• Title/Summary/Keyword: 항생제 치료

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Draft genome sequence of lytic bacteriophage KP1 infecting bacterial pathogen Klebsiella pneumoniae (병원균 Klebsiella pneumoniae를 감염시키는 용균 박테리오파지 KP1의 유전체 염기서열 초안)

  • Kim, Youngju;Bang, Ina;Yeon, Young Eun;Park, Joon Young;Han, Beom Ku;Kim, Hyunil;Kim, Donghyuk
    • Korean Journal of Microbiology
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    • v.54 no.2
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    • pp.152-154
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    • 2018
  • Klebsiella pneumoniae is a Gram-negative, rod-shape bacterium causing disease in human and animal lungs. K. pneumoniae has been often found to gain antimicrobial resistance, thus it has been difficult to treat K. pneumoniae infection with antibiotics. For such infection, bacteriophage can provide an alternative approach for pathogenic bacterial infection with antimicrobial resistance, because of its sensitivity and specificity to the host bacteria. Bacteriophage KP1 was isolated in sewage and showed specific infectivity to K. pneumoniae. Here, we report the draft genome sequence of Klebsiella pneumoniae phage KP1. The draft genome of KP1 is 167,989 bp long, and the G + C content is 39.6%. The genome has 295 predicted ORFs and 14 tRNA genes. In addition, it encodes various enzymes which involve in lysis of the host cell such as lysozyme and holin.

Fever Duration and Renal Scar in Pediatric Urinary Tract Infection (소아 요로감염에서 발열과 신반흔의 관계)

  • Jung, Ji-In;Lim, Dong-Hee;Yim, Hyung-Eun;Park, Man-Sik;Yoo, Kee-Hwan;Hong, Young-Sook;Lee, Joo-Won
    • Childhood Kidney Diseases
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    • v.12 no.1
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    • pp.70-77
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    • 2008
  • Purpose: Urinary tract infections(UTIs) are not uncommon findings in febrile pediatric patients and approximately one third of patients with UTI may have renal scars. This research was intended to establish the relationship between duration of fever and renal scars. Methods: The medical records of 143 patients were reviewed retrospectively. Inclusion criteria were as follows: 1) fever as defined by an axillary temperature $\geq37.5^{\circ}C$, 2) accurate history of fever duration and the use of antibiotics 3) no previous history of UTI and 4) positive urine culture. We observed whether the longer fever duration could be associated with the development of initial renal defects and subsequent renal scars, increased C-reactive protein(CRP), leukocytosis and the presence of vesicoureteral reflux(VUR). Results: 1) Patients with longer fever duration after antibiotics showed more frequent initial renal defects(P=0.014). However, fever duration before antibiotic use was not associated with the development of initial renal defects(P=0.244). 2) Incidence of renal scar increased with fever duration before antibiotic use(P=0.006) and fever duration after antibiotic use(P=0.015). 3) CRP correlated with the fever duration after antibiotic use(r=0.287, P=0.003). 4) There was no relationships between fever duration and VUR(P>0.05). Conclusion: Our data suggest that fever duration before/after antibiotic use is significantly associated with the increased development of renal scars in pediatric UTI.

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Clinical Results of Arthroscopic Treatment for Infection after Total Knee Arthroplasty (슬관절 전치환술 후 발생한 감염에 시행한 관절경적 치료의 임상 결과)

  • Kim, Kyung Tae;Lee, Song;Kim, Jee Hyoung;Kim, Dae Geun;Shin, Won Shik
    • Journal of the Korean Arthroscopy Society
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    • v.17 no.1
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    • pp.38-43
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    • 2013
  • Purpose: To evaluate the efficiency of arthroscopic treatment for infected total knee arthroplasty (TKA), and to investigate the factors affecting the outcomes. Materials and Methods: We analyzed 17 cases which underwent arthroscopic treatment to treat infection after TKA. After confirming infection by hematologic examination and analysis of joint fluid, we performed arthroscopic debridement, synovectomy and irrigation with normal saline mixed with antibiotics. Through routine examination after operation, we checked failure of treatment or recurrence of infection. If there is no recurrence until 2 years after the operation, we considered it as a success of treatment. Results: Of the 17 cases taken arthroscopic treatment, 13 cases were treated successfully with primary arthroscopic treatment only, but 4 cases had to undergo re-operation because of persistence or recurrence of infection. Analyzing the factors affecting the results, we found that symptom duration of the re-operation group is longer than the treated group after arthroscopy (p<0.05). Conclusion: Arthroscopic treatment can be effective when we performed appropriate selection of patients, careful and extensive arthroscopic irrigation and debridement, and suitable use of antibiotics. However, we have to do early arthroscopic surgery as soon as possible when infection after TKA is suspected.

