름산에틸, 에틸페닐탄산, 그리고 디에틸탄산을 사용하였다. 비극성 용매에서, 사용된 염기의 금속이온 크기가 작으면 작을수록 C-아실화 반응이 지배적으로 일어났다. 이탈기 영향에 있어서는 아실화물의 이탈기 능력이 감소할수록 C-아실화 생성물이 증가함을 볼 수 있었다. 또한 용매의 극성이 감소할수록 C/O-아실화 비율이 증가함을 관찰하였다.

• 디지털융복합연구
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• 제14권4호
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• pp.371-378
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• 2016

본 연구에서는 한국의 닭에서 분리된 E. coli 균주들로부터 퀴놀론계 항생제 내성을 나타내는 균주를 분리 동정하고 그 내성 기전과 유병률에 관하여 조사하였다. 또한 multilocus sequence typing (MLST)을 이용하여 E. coli 균주들의 분자생물학적 성상을 분석하였다. 항생제 감수성 테스트에서 63.5% (54/85) 의 E. coli 균주들에서 퀴놀론계 항생제 내성률을 보였다. 또한 퀴놀론계 항생제 내성을 보이는 54개 모두에서 gyrA 유전자의 sense mutations과 parC 유전자의 $57^{th}$, $80^{th}$, or $84^{th}$residues에서 점돌연변이를 관찰할 수 있었다. MLST를 통한 분석에서 E. coli ST는 parE 유전자의 염기치환과 깊은 상관관계를 보이는 것으로 관찰되었다. 이 결과들을 바탕으로 우리가 먹는 가축 및 가금류에 대한 무분별한 항생제 사용은 항생제 내성균의 증가와 유전변이를 초래함을 알 수 있었다. 따라서 식용 동물에 대한 지속적인 감시와 모니터링을 통하여 항생제 내성균의 확산방지를 통제하는 것이 필요할 것으로 사료된다.

• Biomolecules & Therapeutics
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• 제4권3호
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• pp.239-243
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• 1996

DW-116 {(1-(5-fluoro-2-pyridyl)-6-fluoro-7-(4-methyl-1-piperazinyl)-1,4-dihydro-4-oxoquinoline-3-carboxylic acid hydrochloride) is a new quinolone antibiotic with a broad antibacterial spectrum against G(+) and G(-) bacteria. DW-116 was evaluated for the appearance of micronucleus in polychromatic erythrocytes (PCEs) of mouse bone marrow cells after intraperitoneal and oral single administration. We prepared the bone marrow cells at 30hr after drug administration and they were used for measuring PCE with micronucleus. The results showed there was no statistically significant increase in the numbers of PCEs with micronucleus in all DW-116 administered groups compared with a negative control group. The results also showed that the ratio of normochromatic erythrocytes(NCEs) to PCEs of all DW-116 administered groups was not significantly different from that of a negative control group. These results suggested that DW-116 may not cause any chromosomal damage and it has no in vivo mutagenic potential under these experimental conditions.

• 약학회지
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• 제37권2호
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• pp.136-142
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• 1993

To a suspension of 1-cyclopropyl-6,8-difluoro-1,4-dihydro-7-{3,7-diazabicyclo[3.3.0]oct-1(5)-en-3-yl}-4-oxo-3-quinoline carboxylic acid(C1) in sodium hydroxide solution and water is added dropwise with stirring carbon disulfide. [6R-[6$\alpha$, 7$\beta$(Z)]]-7-[[[2-Amino-4-thiazoly)methoxyimino]-acetyl]amino]-3-[[[[7-( 3-carboxy-1-cyclopropyl-6,8-difluoro-1,4-dihydro-4-oxo-7-guinolonyl)-3,7-diazabicyclo[3.3.0]oct-1(5)-en-3-yl]thioxomethyl]thio]methyl]-8-oxo-5-thia-1-azabicyclo[4.2.0]oct-2-en-2-carboxylic acid (DACD) was synthesized from 1-cyclopropyl-6,8-difluoro-1,4-dihydro-7-[7-(mercapto) thioxomethyl-[3,7-dia zabicyclo[3.3.0]oct-1(5)-en-3-yl}]-4-oxo-3-quinoline carboxylic acid disodium salt(C2) and cefotaxime. The invitro activity of novel dual-action cephalosporin, DACD, was compared with the in vitro activities of CENO(cefotaxime 3'-norfloxacin dithiocarbamate), cefotaxime, and norfloxacin against a variety of bacterial species. In vitro activity of DACD was superior to that of norfloxacin against Streptococcus pyogenes. Against Gram-positive and Gram-negative bacteria, its activity was almost equal to that of CENO.

