• Childhood Kidney Diseases
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• v.12 no.2
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• pp.194-201
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• 2008

Purpose : Voiding cystourethrography(VCUG) is required to detect vesicoureteral reflux(VUR), which may manifest as urinary tract infection(UTI) in children. It is well known that VCUG can cause UTI(post-VCUG UTI). In this study, risk factors for post-VCUG UTI and the preventive effect of antibiotics against this complication of VCUG were explored. Methods : Medical records of 284 patients who underwent VCUG at our hospital in 2007 were reviewed retrospectively. The incidence of post-VCUG UTI and risk factors for post-VCUG UTI, and the impact of antibiotic use on prevention of post-VCUG UTI were evaluated. According to antibiotics usage, we divided the enrolled patients into 4 groups of noantibiotics group, prophylactic antibiotics group(prophylactic antibiotics having been used before), antibiotics-for-VCUG group(antibiotics added for VCUG) and antibiotics-for-treatment group(treatment dose of antibiotics). Results : Seven of 284 children(2.5%) developed UTI after they underwent VCUG. Highgrade(grade$\geq$III) VUR was the only statistically significant risk factor(odds ratio[OR] 6.266, P=0.026) for post-VCUG UTI, while sex, age, and other anomalies of urinary system were not significant. Five post-VCUG UTI cases belonged to prophylactic antibiotics group. Antibiotics use (three groups using antibiotics vs. no-antibiotics group) or addition of antibiotics for VCUG (antibiotics-for-VCUG vs. other groups) did not have any effect on prevention of post-VCUG UTI. Conclusion : The risk factor for post-VCUG UTI was high-grade VUR. Antibiotics use did not prevent post-VCUG UTI in this study.

• Korean Journal of Microbiology
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• v.42 no.3
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• pp.185-194
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• 2006

The aim of this study was to identify the bacteria isolated from endodontic lesions by cell culture and to determine the antimicrobial susceptibility of them against 8 antibiotics. The necrotic pulpal tissues were collected from 27 infected root canals, which were diagnosed as endodontic infection. Samples were collected aseptically from the infected pulpal tissue of the infected root canals using a barbed broach and a paper point. The cut barbed broaches and paper points were transferred to an eppendorf tube containing $500{\mu}l\;of\;1{\times}PBS$. The sample solution was briefly mixed and plated onto a BHI-agar plate containing 5% sheep blood. The agar plates were incubated in a $37^{\circ}C$ anaerobic chamber for 2 to 5 days. The bacteria grown on the agar plates were identified by comparison of 16S rRNA gene (rDNA) sequencing method at the species level. To test the sensitivity of the bacteria isolated from the infected root canals against 8 antibiotics, minimum inhibitory concentrations (MIC) were determined using broth dilution assay. The data showed that 101 bacterial strains were isolated and were identified. Streptococcus spp. (29.7%) and Actinomyces spp. (21.8%) were predominantly isolated. The 9 strains were excluded in antimicrobial susceptibility test because they were lost during the experiment or were not grown in broth culture. The percentage of bacteria susceptible for each antibiotic in this study was clindamycin, 87.0% (80 of 92); tetracycline, 75.0% (69 of 92); cefuroxime axetil, 75.0% (69 of 92); amoxicillin + clavulanic acid (5:1), 71.7% (66 of 92); penicillin G, 66.3% (61 of 92); erythromycin, 66.3% (61 of 92); amoxicillin, 44.6% (41 of 92); and ciprofloxacin, 31.5% (29 of 92). The susceptibility pattern of 8 antibiotics was dependent on the host of the bacteria strains rather than the kinds of bacterial species. These results indicate that antibiotic susceptibility test should be performed when antibiotics are needed for the treatment of infected root canals.

