• Title/Summary/Keyword: 항생제 치료

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Prevalence and Clinical Outcome of Penicillin-resistant Pneumococcal Pneumonia (폐렴구균에 의한 지역사회 획득 폐렴에서 페니실린 내성률과 내성에 따른 임상경과에 관한 연구)

  • Hong, Ji Hyun;Lee, Hyung Seok;Jung, Seung Hyun;Kim, Gyu Won;Eom, Kwang-Seok;Lee, Jae Myung;Jang, Seung Hun;Kim, Dong Gyu;Hyoen, In Gyou;Lee, Myoung Koo;Park, Yong Bum;Jung, Ki-Suck;Lee, Young Kyoung
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.3
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    • pp.295-303
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    • 2003
  • Backgroung : The incidence of penicillin-resistant streptococcus pneumoniae(PRSP) accounts for almost 70% of all pneumococcal pneumonia cases in Korea. It is still unclear as to whether the efficacy of penicillin or equally active beta-lactam agents is compromised in PRSP pneumonia. This study investigated the prevalence of PRSP in community-acquired pneumonia and its clinical course. Methods : A total of 42 patients with community-acquired pneumococcal pneumonia were evaluated from July 1999 to May 2001. The cultured strains of Streptococcus pneumoniae were divided into susceptible, intermediately resistant, and resistant strains by an E-test, and the effect of the clinical course was investigated. Results : From a total of 42 patients, 22 (52.4%) patients had an intermediate resistance (MIC $0.1-1{\mu}g/m{\ell}$) and six (14.3%) showed a high resistance ($MIC{\geq}2.0{\mu}g/m{\ell}$) with current penicillin susceptibility categories. However, according to the classification of the DRSPTWG (Drug Resistant Streptococcus pneumoniae Therapeutic Working Group), there were 11 cases (26.2%) of intermediate resistance and no case of high resistance. Under empirical antimicrobial treatment, there was no difference in the clinical outcome between the penicillin susceptible and resistant group. Conclusion : The clinical outcome of PRSP pneumonia with empirical therapy was acceptable. These results suggest that the current MIC breakpoint for penicillin resistance in Streptococcus pneumoniae has been set at a very low level and penicillin resistance according to the NCCLS classification does not significantly influence the outcome of the empirical treatment for pneumococcal pneumonia.

Characteristics of Wheat Flour Dough and Noodles with Amylopectin Content and Hydrocolloids (아밀로펙틴 함량 변화와 하이드로콜로이드 첨가에 의한 밀가루 반죽 및 국수의 특성)

  • Cho, Young-Hwa;Shim, Jae-Yong;Lee, Hyeon-Gyu
    • Korean Journal of Food Science and Technology
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    • v.39 no.2
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    • pp.138-145
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    • 2007
  • The effects of amylopectin and hydrocolloid (locust bean gum and guar gum) content on wheat flour dough and noodle properties were investigated. As the amount of amylopectin increased, the water absorption rate (farinograph), the tension (tension test), the gel stability (freeze-thawing treatment), and the springiness and the cohesiveness (TPA) increased, but the pasting temperature (RVA), the lightness and yellowness (color measurement), and the hardness (TPA) tended to decrease. In sensory evaluations, the scores for cohesiveness, springiness, and acceptability of cooked noodle increased as the proportion of amylopectin increased. The proper combination of amylose/amylopectin ratio and hydrocolloids improved the freeze-thaw stability and the sensory acceptability of wheat flour dough and noodle.

Inhibitory Effects on the Enzymes Involved in the Inflammation by the Ethanol Extracts of Plant Foodstuffs (식물성 일반식품 자원의 에탄올 추출물이 염증 효소계에 미치는 영향)

  • Kwon, Eun-Sook;Kim, Il-Rang;Kwon, Hoon-Jeong
    • Korean Journal of Food Science and Technology
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    • v.39 no.3
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    • pp.348-352
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    • 2007
  • Inflammation is a complex process resulting from a variety of mechanisms. Combined inhibition of the activities of enzymes involved in the process may therefore be considered more important in anti-inflammatory property of plant extracts than any single contribution. In this study, the inhibitory effects of the ethanol extracts of thirty plant foods on the activities of secretory phospholipase $A_{2}$ ($sPLA_{2}$), cyclooxygenase-1 (COX-1), cyclooxygenase-2 (COX-2), and 12-lipoxygenase (12-LOX) were examined. Several legumes, mungbean sprout and some leaf vegetables inhibited the activity of $sPLA_2$, upstream enzyme of inflammation pathway. Only soybean sprout and mungbean sprout significantly inhibited 12-LOX activity. Although most of extracts inhibited the activities of both COX-1 and COX-2, water dropwort and amaranth showed selectivity for the inhibition of COX-2 over COX-1. Especially, mungbean showed anti-inflammatory property at both upstream and downstream of inflammation pathway with relatively low $IC_{50}$ values for $sPLA_{2}$ and COX-2 enzymes. Mungbean sprout exhibited inhibitory effects on all enzymes related to early and late inflammation and soybean sprout suppressed 12-LOX and COX-2 simultaneously, although the activities of these plants were showed at relatively high concentration. Therefore, mungbean, mungbean sprout, and soybean sprout appear to exhibit anti-inflammatory effects by combined inhibition of inflammatory enzymes.