• 약학회지
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• 제37권6호
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• pp.638-646
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• 1993

A cepfialosporin with an aminothiazoiylmethoxyimino-type side chain at the 7 position and bicyclic quinolone dithicarbamate at the 3' position was synthesized. It has broad and potent antivacterial activity in vitro. The antibacterial spectrum reflects contributions of both the cephalosporin moiety and the quinolone moiety. Thus, this compound was named DACD implying a dualaction cephalosporin derivative. In this paper, the physicochemical proper-ties (lipid-water partition, pKa), stability and pharmacokinetics of DACD were determined and compared with cefotaxime 3'-norfloxacin dithiocarbamate (CENO). Stability tests were studied in pH 1.20, 6.80 and 8.00 buffers and in the presence of AB type human plasma, rat liver homogenate and its .betha.-lactamase. The pharmacokinetic parameters of DACD were evaluated in mice after a single intravenous dose of 40 mg/kg. The results are as follows. The lipid-water partition coefficient of DACD was higher than that of CENO. The calculated pKa values of CENO and DACD, were 6.82$\pm$0.03, 7.53$\pm$0.21, respectively. In the hydrolysis test, half-lives (t$^{1/2}$) of CENO and DACD was 66.0 hr and 80.0 hr in pH 6.80 buffer, 190 hr and 91.4 hr in pH 8.00 buffer. CENO and DACD were rapidly hydrolyzed in human plasma and in rat liver hornogenate. Half-lives (t$_{1/2}$ of CENO and DACD were 1.29 hr and 1.15 hr in hyman plasma, 0.62 hr and 0.71 hr rat liver homogenate. In $\beta$-lactamase stability test, CENO and DACD were very stable to the .betha.-lactamases obtained from three different strains. Half-life (t$_{1/2}$) and areas under the curve (AUC) in mice were 2.33 hr and 15.97 (mg.h/1), respectively.

• 한국동물위생학회지
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• 제42권1호
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• pp.17-24
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• 2019

The aim of this study was to investigate the prevalence and characterization of plasmid-mediated quinolone resistance (PMQR) gene in 79 Enterobacteriaceae isolated from dogs and cats. Of 79 isolates, PMQR genes were found in 10 (12.7%) isolates, including aac(6')-lb-cr, qnrB, qnrS and qnrA detected alone or in combination in 8 (10.1%), 4 (5.1%), 2 (2.5%) and 1 (1.3%) isolates, respectively. Interestingly, two qnrS genes were detected in nalidixic acid and ciprofloxacin susceptible isolates. Extended-spectrum ${\beta}$-lactamase (ESBL) was detected in 90% (9 isolates) of PMQR positives isolates. Among ESBL genes, CTX-M, TEM and SHV were detected in 9, 8 and 3 isolates, respectively. Almost all PMQR genes were detected in co-existence with ESBL genes. All PMQR positives isolates were multidrug resistance (i.e. resistant to five or more antibiotics). qepA, OXA and CMY-2 genes were not found. The six transconjugants were obtained by conjugation experiment. The aac(6')-lb-cr, qnrB and qnrS were co-transferred with CTX-M, TEM and/or SHV, whereas qnrA was not observed among transconugants. This is the first report of the presence of aac(6')-lb-cr and qnrA gene among Enterobacteriaceae isolates from dogs in Korea. The prudent use of antimicrobials and continuous monitoring for companion animals are required.

