• Clean Technology
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• v.27 no.1
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• pp.55-60
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• 2021

Antibiotics are compounds broadly used to treat patients with infectious diseases and to enhance productivity in agriculture, fisheries, and livestock industries. However, due to the overuse of antibiotics and their low biodegradability, a substantial amount of antibiotics is leaking into the sewer, subsequently resulting in pollution and the emergence of antibiotic-resistant bacteria. This study explores biodegradable serum albumin's potential as an adsorbent to remove antibiotics from water. Serum albumin is a natural blood protein that transports various metabolites and hormones to all tissues' extravascular spaces. While serum albumin is highly water-soluble, it has intrinsic binding sites which readily accommodate ionic, hydrophilic, or hydrophobic molecules, rendering it a good building block for a nano-adsorbent. To induce coacervation, a desolvating agent, ethanol, was added dropwise into the aqueous albumin solution, resulting in dehydration and liquid-liquid phase separation of albumins into albumin nanoparticles within a size range of 150 ~ 170 nm. The addition of glutaraldehyde as a cross-linker improved the size stability and homogeneity of albumin nanoparticles. Adsorption of amoxicillin antibiotics on albumin nanoparticles was dependent upon glutaraldehyde concentration used in desolvation and pH during adsorption. The maximum adsorption capacity measured by spectrophotometry was found to be 12.4 micrograms of amoxicillin per milligram of albumin nanoparticle. These results demonstrate serum albumin's potential as a building block for fabricating a natural nano-adsorbent to remove antibiotics from water.

• Journal of Food Hygiene and Safety
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• v.36 no.6
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• pp.520-527
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• 2021

In this study, toxin gene and antibiotic resistance of food poisoning strains isolated from indoor air in the cafeteria were analyzed to prevent food poisoning. Staphylococcus aureus (16 strains) and Bacillus cereus (37 strains) isolated from indoor air in child care center were tested. The toxin genes of S. aureus and B. cereus were detected by PCR assay. The antimicrobial susceptibility test followed the disc diffusion method described by the Clinical and Laboratory Standard Institute. The seg and sei toxin genes were detected in 11 of 16 S. aureus strains (68.6%). The nheA and nheB toxin genes were detected in 37 B. cereus strains. In this study, a total of 12 toxin gene patterns of B. cereus were found, among which the nheA-nheB-nheC toxin gene was found to be the most frequent pattern. The result of the antimicrobial susceptibility test of S. aureus revealed 93.8% and 87.5% resistance to ampicillin and penicillin antibiotics, but methicillin resistance S. aureus and vancomycin resistance S. aureus were not detected. All 37 B. cereus tested in this study were resistant to ampicillin and penicillin antibiotics. Based on the result of this study, it was judged that regular ventilation and air quality management were necessary to prevent food poisoning caused by S. aureus and B. cereus contaminated in the indoor air of child care centers.

• Proceedings of the Korean Environmental Health Society Conference
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• 2005.11a
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• pp.169-174
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• 2005

의약품은 일반적으로 치료를 목적으로 제조되었기 때문에 독특한 약리학적 작용을 띤다. 의약품잔류물이 환경 중으로 배출되어 비표적 생물(non-target organism)에 노출될 경우 의도하지 않은 독성영향이 나타날 가능성이 있다. 본 연구에서는 우리나라에서 널리 사용되는 10개의 의약품(4종의 일반 의약품 acetaminophen, carbamazepine, diltiazem, cimetidine과 6종의 설파계 항생제 sulfamethoxazole, sulfamethazine, trimethoprim, sulfachloropyridazine, sulfadimethoxine)을 대상으로 환경중 예상잔류농도와 생태 무영향농도를 예측하여 대상의약품의 생태위해성을 평가하였다. 연구대상 의약품의 예측환경농도는 0.14 ${\sim}$ 16.5 ppb이었으며, 예측환경농도와 예측무영향농도비(PEC/PNEC ratio)를 산출한 결과 acetaminophen과 suifamethoxazole이 각각 1.8과 6.3으로 나타나 이 의약품들이 물생태계에 미치는 위해성에 대한 정밀한 추가연구의 필요성이 제시되었다.