Surgical Treatment for Descending Necrotizing Mediastinitis (하행성 괴사성 종격동염에 대한 수술)

  • Ryu, Kyoung-Min;Seo, Pil-Won;Park, Seong-Sik;Kim, Seok-Kon;Lee, Jae-Woong;Ryu, Jae-Wook
    • Journal of Chest Surgery
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    • v.41 no.1
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    • pp.82-88
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    • 2008
  • Background: Descending necrotizing mediastinitis (DNM) is a serious disease originating in odontogenic or oropharyngeal infection with high mortality despite adequate antibiotics and aggressive surgery. We analyzed results of treatment for DNM. Material and Method: We studied 8 cases diagnosed as DNM from 1998 to 2007. All patients received emergent surgical drainage and debridement with broad spectrum antibiotics just after diagnosis. Antibiotics were changed after bacterial susceptibility testing. The surgical approach included 2 cases of cervicotomy, 6 cases of cervicotomy, and a thoracotomy. Result: The interval between symptom onset and hospitalization was $4.6{\pm}1.8$ days ($1{\sim}9$ day). DNM originated in 4 cases of odontogenic infection (50%), 2 cases of oropharyngeal infection (25%), and 2 cases of unknown origin (25%). Causative organisms were found in 6 cases; Streptococcus in 4 cases, Staphylococcus in 1 case, and Klebsiella in 1 case. The Endo DNM classification was type I (2 cases), IIA (3 cases), and IIB (3 cases). The incidence of thoracotomy was 75%. The surgical mortality rate was 25% (2/8). The cause of death was multiple organ failure caused by septic shock. All mortality cases received only cervicotomy and aggravated infections after initial drainage. Conclusion: Early diagnosis, immediate surgical drainage, and adequate antibiotics, including covered anaerobes, are required. Thoracotomy should be performed with cervicotomy even for localized DNM.

Multi-drug Resistance of Mycoplasma pneumoniae Isolates from Patients with Respiratory Diseases against Quinolone and Macrolide (호흡기질환 환자에서 분리한 Mycoplasma pneumoniae의 Quinolone계와 Macrolide계 항생물질에 대한 다제 저항성)

  • Jun, Sung-Gon;Chang, Myung-Woong
    • Journal of Life Science
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    • v.17 no.3 s.83
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    • pp.435-443
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    • 2007
  • Antimicrobial susceptibility test of the 116 strains of Mycoplasma pneumoniae isolates were performed by a broth micro-dilution method against to moxifloxacin, levofloxacin, sparfloxacin, ofloxacin, ciprofloxacin, clarithromycin minocycline, erythromycin, josamycin, and tetracycline. The initial-minimum inhibitory concentration (I-MIC) was evaluated as the lowest concentration of antimicrobial agents that prevented a color change in the medium at that time when the drug-free growth control, about 7 days after incubation, and the final-minimum inhibitory concentration (F-MIC) was defined a color change about 14 days after incubation. The evaluation to the drug-resistant M. pneumoniae isolates were determined the $MIC{\pm}1.0$ ${\mu}g/ml$ of each antimicrobial agent. According to the I-MIC, single drug-resistant M. pneumoniae strains to ciprofloxacin, ofloxacin, clarithromycin and erythromycin were 79.3, 53.5, 10.3, and 7.8%, respectively. Two kinds of drug-resistant M. pneumoniae strains to ofloxacin and ciprofloxacin, or ciprofloxacin and clarithromycin were 42.2 and 9.5%. Three kinds of drug-resistant M. pneumoniae strains to erythromycin, ofloxacin, and ciprofloxacin, or ofloxacin, ciprofloxacin and clarithromycin were 6.9 and 6.0% . According to the F-MIC, single drug-resistant M. pneumoniae strains to tetracycline, ciprofloxacin, ofloxacin, minocycline,erythromycin, josamycin, clarithromycin and sparfloxacin were 91.4, 91.4, 91.4, 89.7, 68.1, 52.6, 28.5, and 11.2%, respectively. The incidence of two kinds of drug-resistant M. pneumoniae strains were from 20.7% to 91.4%, three kinds of drug-resistant M. pneumoniae strains were from 28.5% to 89.7%, four kinds of drug-resistant M. pneumoniae strains were 2.6%, five kinds of drug-resistant M. pneumoniae were from 2.6% to 21.6%, six kinds of drug-resistant M. pneumoniae strains were from 0.9% to 24.1%, seven kinds of drug-resistant M. pneumoniae strains were from 0.9% to 2.6%, and eight kinds of drug-resistant M. pneumoniae strains were 1.7%. These results suggest that sparfloxacin, moxifloxacin and levofloxacin might be promising antimicrobial agents for the treatment of M. pneumoniae infection in Korea. However, most strains of M. pneumoniae isolates were single or multi-resistance pattern to the other tested antimicrobial agents. Therefore, tetracycline, minocycline, erythromycin, clarithromycin, and second-generation quinolones are more carefully used to patients with M. pneumoniae infection in Korea.

