• Title/Summary/Keyword: Antibiotics use

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Risk Factors and Clinical Outcomes for Vancomycin-Resistant Enterococcus Colonization on Intensive Care Unit Admission (중환자실 환자의 입실시 반코마이신 내성 장구균 집락의 위험요인과 임상적 결과)

  • Byun, Sook-Jin;Kang, Jiyeon
    • Journal of Korean Academy of Nursing
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    • v.43 no.2
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    • pp.287-295
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    • 2013
  • Purpose: The purpose of this study was to identify vancomycin-resistant enterococcus (VRE) colonization rate in patients admitted to the intensive care unit (ICU), associated risk factors and clinical outcomes for VRE colonization. Methods: Of the 7,703 patients admitted to the ICUs between January, 2008 and December, 2010, medical records of 554 VRE colonized and 503 uncolonized patients were reviewed retrospectively. To analyzed the impact of colonization on patients' clinical outcomes, 199 VRE colonized patients were matched with 199 uncolonized patients using a propensity score matching method. Results: During the study period, 567 (7.2%) of the 7,703 patients were colonized with VRE. Multivariate analysis identified the following independent risk factors for VRE colonization: use of antibiotics (odds ratio [OR]=3.33), having bedsores (OR=2.92), having invasive devices (OR=2.29), methicillin-resistant Staphylococcus aureus co-colonization (OR=1.84), and previous hospitalization (OR=1.74). VRE colonized patients were more likely to have infectious diseases than uncolonized patients. VRE colonization was associated with prolonged hospitalization and higher mortality. Conclusion: Strict infection control program including preemptive isolation for high-risk group may be helpful. Further research needs to be done to investigate the effects of active surveillance program on the incidence of colonization or infection with VRE in the ICU.

$Ureaplasma$ infections in pre-term infants: Recent information regarding the role of $Ureaplasma$ species as neonatal pathogens

  • Sung, Tae-Jung
    • Clinical and Experimental Pediatrics
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    • v.53 no.12
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    • pp.989-993
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    • 2010
  • Although numerous clinical observational studies have been conducted over a period of over 30 years, the clinical significance of $Ureaplasma$ infection is still under debate. The $Ureaplasma$ speices. is a commensal in the female genital tract and considered to have of low virulence; however, $Ureaplasma$ colonization has been associated with infertility, stillbirth, preterm delivery, histologic chorioamnionitis, and neonatal morbidities, including congenital pneumonia, meningitis, bronchopulmonary dysplasia, and perinatal death. Recently, $Ureaplasma$ was subdivided into 2 separate species and 14 serovars. $Ureaplasma$ $parvum$ is known as biovar 1 and contains serovars 1, 3, 6, and 14, and $Ureaplasma$ $urealyticum$ (biovar 2) contains the remaining serovars (2, 4, 5, and 7-13). The existence of differences in pathogenicities of these 14 serovars and 2 biovars is controversial. Although macrolides are the only antimicrobial agents currently available for use in neonatal ureaplasmal infections, in the current clinical field, it is difficult to make decisions regarding which antibiotics should be used. Future investigations involving large, multicenter, randomized, controlled studies are needed before proper recommendations can be made for clinical practice.

Characterization of Antimicrobial Substance Producing Lactococcus sp. HM58 Isolated from Gastrointestinal Track of Flounder

  • Jeong Hyun-Mi;Yum Do-Young;Lee Jung-Ki;Choi Mi-Young;Kim Jin-Man
    • Fisheries and Aquatic Sciences
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    • v.6 no.1
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    • pp.27-33
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    • 2003
  • A lactic acid bacterium showing antimicrobial activity against fish pathogen was isolated from gastrointestinal tract of flounder for the purpose of use as an aquaculture probiotics. From the analysis of morphological and physiological characteristics, the isolated strain was named as Lactococcus sp. HM58. Antimicrobial substance (AMS) from Lactococcus sp. HM58 showed strong growth inhibitory activity against Streptococcus sp., which is a fish pathogenic bacterium. AMS was presumed a proteinaceous compound with stability in heat and wide pH range from 2 to 10. It was started to produce in exponential growth phase and was not produced any more in stationary phase. It showed comparatively broad antimicrobial spectrum against most of gram positive bacteria used for this study. About $84\%$ of Lactococcus sp. HM58 was able to survive in the artificial gastric juice though it was low to the extent in the artificial bile juice. In the sensitivity test for various antibiotics, this strain was highly sensitive for doxycycline, erythromycin, amoxicillin clavu1anic acid and ampicillin.