• 한국임상약학회지
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• 제22권1호
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• pp.55-64
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• 2012

The quinolones are broad-spectrum antibiotics and enhanced antimicrobial activity has extended the use of the quinolones beyond the traditional indications for quinolone antibiotics in the treatment of urinary tract infections. The quinolones are effective in a wider variety of infectious diseases, including skin and respiratory infections. Because of their excellent safety and tolerability, they have become popular alternatives to penicillin and cephalosporin derivatives in the treatment of various infections. A retrospective study was performed to evaluate efficacy and safety of IV quinolones for inpatient use. Total 117 patients who administerd quinolones for longer than 3 continuous days at community hospital from October 1st, 2008 to December 31st, 2008 were reviewed. The criterias for drug evaluation were included the validation of indication, outcome, dosage and side effects. In the results, ciprofloxacin 13 (total 93), levofloxacin 3 (total 59) and moxifloxacin 2 (total 19) cases were not met the criterias based on the culture results. Major indications were pneumonia (ciprofloxacin 16.3%, levofloxacin 67.8%, moxifloxacin 84.2%), urinary tract infection (ciprofloxacin 44.1%), skin infection (ciprofloxacin 7.5%, levofloxacin 20.3%, moxifloxacin 10.5%), intra-abdominal infection (ciprofloxacin 10.8%, moxifloxacin 5.3%), etc.. In the results of quinolone monotherapy, the frequencies were each ciprofloxacin 74.2%, levofloxacin 50.8% and moxifloxacin 47.4%. In the results of dosage validation, the validities were each ciprofloxacin 54.8%, levofloxacin 94.9% and moxifloxacin 100.0%. In the results of duration validation, the validities were each ciprofloxacin 59.1%, levofloxacin 78.0% and moxifloxacin 89.5%. Adverse drug reactions were reported for total 49 cases and those were gastrointestinal tract effects including nausea, vomiting, diarrhea and central nervous system effects including headache, dizziness. In summary, the quinolones appropriately used for hospitalized patients based on this study. A focused approach emphasizing "correct use of quinolones" may reduce development of antimicrobial resistance and maximize class efficacy. Consequently, correct use of antibiotics will contribute to decrease medical expenses for person and community.

• 미생물학회지
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• 제50권3호
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• pp.185-190
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• 2014

원유시료에서 분리한 대장균의 quinolone 항생제 내성비율과 그 내성 결정인자를 분석하였다. 원유시료에서 대장균을 분리하고 quinolone 항생제인 nalidixic acid와 ciprofloxacin에 대한 MIC값을 결정하였으며 내성균을 대상으로 염색체상에 있는 quinolone 내성 결정부위(quinolone resistant determining region, QRDR)인 gyrA, gyrB, parC, pareE의 염기서열 분석, 플라스미드상에 존재하는 내성유전자(plasmid mediated quinolone resistant, PMQR) qnrA, qnrB, qnrS, aac(6')-lb-cr, qepA의 분석 및 약물 유출펌프 유전자인 acrB의 발현을 비교 분석하였다. 그 결과 총 487개의 대장균군 세균중 9개의 균이 nalidixic acid에 내성임을 확인하였으며($MIC{\geq}64{\mu}g/ml$) 이중 6개 균주가 ciprofloxacin에도 내성임을 확인하였다(MIC $4-16{\mu}g/ml$)). 9개의 내성 균주 모두 QRDR의 gyrA 영역 codon 83에 변이(S83L)를 갖고 있었으며 그 중 2균주는 codon 83과 87 (S83L and D87N)에 이중 돌연변이를 갖고 있었다. 한편 9균주 중 3개의 균주에서 parC 영역 codon 80 (S80I)에 변이를 갖고 있었다. 플라스미드 상에 존재하는 내성유전자인 qnrA, qnrB, qnrS, aac(6')-lb-cr 및 qepA 유전자는 존재하지 않았으며 AcrAB-TolC efflux pump 유전자인 acrB 유전자가 대조균인 E. coli ATCC 25922와 비교하여 ciprofloxacin 내성 균주 6균주 중 4균주에서 유의적으로 과발현(2.15-5.74배) 되고 있음을 확인하였다.