A Ruptured Salmonella-Infected Abdominal Aortic Aneurysm of the Suprarenal Type -A case report- (신동맥 상방의 파열된 Salmonella 복부 대동맥류 - 1예 보고 -)

  • Moon, Jong-Hwan;Hong, You-Sun;Lim, Sang-Hyun;Jung, Joon-Ho
    • Journal of Chest Surgery
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    • v.43 no.2
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    • pp.199-203
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    • 2010
  • Infected aortic aneurysms are rare, but the mortality of patients with infected aortic aneurysms remains high. Open surgical procedures are the standard of care for infected aneurysms of aorta, but the surgical results are often disappointing. The risk factors related to the high mortality include aneurysm rupture and a suprarenal aneurysm location. The classic method for treating infected aneurysms has been aneurysm resection, soft tissue debridement, remote arterial reconstruction out of the field of infection and antibiotics. Infected anuerysms located in the suprarenal aorta are highly lethal because of the need to reimplant the visceral or renal arteries and the graft related complications. We reported here on a case of suprarenal infected aortic aneurysm in a 55-years-old man. We also include a review of the relevant medical literature.

Arthroscopic Treatment of an Acute Septic Arthritis after Meniscal Allograft Transplantation - A Case Report - (반월상 연골 동종 이식술 후 발생한 화농성 관절염의 관절경적 치료 - 증례 보고 -)

  • Kim, Yeub;Yoon, Jung-Ro;Suh, Dong-Hoon;Jang, Hyoung-Won
    • Journal of the Korean Arthroscopy Society
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    • v.13 no.1
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    • pp.63-67
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    • 2009
  • We report the case of a 21-year-old man with acute septic arthritis of the knee after meniscal allograft transplantation, which was successfully treated with repeated arthroscopic debridement and irrigations. Our procedures included arthroscopic debridement and irrigation with 10L normal saline, repeated arthroscopic irrigations (5 times), and intravenous antibiotics. Our decision to repeat the debridement was based on clinical and laboratory results. The significance of this case is that early aggressive arthroscopic debridement and repeated irrigations as part of a treatment protocol of acute septic arthritis after meniscal allograft transplantation can be an effective treatment option in selected cases.

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The Scope of Regenerative Endodontics on Open-Apices in Young Permanent Teeth (영구치의 개방성 치근첨에 대한 재생 근관치료적 의견)

  • Cho, Yongbum
    • Journal of the korean academy of Pediatric Dentistry
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    • v.42 no.2
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    • pp.197-202
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    • 2015
  • Numerous challenges in treating permanent dentition are encountered, especially in treating immature teeth with pulp necrosis. Historically, calcium hydroxide application during long periods of time was used to induce the formation of a calcific barrier across the open apex. In 2004, a new treatment modality for the management of the open apex was introduced. This treatment was named as 'revascularization' and gained acceptance among dentists. The protocol was different from the traditional apexification techniques in that the canal was irrigated and disinfected with a combination of three antibiotics (ciprofloxacin, metronidazole and minocycline). At the next appointment, bleeding was induced and the canal was sealed with MTA. Successful regenerative endodontic treatment of necrotic immature permanent teeth can provide continued root development, increased thickness in the dentinal walls and apical closure. These developments of a functional pulp-dentin complex have a promising impact on retaining the natural teeth, the goal of the dental health care.

Bacteremia in Pediatric Cancer Patients : Causative Organisms and Antibiotic Sensitivities (소아 암 환자에서 발생한 균혈증 : 원인균과 항생제 감수성)

