• Tuberculosis and Respiratory Diseases
• /
• 제73권1호
• /
• pp.32-37
• /
• 2012

Background: This study evaluates the bacterial pathogens of Ventilator-associated pneumonia (VAP) in a tertiary referral hospital. Methods: A total of 109 bacterial pathogens from 91 adult patients with VAP, who were admitted to the medical intensive care unit from January 2008 to December 2009, were examined. Clinical characteristics, bacterial pathogens, and resistance profiles were analyzed. Results: Staphylococcus aureus (44%) was the most frequently isolated. Acinetobacter baumanii (30%), Pseudomonas aeruginosa (12%), Stenotrophomonas maltophilia (7%), Klebsiella pneumoniae (6%), and Serratia marcescens (2%) were isolated from the transtracheal aspirates or bronchoalveolar lavage in patients with VAP. There was no significant difference of bacterial pathogens between early and late onset VAP. All isolated S. aureus were methicillin resistant S. aureus; the imipenem resistance rate of A. baumanii was 69%. Conclusion: The two most frequent pathogens of VAP were S. aureus and A. baumanii. There were no pathogenic differences between early and late onset VAP.

• Pediatric Infection and Vaccine
• /
• 제18권1호
• /
• pp.97-102
• /
• 2011

Acinetobactor baumanii 는 기회 감염균으로 carbapenem의 사용이 증가하면서 MDRAB와 같은 내성균으로 출현하고 있다. 저자들은 경희의료원에서 carbapenem을 투약받지 않았더라도 집중치료실에 장기간 입원하여 기관삽관과 인공호흡기 치료를 받거나 침습적인 수술을 받아 도관을 유지하는 환아에서 MDRAB가 동정되었다는 것을 확인하였다. carbapenem을 사용하지 않았더라도 장기간 집중치료실에 입원할 것으로 예상되는 환자들에게 원내전파를 통한 감염을 최소화하기 위하여 원내감염관리에 최선을 다해야 할 것이기에 이상의 증례를 통하여 보고한다.

• 융합정보논문지
• /
• 제10권4호
• /
• pp.104-114
• /
• 2020

본 연구는 식물에서 항생제로 알려진 11 가지 에센셜 오일(피톤치드)을 선별 한 후 혼합한 정유를 사용하여 최고의 항생제를 조사하였다. 최소억제농도 (MIC)와 최소사멸농도 (MBC) 측정 결과 Essential Oil B와 E가 목적 균의 억제효과가 높았다. 이 실험에 사용 된 S. aureus를 함유하는 모든 그람 양성 박테리아는 높은 항생제 활성을 나타냈다. 그리고 그람 양성 박테리아에서 A. baumanii와 곰팡이에서 C. albicans만이 높은 항생제 활동을 보였다. 우리의 실험에 사용 된 에센셜 오일은 항생제 활성이 뛰어난 천연 항생제 및 자연 의학의 에센셜 오일을 사용한 주요 연구와 비교할 때 더 우수한 항생제 활성을 보였다. 시험에 사용한 공시물질인 Essential Oil이 어떤 항균활성의 기전을 가지는지 알 수 없으나 다른 선행 연구결과와 비교해 볼 때 세포벽의 합성저해기전으로 해석하고 있다. 이러한 결과로부터, 항생제 활성을 갖는 일부 물질 또는 기능성 제품이 개발 될 것으로 예상된다.

• 미생물학회지
• /
• 제52권3호
• /
• pp.327-335
• /
• 2016

본 연구에서는 신규 Amycolatopsis 균주 KCTC 29142를 분리하여 형태학적 관찰, 계통분석 및 화학분류학적 분석 등 다상 분류분석을 통해 분석하였다. KCTC 29142 균주의 에틸아세테이트추출물은 강한 항균활성을 나타났고, 활성물질은 철 이온 킬레이트 물질인 siderochelin A로 동정되었다. 본 연구에서 분리된 siderochelin A는 다제내성균인 Acinetobacter baumanii, methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant Staphylococcus aureus (VRSA), 및 Escherichia coli (E. coli)에 대해 강한 활성을 보였고, 임상에서 분리된 다제내성균에 대한 MIC를 결정하였다.