• Clinical and Experimental Pediatrics
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• v.50 no.1
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• pp.33-39
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• 2007

Purpose : In spite of medical advances, empyema is a serious complication of pneumonia in children. Vaccination practices and antibiotic prescribing practices promote the change of clinical manifestations of empyema and causative organisms. So we made a nationwide clinical observation of 122 cases of empyema in children from 32 hospitals during the 5 year period from September 1999 to August 2004. Methods : Demographic data, and clinical information on the course and management of empyema patients were collected retrospectively from medical records in secondary and tertiary hospitals in Korea. Results : One hundred twenty two patients were enrolled from 35 hospitals. The most frequent age group was 1-3 years, accounting for 48 percent of all cases. The male to female sex ratio was 1.2:1. The main symptoms were cough, fever, respiratory difficulty, lethargy and chest pain in order of frequency. Hematologic findings on admission revealed decreased hemoglobin levels ($10.4{\pm}1.6g/dL$) and increased leukocyte counts ($16,234.3{\pm}10,601.8/{\mu}L$). Pleural fluid obtained from patients showed high leukocyte counts ($30,365.8{\pm}64,073.0/{\mu}L$), high protein levels ($522.3{\pm}1582.3g/dL$), and low glucose levels ($88.1{\pm}523.5mg/dL$). Findings from pleural fluid cultures were positive in 80 cases(65.6 percent). The most common causative agent was Streptococcus pneumoniae. The majority of patients were treated with antibiotics and closed drainage. Some patients needed open drainage (16.4 percent) or decortication (3.3 percent). The mean duration of hospitalization was $28.6{\pm}15.3days$. Conclusion : We analyzed childhood empyema patients during a period of 5 years in Korean children. The most frequent age group was 1-3 years and the most common causative agent was Streptococcus pneumoniaeiae. The majority of patients were treated with antibiotics and close drainage.

• Clinical and Experimental Pediatrics
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• v.48 no.5
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• pp.523-526
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• 2005

Purpose : Hypoalbuminemia is a rare cause of pleural effusion. The relationship between the severity of hypoalbuminemia and the clinical course of pleural effusion is unclear. The aim of this study was to evaluate the change of clinical course according to the severity of hypoalbuminemia due to pleural effusion in children. Methods : A total of 96 patients admitted to Pusan National University Hospital with pleural effusion from August 1998 to August 2004 were studied retrospectively. The 79 patients who had only infectious causes were evaluated according to their albumin levels. They were divided into the two groups : group 1 had serum albumin levels of ${\leq}2.5g/dL$; group 2 : >2.5 g/dL. The clinical courses of each group were compared. Results : The nature of pleural effusion was transudates in seven cases and exudates in 89 cases. The most commom causes of transudates were renal failure(four cases) and the most common causes of exudates were parapneumonic effusion(58 cases). There was no statistical significance in mean ages, BUN, creatinine, potassium, bilirubin and WBC in each group. Four patient in group 1 and 26 patients in group 2 improved after medication of antibiotics or anti-tuberculosis agents only. Fourteen patients in group 1 and 26 patients in group 2 improved after thoracostomy with use of antibiotics. Eight patients in group 1 and one patient in group 2 had ventilator care with use of antibiotics therapy. Conclusion : Children who were diagnosed as pleural effusion with low serum albumin levels on admission had poorer prognoses than those with normal levels. We conclude that lower serum albumin level on admission is an important prognosis factor in a patient with pleural effusion.

• Clinical and Experimental Pediatrics
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• v.53 no.1
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• pp.48-55
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• 2010

Purpose : Staphylococcal scalded skin syndrome (SSSS) is a relatively uncommon superficial blistering skin disease that is due to Staphylococcus aureus. We had experienced a regional outbreak of SSSS over 3 years in healthy children. Methods : We retrospectively reviewed the medical records of those patients diagnosed as SSSS. Most of neonatal cases were nosocomial infections and excluded from the analysis. The clinical features, laboratory findings, the isolation and antibiotic resistance of S. aureus, the antibiotic management and other supportive treatments were analyzed. Results : Fifty-five patients with SSSS were admitted to our hospital from October 2001 to September 2004. The median age of patients was 3.0 years. Of the 55 patients, 9 were the generalized type, 13 were the intermediate type and 33 were the scarletiniform rash. All the patients were living in neighborhood of the Jinju area. S. aureus were isolated from 9 of the patients and all of the isolated S. aureus were methicillin resistant. All the patients except two were treated with intravenous flocloxacillin or nafcillin and/or cefotaxime. All the patients recovered during the follow-up period of 2 to 3 weeks. Conclusion : We experienced a regional outbreak of SSSS in previous healthy children. Further study for finding the carriers of S. aureus caused SSSS and preventing the spread of this disease is needed. Additionally, guidelines for treating SSSS due to methicillin resistant S. aureus should be established.