Antimicrobial Resistance and Multi-Drug Resistance Patterns of Pathogenic Bacteria Isolated from Food Poisoning Patients in Incheon (인천지역 식중독 환자에서 분리한 병원성 세균의 항생제 내성 및 다제 내성 양상)

  • Huh, Myung-Je;Oh, Sung-Suck;Jang, Jae-Seon
    • The Korean Journal of Food And Nutrition
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    • v.26 no.1
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    • pp.132-136
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    • 2013
  • Antimicrobial resistance and multi-drug resistance patterns have been carried out on total of 210 isolated of Salmonella spp. and pathogenic E. coli isolated from food poisoning patients on January through December 2012 in Incheon, Korea. The highest percentage of antibiotics resistance was found to the following antimicrobial agents: tetracycline 43.8%, ampicillin 34.8%, nalidixic acid 23.8%, sulfamethoxazole/trimethoprim and chloramphenicol 12.4%, and ampicillin/sulbactam 11.4%. The highest percentage of resistance was 37.5% to ampicillin for Salmonella spp. and 59.0% to tetracycline for pathogenic E. coli. Overall the multidrug resistance rates of 1 drug was 26.2%, 2 drugs 9.0%, 3 drugs 9.5%, 4 drugs 7.1%, and 5 or more drugs 12.46%. The multi-drug (MDR) strains to four or more antimicrobial agents among the resistant organisms were quite high: 15.9% and 22.1% for Salmonella spp. and pathogenic E. coli, respectively. The study implies that limitation of unnecessary medication use is pertinent in order to maintaining the efficacy of drugs.

Antibiotic Resistance and Safety Assessment of Enterococcus faecium CKDB003 for Using as Probiotics (프로바이오틱스 Enterococcus faecium CKDB003의 항생제 내성 및 안전성 평가)

  • Kim, Han Jun;Kang, Soon Ah
    • The Korean Journal of Food And Nutrition
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    • v.33 no.3
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    • pp.223-236
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    • 2020
  • In this study, a safety evaluation was conducted to confirm if the Enterococcus faecium CKDB003 strain obtained by selection from a mixed fermentation of fruit and milk is suitable for use as a probiotic. The MIC value for the 10 antibiotics specified in the EFSA guidance was below the acceptable cut-off value. The antibiotic resistance genes aac(6')-li, eatAv, and msr(C) exist by whole genome sequencing, but are in the chromosome and not in the plasmid, thus confirming that there is no possibility of transmission to other microorganisms. It was confirmed that cytolysin (cylA, cylB, cylI, cylL-l, cylL-s, cylM, cylR1, cylR2), aggregation substance (asa1, asp1), collagen adhesion (ace), enterococcal surface protein (esp), endocarditis antigen (efaA), hyaluronidase (hyl) and gelatinase (gelE) were not present in the genome by examining the genes of factors related to virulence. Also, the biochemical analysis showed no toxic enzyme activities, and no virulence genes were detected by the PCR method. Thus, the E. faecium CKDB003 strain can be safely used as a health functional food probiotic, based on the results of the safety assessment.

Clinical Considerations on Contamination Rates of Cryopreserved Autologous Fat (냉동보존한 자가지방의 오염률에 대한 임상적 고찰)

  • Kim, Jeong Tae;Seo, Woo Jin;Kim, Yeon Hwan
    • Archives of Plastic Surgery
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    • v.36 no.6
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    • pp.685-690
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    • 2009
  • Purpose: Autologous fat graft is a widely accepted technique used for soft tissue augmentation. Nonetheless, the use of fat graft is limited by unpredictable survival rates and repeated grafting. To avoid repeated grafting, cryopreserved fat graft technique has recently been widely used. On the other hand, the number of patients with chronic infection(who received cryopreserved fat injection) has currently been increasing. Therefore, this study was focused on the safety of cryopreserved fat injection from the infection. Methods: We collected 150 samples from local aesthetic clinics to examine the safety of cryopreserved autologous fat. To test for microbacterial contaminations of the cryopreserved fat specimens, microbacterial cultures & antibiotics sensitivity tests were performed. Then, we examined possible correlation between the preservation period and donor sites, focused on the results of microbacterial culture. Results: Cultures were positive for Staphylococcus epidermidis in 5 samples(methicillin - resistant Staphylococcus epidermidis in 4 samples), Micrococcus species in 3 samples. An average duration of preservation was 191 days and there was no significant correlation between the duration of preservation and microbacterial growth. Conclusion: Staphylococcus epidermidis was the leading cause of cryopreserved fat contamination, and the resistance to methicillin is common. Based on the above results, aseptic handling of fat during harvesting and preservation appeared to be most important.