• Archives of Plastic Surgery
• /
• 제38권5호
• /
• pp.590-593
• /
• 2011

Purpose: Surgical site infections (SSIs) are the third most frequently reported nosocomial infection. Of these SSIs, mostly were confined to the incision associated with underlying disease as diabetes, cigarette smoking, systemic steroid use, obesity, operating room environment, suture and surgical technique. This study has been planned to reduce the SSIs by using Vicryl $plus^{(R)}$ (Ethicon, USA) which contains triclosan, a broad-spectrum antibacterial agent, into the infected wound to evaluate whether or not Vicryl $plus^{(R)}$ (Ethicon, USA) is effective to nosocomial bacteria using a zone of inhibition assay. Methods: We did a comparison of Vicryl $plus^{(R)}$ suture (with triclosan) size 2-0, 5-0 with $Vicryl^{(R)}$ suture (without triclosan) size 4-0 each as treatment and control group, applied in Mueller-Hinton agar infected by following mircroorganisms: Methicillin-sensitive $Staphylococcus$ $aureus$ (MSSA), Methicillin-resistant $Staphylococcus$ $aureus$ (MRSA), Acinetobacter baumanii, $Escherichia$ $coli$, Enterobacter faecalis, Pseudomonas aeruginosa, Candida albicans. Cultures were made of the selected mircroorganisms, seeding the study strain in agar plates for 24 and 48-hour period in an oven at $37^{\circ}C$ followed by zone of inhibition assay. Results: Vicryl $plus^{(R)}$ group has demonstrated to create a zone of inhibition against MRSA, MSSA and $A.$ $baumanii$, but no effect on $E.$ $faecalis$, $P.$ $aeruginosa$, $C.$ $albicans$. Vicryl $plus^{(R)}$ suture size 2-0 also had antibactericidal effect while Vicryl $plus^{(R)}$ suture size 5-0 did not. $Vicryl^{(R)}$ group had no zones of inhibition showing colonization at all mircroorganisms. Conclusion: Our results seem to warrant the use of Vicryl $plus^{(R)}$ as absorbable buried suture when concerning SSIs as a prophylaxis against surgical nosocomial infection.

• Archives of Pharmacal Research
• /
• 제16권4호
• /
• pp.327-330
• /
• 1993

A series of 2-chloro and 2-bromo-3-(substituted)-1, 4-naphthalenedione derivatives (1-25) were tested for antifungal and antibacterial activities in vitro against Candida albicans 10231 aand Local, Aspergillus niger KCTC 1231, Tricophyton mentagrophytes KCTC 6085, Fusarium oxysporium KTCC 6501, Bacillus subtilis ATCC 6633, Pseudomonas arruginosa NCTC 10490, Staphylococcus aureus ATCC 6358p, Escherichia coli NIHJ and Acinetobacter baumanii Local. The MiC values were determined by twofold afar diution/streak method. Among thee derivatives, 1, 9, 20, 21, 23 and 25 showed more potent antifungal activities than fluconazole. 20 and 23 completely inhibited the gorwth of fungi, such as Candida albicans, Aspegillus niger, Ticophyton mentagrophytes and fusarium oxysporium, at $3.2\;\mu{g/ml}$. Also some derivatives had the antibacterial activities against Gram-positive bacteria.

• 대한임상검사과학회지
• /
• 제50권4호
• /
• pp.431-437
• /
• 2018

Acinetobacter baumannii는 광범위한 항생제에 대한 저항성으로 인해 감염된 환자의 사망률이 높아지는 적색 경보 병원체로 분류됩니다. 이 연구에서 다제 내성 A. baumannii(MRAB)의 18가지 임상 분리 균주에 대해 일부 에센셜 오일(티트리, 로즈마리, 라벤더 오일)의 항균 활성을 평가하고자 하였다. Carbapenemase 선별을 위한 Hodge 시험법은 A. baumannii의 20 가지 균주가 모두 imipenem에 내성이 있음을 보여주었습니다. 다제 내성 미생물의 확인은 VITEK 시스템을 통해 수행하였다. 에센셜 오일의 항균 활성은 MRAB에 대한 디스크 확산 방법으로 평가하였다. 디스크 확산 방법에서 tee tree는 라벤더 오일에 비해 억제 크기가 가장 크게 증가했으며, 로즈마리는 항균 효과가 없었다. 티 트리 오일은 가장 일반적인 인간 병원균 및 MRAB 감염의 치료 및 예방을 위한 대체 천연 제품으로 유용할 것으로 보인다. 따라서 이 연구의 결과는 다제 내성 A. baumannii의 항균 효과를 입증했으며, 미래에 천연 에센셜 오일을 사용하는 손 소독제와 같은 항균제로 사용될 것으로 예상됩니다.