• Journal of Dental Rehabilitation and Applied Science
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• v.31 no.2
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• pp.150-157
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• 2015

The purpose of this report is to suggest clinical managements of implant periapical lesions by presenting three clinical cases managed by either the infected form or the inactive form with the follow-up period of five to twelve years. One patient with no clinical symptom was regarded as inactive form. Two patients having pain were regarded as infected form and have been under the systemic antibiotic therapy. In one patient, the symptom subsided and the size of radiolucent lesion decreased. However, the other patient showed increased size of lesion causing the implant unstable, which leaded to remove the implant and to replace it. There was neither additional increase of the lesion nor functional problem for all three. It is important to detect implant periapical lesion in early stage before jeopardizing the stable implant and manage properly using systemic antibiotic therapy and surgical approach if needed, depending on infected form and inactive form.

• Journal of Marine Life Science
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• v.4 no.1
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• pp.29-37
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• 2019

In order to control disease caused by multi-drug resistant bacteria in the aquaculture, the use of veterinary antibiotics, which are prohibited to fish, is increasing, instead of the existing fisheries antibiotics. Among them, tiamulin is illegally used in some cultured fish because it exhibits effective antibacterial activity against Gram-positive bacteria. To prevent unauthorized use, treatment of fish should be accompanied by a prescription from veterinarians or fisheries disease managers through research on fish of tiamulin. Tiamulin was injected intramuscularly at 5, 10 and 15 mg kg^-1 for the streptococcus-infected starry flounder, but did not show any therapeutic effect. Oral administration at a concentration of 15 and 30 mg kg^-1 was similarly ineffective. The concentrations of 30 and 60 mg kg^-1 resulted in death due to toxicity of antibiotics. Therefore, it is inappropriate to treat antibiotics with streptococcus-infected starry flounder.

• Korean Journal of Clinical Laboratory Science
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• v.51 no.3
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• pp.294-300
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• 2019

To investigate the inhibition effect on pathogenic microbes and the antimicrobial resistance of probiotics, a total of 140 probiotics were isolated from 35 kinds of Korean commercially available Kimchi. Of those, L. plantarum was identified from 53 strains (37.9%), E. faecium from 27 strains (19.3%), and L. rhamnosus from 7 strains (5.0%) using 16S rRNA gene sequencing. Sixty nine strains (49.3%) showed overall antimicrobial activity against pathogenic microbes, namely S. Typhi, S. Enteritidis, E. coli O157:H7, S. flexneri, NAG Vibrio, Listeria monocytogenesis, Y. enterocolitica, S. aureus, S. pyogenes, G. vaginalis, C. albicans, and P. acne. The proportions of L. plantarum, E. faecium, and L. rhamnosus strains to pathogenic microbes were 75.5%, 40.7%, and 28.6%, respectively. In addition, a resistance test with 18 antimicrobial agents using a disk diffusion assay revealed a resistance incidence of 98.6% for nalidixic acid, 83.6% for streptomycin, 75.7% for gentamicin 73.6% for vancomycin, 72.1% for norfloxacin, and 67.9% for ciprofloxacin. In conclusion, L. plantarum, L. sakei, and E. faecium strains with various antimicrobial activities and broad antibiotic resistance are useful for treating diarrhea in long-term inpatients and for the alternative use for treating Candida species female vaginitis.