• The Safety technology
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• no.175
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• pp.20-21
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• 2012

의학발달로 인류의 평균 수명은 크게 늘어나게 됐다. 단순히 생명만 연장된 것은 아니다. 이전보다 훨씬 건강하고 행복한 삶을 영위할 수 있게 된 것이다. 특히 각종 의약품은 인류를 질병의 고통에서 벗어나게끔 하는데 큰 역할을 했다고 볼 수 있다. 곧 의약품의 품질은 인류의 생명과 직결돼 있는 것이다. 그만큼 중요한 것이 의약품의 품질이다. 이런 좋은 품질의 의약품을 생산하는 곳이 바로 영진약품 남양공장이다. 이곳에서는 항생제, 소화제를 비롯해 순환기계질환, 중추신경계질환 등의 예방 치료를 위한 각종 완제의약품이 생산되고 있다. 특히 이곳은 지난해 세파계 항생제 전용공장이 들어서면서 의약계의 이목을 집중 받은 바 있다. 150억이 넘게 투자된 세파제 전용공장에는 제품상호 간의 교차오염방지를 위해 100% 배기 시스템을 설치한 것은 물론 비주얼 오더블 기능을 함께 갖춘 인터록 설비를 구축하는 등 첨단화된 생산설비를 갖췄다. 이는 식품의약품 안전청의 사전 컨설팅에서 높은 접수를 받았을 정도다. 이처럼 완벽한 설비를 갖추고 있는 것과 더불어 이곳은 꼼꼼한 안전관리가 전개되고 있는 것으로도 유명하다. 품질 높은 의약품을 생산하기 위해서는 안전이 그 무엇보다도 중요하다는 인식에 따라 근로자 개개인의 안전을 최우선으로 하고 있기 때문이다. 가장 안전한 작업에서 최고의 품질을 보장하는 의약품이 생산된다는 기치 속에서 안전현장을 일궈내고 있는 영진약품 남양공장을 찾아가 봤다.

• Tuberculosis and Respiratory Diseases
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• v.41 no.5
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• pp.537-545
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• 1994

Background: In 1987, the British Thoracic Society (BTS) subjected an extensive list of patient variables to statistical analysis in a prospective study of prognosis in 453 adults with community-acquired pneumonia and, subsequently published guidelines for management of severe community acquired pneumonia. It was hoped that those at risk of dying from community acquired pneumonia could be easily identified and treated appropriately, thereby reducing mortality. To date, severe community acquired pneumonia has not been well studied in Korea. Therefore, we studied retrospectively 10 patients dying of severe community acquired pneumonia in Dongsan Hospital to see clinical manifestations of dying of severe community-acquired pneumonia. Methods: Between July 1987 and july 1993, 498 patients were admitted to Keimyung University Dongsan Hospital with community acquired pneumonia, and 77 of them received intensive care. Of the 77 patients, 10 patients died. We reviewed medical records of these patients. Results: 1) The mean age of the patients was 56.2 years(range, 25 to 75 years). There were 7 men and 3 women. Seven patients(70%) were older than 60years of age. 2) The clinical features on admission were as follows: tachypnca, hypoxemia, mental change, cyanosis, leukopenia, leukocytosis, azotemia, hypotension, hypoalbuminemia in order of frequency. Three patients had one abnormal physical finding, 3 patients had 2, 2 patients had 3, and 2 patients had none of these abnormal physical findings. All patients had at least one of the abnormal laboratory findings. 3) A potential bacterial pathogen was isolated in sputum culture from 2 patients. One was E.coli, the other Enterobacter species. Sputum stain were positive in eight cases (G(+)cocci in six, G(+) cocci and G(-)bacilli in two). 4) Features of respiratory failure were the main reasons for ICU transfer, but two patients were transferred only following a cardiac or respiratory arrest in the general ward. 5) The mean of 2.7 different antibiotics were given to the patients. The aminoglycoside and first generation cephalosporin were the most frequently prescribed antibiotics, followed by the third generation cephalosporin and vancomycin. The most frequently prescribed antibiotics combination was a 1st generation cephalosporin plus an aminoglycoside. 6) Seven patients death(70%) occured after admission within the first five days, and a mean duration of hospitaliztion was 11.2 days. Conclusion: As the results show most death occured within the first five days after admission and aged patients; consequently, an aggressive intensive treatment should be provided early to the patients with severe community acquired pneumonia, and we should pay more attention to the aged patients.