Studies of the Non-Mevalonate Pathway I. Biosynthesis of Menaquinone-7 in Bacillus subtilis II. Synthesis of Analogs of Fosmidomycin as Potential Antibacterial Agents

  • Kim, Dojung;Phillip J. Proteau
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1998.11a
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    • pp.158-158
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    • 1998
  • The non-mevalonate pathway is a newly discovered isoprenoid biosynthetic pathway in some bacteria, cyanobacteria, algae and plants. Because isoprenoid metabolites (ubiquinone, menaquinone, undecaprenol) are essential for bacterial growth, this pathway may represent a novel target for antibacterial agents. Antibiotics with a unique mechanism of action are needed to combat the risk of antibiotic resistance that is a current worldwide problem. In order to study this pathway as viable target, it was necessary to verify use of the pathway in our model system, the bacterium Bacillus subtilis. Incubation experiments with [6,6-$^2$H$_2$]-D-glucose and [l-$^2$H$_3$]-deoxy-D-xylulose were conducted to provide labeled menaquinone-7 (MK -7), the most abundant isoprenoid in B. subtilis. $^2$H-NMR analysis of the MK-7 revealed labeling patterns that strongly support utilization of the non-mevalonate pathway. Another approach to study the pathway is by structure activity relationships of proposed inhibitors of the pathway. Fosmidomycin is a phosphonic acid with antibacterial activity known to inhibit isoprenoid biosynthesis in susceptible bacteria and may act by inhibiting the non-mevalonate pathway. Fosmidomycin and an N-methyl analog were synthesized and tested for antibacterial activity. Fosmidomycin was active against Escherichia coli and B. subtilis, while N-formyl-N-methyl-3-amino-propylphosphonic acid was inactive.

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Femoral Endarteritis as a Complication of Percutaneous Suture Closure Device -A case report- (경피적 혈관봉합술 후 발생한 대퇴동맥 내막염 -1예 보고-)

  • Hong, Joon-Hwa;Choi, Jin-Wook;Moon, Jong-Hwan;Soh, Dong-Moon
    • Journal of Chest Surgery
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    • v.39 no.11 s.268
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    • pp.864-867
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    • 2006
  • Percutaneous suture closure device is known as relatively safe and convenient tool, which can decrease not only bed rest period of patient but also time consuming effort of manual compression of doctor after femoral artery puncture. However[C1], there are also some reports on complication of its use. We report a 62-year-old male patient who had femoral artery endarteritis[0] with pseudoaneurysm as a complication of percutaneous suture closure device after percutaneous coronary angiography[C2]. He was treated successfully by appropriate antibiotics and vessel reconstruction using autologous saphenous vein patch.

Application of Bioabsorbable Plates in Orthognathic Surgery

  • Kim, Young-Kyun;Shim, Cheong-Hwan;Bae, Ji-Hyun;Yun, Pil-Young
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.32 no.1
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    • pp.60-64
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    • 2006
  • Backgrounds: Though they are considered as reliable devices, titanium plates and screws have limitations due to some potential problems. To overcome these problems, researches on bioabsorbable materials for internal fixation have been continuing. Recently, there are many clinical trials to apply biodegradable internal fixation devices in oral and maxillofacial surgery. The purpose of this study was to evaluate the clinical results of application of bioabsorbable plates and screws in orthognathic surgery. Methods: Fifty-four patients with dentofacial deformity (17 male patients and 37 female patients) were selected in this study. The patients were treated by internal fixation using bioabsorbable plates and 2.4-mm, 2.0-mm pretapped screws (Biosorb FX, Bionix Implants, Inc., Finland). The patients were evaluated for complications during the follow-up period. Results: Five patients (9.3%) experienced complications. All complications in these cases were infection. No other complications related with physical or mechanical properties of bioabsorbable plates were found such as malunion or nonunion, fractures of plates and loosening of screws. All complications were minor and adequately managed with drainage and supportive care with antibiotics coverage. Conclusions: From the results, the use of these fixation systems in orthognathic surgery will provide a promising alternative titanium fixation in appropriate cases.

Respiratory Reviews in Asthma 2013

  • Kim, Tae-Hyung
    • Tuberculosis and Respiratory Diseases
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    • v.76 no.3
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    • pp.105-113
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    • 2014
  • From January 2012 up until March 2013, many articles with huge clinical importance in asthma were published based on large numbered clinical trials or meta-analysis. The main subjects of these studies were the new therapeutic plan based on the asthma phenotype or efficacy along with the safety issues regarding the current treatment guidelines. For efficacy and safety issues, inhaled corticosteroid tapering strategy or continued long-acting beta agonists use was the major concern. As new therapeutic trials, monoclonal antibodies or macrolide antibiotics based on inflammatory phenotypes have been under investigation, with promising preliminary results. There were other issues on the disease susceptibility or genetic background of asthma, particularly for the "severe asthma" phenotype. In the era of genome and pharmacogenetics, there have been extensive studies to identify susceptible candidate genes based on the results of genome wide association studies (GWAS). However, for severe asthma, which is where most of the mortality or medical costs develop, it is very unclear. Moreover, there have been some efforts to find important genetic information in order to predict the possible disease progression, but with few significant results up until now. In conclusion, there are new on-going aspects in the phenotypic classification of asthma and therapeutic strategy according to the phenotypic variations. With more pharmacogenomic information and clear identification of the "severe asthma" group even before disease progression from GWAS data, more adequate and individualized therapeutic strategy could be realized in the future.