• Clinical and Experimental Pediatrics
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• v.46 no.7
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• pp.710-713
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• 2003

Purpose : Although chloramphenicol and doxycycline have been used for the treatment of tsutsugamuchi disease, a difficulty exists in determining which drugs to use in treating children because of potential complications such as aplastic anemia or teeth discoloration. We evaluated the effect of roxithromycin, a macrolide antibiotic, on tsutsugamushi disease in children. Methods : A retrospective analysis was conducted on 39 children with tsutsugamuchi disease(scrub typhus) who were treated with doxycycline(DC), chloramphenicol(CM), or roxythromycin(RM) between 1991 and 2000. We divided the patients into a DC-treated group(DC group; 16 children), a CM-treated group(CM group; 14 children), and RM-treated group(RM group; 9 children) and compared these groups. Results : Most cases(97%) developed in October and November. Fever and rash were observed in all 39 cases and an eschar was noted in 36 cases(92%). No statistical differences could be found between the three groups in mean age, duration of fever before admission, white blood cell(WBC) count, and complications including abnormal liver enzymes. In most cases defervescence after treatment was within 24 hours(34 cases, 87%), and during 24-48 hours in two cases in the DC group, one in the CM group, and two in the RM group(no statistical difference). Conclusion : Roxythromycin was as effective as conventional doxycycline or chloramphenicol, in children with scrub typhus and may be safer to use.

• Tuberculosis and Respiratory Diseases
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• v.52 no.3
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• pp.207-218
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• 2002

Background : Intensive care units (ICUs) are generally considered epicenters of antibiotic resistance and the principal sources of multi-resistant bacteria outbreaks. The antibiotic resistance in newly opened intensive care unit that has no microbial colonization on and around the devices was investigated. Materials and Methods : The authors analyzed the antibiotic resistance patterns for common hospital acquired-pneumonia pathogens in the ICUs(Staphylococcus aureus, Pseudomonas aeruginosa, Acinetobacter spp.) at the newly opened ICU of Hanyang University Medical Center, Kuri Hospital during 6 years(1995-2000). Results : 1) Regarding Staphylococcus aureus, the resistance rate to methicillin was 15% at 1995, 21% at 1996, 20% at 1997, 23% at 1998, 22% at 1999, 55% at 2000. 2) Regarding Pseudomonas aeruginosa, the resistance rate to $3^{rd}$ cephalosporin was 50% at 1995, 50% at 1996, 78% at 1997, 40% at 1998, 77% at 1999, 39% at 2000. Imipenam was 0% at 1995, 27% at 1996, 65% at 1997, 12% at 1998, 16% at 1999, 12% at 2000. Ciprofloxacin was 0% at 1996, 56% at 1997, 36% at 1998, 57% at 1999, 58% at 2000. Tobramycin was 7% at 1995, 10% at 1996, 67% at 1997, 36% at 1998, 65% at 1999, 12% at 2000. Gentamycin was 14% at 1995, 36% at 1996, 67% at 1997, 36% at 1998, 65% at 1999, 12% at 2000. Amikacin was 14% at 1995, 30% at 1996, 61% at 1997, 16% at 1998, 39% at 1999, 18% at 2000. 3) Regarding Acinetobacter spp., the resistance rate to $3^{rd}$ cephalosporin was 92% at 1996, 89% at 1997, 88% at 1998,84% at 1999, 77% at 2000. Imipenem was 50% at 1996, 48% at 1997, 45% at 1998, 49% at 1999, 50% at 2000. Ciprofloxacin was 0% at 1996, 48% at 1997, 33% at 1998, 27% at 1999, 71% at 2000. Tobramycin was 67% at 1995, 100% at 1996, 89% at 1997, 95% at 1998, 87% at 1999, 77% at 2000. Gentamycin was 67% at 1995, 100% at 1996, 89% at 1997, 95% at 1998, 87% at 1999, 83% at 2000. Amikacin was 33% at 1995, 83% at 1996, 82% at 1997, 88% at 1998, 75% at 1999, 69% at 2000. Conclusion : The S.aureus resistance to methicillin, the Pseudomonas aeruginosa resistance to ciprofloxacin, and the Acinetobacter spp. resistance to ciprofloxacin have rapidly increased during 6 years. There is a need to pay speicial attention when using the the antibiotics for the above pathogens. This data may be useful in antibiotic therapy in newly opened intensive care units.