• Pediatric Infection and Vaccine
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• v.18 no.1
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• pp.23-30
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• 2011

Purpose : Acinetobacter baumannii is an aerobic, gram negative coccobacillus. Due to its pathogenicity and ability to accumulate diverse mechanisms of resistance, the importance of this organism is increasing. Many reports have targeted adults, and studies of pediatric patients are limited. This study aims to investigate the current status of A. baumannii infection in children. Methods : From January 2001 to December 2008, 505 patients hospitalized with A. baumannii infection were enrolled. Admission records for underlying disease, duration of hospitalization, previous antibiotic use, location of admission, presence of ventilator care, and resistance to antibiotics were retrospectively reviewed and analyzed. Results : Hemato-oncological disease and neurological disease were 30.6% and 24.3% of all cases; therefore, these were the most common underlying diseases of patients with A. baumannii infection. Prevalence of A. baumannii infection was 78.1% in patients with previous antibiotic use, which was higher than that of the group not using previous antibiotic. And prevalence of multi-drug resistant and pan-drug resistant A. baumannii infection was 76.4% and 38.3% in patients with ICU care, 76.8% and 38.9% with ventilator care, and these were higher than the others. Rate of resistance to all groups of antibiotics showed a gradual increase to over 50% in 2008. Multi-drug resistant A. baumannii was 63.5% and pan-drug resistant A. baumannii was 48.2% of all cases. Conclusion : Prevalence of A. baumannii infection and resistance to antibacterial agents of A. baumannii is increasing. Adequate use of antibiotics and infection control should be emphasized in pediatric patients.

• Pediatric Infection and Vaccine
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• v.28 no.2
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• pp.82-91
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• 2021

Background: The purpose of this study was to investigate the association between antibiotic use and the antimicrobial resistance of gram-negative bacteria isolated from blood cultures in a pediatric population. Methods: From January 2014 to June 2018, the antibiotic resistance pattern of Acinetobacter baumannii, Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa obtained from bacteremic patients aged ≤18 years hospitalized at Asan Medical Center Children's Hospital was analyzed and the parenteral antibiotic consumption data were retrieved. Results: During the study period, the blood culture was positive for K. pneumoniae (6.4%; 105/1,628), E. coli (5.6%; 91/1,628), P. aeruginosa (3.3%; 54/1,628), and A. baumannii (2.5%; 41/1,628), and the extended-spectrum antibiotic resistance rate of gram-negative bacteria was consistently high. The overall resistance rate of E. coli and K. pneumoniae to extendedspectrum cephalosporin was 49.3% and 54.4%, respectively. Carbapenem-resistant E. coli was first detected in 2014; its overall resistance rate to carbapenem was 5.3%. There was a linear correlation between the usage of 3rd generation cephalosporin and the resistance of A. baumannii (r²=0.96, P=0.004) and carbapenem usage and the resistance of K. pneumoniae (r²=0.79, P=0.045). Conclusions: A positive linear correlation was observed between antibiotic resistance and the corresponding antibiotic usage in 3rd generation cephalosporin resistant A. baumannii and carbapenem resistant K. pneumoniae. The judicious use of antibiotics in healthcare settings is important to minimize selection for extended-spectrum β-lactamase (ESBL) and carbapenem resistance in gram-negative bacteria.