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RETROPHARYNGEAL AND MEDIASTINAL ABSCESS SECONDARY TO ODONTOGENIC INFECTIONS : REPORT OF THREE CASES (치성감염에 의해 발생된 후측인두부 및 종격동 농양)

  • Park, Mun-Seong;Kim, Chang-Lyong;Lee, Seung-Ho;Jung, Joo-Sung;Jeong, Jong-Cheol;Kim, Keon-Jung;Ryu, Sun-Youl
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.4
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    • pp.626-635
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    • 1996
  • Odontogenic infections are usually locally confined, self-limiting processes. However, under certain circumstances, they may break through the bony, muscular, and mucosal barriers and spread into contiguous fascial spaces or planes far from the initial site of involvement, resulting in severe life-threatening complications, such as retropharyngeal spread, suppurative mediastinal extension, airway obstruction, pleuropulmonary suppuration, and hematogenous dissemination to distant organs. The mortality arte for mediastinitis from odontogenic infection ranges from 40% to 60%. Therefore rapid evalution and treatment is essential with a combination of life support, antibiotic therapy, and surgical intervention. Recently, we experienced three cases of retropharyngeal and mediastinal abscesses secondary to odonogenic infections. In all patients, early diagnosis was possible by CT scanning and physical examination. The prognosis was good in all patients by using urgent aggressive surgical and antibiotic therapy.

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Recurrent Brain Abscess In Chronic Sinusitis : A Case Report (만성부비동염을 가진 환자에서 재발된 뇌농양 : 증례보고)

  • Yi, SangHak;Hwang, Yong;Lee, Hak Seung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.6
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    • pp.275-279
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    • 2018
  • A brain abscess is caused by an infection in the central nervous system and leads to significant neurological sequelae. Despite advances in neurocritical care, high morbidity and mortality rates are still associated with brain abscess, especially in certain high-risk patients. Thus, a brain abscess is a medical emergency requiring prompt diagnosis and treatment with antibacterial therapy. However, the recurrence of brain abscess is rare. A 59-year-old man presented at our neurology clinic with a headache and was found to have chronic otitis media. Serial brain magnetic resonance imaging (MRI) scans of the patient demonstrated a brain abscess in the right frontal lobe. Following stereotactic aspiration of the brain abscess and proper antimicrobial treatment, the patient recovered completely. Five months after discharge, the patient revisited our clinic with a headache and seizure symptoms, and recurrence of the brain abscess was confirmed by brain MRI. Recurrent brain abscess has been documented in patients with predisposing conditions such as retained foreign bodies, chronic sinusitis, arteriovenous fistula, and right-to-left shunt.

Therapeutic strategies to manage chronic wounds by using biofilm dispersal mechanisms (생물막 분산기작을 이용한 만성창상의 치료전략)

  • Kim, Jaisoo;Kim, Min-Ho
    • Korean Journal of Microbiology
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    • v.55 no.2
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    • pp.87-102
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    • 2019
  • Most chronic wounds persist in the inflammatory phase during wound healing due to the biofilm. Biofilms are resistant to antibiotics, weakening penetration, resistance to biocides and weakening local immune responses. The biofilm is firmly attached to the surrounding tissues and is very difficult to remove. Therefore, strategies to remove hard biofilms without damaging surrounding tissue are very important. One of possible strategies is dispersal. So many studies have been done to develop new strategies using dispersal mechanisms. In this review paper, especially chemotaxis, phage therapy, polysaccharides, various enzymes (glycosidases, proteases, and deoxyribonucleases), surfactants, dispersion signals, autoinducers, inhibitors were introduced. Combination therapies with other therapies such as antibiotic therapy were also introduced. It is expected that the possibility of treatment of chronic wound infection using the knowledge of the biofilm dispersal mechanisms presented in this paper will be higher.

Etiologies of Bacterial Pneumonia with Implications for Therapy (세균성 폐렴의 원인균과 그 치료)

  • Woo, Jun-Hee;Lee, Jae-Seok;Kwon, Kwang-Ho;Kim, Kyung-Ho;Choi, Chang-Hyun;Park, Choon-Sik;Lee, Wee-Gyo;Choi, Tae-Youn
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.1
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    • pp.67-75
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    • 1995
  • Background: Although we gain new knowledge, the problem of pneumonia will not be eliminated. We should understand who is at risk, why these people develop this problem, what causes the pneumonia, and how to manage and prevent respiratory infection. To clarify the alterations of the etiologies of bacterial pneumonia we analysed the recent causative organisms and evaluated the therapeutic implications. Methods: A retrospective four-year study of bacterial pneumonia was conducted in Soon Chun Hyang University Hospital. 190 episodes of bacterial pneumonia was investigated. Results: 1) The causative organisms were isolated in 173 cases on the sputum culture: 154 cases (89%) were gram negative bacilli and 19 cases(11%) were gram positive cocci. The major organisms were Pseudomonas species 49 cases(28%), Klebsiella pneumoniae 29 cases(17%), Enterobacter species 25 cases(14%), and Acinetobacter species 20 cases(12%) in decreasing order. Pseudomonas species(13 cases, 34%) were frequently found in nosocomial pneumonia. 2) The causative organisms were isolated in 16 cases on the blood culture: 7 cases(43%) were gram negative bacilli and 9 cases(57%) were gram positive cocci. The major organisms were Staphylococcus aureus(6 cases, 38%), Pseudomonas species(3 cases, 19%) in decreasing order. 3) In the susceptibility test of causative organisms to antimicrobial drugs, Pseudomonas was susceptible to amikacin, ciprofloxacin, aztreonam, ceftazidime(more than 50%) and resistant to piperacillin, gentamicin, carbenicillin(more than 60%). Klebsiella was susceptible to chloramphenicol, gentamicin, cefotetan(more than 70%) and resistant to carbenicillin, ampicillin(more than 70%). Staphylococcus was susceptible to methicillin(64%), and Streptococcus pneumoniae was susceptible to oxacillin(94%). 4) The response rate after antibiotics therapy was 81% and the mortality rate was 19%. Conclusion: As considering the changes of causative organisms and antibiotic resistance, it behooves us to exercise caution in dispending antibiotics in order to maximize their continued efficacy and to do appropiate antibiotics therapy based on cultures and susceptibility test.