• Journal of Yeungnam Medical Science
• /
• 제10권1호
• /
• pp.28-36
• /
• 1993

1992년 12월부터 1993년 4월까지 영남대학교 의과대학 부속병원 임상병리과 세균검사실에 의뢰된 입원환자전체를 대상으로 1차 항생제 감수성 검사에서 모든 항생제에 내성을 보인 그람음성간균에 대해 2차 항생제 감수성 검사를 실시하여 그 결과를 분석하였다. 1차 항생제 감수성 검사에서 모든 항생제에 내성을 보인 균주의 빈도는 A. baumanni, E. cloacae, E. coli, P. aeruginosa, Serratia species순이었다. 소변에서는 기본 항생제에 내성을 보인 균종은 E. coli가, 호흡기와 창상감염에서는 A. baumanni가 가장 많았으며, P. aeruginosa는 모든 검체에서 높은 빈도로 분리되었다. 2차 항생제 감수성 검사에서 전 검체의 53%가 모든 2차 항생제에 대해 내성을 보였다. ceftazidime, aztreonam, ciprofloxacine 등은 상대적으로 항균효과가 높았으나 cefamandole은 모든 균종에서 효과가 없는 것으로 나타났다.

• Journal of Korean Neurosurgical Society
• /
• 제41권4호
• /
• pp.236-240
• /
• 2007

Objective : The aim of this study is to analyze on the external ventricular drainage [EVD] related ventriculitis, especially on their risk factors, management, and prevention. Methods : From January 2003 to December 2005, a total of 174 EVD catheters were placed in 112 patients at our institution. Of these patients, EVD-related ventriculitis were developed in 15 cases. Clinical variables such as age, sex, prior clinical diagnosis, placement of EVD insertion, duration of EVD, total numbers of EVD per person, and outcome were analyzed in theses cases to verify the risk factors, causative agents and outcomes. Results : Fifteen cases of EVD related ventriculitis were noted presenting infection incidence of 13.39 % per patient and 8.62% per procedure. Of these, five patients died from sepsis, seven patients were recovered from infection but neurological complications remained and three patients were recovered without any complications. Microbes were obtained from cerebrospinal fluid only in six patients. Acinetobactoer baumanii was the most common pathogen in our study [4 cases]. Among the various risk factors, only the prior clinical diagnosis showed the statistical significance. Patients who underwent decompressive craniectomy after severe brain trauma showed unfavorable outcome because of possible contaminative environment compared with other cases. Conclusion : EVD is considered as a safe procedure with good control of intracranial pressure if meticulous care is provided for EVD procedure and maintenance. With regards to risk factors and prevention, the higher incidence and unfavorable outcome was seen especially in patients with severe head trauma. Thus, special attention is required in these clinical settings.

• 한국임상약학회지
• /
• 제23권4호
• /
• pp.307-315
• /
• 2013

Objective: Colistimethate was first became available in 1950s and used until the early 1980s to treat infections caused by gram-negative bacteria and was abandoned due to its nephrotoxicity and neurotoxicity. However, it was recently reintroduced into the clinical practices due to emergence of multidrug-resistance gram-negative bacteria, particularly Pseudomonas aeruginosa and Acinetobacter baumanii. Therefore, it is increasingly used in the intensive care unit settings as a salvage therapy. This study was designed to investigate the incidence rates and risk factors of acute kidney injury associated with colistimethate by using the standardized definition in critically ill patients. Methods: This study retrospectively reviewed the electronic medical records of 71 adult patients above 18 years old receiving intravenous colistimethate at least 48 hours at intensive care unit, university-affiliated hospital from Nov 2012 to Aug 2013 and excluded patients with end-stage renal disease (ESRD) and required renal replacement therapy before initiation of the colistimethate therapy. Acute kidney injury (AKI) was determined by using the standardized RIFLE criteria, classified with risk, injury, failure, loss and ESRD according to serum creatinine (Scr) levels. Results: Among the 71 patients included in the analysis, AKI developed in 40 patients (56.3%) and 6 patients (8.4%) had irreversible kidney injury. AKI occurred within 5 days in 20 patients (50.0%). Maximum Scr level showed a significant increase in the patients with AKI ($1.92{\pm}0.86mg/dL$ vs. $1.12{\pm}0.46mg/dL$ p=0.001), maximum BUN also increased ($64.2{\pm}28.7mg/dL$ vs. $48.4{\pm}24.9mg/dL$ p=0.017) and minimum creatinine clearance (CLcr) was significantly decreased in the patients with AKI than non-AKI ($34.5{\pm}18.6ml/min$ vs. $64.4{\pm}33.7ml/min$ p=0.185). The patients with AKI had significantly longer duration of colistimethate therapy ($21.1{\pm}17.0$ days vs. $13.0{\pm}11.5$ days, p=0.020) and larger cumulative doses of colistimethate ($6465.9{\pm}4717.0mg$ vs. $4438.1{\pm}3426.7mg$, p=0.040). Conclusion: The incidence and severity of AKI associated with colistimethate in critically ill patients was high and serious. Drug monitoring program should be performed to shorten duration of therapy and reduce cumulative dose from initiation of colistimethate therapy for minimizing AKI of colistimethate.