• Journal of Food Hygiene and Safety
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• v.35 no.2
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• pp.103-108
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• 2020

Recently, consumer demand for safe but minimally processed food has rapidly increased. For this reason, many food processing industries are applying hurdle technology to enhance food safety, extend shelf life, and make foods appear minimally processed. Meanwhile, studies have shown that a treatment (stress) meant to inactivate foodborne pathogens may trigger adaptation mechanisms and could even offer cross protection against subsequent treatments. Also, certain routine farm practices such as antibiotic and herbicide use could result in the development of antibiotic-resistant pathogens. Such bacteria may be tolerant to food processing-associated stress and be more likely to remain viable in processed foods. In this review, we discuss the correlation between food processing-associated stress and antibiotic resistance. We also discuss molecular mechanisms such as the use of sigma factors, SOS response pathways and efflux pumps as means of cross protection against antimicrobial compounds and other food processing-associated stresses.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.5 no.2
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• pp.150-157
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• 2002

Purpose: As the incidence of non-typhoidal salmonella strains resistant to antibiotics has been increased, we attempted to investigate clinical aspects of non-typhoidal salmonella gastroenteritis and antibiotics resistance. Methods: From January 2000 to June 2002, 99 children with positive stool culture of non-typhoidal salmonella were studied about clinical features, the incidence of antibiotics and multi-drug resistance and the difference of incidence of antibiotics resistance according to immune status. Results: There were 66 males and 33 females. The majority of them were under 5 years of age (71%). 25 children were immunocompromised due to chemotherapy, steroid or immunosuppressive treatment. Serogroup D was the most common isolates (65%) followed by B (16%), C (8%) and E (8%). Resistance rate of 30% to ampicillin, 12% to chloramphenicol, 20% to trimethoprim-sulfamethoxazole (TMP-SMX), 11% to cefotaxime and 8% to cefixime were obtained. All isolates were susceptible to ciprofloxacine. Resistance rate to cefotaxime and cefixime in immunocompromised patients was 24% and 14.3% respectively, which were significantly higher compared to that in immunocompetent patients (6.8%, 5.6%, p<0.05). 11 isolates were resistant to three or more antibiotics. The incidence of multi-drug resistant isolates was significantly higher in immunocompromised patients (24%) than that of immunocompetent patients (6.8%). Conclusion: Because of the high prevalence of non-typhoidal salmonella strains resistant to ampicillin, chloramphenicol and TMP-SMX, third-generation cephalosporin might be the treatment of choice in non-typhoidal salmonella gastroenteritis. In particular, antibiotics should be carefully selected in immunocompromised patients because non-typhoidal salmonellas from them showed the higher incidence of antibiotic resistance and multi-drug resistance.

• Childhood Kidney Diseases
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• v.10 no.1
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• pp.18-26
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• 2006

Purpose : Empirical antimicrobial treatment is indicated before bacteriological results are available for young children with febrile UTI to minimize renal scarring. To ensure appropriate therapy, knowledge of the prevalence of causative organisms and their susceptibility patterns to antimicrobials is mandatory. We performed a retrospective analysis investigating the local prevalence and resistance patterns of uropathogens, primarily E. coli, isolated from community-acquired UTIs. Methods : A total of 103 positive urine cultures from children with febrile UTI collected at Bundang CHA General Hospital from February 2004 to February 2005 were analyzed. Inclusion criteria were fever higher than $37.5^{\circ}C$, significant bacteriuria with single strain growth of at least 10s colony forming units/mL urine, and leukocyturia >5/HPF. Results : E. coli(89.3%) was the leading uropathogen followed by Enterococcus spp.(3.9%) Klebsiella spp.(2.9%), Citrobctcter spp.(1.9%) and Enterobacter spp.(1.9%). E. coli strains revealed a low proportion of antimicrobial susceptibility to ampicillin(AMP; 27.2%) ampicillinsulbactam(AMS; 34.8%) and trimethoprim-sulfamethoxazole(SXT; 65.2%). Susceptibility patterns to cephalosporins were as follows; cefazolin(1st generation; 91.3%), cefoxitin(2nd; 100%), ceftriaxone(3rd; 97.8%) and cefepime(4th; 97.8%). Three E. coli isolates produced ex tended - spectrum beta-lactamase(ESBL). Conclusion : Empirical treatment with AMP, AMS and SXT, which are commonly used in pediatric clinics, is not recommended for childhood UTI due to high incidence of resistance. The high level of susceptibility to cephalosporins makes these drugs reasonable alternatives. However the emergence of ESBL-producers, even though they are quite few, may have an impact on cephalosporin treatment in the future. (J Korean Soc Pediatr Nephrol 2006;10:18-26)