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A case of lung abscess caused by Burkholderia cepacia in healthy child (건강한 소아에서 발생한 B. cepacia에 의한 폐농양 1례)

  • Lee, Jung Hwa;Lee, So Hee;Hong, Seong Jin;Choi, Young Chil;Hwang, Eun Gu
    • Clinical and Experimental Pediatrics
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    • v.50 no.1
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    • pp.89-92
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    • 2007
  • Burkholderia cepacia is a Gram-negative aerobic bacillus known to cause opportunistic infections in the immune-compromised hosts. This microorganism is strongly virulent and causes a necrotising invasive infection that may lead to death. As B. cepacia is highly resistant to various antimicrobials, combination antimicrobial therapy must be used instead of monotherapy. We report a successful treatment of lung abscess that was naturally caused by B. cepacia in a healthy child, through combination antimicrobial therapy of meropenem and trimethoprim/sulfamethoxazole and operative management.

The Use of Fluoroquinolones in Children: Recent Advances (소아에서의 Fluoroquinolones 사용: 최근 경향을 중심으로)

  • Choi, Kyong Min
    • Pediatric Infection and Vaccine
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    • v.15 no.2
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    • pp.93-99
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    • 2008
  • Fluoroquinolones have been widely used since the development of nalidixic acid because of the excellent spectrum of activity, superior tissue penetration, and convenient route of administration. Despite such advantages, the usage in children is limited by concerns of toxicity to cartilage, damage to joints in animal studies, and an increase in antibiotic resistance. However, pediatric use has been increasing under certain circumstances with no report of such adverse effects. Further study is required prior to recommendation for general use of fluoroquinolones in children. The careful administration of fluoroquinolones is recommended only in limited circumstances, such as failure of primary antibiotics and lack of alternative antibiotics.

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Salmonellosis in children: Analysis of 72 Salmonella-positive culture cases during the last 10 years (소아의 살모넬라 감염증: 최근 10년동안 살모넬라 배양 양성인 72례에 대한 분석)

  • Noh, Sung Hoon;Yu, Ka Young;Kim, Jung Soo;Hwang, Pyoung Han;Jo, Dae Sun
    • Clinical and Experimental Pediatrics
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    • v.52 no.7
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    • pp.791-797
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    • 2009
  • Purpose : We aimed to investigate the clinical manifestations of and antibiotic resistance in culture-proven childhood salmonellosis. Methods : Clinical manifestations and laboratory data of and antibiotic use in subjects with culture-proven childhood salmonellosis, who were treated at the Chonbuk National University Hospital between September 1998 and August 2008, were analyzed retrospectively. Patients with underlying diseases or concomitant illnesses were excluded. Results : We assessed a total of 72 patients. There were 68 stool culture-positive cases, 7 blood culture-positive cases, and 3 both stool culture- and blood culture-positive cases. Salmonella group D was the most frequent pathogen in stool (63.9%) and blood (71.4%) cultures. Salmonella typhi was isolated in 1 case. Of the 72 patients, 45 (62.5%) were male children, of which 29 (40.3%) were aged <3 years. The patients most commonly presented with diarrhea (90.2%) and fever (83.3%). Leukocytosis (leukocyte count, >$15,000/{\mu}L$) and leukopenia (leukocyte count, <$4,000/{\mu}L$) were detected in 8.3% and 5.6% of the patients, respectively. Elevated serum C-reactive protein concentration (>5 mg/dL) and erythrocyte sedimentation rate (>20 mm/h) were observed in 88.9% and 58.3% of the patients, respectively. Fifty-two (85.2%) of 61 patients who had undergone antibiotic treatment received a third-generation cephalosporin as definitive antibiotic therapy. Multidrug resistance rate was 40.0 % in the first 5 years of the study and 71.4% in the last 5 years. No fatalities occurred in this series. Conclusion : Children with culture-proven salmonellosis showed relatively benign clinical outcomes. Appropriate antibiotic treatment of <2 weeks is probably adequate for those without a suppurative focus of infection. The incidence of antibiotic resistant isolates was recently seen to increase.