  • Kim, Yong-Han;Lee, Hyun-Dong;Hah, Jeong-Ok
    • Clinical and Experimental Pediatrics
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    • v.48 no.6
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    • pp.619-623
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    • 2005
  • Purpose : Bacteremia in immunocompromised pediatric cancer patients can lead to high morbidity and mortality, if not treated early and properly. The incidence and antibiotic sensitivities to common pathogens of bacteremia in pediatric cancer patients are liable to change, according to region and time. We investigated the causative organisms and antibiotic sensitivities of bacteremia in pediatric cancer patients to assess the adequacy of empiric antimicrobial therapy. Methods : From September 1995 to August 2003, we retrospectively evaluated 58 episodes in 39 pediatric cancer patients with bacteremia treated at the Pediatric Department of Yeungnam University Hospital. We investigated and analyzed the causative organisms and the antibiotic sensitivity test results by reviewing the records of the microbiologically proven positive blood culture results. Results : The incidence of bacteremia in pediatric cancer patients in this study was 5.7 percent (58 episodes out of 1,022 occasions of blood cultures). Gram-positive organisms were isolated more often than gram-negative organisms (63.8 percent vs 36.2 percent) in the following order : Staphylococcus epidermidis (37.9 percent), Staphylococcus aureus (17.3 percent), Escherichia coli (12 percent), Streptococcus (8.6 percent), Enterobacter (6.9 percent), Klesiella (6.9 percent), Serratia (3.5 percent), Acinetobacter (3.5 percent), Proteus (1.7 percent) and Morganella morganii (1.7 percent). In antibiotic sensitivity tests, only six of 37 isolates (16 percent) of gram positive bacteria were sensitive to penicillin and 15 of 37 isolates (40 percent) were sensitive to oxacillin. All except one Staphylococcus aureus were sensitive to vancomycin and all except one Staphylococcus epidermidis were sensitive to teicoplanin among 37 isolates of gram positive bacteria. In the case of gram negative bacteria, two of 21 isolates (10 percent) and four of 21 isolates (19 percent) were sensitive to cefotaxime and ceftazidime, respectively. Only six of 21 isolates (29 percent) were sensitive to aminoglycoside, but all 21 isolates (100 percent) were sensitive to imipenem. All seven isolates tested after the year 2000 were sensitive to meropenem. Conclusion : In conclusion, we should choose the proper antimicrobials in treating pediatric cancer patients with suspected bacteremia, reflecting the increasing episodes of gram positive bacteremia and polymicrobial resistance of gram positive and negative organisms.

The Causative Organisms of Otitis Media Accompanying Otorrhea in Children and Their Antimicrobial Susceptibility (소아에서 이루를 동반한 중이염의 원인 및 항균제 감수성)

  • Jung, Do Seok;Kim, Heon Sang;Park, Chul Won;Oh, Sung Hee
    • Pediatric Infection and Vaccine
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    • v.7 no.2
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    • pp.233-239
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    • 2000
  • Purpose : A great deal of youngsters suffer from otitis media, for which antimicrobials are frequently prescribed. Increased antimicrobial resistance forces physicians to judiciously use antimicrobial agents in treating patients with acute otitis media. There have however been few references with regard to otitis media in Korean children, and authors proceeded investigation to look for the causative agents of otitis media in Korean children and their antimicrobial susceptibility. Methods : The study included 65 patients younger than 15 years old who had been cared at the department of pediatrics and otolaryngology in Hanyang University Hospital from July 1994 to June 1999, and diagnosed of otitis media with otorrhea which contained microorganisms isolated in otorrhea culture. The medical records were reviewed for demographic data, isolated organisms and their antimicrobial susceptibility. Results : Among 65 patients, 37(57%) were boys and 28(43%) girls. Distribution of the patients was reciprocal to the age of the patients; 27 patients(41.5%) were younger than 1 year old, 24(36.9%) were 1 to 3 years old with the average of 2.9 years of age. Staphylococus aureus was isolated in 32 patients(49.2%), Streptococcus pneumoniae in 19 patients(29.2%) Haemophilus influenzae in 9 patients(13.8%), Streptococcus oralis in 3 patients(4.6%), Moraxella catarrhalis in 1 patient(1.5%). The isolated microorganisms were not different whether patients had cleft lip/palate or not. The antibiotic resistance rates of S. aureus were ${\geq}90%$ to erythromycin, imipenem, cephalothin, and clindamycin, 86.2% to oxacillin, 25% to chloramphenicol, 12.5% to trimethoprim/sulfamethoxazole(TMP/SMX), and 0% to vancomycin and teicoplanin. The antibiotic resistance rates of S. pneumoniae were 71.4% to penicillin and greater than 60% to erythromycin, tetracycline, TMP/SMX, 7.1% to chloramphenicol, and 0% to vancomycin and teicoplanin. The antibiotic resistance rates of H. influenzae were 55% to ampicillin and TMP/SMX, and 0% to chloramphenicol, ceftriaxone, aztreonam, imipenem and ciprofloxacin. Conclusion : With otorrhea culture, the causative organisms of otitis media appear to be S. aureus, S. pneumoniae and H. influenzae. The high antibiotic resistance rates of the isolated organisms should affect the choice of antibiotics in treating patients with otitis media. Prospective investigations utilizing tympanocentesis in microbiologic studies are needed.

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